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Fighting to Survive in a Country Overwhelmed by Malnutrition

UNICEF Yemen/2017/RI
© UNICEF Yemen/2017/RI
When Relief International first started treating Yahya, his Mid-Upper Arm Circumference (MUAC) was only 8.5 centimetre.

By Thomas Charteris

Yahya is four years old, from a small village in a remote area in the north of Hajjah governorate. He suffers from Severe Acute Malnutrition (SAM) and is at risk of developing many related health issues as a result.

Sana’a, Yemen, 18 October 2017 - A savage war has been raging across Yemen for more than two years; much of the country’s infrastructure has been destroyed; and over 14 million people do not have access to enough food. Diseases from drinking unclean water have spread everywhere, which causes diarrhea, especially in children, and health services are barely available for most people. Crippled by diarrhea and not able to get enough food, over 380,000 children just like Yahya are at risk of severe acute malnutrition.

50-year-old Muhammad is desperate when he reaches Relief International’s (RI’s) mobile medical team (MMT). He has come on foot, carrying his feather-light son, Yahya, in his arms for one hour because he knows he is very ill. There are no health facilities out here and very few people have the money to be driven the three hours along rocky mountainous roads to the nearest hospital. Muhammad has seen other children in his village die from malnutrition and he’s terrified the same fate awaits Yahya.

“He is very weak and cannot even walk anymore. He’s lost so much weight”.

Muhammad is a wheat farmer and together with his wife they have 10 other sons. The family all live together in a small stone house with dirt floors and there are no toilets or running water anywhere in their village. He heard about the services being provided by the MMT when our community volunteers came to his house, screening children for malnutrition. They told him Yahya needs to urgently go to the MMT site for treatment. When Muhammad arrived, he told us “I knew Yahya could die if I didn’t reach this mobile facility and get help. I don’t know what is wrong with him but there is no one else to help us out here.”

Ali Jobran, the MMT nurse, took Yahya’s measurements, explaining that he was Severely Acutely Malnourished (SAM) and that in all likelihood he would die in the coming weeks without treatment. The nutrition team provided Muhammad with 15 sachets of the nutrition
supplement, Plumpy Nut, and told him Yahya needs to take two per day and then return to the MMT site in one week, when we will be back in the area for a follow up checkup.

Over 18 million people in Yemen (almost the entire population) are in need of humanitarian or protection assistance. 7 million people do not even know where their next meal will come from – and more than half of those are children. Basic health services and the institutions that provide them are all collapsing, placing enormous pressure on the humanitarian response. But every day we try. UNICEF has been funding RI to provide primary healthcare and life saving nutritional supplements to children and mothers through MMTs in some of the most remote, inaccessible areas of Yemen since 2015. We use innovative community-based awareness-raising activities in the villages to address underlying causes of unhealthy environments, prolonged illness, and inadequate care. We train local volunteers in the communities on safe hygiene and nutrition practices; and these people go door-to-door, raising people’s awareness on the importance of exclusive breastfeeding, why it’s necessary to wash your hands, and how to keep food and water from getting contaminated. They also screen children for malnutrition and tell their parents about the services that are available and how and when to reach them. This is how Muhammad learned how he might save Yahya’s life.

UNICEF Yemen/2017/RI
© UNICEF Yemen/2017/RI
Ali Jobran, the nurse in Relief International’s mobile medical team checking Yahya's condition.

Muhammad brought Yahya back to the MMT every week for more supplies of Plumpy Nut and so RI’s nutrition team could monitor his improvement. Although he is still SAM, his condition has improved significantly and his Mid-Upper Arm Circumference (MUAC) is now almost 10.5cm. Yahya is visibly happier and more active than he was the first time he came. He can walk again and even his hair is a bit thicker. Although Yahya is still very much at risk of deteriorating and could still die, Muhammad is extremely happy. “I’m so pleased that he is starting to get better and I hope he recovers soon.” We gave Muhammad another week’s supply of Plumpy Nut and told him to continue monitoring Yahya’s condition closely.

Unfortunately, shortly after Muhammad’s eighth visit to RI’s MMT, this project funded by UNICEF ended and the MMT staff have not been delivering services in this area for the past two months. RI wants to go back to this same district and expand the same services to five governorates across the country, however, our MMTs are unable to return to priority districts, including Yahya’s area, until funding is secured. In the meantime, no other humanitarian actors are operating here and cases like Yahya’s are not being seen. Since our MMTs stopped operating, Muhammad has taken Yahya to the nearest health facility instead, which is only partially operational as it was hit by an airstrike last year and it is further away from his village. We have since heard that Yahya’s condition has improved but he has not received enough medical attention, probably due to the long distance to walk there. RI staff are hoping to find Yahya when our MMT goes back to this area and our staff can pick up where we left off until Yahya becomes healthy again.

*Names of beneficiaries were changed to protect their identity.

The writer is a Grants, Reporting, and Communications Officer for Relief International in Yemen



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