Case studies from the field

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.