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Burundi, 14 July 2015: Refugee movements exacerbate food insecurity

By Yves Nijimbere and Eliane Luthi

As low rains, poor harvests and fleeing residents increase the threat of malnutrition in a Burundi community, one resident struggles to bring her young granddaughter back to health.

14 July 2015, BUJUMBURA – “When I look at my granddaughter, I start crying,” Anesie says in a low voice. “She looks like a two-month-old child. She doesn't have enough appetite. She coughs and she has fever.”

© UNICEF Burundi/2015/Nijimbere
Anesie cares for her grandchildren in Kirundo province in Burundi, where many residents have have fled to neighbouring Rwanda.

 
Kelicia, Anesie's granddaughter, is actually 18 months old, but her health has been deteriorating quickly in the past few weeks. The commune where they live, near Lake Cohoha, has been the scene of mass departures to Rwanda, just a few kilometres away. Anesie has already witnessed thousands of her countrymen cross the border, driven by increasing instability and fear.

Meanwhile, the health of her granddaughter has been worsening.

“I almost left myself,” she says, remembering how she had to make that decision. “I heard on the radio that in [the capital] Bujumbura, security wasn't very good, and ever since private radios stopped broadcasting, some of the neighbors have fled. But I decided to stay here, with my granddaughter.”

Highly vulnerable

Kirundo province has been especially affected by the departures: 72 per cent of Burundians currently in refugee camps in Rwanda are from the province. And with a series of bad harvests and less regular rain, Kirundo was already highly vulnerable to food insecurity. Many adults had only one meal a day.

“Today it's very difficult to feed children three times a day,” Anesie says. “We plant without hope of harvesting. I grow sunflowers, corn and beans on some land about half an hour from here, which belongs to my husband, but the harvest isn't good anymore.”

The increasing vulnerability of the population in Kirundo has led UNICEF to support partners in conducting a door-to-door malnutrition screening of children.

© UNICEF Burundi/2015/Nijimbere
Kelicia, 18 months old, is checked for malnutrition with a MUAC tape. Her reading is in the 'red zone'.

 
“During my visits, I’ve identified numerous malnourished children in this area,” says Sylvestre Bambasi, a community health worker in Busoni. “It’s caused by the lack of rain on one hand, and the movements towards other countries on the other. In the area that I'm in charge of, a lot of children are in the ‘yellow zone.’ But Kelicia is in the ‘red zone’ – which means she has severe acute malnutrition.”

Saving lives

The work of Mr. Bambasi and other community health workers, who go directly into vulnerable households to screen children and provide advice in nutrition, health and hygiene, is instrumental in the current situation: Their work can save lives. Screening using the MUAC (mid-upper arm circumference) measuring tape allows for immediate analysis of the nutritional state of children, and referral of cases like Kelicia’s to health centres.

“The current political and economic situation risks aggravating the nutritional situation of children in Kirundo province even more,” says John Ntambi, UNICEF Burundi Nutrition Specialist. “That's why we are doing screening of all children aged 6 to 59 months. Children like Kelicia, identified as suffering from severe acute malnutrition, will benefit from nutritional products which have already been pre-positioned by UNICEF in Kirundo province.”

© UNICEF Burundi/2015/Nijimbere
“During my visits, I’ve identified numerous malnourished children in this area,” says Sylvestre Bambasi, a community health worker.

 
With more than 66,000 Burundian refugees in Rwanda (as of 7 July) and repeated displacements, it is becoming critical to ensure that solid structures are in place to strengthen the resilience of the population, especially since new displacements and returns are expected. “We're increasing nutrition education sessions on the community level and seeing how we can prepare for those that will be coming back,” says Mr. Bambasi.

Getting treatment

Anesie is bringing Kelicia to the health centre to make sure she is treated for severe acute malnutrition. And thanks to the advice of Mr. Bambasi, she now knows how to make sure her granddaughter does not relapse.

“He gave me advice and explanation on the illness of my granddaughter. I now know how to identify the signs of a child with malnutrition,” says Anesie. “My hope is that all children be in good health. I would be happy to see Kelicia in good health again.”

To respond to the increasing nutritional vulnerability of children in Kirundo province, UNICEF, in collaboration with partners like Concern Worldwide, is supporting the Ministry of Health in the prevention, screening and treatment of malnutrition, including through providing ready-to-use therapeutic foods for children like Kelicia.

UNICEF is also supporting local partners in creating Positive Deviance/Hearths, a community-based nutrition program for children, where caretakers learn how to prepare balanced, nutritious meals for children in order to prevent child malnutrition.

 

 
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