Medecins Sans Frontieres is widening its
health and nutrition programmes in Chad to
respond to the growing malnutrition crisis in
the country. The aid organisation is currently
treating malnourished children at five projects
in the country, and has dispatched emergency
teams to conduct additional screenings
in other affected areas, to assess whether
more interventions are required.
At one of MSF’s long-term projects in
Am Timan, located in Salamat region, in
southeast Chad, the aid group is
expanding the number of outreach
centres from eight to twelve to respond to
escalating malnutrition rates. Between
January and April, 2,478 children were
admitted to ambulatory therapeutic
feeding centres – almost twice as many as
at the same time last year.
Even in a normal year, Chad has one of
the highest rates of chronic malnutrition
in the world. In early 2012, in some areas
of the country, rates of global acute malnutrition
as high as 24% were reported,
among children under the age of five. A
combination of factors are behind the
alarming numbers, including failed
harvests, erratic rains, soaring food prices
and an early depletion of food stocks.
In an effort to reduce mortality rates, MSF teams are treating malnourished children
with therapeutic food and vaccinating
them for measles. Children who are
very sick are referred to our paediatric ward
at the Am Timan hospital, where we have
an intensive care unit to treat severe
conditions. These are usually children
who, due to the immunodeficiency caused
by malnutrition, suffer from additional
illnesses, such as respiratory tract infections,
diarrhoea, or even tuberculosis.
They may also be too weak to eat and must
be fed through a gastric tube.
Emma Augustine Zoba is the Medical
Team Leader in Am Timan.
What is the situation in Am Timan?
Emma Augustine Zoba: The situation is
dire because we are seeing double the
number of malnutrition cases in children
under the age of five, compared to last
year at the same time, and we expect it to
worsen as we move into the peak of the
malnutrition season in July. From
November to January these children were
in the fields with their families, and when
they got sick their parents didn’t take
them to hospital. When the harvest
ended in January, and families returned to
their villages, we suddenly saw a growing
number of sick children come to hospital.
Some of these kids are also suffering from
measles or meningitis.
We know there was a lack of rain and
crops failed. Are there other factors
that have caused this crisis?
EAZ: There is definitely a food problem,
but when you talk to mothers with
malnourished children there is also a
problem with water. There is a lack of
clean water. Culturally many mothers
wean their babies from breastfeeding
quite early. They feed their babies animal
milk and dirty water so by the time they
come to hospital they have diarrhoea and
are already severely malnourished. The
death rate of children admitted to
hospital is high because they arrive in the
last stage of their illness and we can’t
How are these children being treeated?
EAZ: We have two programmes: we have
an outpatient program where we travel to
eight health centres in and around Am
Timan, and test children for malnutrition
and other diseases, such as malaria. We
also vaccinate children against measles,
and if they have an infection, we treat that
too. If a child is diagnosed as severely malnourished, we supply mothers with a
week’s worth of enriched peanut paste for
their child and they are asked to return for
weekly check-ups. If a severely malnourished
child has become critically ill we
transport them to hospital where they
receive treatment and medical supervision.
To help their body adjust to food again,
they are given special therapeutic milk,
and when they regain their appetite, they
are fed enriched peanut paste in order to
gain more weight, until they are well
enough to leave.
During this crisis is there a particular
story that has touched you?
EAZ: At one outreach centre I visited early
on, I saw the state of the water people were
drinking and it made me cry. They were
collecting muddy water from a river and
cleaning it by running it through a cloth.
When we visit we bring clean water with
us and we feed the children with therapeutic
food. But we cannot do any more
after we leave. These babies and young
children drink dirty water and get terrible diarrhoea and, as a result, it’s difficult to
get them to their target weights. We face
epidemics and disease, but water is a big
problem in this area. Having said that, I do
believe we are making a difference. We
know our outreach clinics are helping to
reduce the number of children who are
Médecins Sans Frontières is an
international medical humanitarian
organisation that delivers aid to
people affected by armed conflict,
epidemics, natural disasters or
exclusion from health care in
more than 60 countries around
of upload: 26th Jul 2012