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MIDDLE EAST AND NORTH AFRICA feature story for Yemen

© UNICEF Yemen/2009/Brekke

UNICEF Yemen Health and Nutrition Chief Kamel Ben Abdallah measures the arm circumference of 14-month-old Ghonia, who is severely malnourished. Her family is among 175,000 people displaced by conflict in the northern province of Sa’ada.

TREATING MALNUTRITION AMONG DISPLACED CHILDREN IN YEMEN

AL-MAZRAK, Yemen, September 2009 – Ghonia Jaber cries and wriggles in the doctor’s arm as the he takes her measurements. Using a metre tape, the health worker checks the circumference of the baby's middle upper arm. He is trying to find out whether the 14-month-old is malnourished. The tape shows red - she is a severe case. 

Ghonia is just one of many of hundreds of children UNICEF has screened for malnutrition in the Al-Mazrak camp for people displaced by conflict in northern Yemen. The camp is located some 40 kilometres from the town of Harad in the deserts of western Yemen. Living conditions here are tough. All 12 members of Ghonia's family live under one tent. But it’s better than the situation back in their remote mountain village in Sa’ada province, where fighting is still raging. When the conflict reached their village, Ghonia's family walked for four days before they reached the camp, exhausted from the effort.

The march took its toll on Ghonia and her eight siblings. Her parents took turns carrying the youngest ones, but Ghonia still had to walk for several hours every day. The examination revealed that she suffers from severe acute malnutrition. Her twin brother Ali is in an equally bad state, as are three other children in the family. The others are moderate malnutrition cases. Only the eldest sister Fatma, age 7, is out of danger. She helps out by looking after her younger brothers and sisters, keeping the tent tidy and getting water from the nearby water tank.

Fighting in Sa’daa in the north of the country, pitting government troops against Houthi rebel forces, has forced more than 175,000 people to flee from their homes. The crisis is taking an especially heavy toll on children. Since the conflict intensified in August, cases of severe acute malnutrition in the area have increased by three times.  Even before the recent conflict flared up, nearly half of all children in Yemen were underweight, a situation further aggravated by the war.

The results of the nutrition screening among the internally displaced people in Al-Mazrak are stark: One in five children under five years of age suffers from acute malnutrition, with about half of the cases considered severe. 

“The situation is very serious. If not treated, these children are at a high risk of death,” says UNICEF Yemen Chief of Young Child Survival and Development Dr. Kamel Ben Abdallah. He adds that malnutrition accounts for 60 per cent of deaths among the under-five population. Malaria is also a threat as the rainy season begins, and malnourished children are at increased risk of disease.

As new families arrive at the camp, UNICEF-trained health workers and volunteers screen all children under five. Severe cases are referred to UNICEF’s out-patient therapeutic programme, where they receive Plumpy nut, a ready-to-use therapeutic food that provides the calories, nourishment, vitamins and protein, therapeutic milk and medication. Extreme cases are referred to the hospital in Harad.

Approximately 12 to 20 new families arrive in the camp every day; with an average of seven people per family the number of displaced people in Al-Mazarak camp is increasing rapidly.  “As the number of children in the camp is rising, we need to bring in more supplies to keep up,” explains Dr. Kamel.

The children are usually in a very weak state upon arrival at the camp, making them especially vulnerable to infectious diseases and illnesses such as measles, malaria and diarrhoea. UNICEF therefore is also focusing on safe drinking water, sanitation and hygiene – as well as nutrition screening and treatment – to prevent a disease outbreak among the 10 - 12,000 people currently living in the camp.

To improve the situation, UNICEF is also setting up more therapeutic feeding facilities for children in Al-Mazrak as well as continuing to support nutrition screening of children by community volunteers who have been recruited from among the displaced population. Meanwhile, Al-Mazrak camp’s outpatient therapeutic programme is also focusing on children’s long-term nutrition needs with an emphasis on breastfeeding, appropriate complimentary feeding and dietary requirements.