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Amidst severe food crisis, health and nutrition centres support children in Chad

© UNICEF/Chad/2010/Gangale
Achta, 2, on her mother's lap. She suffers from severe malnutrition with medical complications. She will be admitted at the intensive therapeutic care.

Moussoro, Chad, 27 May 2010 – Radié Hami holds her baby girl, Achta, close to her as they wait at the new Moussoro health and nutrition centre. The young mother is accompanied by her husband and an uncle. It is the nomadic family’s first visit to the centre and, in fact, their first trip to the town.

Achta, 2, has been sick for three months. Her parents first tried traditional medicine such as melted butter to sooth her cough. But it didn’t work, and Achta kept losing weight. Finally, Ms. Hami and her husband decided to make the 20 km journey to the nutrition centre in Moussoro, the capital of Chad’s Bar-el-Ghazel province, which lies in Africa’s dusty Sahelian belt.

Supported by UNICEF and its partners, such nutrition centres are working to reverse the trend of severe acute malnutrition in young children across the region.

Increasing hardship
Achta’s is one of many nomadic families that have travelled from the desert seeking assistance at the nutritional feeding centres. Access to health care and safe water is limited or non-existent in the desert, making children vulnerable to malnutrition and disease.

Because Ms. Hami was sick when she was pregnant, Achta – like many children in the region – was born underweight. Ms. Hami was unable to breastfeed Achta because she herself was malnourished. Instead, she fed her daughter goat’s milk from the small herd that supports their family.

People from this semi-arid Sahel are accustomed to difficult living conditions. Malnutrition is so widespread here that parents often don’t realize how wasted their children have become. With malnutrition rates above emergency thresholds for a decade, nutritional health has become a persistent challenge in Chad.

‘Lean season’ is severe
Every year between May and August, the stocks of food from the previous harvest run out and many people go hungry. This year, the ‘lean season’ is worse than most; Chad has been severely affected by the food crisis that has swept across much of the region, and people have exhausted their limited stocks earlier than usual.

Tens of thousands of severely malnourished Chadian children under the age of five will likely need life-saving treatment and food assistance in the coming months.

With UNICEF support, 42 outpatient nutrition centres are now operational here. As the widespread nutrition crisis continues, these centres are helping to treat child malnutrition more effectively.

Children referred for treatment
When it is Achta’s turn to be examined, a nutrition officer measures her left arm. Its circumference is less than that of a thin bottleneck, meaning that Achta is in the ‘red zone’ – that is, she is suffering from severe acute malnutrition. The nutrition officer calculates that the child’s ‘weight for height’ ratio is less than 60 per cent of the median for children her age, and well below the commonly-used 70 per cent criteria for severe acute malnutrition.

Alexis, the nurse in charge of the health and nutrition centre, listens to Atcha’s chest and confirms that she is also suffering from a respiratory infection.

The centre does not have the resources needed to treat Achta’s acute condition. Instead, she is referred to a therapeutic feeding centre in Moussoro’s hospital.

More options for mothers
When she hears the word ‘hospital,’ Ms. Hami shivers. She has already lost a child, who died in hospital when he was 11 months old, after suffering from malnutrition and diarrhoea. The family couldn’t afford to pay for treatment and reached the hospital too late.

Today, however, more UNICEF-supported outpatient nutrition centres exist in Chad’s Sahelian belt, bringing nutritional screening closer to home. In cases like Atcha’s, they are helping to identify severe acute malnutrition earlier and provide treatment more quickly. They also give mothers more options to protect their children – even when food shortages are severe.

Holding Achta, Ms. Hami leaves the health centre and walks down the sandy avenue leading to the hospital. A doctor there takes a blood sample and admits the child. He writes a prescription for her treatment. Despite her weak cries, Achta now has a good chance of surviving.

By Anne Fouchard



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