Khadija’s 6-month-old son, Nawal, had been suffering from vomiting and diarrhoea for days, but she thought it was related to his teething. Finally, when his fever did not go down, she brought him to a clinic in N’Djamena, where he was diagnosed with severe acute malnutrition. Report by Eva Gilliam

VIDEO: UNICEF correspondent Eva Gilliam reports on the alarming rates of malnutrition in Chad, a country affected by the Sahel region’s food and nutrition crisis. Photo © UNICEF/NYHQ2012-0194/Holt

“We have some trouble at home with [having] enough to eat,” explained Khadija. “My husband is a motorcycle taxi-man, but what he makes is no longer enough to feed the family.”

Khadija is not alone. Hundreds of mothers were bringing their children into the Notre Dames de Apostles clinic in the nation’s capital.

“Yesterday, we treated 62 cases of severe malnutrition,” said Sister Merceline M’po, a nurse and nutritional expert at the clinic. “And today we have over 70.”

Crisis for already fragile children

Even in a normal year, Chad has one of the highest rates of chronic malnutrition in the world.  The region experiences a yearly ‘lean’ or ‘hunger’ season, and according to UNICEF data from 2010, 15.7 per cent of children under age 5 were already suffering from severe acute malnutrition.

But in 2011, the rains did not come.

The failed rains, coupled with low crop yields, are causing a dramatic increase in rates of malnutrition – not only in Chad, but throughout the Sahel region.

This year, Chad’s lean season is expected to run from April to September instead of the normal June to September. Making matters worse, the Government of Chad estimates that the price of cereals has increased 22 to 43 per cent. The rising costs are affecting not only children but also the health system charged with treating them.

“Last year, a bag of flour for feeding the children with moderate malnutrition cost us 15,000 francs [US$30]. This year, it is at 24,000 [US$48],” said Ms. M’po. “If it is hard for us to buy that, imagine what it is like for the families.”

Response wastes no time

Learning from last year’s food crisis in the Horn of Africa, the World Health Organization (WHO) and UNICEF have shifted their guidelines for determining severe acute malnutrition, allowing for an earlier response.

“WHO and partners have introduced new criteria which enable us to diagnose children under-5 with severe acute malnutrition earlier, thereby allowing us to refer children to the health centres earlier to be treated before the most critical stages,” said Dr. Yaron Wolman, Chief of Health and Nutrition section at UNICEF.

UNICEF and partners have wasted no time. In Chad, over 276 feeding centres are being supported by UNICEF, and additional efforts are being rolled out.

“We have seen for months that this is coming, and we have been working with the Chad Ministry of Health and other partners to scale up, including the number of screening centres, and get a head start through these first few months of crisis. But beyond that, we need international assistance,” Dr. Wolman said.

The emergency response is in place, but additional resources are desperately needed.

A problem with many roots

“This crisis is due to a combination of factors, the major one being food insecurity,” said Roger Sodjinou, the Nutrition Programme Officer with UNICEF in Chad. “But there are also other causes, like the lack of access to appropriate infant and young child feeding, poor access to health care and poor access to hygiene and sanitation.”

To address this, UNICEF and partners are responding to the crisis with an integrated approach.

“Addressing the immediate needs of malnutrition, this is, of course, the nucleus and the basis of our response,” said Dr. Wolman. “But our response also includes also health interventions, water and sanitation, education, HIV/AIDS interventions, protection interventions, and a whole package of high impact interventions, which will reduce incidences, and mainly which will reduce mortality, which is related to malnutrition.”

According to UNICEF’s estimation, 127,000 Chadian children under the age of 5 will face severe acute malnutrition over the next eight months.  An additional 300,000 children under 5 will suffer from moderate acute malnutrition in the same time span.

“If we don’t respond quickly, it’s going to get worse,” said Ms. M’po. “We will become overwhelmed by cases, and the children will die.”