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Somalia, April 2015: Preventing and tackling child malnutrition close to home

UNICEF Somalia/2015/Makundi
© UNICEF Somalia/2015/Makundi
A community worker discusses the importance of breastfeeding, proper nutrition for young children and home hygiene and sanitation with mothers at Una village 10km from Dollow town, South Somalia.

By Athanas Makundi

April 2015, DOLLOW, Gedo, South Somalia – One and half year old Ladan Mohamed Mahmoud gives a loud cry as he is placed in the spring scale with his legs dangling in the air. A health worker quickly notes down his weight before lifting him out and returning him to his mother. The news is not good. Ladan weighs five kilos, only two thirds the average weight of a normal toddler his age.

“My baby is very sick,” says Hawa Noor Dirie staring at her son. She has been queuing with other mothers of malnourished children at Una health clinic, 10 kilometers from Dollow town in Southern Somalia. “For four days, he has been suffering from severe diarrhoea, high fever and lack of appetite.”

At any given moment in Somalia there are around 38,000 severely malnourished children in need of life saving therapeutic food. There are about 650 Outpatient Therapeutic Programme (OTP) Centres in Somalia including 16 in Dollow. At Una Clinic the health of malnourished children is thoroughly checked. If they are not sick, they are enrolled in the outpatients programme, receiving a weekly supply of nutritious peanut-based paste.

“From the screening and weight records Ladan is severely malnourished but with no complications,” says Ahmed Abdikadir Ibrahim, Nutrition Officer for the local NGO Community Empowerment and Development Action which is implementing the UNICEF-supported programme. “We have many cases like these coming to the Outpatient Therapeutic Programme. This month alone, we received 14 new cases of severe malnutrition.”

Next in the queue is Burwaqo Mohamed with her eight months old baby – Ayan Mohamed Hassan. Two months ago, the child had acute diarrhoea and became severely malnourished. At that time she weighed four kilogrammes but after treatment and a supply of the peanut-based paste, she is nearly double that weight.

“I couldn’t produce breast milk, I used to feed her cows’ milk and tea before I knew it was not good for her,” says Burwaqo Mohamed a mother of seven children. “Today, I was told it is her last day at the clinic, she is better now.”

The Nutrition Officer explains that the major causes of malnutrition in the region include lack of breastfeeding, inappropriate food for babies and children, poor hygiene and sanitation as well as drinking contaminated water from the river.

“The other challenge is that there is not enough food in many homes,” says Ahmed. “If a mother has not eaten well, she will not be able to produce enough milk to breastfeed her child and that is big problem here.”

UNICEF Somalia/2015/Makundi
© UNICEF Somalia/2015/Makundi
A Somali mother watches a presentation by a community worker on age appropriate feeding for babies and children at Una village 10km from Dollow town, South Somalia.

Despite the challenges, UNICEF is working to boost the resilience of the most vulnerable by strengthening basic services through its integrated management of acute malnutrition programme.

“We are supporting both preventive activities and curative services to combat malnutrition,” says Abdirizak Osman Hussien, UNICEF Nutrition officer in Dollow.

“For preventive activities, we have established the infant and young child feeding programs at the village level, where mothers learn the importance of breastfeeding, proper nutrition and home hygiene and sanitation from trained community workers.

“In terms of curative services, we are providing OTP services for severely malnourished children without complications. A referral hospital is needed for the severely malnourished children with complications.”

During a recent visit to Una village, UNICEF Somalia Representative, Stephen Lauwerier praised the community-based approach as the key to combating malnutrition.

“Nutrition starts with the family itself and a lot of malnutrition cases are not because of lack of food but the lack of an enabling environment,“ he said. “If we emphasise breastfeeding then mothers will come to understand that exclusively breastfeeding a child for six months will make him or her more healthy and less prone to malnutrition.”

At the same time UNICEF and its partners are working to prevent malnutrition at the household level.

“We need to dialogue with the community to ensure they understand basic measures, “says Mr. Lauwerier. “For example, boiling water is a simple thing – every mother should know giving a child boiled water will keep malnutrition away, because the child won’t get diarrhoea.”

One in seven children in Somalia dies before their fifth birthday and all too often malnutrition is a contributing factor. There is an urgent need to continue to provide crucial health care to sick and malnourished children. In January and February 2015, UNICEF supported the treatment of 189 severely malnourished children under five in Dollow, while 1,695 severely malnourished children were treated at UNICEF supported nutrition centres last year.



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