Merlin USA

Merlin specializes in health, saving lives in times of crisis and helping to rebuild shattered health systems worldwide. We do whatever it takes and we stay for as long as it takes. Merlin works within existing health systems to realize everyone's right to accessible, appropriate, affordable health care. We are specialists in rapid medical response and rebuilding health systems, effectively taking countries from emergency to recovery.
Aug 15, 2013

The Sahel Food Crisis

Massaguet: volunteer screens baby for malnutrition
Massaguet: volunteer screens baby for malnutrition

The Sahel Food Crisis

Every indicator in 2011 pointed to a looming food security crisis in the Sahel, with poor rain patterns and failing harvests. The crisis in 2012 was driven by chronic poverty, malnutrition, high food prices, drought and low agricultural production, affecting 18.7 million people across the region and triggering a large humanitarian response. Food insecurity is endemic in Chad, malnutrition is a recurrent public health problem, with rates frequently above the threshold for a critical situation, putting a large number of children at immediate risk of death and long- term disability. Food shortages made the hunger gap start two months earlier, with households stocks exhausted by April instead of July. Coupled with rising food prices, families faced a real challenge resulting in malnutrition rates above emergency thresholds. The 2012 crisis closely followed the severe food and nutrition crisis in 2010, leaving families with limited ability to cope with more frequent and brutal food shocks.

Merlin’s Response

Merlin deployed an emergency response team as early as February 2012 to carry out an assessment in the area of Hadjer Lamis, north of the capital N’Djamena, where no NGO was operating. The assessment found that the health services were not able to cope with the magnitude of the impending food crisis. Merlin decided to mount a response offering nutrition and primary health care and targeting pregnant and lactating women and children. This response supported local health authorities and providers, strengthening existing services rather than duplicating them, in order to make a lasting difference. The program targeted malnourished pregnant and lactating women and children, and provided treatment for high-prevalence illnesses such as malaria, acute respiratory infections, and diarrhea. Our response also improved general awareness of optimal nutrition and health practices, as well as hygiene and sanitation.

Key activities

Improving the prevention, diagnosis and treatment of malnutrition:

- 16 Health facilities supported are providing supplementary feeding program (SFP) and Outpatient Therapeutic Program (OTP) services;

- One stabilization center was set up, assisting 255 children suffering from severe malnutrition with complications;

- In total, 6,565 children under-5 were treated for severe acute malnutrition;

- 10,423 children under 5 and 4,191 pregnant and lactating women were treated for moderate malnutrition;

- 16,704 caretakers received health and nutrition training;

- 210 community health workers were trained on community-based management of acute malnutrition (CMAM);

- 48 health workers from the Ministry of Health were also trained on CMAM;

Improving access to health:

- 3,568 patients were effectively treated for malaria, acute respiratory infection (ARI) and diarrhea;

- 2,190 children were vaccinated against measles;

- 1 mobile clinic provided nutrition and health services to 6 remote sites;

 Improving the preparedness of communities:

- 1 cholera preparedness and response plan was developed for Massaguet health district by the local health authorities, with Merlin’s support;

- 1 cholera kit was positioned in advance in the district and all Health personnel and community informed on cholera case definition and procedures to reduce contamination;

Feed the Body Feed the Mind

A growing body of research shows that integrating early childhood development activities into emergency nutrition programs is crucial child health. Child growth and brain development depend not only on good nutrition but also on stimulation and caretaker emotional responsiveness. Merlin is piloting the integration of psychosocial and early childhood development services within its stabilization center to improve support for the recovery of malnourished babies, and strengthen their caretakers’ abilities to adequately care for the child.

Challenges faced

Heavy rainfalls have caused large flooding in areas around Lake Chad, close to Merlin’s intervention areas. Merlin mounted an emergency WASH response to mitigate the risks of WASH-related diseases, in a cholera-prone location. In addition, during the rainy season, access to some of the villages was is limited. This led to lower community outreach and potentially untreated cases of malnutrition and other illnesses.

