|One-year-old Saar and her mother at the hospital nutrition centre in Kaedi, Mauritania.|
By Martin Dawes and Brahim Ould Isselmou
KAEDI, Mauritania, 27 July 2009 – One-year-old Saar was clearly ill when a woman from her village told the baby girl’s mother to get her to the nutrition centre at Kaedi Hospital.
At the centre, surrounded by six other mothers with children in need of special feeding, Saar’s mother explained how the village council gave her money to take a donkey cart on the 9 km journey to Kaedi.
Nurse Kaadijetou Yero N’diaye, who assessed Saar, found that she was malnourished and had another condition that was causing vomiting. Not so very long ago, her more apparent symptoms would have been mentioned first, with malnutrition logged as another issue to be dealt with later, if at all.
“We speak about most child deaths being caused by malaria or respiratory diseases, but malnutrition is a significant factor that allows other diseases to become even more deadly,” said UNICEF Representative in Mauritania Christian Skoog. “By ensuring that malnutrition is a priority, we are dramatically reducing the vulnerability of children to serious illnesses, while ensuring other benefits such as improved physical and mental development.”
Considerable work is under way to ensure that everyone in Mauritania is ‘malnutrition aware’. Volunteers supported by the French Red Cross and the European Union visit villages to spread awareness and distribute dry rations, which are bagged and ready for children under treatment at home.
Seven organizations are involved in this effort, set up by UNICEF under a plan that works on multiple levels. It is all part of the global ‘REACH’ initiative supported by various UN agencies and partners to reduce child hunger and malnutrition. The initiative is being piloted in Mauritania and Laos.
The initiative’s dual pillars: to ensure a coordinated approach by all actors and to look at nutrition in the broader sense – analyzing both underlying causes and wider consequences of poor nutrition, and promoting both prevention and treatment.
Mobile teams and training
In his office at Kaedi Hospital, Ibrahim Bar has figures showing how many children in the district are being treated each month. According to his records, a severely malnourished baby was placed in a special treatment unit in May; 33 other acutely malnourished children came into clinics during the same month.
Two years ago, such figures were simply unavailable.
Now there are also mobile teams going into rural areas, a programme for training health personnel and at least two campaigns a year for treating difficult-to-reach malnourished children.
National Protocol sets ground rules
The malnutrition screening and treatment approaches now being used here were laid out in a National Protocol published in March 2007 and adopted by the government. Developed with technical support from UNICEF and the World Health Organization, this document was groundbreaking in a country more than 10 per cent of children are severely underweight and tens of thousands suffer from acute malnutrition.
The protocol sets very specific standards. Mr. N’diaye, the nurse at Kaedi, was clear when asked how long baby Saar would need to spend at the hospital. Because she was sick, he explained, “the protocol” stated that she would have to stay for at least two weeks.
Saar’s mother received accommodations to remain at the hospital for as long as her baby was ill. She was given some soap and a blanket, and would get two meals per day during the duration of her stay.
The mother was now comforted. “Saar is saved” she said, smiling.