Malnutrition: A critical situation in Akuem, Sudan

The figures speak for themselves: 4% severe malnutrition; 26% global malnutrition; 60-70 new admissions every week to the MSF supplementary feeding centre (SFC); 40-50 new admissions per day to the therapeutic feeding centre (TFC). Everything points to the particularly critical nutritional situation reigning during the "hunger gap" in Akuem, Aweil East County and Bahr-el-Gazal.

In Bahr-el-Ghazal the 'hunger gap' is always a period of chronic food insecurity.

"In 'normal' years, the sorghum stocks, the main crop of the area, already start to wane in January and February," explains Claire Magone, Head of Mission in southern Sudan. "This leads the population to rely on wild foods, fishing, goat or cow's milk as well as any secondary crops (maize, okra, sesame) that are harvested at the end of July. Between the end of the sorghum stock and the nearest harvests, the 'hunger gap' is a period of attrition - particularly in June and July".

In addition to this chronic food insecurity, there are additional factors that increase the risk of malnutrition: insufficient access to water and healthcare, inadequate hygiene conditions and ill adapted weaning practices.

The last drop...

It takes just one aggravating factor to turn this relative insecurity into a real emergency. Last year the low rainfall and the drought that followed resulted in poor harvests and lower food stocks than in previous years. The drought triggers a vicious spiral, as it reduces the grazing available for livestock.

To make matters worse, with the signing of the peace process between the North and the South in January this year, many of those who had been displaced, fleeing the war in Bahr-el-Gazal to take refuge in the north, are starting to return home. These "returnees" set up home near their families.

The first three months of 2005 saw the return of 87,000 people to the Bahr-el-Gazal area, and 25,000 to Aweil East County. Today the small amount of food that is available has to be shared with far more people than before.

4% of severe malnutrition

Consequently, the feeding centre has seen admissions rise sharply over the last weeks. At the end of June, there were 232 children being treated in the therapeutic feeding centre; a large majority of them have had to be hospitalised, whilst others received outpatient care. There are 600 children who have already been admitted to the supplementary feeding centre.

The nutrition survey carried out by Epicentre for the period June 18-22 has revealed a very critical situation. In the four districts were the nutrition survey was carried out, the total population is estimated at over 200,000 people. The teams are expecting to have to treat up to 1,000 severely malnourished children and 7,000 moderately malnourished.


A "blanket feeding" operation is now being planned (i.e. the distribution of 60,000 family food rations) with the aim of preventing moderate malnutrition and preventing children from degenerating into severe malnutrition.

"This will help us reach more children than we can with the supplementary feeding centres, even though our priority is still to treat those with severe malnutrition and keep the mortality rate down," says Pauline Horrill, Programme Manager.

MSF teams are going to reinforce the treatment capacity of the TFC. The treatment has been designed in two phases: one for children needing hospitalisation; and one for those who, while severely malnourished, do not need to be kept at the centre - they will be examined once a week and receive a family food ration.