Ethiopia: Treating children against the ‘evil eye’ of malnutrition in the pastoralist community of Fiq

Two-year-old Hawsak lies fatigued in a small camel skin bed, gripped by the agony of an ‘identified’ illness. She is emaciated and has been suffering diarrhoea and vomiting for the past four weeks.

Her house is one of the small bush houses in Fiq woreda (administrative district) in the Somali region of Ethiopia. Her grandmother, Ansha, explained that the family felt Hawsak’s problem was caused by demons and that they had to take her to traditional healer to determine how to pacify the offended gods.

The traditional healers determined that the illness had been caused by an ‘evil eye’ and to rid the child of the demons, Hawsak’s family had to slaughter a 3-week-old camel, skin it and cover the child with the camel’s stomach. The child also had to inhale the smoke of ‘ubuore’ (traditional medicinal) leaves, which would make her sweat and discharge lots of phlegm as a sign of exorcising the demons from her body.

Unfortunately, days went by without Hawsak’s condition improving. Numerous subsequent trips to the traditional healers proved futile, but her family’s hope remained undiminished by every prescribed ‘treatment’. Finally, Ansha decided to look for another solution to keep her grandchild alive, and a hospital was all she could think of. “Two weeks earlier, there was talk around the village of a humanitarian organisation of doctors that provided free health services,” she explained. “So I decided to take my Hawsak there to see if they could help her.”

On arrival at the hospital, Hawsak was admitted immediately. She was suffering from severe acute malnutrition with complications. Meeting the little girl in the hospital’s stabilisation centre, four days after her admission, she still looked tired, but she was in much better condition than when she was first admitted and her eyes were slowly starting to sparkle with life.

Since October 2014, MSF has been involved in strengthening the provision of secondary healthcare and nutrition activities at Fiq hospital in the Nogob zone of the Somali Regional State. Additionally, MSF’s support at the hospital includes the provision of services in the emergency and operation rooms, reproductive healthcare and medical support at the in- and out-patient departments for children under five years of age.

“Malnutrition is a common problem among the Somali pastoralists. However, local beliefs regarding the causes of the problem pose serious challenges to health organisations like MSF attempting to address the disease from a medical perspective,” says Ibrahim. This is why, through its outreach programme, MSF provides health education to strengthen social mobilisation in the community.

A relieved Ansha remarked:Hawsak is now recovering well. She is taking milk and food. When I return to my community I will pass on the message to everyone. I will tell them that it is not the ‘evil eye’. There are a lot of children who are in a similar health condition and I will help bring them here.”

About the Fiq project

MSF started offering healthcare services at the Fiq hospital, with the overall objective of reducing morbidity and mortality rates in the vulnerable population of Nogob zone, mainly by providing medical and nutritional assistance. The direct beneficiaries are the population of Fiq woreda, an estimated 150,000 people. The general population of Nogob zone (436,345 people), also benefits from the services offered at Fiq hospital.