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Diary from Ethiopia: Witness to the silent killer

© UNICEF Ethiopia/2005/Getachew
A five-year-old boy is weighed at Derara Health Centre where he is being treated for severe malnutrition.

By Pat Lone

BORICHA WOREDA, Ethiopia, 26 April 2005 - Space is cramped at Derara Health Centre, where 34 children were being treated for severe acute malnutrition on the day we visited.

The immediate impression is the quiet in the four treatment rooms or tents. Severe acute malnutrition silences and immobilizes children. They lie still in their parents’ arms, or next to them on the mattresses that fill the floor space, too weak even to cry.

In the large blue tent set up to house those children who have been stabilized and are now recovering, a few soundlessly bury their heads in their parent’s chest. One little girl manages a shy smile.

We’re told that more than 130 children with severe acute malnutrition were admitted to the Derara and Yirba Health Centres, the two therapeutic feeding centres UNICEF has helped establish in this region over the past month. Those admitted are so ill that they require skilled in-patient medical care and nutritional support to save their lives. Most stay two weeks or more. The day before we visited, one child had died; his sister was still struggling to survive.

© UNICEF Ethiopia/2005/Getachew
This three-year-old girl was burned by a traditional healer who tried to drive out the spirit that was causing her body to waste. Now she is getting medical treatment for her severe malnutrition at Derara Health Centre.

The rains have been late and food crops are failing. The Government safety net programme for vulnerable families has been delayed and food prices for the cash crops many families rely on have plummeted. Children are the first to feel the effects of chronic food shortages. The joint UNICEF/WFP Enhanced Outreach Strategy/Targeted Supplementary Feeding initiative is helping identify those children and mothers at gravest risk.
As well as those receiving intense rehabilitation at Derara and Yirba, nearly 400 other children with severe malnutrition (but without complications) are being followed in seven out-patient centres in Boricha Woreda. About 100 pregnant or lactating mothers and 143 children in precarious nutritional states are receiving supplementary feeding at home.

One little boy of three, recently admitted, leans against his father on the mattress. His face and entire body is swollen, a confusing plumpness to the untrained eye. The Save the Children (US) physician overseeing the Derara Centre explains that severe acute malnutrition can trigger oedema in children, signalling serious metabolic and electrolyte imbalances that can quickly kill.  

Therapeutic feeding is a lifesaver and the centre is an oasis of hope in the hard-hit region. But when we leave, depression hangs heavy over us. We carry the silence of the centre and the children.



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