Interview: Malnutrition in Sahel
One million severely malnourished children will be treated this year in the countries of the
One million children suffering from severe malnutrition will be treated this year by governments and aid organizations across the
Susan Shepherd: It’s both a failure and a success. The failure is that each year, countries within the
Stéphane Doyon: Prior to the 2005 nutrition crisis in
Is this year worse than usual?
Susan Shepherd: For young children in the
Nonetheless, there are some good news. We are beginning to see the extent of the malnutrition problem in this region. Effective prevention methods are now available, thanks to ready-to-use nutritious food supplements, with milk and adapted to the needs of children. A child who is immunised, is shielded from malaria, and eats the right kind of food, will not become malnourished.
Stéphane Doyon: Treating a million children is both ambitious – each of these countries faces its own particular constraints, but remains realistic – the will and the means are there. In Chad, for example, we are almost starting from zero: the response to the nutritional crisis this year will have to be built on top of a very weak health system and the intentions are to treat twice as many children this year (127,000) compared to 2011 (65,000). And the impending rainy season will make the deployment of aid even more complex. In
How to break the cycle?
Stéphane Doyon: Today, the management of this nutritional crisis is done in emergency mode. When we speak of an emergency, we are mostly referring to humanitarian interventions. This is where we run into one of the major challenges to enacting true change: for governments, these models of humanitarian action are difficult to repeat and to sustain over the long term. Therefore, we have to break out of this emergency response model, and start developing a longer term approach. Another challenge lies in understanding what exactly malnutrition is: a medical problem, related to a lack of food that satisfies the particular needs of children. Countries which have successfully addressed the problem of childhood malnutrition include nutrition in health systems. Long-term solutions should therefore include medical responses; development, agriculture and treatment of malnutrition are all complementary.
Susan Shepherd: Malnutrition should be treated any time and anywhere it occurs, just like any other early-childhood illness. Early treatment and malnutrition prevention measures should be implemented the same way immunisations are for childhood diseases. Food for a young child is just as important as being immunised and sleeping under a mosquito net! The idea is therefore that the treatment and prevention of malnutrition should be integrated into a country’s health system, and treated as true public health measures.
However, to reach this point, we need to make prevention and treatment as simple as possible for mothers because it is thanks to the mothers that the treatment of children can now be done at home, instead of in the hospital. Mothers are also the ones who have made the preventive distribution of ready-to-use supplementary foods such a success, since they are the ones who administer these foods to their child. Today, in MSF’s nutritional programs throughout the region, we are trying out different operational strategies as a way to find the most practical and effective approach possible. For example, we are thinking of having the mothers themselves measure the MUAC (middle upper arm circumference) to assess the nutritional status of their child. The solutions are out there, we just have to find them.
* Source: UNICEF