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Central African Republic

In Central African Republic, going door to door to beat malnutrition

© UNICEF Central African Republic/2013/Hug
Nineteen-month-old Dieu-Donné Pamad (right) with his mother Karine and younger sister at the therapeutic feeding unit at the Bambari Hospital.

By Thomas Hug

Amidst continued insecurity in the Central African Republic, mobile medical teams are taking a proactive approach in addressing malnutrition.

BAMBARI, Central African Republic, 5 September 2013 - Dieu-Donné Pamad sits on a thin hospital bed watching his baby sister laugh and play with their mother. Despite being more than a year older at 19 months, the boy is barely bigger than his 4-month-old sister.

Dieu-Donné is at the therapeutic feeding unit in the Bambari Hospital recovering from kwashiorkor, a form of severe acute malnutrition caused by protein insufficiency and characterized by swelling of the feet and abdomen, a condition called oedema.

Since December 2012, when a coalition of armed rebels sparked conflict and insecurity throughout much of the country, access to nutritious food and medical care has been particularly difficult. In response, UNICEF has made efforts to reach malnourished children through a community-based approach, working with NGO partner International Medical Corps (IMC).

Going door to door

As a result of these interventions, Dieu-Donné, like many other children, is now recovering. “He is getting better; he does not throw up anymore. The diarrhoea has stopped, and he is starting to gain weight,” says Karine Pamad, Dieu-Donné’s mother, who has not left his side since he was admitted at the therapeutic feeding unit.

With so many families displaced or too afraid to go to health centres, mobile teams are going door to door to screen children for malnutrition. For more serious cases, like Dieu-Donné’s, admission is arranged for inpatient therapeutic feeding care.

“I did not know these services existed. The team came to my house and diagnosed him,” Ms. Pamad says. “I could see that he was not getting better, so I accepted to bring him to the hospital, and we have been here for the past ten days.”

© UNICEF Central African Republic/2013/Hug
A UNICEF mobile team delivers boxes of essential drugs to the Bambari Hospital.

Along with five other children, Dieu-Donné is being treated with Plumpy’nut, a high-protein, high-energy, peanut-based therapeutic food. In the next room, another nine children are being treated with therapeutic milk.

The therapeutic feeding unit at the Bambari Hospital has the capacity to treat 22 children at one time, but displacement and insecurity have resulted in fewer parents seeking medical help for their children, even when it is badly needed.

“People were also too afraid to come out of hiding and bring their children for treatment when they fall sick,” says one medical aid. “With the onset of the rainy season, people are in the fields trying to salvage their crops.”

Restarting services

 “UNICEF’s medical supplies are helping us restart health services here at the hospital,” says Dr. Joseph Sembre Bama, head of the Bambari Hospital. In addition to providing Plumpy’nut and therapeutic milk, UNICEF is also supplying health facilities in the Bambari area with essential drugs and medicines, and also equipment to support the resumption of emergency health services. In the northern and northeastern regions, UNICEF is helping restart inpatient and outpatient nutrition services, which have been able to treat 13,075 acutely malnourished children throughout the country. 

“Even before the recent crisis, Central African Republic had some of the worst development indicators in the world,” says UNICEF Central African Republic Representative Souleymane Diabate. “Children in the interior of the county are particularly affected by the crisis, as they have been cut off from basic health services for months now. Our priority is to urgently reach these children with health, nutrition and life-saving interventions.”

In addition to providing assistance in health and nutrition, the UNICEF mobile teams are also helping to resume primary school education activities and playing an important role in collecting data and conducting assessments that inform humanitarian response to those in need.



UNICEF Photography: Former child soldiers

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