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Scaling up therapeutic feeding as nutrition crisis deepens in Chad

© UNICEF Chad/2010/Gangale
Hissène, 18 months, with his mother Eta Brahim at a nutrition centre in Moussoro, Chad, where he receives therapeutic food.

By Anne Fouchard

MOUSSORO, Chad, 13 May 2010 – There was no question that 18-month-old Hissène needed treatment when he arrived at the nutrition centre in Moussoro, a dusty town in western Chad.

Fatimé, a nutrition worker who welcomes children at the centre, immediately recognized the signs. When she measured the circumference of Hissène’s upper arm, the gauge on the bracelet slipped into the red zone, signifying danger.

A widespread crisis

Hissène’s is not an isolated case. He is one of many thousands of severely malnourished children in Chad who will need assistance in 2010. To date this year, UNICEF-supported nutrition centres like the one in Moussoro have admitted twice the usual number of malnourished children.

© UNICEF Chad/2010/Gangale
Eta Brahim with her baby Hissène at a Moussoro, Chad feeding centre. After receiving nutrient-rich therapeutic food for Hissène, Ms. Brahim is trained to wash her and her child's hands.

Moussoro, the capital of Bar-El-Ghazel province, lies in Africa’s semi-arid Sahel region. Acute malnutrition among children here has been above the emergency threshold of 15 per cent for a decade. But this year, as the region faces an uneven and below-average rainy season, the outlook for food security appears far worse. People have already used up their food stocks. Cattle are dying and crops are poor.

Since April 2009, a community-level network has been established in Chad to fight malnutrition. Mobile teams go village-to-village, training and supervising volunteers chosen by the community to detect malnutrition and to refer affected children to outpatient nutrition centres. Through these local screenings, health authorities hope to identify and treat malnutrition earlier.

Forty-four more nutrition centres will open in 2010 to confront the crisis.

Therapeutic feeding

As Hissène and his mother, Eta Brahim, sat waiting at the centre, the small room filled up with mothers and children – many also suffering from severe acute malnutrition. Children in these advanced cases need specialist feeding and medical care to recover. At nutrition centres like this one, mothers receive therapeutic food for their children every week.

Hissène met with a nutrition officer and received a packet of ready-to-use therapeutic food. At first, the weak child coughed and refused the mixture. But Ms. Brahim kept trying, putting some of the peanut butter-like substance on her finger for him. Hissène finally swallowed and stopped frowning.

The undernourished child had been sick for about two months, but Ms. Brahim lacked the money to bring him to town. Then a mobile team told her to go to Moussoro for immediate help. At dawn the following day, Ms. Brahim left with Hissène. Her husband stayed with their four other children and their herd of cattle.

‘We live day by day, and hope’

Hissène grabbed the brightly coloured food package and cried for more, his appetite returning. Ms. Brahim smiled. The child would soon recover. The following week, she would travel again to Moussoro to feed him more of the nutrient-rich paste.

When asked if life is difficult this year, Ms. Brahim nodded. Her family had to sell their goats, she said, and “at give-away prices” – meanwhile eating only maize, a cheap grain that is the only food most households here can afford. But this is not enough for young children who need more nutrients to thrive.

Ms. Brahim said she did not know what would happen if they had no more goats to sell. “We live day by day, and hope,” she said. “Maybe, if you tell the world what is going on here, they will help us.”



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