Six weeks after arriving in the region of Shariya in South Darfur, Médecins Sans Frontières (MSF) is completing its first distribution of high-energy biscuits to approximately 10,000 children under five in the towns of Muhajariya and Labado. The aim is twofold: to assist the population which has come under pressure as they are hosting thousands of displaced, help them maintain acceptable nutritional standards and prevent famine in the community; to detect all malnourished children via a so-called MUAC (mid-upper arm circumference) screening and enroll all moderately and severely malnourished children in MSF feeding centers.
"We came to this region because we heard that people were recently displaced by violence and we believed there was a serious nutritional problem", said project coordinator Lis List. "But we didn't realize how great the need actually was until we started working. For instance, near Muhajariya a new camp sprung up with displaced who arrived over the last couple of weeks. They built very small shelters made out of sticks and don't have any kind of plastic to protect them from the rain. They are using the sarongs that the women wear - real thin pieces of cloth to give them some shade. They don't have anything to carry their water in and have to walk far and dig deep to find water underground. I didn't see any food in the homes I went into.".
As MSF is the only organisation to have set up in this region, we decided to quickly organise a blanket feeding distribution. Getting supplies to the region is not easy.
"We face a lot of constraints in terms of movements," says logistician Nicolas Barrouillet, who is in charge of the distributions. "For example, it takes us seven hours to drive 70 kilometers with the trucks. They have flat tires or get stuck repeatedly. It is hard to organize the work and it is a lot of work to organize a blanket feeding distribution. But the population has been very cooperative. At each location we needed hundred volunteers to help out and we have had no problems whatsoever to mobilize people. There is a real community feeling."
Two days before the actual distribution, volunteers are trained to correctly measure the MUAC of a few thousand children. MSF doctor Sylvia asks one of the volunteers to measure her MUAC by fitting the bracelet around her upper arm. The volunteer cries out "very, very green!" and all of them burst out laughing.
Sylvia then asks another volunteer to fit the bracelet around her two fingers until the window turns red.
"If these two fingers are the child's arm, the child is severely malnourished. Then we don't give it biscuits, but immediately take it to the tent where it can receive high-proteine milk."
For organisational purposes, each distribution is spread over two days - one day for the girls and another for the boys - which also allows MSF to get an indication of the breakdown between boys and girls in the population.
So far, MSF has enrolled close to 700 children in its feeding centers in the region of Shariya, a third of whom are severly malnourished. After completing today's distribution, the numbers are likely to increase.
Lis observes that "even though the communities have good coping mechanisms and have been very supportive of the displaced population, their ability to support them is being very stretched with the increased number of displaced arriving. So I think, for at least another six months, MSF will certainly have to remain here. Many people have left their fields behind, and they may have had a good harvest, but they are not there to take care of it now."
MSF started assisting refugees in Chad in September 2003 and has worked in Darfur since November 2003. Today, more than 180 international staff and approximately 2,000 Sudanese staff are providing health care and nutritional support in 26 locations in North, West and South Darfur. More than 10,000 malnourished children are currently being treated in MSF feeding centers.