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Maintaining a nutrition lifeline in West Darfur

A child receives treatment at a feeding centre in West Darfur
© UNICEF Sudan/2009/Steinar Sveinsson
A malnourished child receives treatment from a health worker at the Krinding 1 camp for internally displaced persons in West Darfur.

By Steinar Sveinsson, UNICEF writer.

Krinding1 camp for internally displaced persons, June 2009. In the aftermath of the decision by the Government of Sudan to expel 16 international non-governmental organizations and suspend the activities of three national aid agencies in March this year, and faced by the forthcoming hunger gap and rainy season in Darfur, there was an acute need amongst remaining humanitarian agencies to find a rapid response to immediate life-saving needs.

The need was perhaps greatest in the nutrition sector, where the The expelled NGOs were amongst the key players in providing care to Darfur’s malnourished children – especially in the sprawling camps for those forced to flee their homes by the ongoing conflict. expelled NGOs were amongst the key players in providing care to Darfur’s malnourished children – especially in the sprawling camps for those forced to flee their homes by the ongoing conflict in the west of Sudan.

Even before the March decision, malnutrition was a key issue facing aid agencies – despite an overall reduction in global acute malnutrition rates in Darfur since 2004, those rates had started to show signs of rising again in the last two years.

The NGO expulsions left key gaps in the provision of vital services

In West Darfur alone, nineteen feeding centers in camps for internally displaced people were affected by the suspension of the aid agencies – the challenge was how to keep them operational in the absence of qualified and experienced staff.

“UNICEF immediately contacted all the local staff of the feeding centers, over 200 people, and told them that they could continue their work as usual with UNICEF stepping in to support the operation of the programmes in the short-term, including providing necessary supplies and paying staff incentives,” explains UNICEF nutritionist Douglas Jayasekaran.

“We assured them that UNICEF would continue to provide the same pay that they had been receiving previously from the expelled NGOs – at least for the first few months.”
“We also decided to directly hire some of the staff that the NGOs had employed – these are now responsible for monitoring and supervising the activities of the feeding centres, overseeing payment of the local staff through the State Ministry of Health, and reporting on progress – it’s a temporary measure, but essential to keep the centres running.”

The work carried out in the feeding centres is extremely important for the youngest and most vulnerable among the camp inhabitants. The staff of the centres regularly move around the camps and screen all children under five year old for signs of malnutrition.

Woman and child outside feeding centre in West Darfur
© UNICEF Sudan/2009/Steinar Sveinsson
Nineteen year old mother Atama with her child outside the UNICEF-supported feeding centre in Krinding 1 camp in West Darfur. Her son is one of 130 children registered for treatment at the centre.

When a simple measurement can be cause for concern

A simple measurement of a child’s mid-upper arm circumference is a good test for malnutrition; if it is less than 12.5 centimetres then the child is considered to be malnourished and referred to a relevant specialist feeding centre. As of June 2009, UNICEF was directly supporting 17 such feeding centres in West Darfur.

One is in Krinding One camp, home for more than 50,000 internally displaced people on the outskirts of the town of El Geneina in West Darfur.

It is Tuesday and today the centre’s 13 staff are busy receiving children, assessing them, and handing out specialist nutritional foods and medications to their mothers. A man in a white shirt sits at the registration desk surrounded by colourfully dressed women holding their young children who have been admitted into the feeding programme.

One hundred and thirty children are now registered into the feeding programme here in Krinding One. Older brothers and sisters who have accompanied their mothers play close by as the youngest member of the family is being looked after. The distance between tears and laughter is often small.

Atama is 19 years old and she is here with her first child, 16 month old Nastalla. He had diarrhoea and was not eating well but is now recovering after having treatment at the feeding centre. This is not the first time young Atama has been here; sadly Nastalla has suffered before from the same condition, underlining the invaluable role played by the former NGO staff in maintaining follow-up and outreach work in the camp.

“We were supporting all the feeding centres with supplies even when the NGOs were running them so we knew the operation well,” says Douglas Jayasekaran. “But we have taken on a much greater workload now – the day-to-day management and supervision as well as the logistics are all major challenges in an environment like this.”

“We need to make sure that the feeding centres do not run out of supplies, and have to undertake more field trips to monitor activities and support the local staff – All of this requires human resources, and is dependant on safe access in an environment that is usually highly volatileall of this requires human resources, and is dependant on safe access in an environment that is usually highly volatile.”

A short-term need, but a longer-term challenge

Initially, UNICEF guaranteed to support the feeding centres until the end of this month; however, it has been extremely difficult to find an appropriate partner who has expertise in running such specialist services to take over the longer-term programme – another example of the vacuum that has been left after the departure of the former NGOs.

With the annual rainy season and hunger gap on the horizon – a period when malnutrition traditionally increases across Darfur – UNICFEF has decided to extend its support to these feeding programmes until the end of September to ensure programmes are not interrupted during some of the most critical months of the year.

The real test for these centres has yet to come – in a large camp like Krinding One the threats to children’s health from lack of clean water, poor hygiene and sanitation and resulting diseases increase during the summer months.

But it will be some comfort to mothers like Atama that if their children do fall prey to malnutrition and sickness, some assistance is not far away.



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