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Children in southern Madagascar still threatened by severe acute malnutrition

By Sara Johansson

MADAGASCAR, 19 July 2010 – Seven districts in three regions of Madagascar are recovering from a nutrition crisis that affected the south of the country in 2009, mainly due to inadequate rainfall, a prolonged ‘lean season’ and a very limited harvest. The crisis was compounded by limited access to safe water and health services in scattered villages.

VIDEO: UNICEF's Katharina Koeller reports on efforts to treat malnutrition in drought-stricken Madagascar.


This year, due to a lack of rain in time for the crops to grow, the lean season – during which existing food stocks have already been used up – is again prolonged.

The consequences for the population in the south are serious. Children and pregnant or breastfeeding women, weakened by the long period without enough food, are especially vulnerable.

Detecting malnutrition early

Armand Laha, administrator of Bevoalavo village, is overwhelmed by the situation. “People that have a bit of savings buy small quantities [of food] at the market. Those that have no money only eat ‘raketa’ [cactus fruit],” he says.

© UNICEF Madagascar/2010/ Andriamasinoro
Community agent Zeavine Heltine weighs a baby during the regular check-up and screening for malnutrition conducted in Beloha district, in southern Madagaascar's Androy region.

If children are identified at an early stage of malnutrition, they can be treated in their homes with ready-to-use therapeutic food – such as Plumpy’nut, a high-protein, peanut-based paste – along with regular check-ups at the closest health centre. However, in some cases, other medical complications make it impossible to treat children at home, and they are referred to hospitals.

Ellya is 10 months old and weighs only 4.5 kilos. She was admitted to hospital for severe malnutrition and later diagnosed with tuberculosis. Like many women in this region, her mother married early; she had her first child at 15. Ellya is the youngest of seven siblings.

“We are afraid, because if we cannot find food for our children, they are facing death,” says Ellya’s mother.

Prevention and treatment

Since early 2009, UNICEF and its partners here have been establishing a system to identify cases of malnutrition and ensure adequate treatment. About 11,000 children under the age of five were treated for severe acute malnutrition in three regions of southern Madagascar in 2009.

© UNICEF Madagascar/2010/Andriamasinoro
A mother and young child leave the Kirimosa health centre in southern Madagascar after the child was treated for severe malnutrition.

According to a survey conducted by UNICEF and partners in April of this year, the number of children under five affected by severe acute malnutrition in these areas has decreased due to the successful prevention and treatment programme.

But despite the success of the programme – now extended to over 145 health centres, seven hospitals and 7,000 community agents – the situation remains fragile. Severe acute malnutrition could return to critical levels if food insecurity and lack of access to safe water and appropriate medical care persist.

Need for continued interventions

In response to this danger, UNICEF has reinforced its efforts to address malnutrition in the south of Madagascar. The agency is working with local partners to save lives by providing treatment in health centres and hospitals, and it is training both health workers and community agents to prevent, detect and treat severe malnutrition.

“We are concerned about the general erosion of the health system in the country and the impact this might have on the capacity to treat severely malnourished children,” says UNICEF Representative in Madagascar Bruno Maes.

“Children will die without this treatment, which has to be given for free, as families’ coping mechanisms are severely weakened due to the long lean period,” he adds. “To be able to continue these activities, UNICEF is urgently in need of funding for nutrition, health and water-related interventions.”



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