One of the Nutrition Champions, Nicolas Tchouyabe, works in Moussoro, a town in the region of Bahr-el-Ghazal in western Chad. Below is an account of the struggle mothers face to feed their children in Bahr-el-Ghazal and the work that ACF does to combat malnutrition.
Four year old twins Cherefie and Acete are hiding shyly behind the cloth which serves as the entry to their hut. Both children are suffering from severe acute malnutrition, a condition which can be fatal if left untreated. When the children got weaker and started suffering from fever, the village chief told Fatima to bring them to Action Against Hunger’s outpatient mobile clinic, supported by UKaid from the Department for International Development (DFID). These mobile clinics regularly visit remote villages to detect and treat malnutrition in young children as well as providing health and nutrition education and referring complicated cases of malnutrition to the regional hospital for intensive care.
At the mobile clinic, the twins were measured and weighed, and received medical care. Both children were put on a treatment programme with specially formulated micronutrient-enriched food, such as high-energy peanut paste, that's ready to use at home. For the past few days, Fatima has been feeding the twins with this therapeutic paste in regular intervals, as instructed by the health workers. Once a week, the mobile clinic return to the village and Fatima takes the twins to this clinic to monitor their progress and for follow-up care.
One out of every four children under five suffers from acute malnutrition in the Sahel region of Western Chad, according to recent nutrition surveys carried out by Action Against Hunger. While the region frequently experiences acute malnutrition rates exceeding the emergency threshold set by the World Health Organisation during the “hunger gap”—a period of routine scarcity between harvests—the last two years have been particularly harsh. Drought and erratic rainfall have pushed nearly two-thirds of households into food insecurity. Problems with access to arable land, water and health care also contribute to the skyrocketing malnutrition rates.
“The last two years have been very difficult,” said Fatima. “We’ve run out of food. Our sheep are not producing enough milk because they are hungry too. Our livestock perished and we cannot afford the food on the markets. My husband left to the North, to look for work. He’s been gone for many months now and occasionally he sends us some cash; but there are so many mouths to feed; my youngest daughter is only a few months old.”
With no other ingredients available, Fatima starts diluting the burnt leftovers of her neighbour’s millet porridge with water to prepare what she refers to as ‘bule’ – the family’s only meal today. She hopes that her sheep will give birth soon to be able to sell the lamb in exchange for some cash.
Meanwhile, she continues to feed the twins with the therapeutic peanut paste provided by Action Against Hunger. “Cherefie and Acete are already getting better and are out and about playing again. I hope that times will get better so that my children don’t fall ill again.”
The current food crisis in Chad has been devastating for families in this isolated region of Chad. Both immediate assistance to save malnourished children and long-term solutions such as income-generating activities and farming are crucial to address the situation and avert future crises.
The Aid for Needy Development Programme (ANDP) in Liberia is a local non-governmental organisation supported by ACF. This is the story of Mark, one of the many malnourished children which the ANDP has helped in and around Monrovia, the country's capital. Abraham Zharn, another of our Nutrition Champions, is the Nutrition Programme Manager for the ANDP.
This is Mark’s fourth time in the ACF supported therapeutic feeding centre (TFC) in Voice of America, Monrovia. The average weight for a child of 39 months, like Mark, is approximately 15kg; however, weighing in at just 5.4kg and with a shocking mid-upper arm circumference of 77mm, Mark is dangerously malnourished. The vacant look in his eyes is not only a symptom of his condition but also echoes the absence of a loving relationship with his teenage mother, who expressed to the staff at the centre: “If you find somebody who wants him, then they can take him”.
Sadly, Mark’s situation is not an isolated case and is typical of thousands of malnourished Liberian children with young mothers. Liberia has one of the highest teenage pregnancy rates in West Africa and widespread beliefs about the perils of breastfeeding and maternity life are threatening the health of thousands of children. Although plagued by many of the recurrent problems that trigger malnutrition, such as unsanitary living conditions and poor quality of water, this new dimension of disintegrating mother-baby bonds cannot be underestimated.
Still recovering from a decade-long, brutal war, the social fabric of the country has been devastated and consequently, childrearing practices traditionally passed down from older generations have been thrown into turmoil. With no extended family to teach them how to raise a child, young teenage mothers are struggling to care for their children. The lack of a family network is often exacerbated by a lack of support from their partners who abandon these young mothers due to beliefs forbidding sexual relations with pregnant or lactating women. Left with no means of living, an absence of child care knowledge and a strong desire to continue schooling, many young mothers like Mark’s, believe their child would be better off with someone else.
Against this backdrop, in collaboration with Aid for the Needy Development Programme (ANDP), an NGO set up by former ACF staff, ACF is launching a new health promotion and education programme to reconnect mother and baby. In ACF’s TFC, malnourished children are nurtured back to health with ready-to-use therapeutic foods and now alongside this treatment their mothers will receive educational sessions covering health, hygiene, care practices and nutrition. By explaining the virtues of breastfeeding, teaching young mothers how to prepare weaning food and dispelling popular myths, the health of many children will be given a fighting chance. Most importantly, through games and physical touch this programme will aim to rebuild the broken mother-baby bond and give the young mothers the confidence and desire to fight for their children.
As of June 2010, Mark continues to improve and is still receiving life-saving treatment via the TFC in Monrovia.