The State of the World's Children 1998: Features

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In Burundi camps, the spectre of malnutrition looms

Wrapped in a small green-and-yellow blanket, 16-month-old Richard Nsabimana juts two tiny open palms into the air, searching for his mother's arms. His hair is thin and white, and his skin is broken, wrinkled and spotted with scabies. On his legs, open sores invite a cluster of flies, and on his foot, the squeeze of a thumb leaves an exceedingly prolonged imprint. He is weak, has little appetite and is severely malnourished.

It is a condition by no means uncommon in Burundi, where the ghost of malnutrition has long since established itself in hills and homes throughout the tiny Central African nation's impoverished but verdant countryside, easily striking children whose access to food, health, sanitation and proper care is limited.

However, since the outbreak of civil war in 1993, levels of malnutrition in Burundi have only increased, climbing ever higher as the overall health situation deteriorates. Conditions are the worst by far in makeshift camps for the displaced. About 600,000 people — as many as 25 per cent of whom are children — have been displaced inside Burundi during the past five years. In some of the worst-hit areas, particularly regroupment camps in Karuzi, rates of malnutrition for children have reached 18.7 per cent, and rates of severe malnutrition 4.9 per cent.

Malnutrition's causes are many and difficult to determine. "I don't know why he's sick," says Richard's mother, 24-year-old Madelene, cradling him in her arms. Richard has kwashiorkor, and its causes are rooted in a combination of factors: part diet, part health, part education, part access to food, part care, and all amplified by the civil war.

Before the war, Richard's family cultivated a small plot of land in the province of Karuzi, in central Burundi. The yield was relatively abundant, and they were able to sell the surplus of sweet potatoes, manioc and bananas in local markets. "Before the crisis," says Madelene, "we had just enough to make a good living." When civil war finally reached their fields late last year and military authorities forced them into a regroupment camp ostensibly for their own protection — all that changed. Their access to their fields, and therefore to their food, plummeted.

A month after entering the camp, Richard fell ill with diarrhoea and intestinal worms. His parents are now sick as well: his father with malaria; his mother, like him, with scabies. The nearest health centre is 3 kilometres away, but many times, Madelene says, they use traditional healers instead.

Their diet consists primarily of beans, porridge and supplementary food from an NGO. But, she says, "it is not enough." Like many families in Karuzi, they have been unable to cultivate their fields, partly due to sickness, partly to restrictions placed on their movement by authorities. And when Madelene is able to go back to her fields 2 km away, she gathers whatever food she can for her family. But, she says, "whatever is there is there by the grace of God."

The atmosphere in this camp, like in many others, has aggravated and compromised the nutritional status of the children of Burundi. Richard Nsabimana, unfortunately, is not alone.

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