A new report by UNICEF to be issued on 15 April reveals the high prevalence of stunting in children under 5, but also outlines the tremendous opportunities that exist to make it a problem of the past. (byLaure Poinsot).
MONGO, Chad, 11 April 2013 – The father wipes his eyes with the sleeve of his white boubou.
“We did all we could,” says Dr. Kaimbo. “Unfortunately, the boy was too weak.”
© UNICEF VIDEO
UNICEF reports on how new health centres and community outreach are targeting the vicious circle of disease and malnutrition in Chad.
Vicious circle of disease and malnutrition
Days like today weigh heavily on Dr. Kaimbo, who is part of a UNICEF-supported programme aimed at saving the lives of children affected by nutrition crisis in Chad. The programme is funded, among others, by the European Union humanitarian aid department (ECHO).
Chad experiences chronic drought, among its harsh and erratic climatic conditions. The country is also faced with massive developmental challenges. Nearly 20 per cent of children die before their fifth birthdays. During periods of drought, many children suffer from severe acute malnutrition.
“[I]t’s not just drought and famine that causes malnutrition,” says UNICEF Chad Representative Bruno Maes. “There are three big factors in the vicious circle of disease and malnutrition. One is food insecurity due to bad harvests and rising food prices. Second is the poor health services. And the third is the parents’ lack of knowledge about food and basic hygiene. Then there’re also the risks associated with child marriages and polygamy.”
Scaling up the response
In response to nutrition crisis in Chad and the Sahel Belt region, UNICEF, the Government of Chad and partners such as ECHO have scaled up services and facilities to treat the growing number of children affected by malnutrition. “The number of treatment centres has doubled, from 210 to 425,” says Mr. Maes. “Two hundred thirty paramedics have been trained and despatched; hundreds of tonnes of supplies and materials have been delivered to reach as many children as possible.”
UNICEF recruits, trains and deploys paramedics. It also supports establishing therapeutic nutrition centres and outpatient nutrition centres, setting up nutrition outreach efforts and purchasing supplies.
Health official in the Guera region Dr. Honoré Dembayo says that these efforts have helped to alleviate some of the shortages of medicine and healthcare staff. “All this explains the good results seen in Guera – a cure rate of over 75 per cent.”
Screening and treatment for malnutrition
The success in Guera region is largely the result of careful screening of children at the community level and at health centres to make sure they receive the treatment they need – when they need it. Children are tested for malnutrition by checking their height and weight, the circumference of their mid-upper arm and any swelling. Depending on the results, they may be admitted into the nutrition programme.
The children then take an appetite test. They are given ready-to-use-therapeutic food made up of a peanut butter paste enriched with sugar and vitamins.
“Children who struggle to eat [the therapeutic food] have reached a highly advanced stage of malnutrition,” says UNICEF Nutrition Officer Jean-Pierre Mansimadji Mandibaye. “They are immediately taken to hospital, because their lives are in danger.
“The others can benefit from our programme and receive packets of therapeutic product. They must return every week until they’re cured.”
Outreach in communities
Once the children are back home, outreach volunteers monitor progress throughout the treatment period. They also teach families about good hygiene and nutrition, to keep the problem from
“It’s a lot of work, but I’m proud of saving children,” says Abderrahim Massadi, an outreach volunteer in Koulji, 15 km from Mongo.
There are 250 families in the village of Koulji, including about 1,500 children. One of these children is Saidja’s son. The little boy has successfully completed his treatment, and now Saidja is applying the skills she’s learned to keep him healthy. With support from the outreach volunteers, she has learned to make a healthier porridge for him, using fresh ingredients when she can afford them.
“I put in millet, some beans, a bit of peanut butter and sugar,” she says. “Since I started making him this porridge, he doesn’t get sick anymore. They also taught me to use soap to wash his hands and mouth before meals, and how to properly clean the kitchen utensils.”