Coordination

Merlin has been successful in establishing solid relationships with both local authorities and communities. Merlin has ensured that its programs were developed in support of existing health authorities so as not to duplicate efforts, and to create unsustainable services. Merlin conducts regular meetings with community leaders and local authorities to discuss issues, and coordinates with all existing humanitarian forums. We continue to be open with authorities and respectful of cultures so as to ensure that we operate effectively.

Monitoring and Evaluation

Merlin monitors its programs systematically to be able to anticipate issues and provide solutions to mitigate them. Supported health centers report on a weekly basis to Merlin and our staff conducts regular monitoring visits to every center.

Impact

Merlin responded quickly to malnutrition and food crisis in Chad and has managed to set up a successful program. Local authorities have expressed their appreciation of the program and of Merlin, and this will be the basis for our expansion of operations in Chad. We have successfully implemented activities that will reduce the vulnerability of communities to malnutrition.  Drawing from this experience, Merlin is designing longer-term programming using its own expertise, to address the underlying causes of malnutrition, such as poor access to clean water, hygiene and sanitation, child and infant feeding and care, and health promotion.

Massaguet Hospital, checking medicine stocks
Massaguet Hospital, checking medicine stocks
May 8, 2013

Improving Responses to Malnutrition in Chad

Massaguet district, Chad
Massaguet district, Chad

The Sahel Food Crisis

Merlin responded quickly to malnutrition and food crisis in Chad and has managed to set up a successful program. Local authorities have expressed their appreciation of the program and of Merlin, and this will be the basis for our expansion of operations in Chad. We have successfully implemented activities that will reduce the vulnerability of communities to malnutrition.  Drawing from this experience, Merlin is designing longer-term programming using its own expertise, to address the underlying causes of malnutrition, such as poor access to clean water, hygiene and sanitation, child and infant feeding and care, and health promotion.

Key activities

Improving the prevention, diagnosis and treatment of malnutrition:

· 16 Health facilities supported are providing supplementary feeding program (SFP) and Outpatient Therapeutic Program (OTP) services.

· One stabilization center was set up, assisting 255 children suffering from severe malnutrition with complications.

· In total, 6,565 children under-5 were treated for severe acute malnutrition next hunger trap.

· malnutrition with complications.

· In total, 6,565 children under-5 were treated for severe acute malnutrition.

· 10,423 children under 5 and 4,191 pregnant and lactating women were treated for moderate malnutrition.

· 16,704 caretakers received health and nutrition training.

· 210 community health workers were trained on community-based management of acute malnutrition (CMAM).

· 48 health workers from the Ministry of Health were also trained on CMA.

 

Improving access to health:

· 3,568 patients were effectively treated for malaria, acute respiratory infection (ARI) and diarrhea.

· 2,190 children were vaccinated against measles.

· 1 mobile clinic provided nutrition and health services to 6 remote sites.

 

Improving the preparedness of communities:

· 1 cholera preparedness and response plan was developed for Massaguet health district by the local health authorities, with Merlin’s support.

· 1 cholera kit was positioned in advance in the district and all Health personnel and community informed on cholera case definition and procedures to reduce contamination.

 

Feed the body – feed the mind:

A growing body of research shows that integrating early childhood development activities into emergency nutrition programs is crucial child health. Child growth and brain development depend not only on good nutrition but also on stimulation and caretaker emotional responsiveness. Merlin is piloting the integration of psychosocial and early childhood development services within its stabilization center to improve support for the recovery of malnourished babies, and strengthen their caretakers’ abilities to adequately care for the child.

 

Coordination

Merlin has been successful in establishing solid relationships with both local authorities and communities.  Merlin has ensured that its programs were developed in support of existing health authorities so as not to duplicate efforts, and to create unsustainable services. Merlin conducts regular meetings with community leaders and local authorities to discuss issues, and coordinates with all existing humanitarian forums. We continue to be open with authorities and respectful of cultures so as to ensure that we operate effectively.

Monitoring and Evaluation

Merlin monitors its programs systematically to be able to anticipate issues and provide solutions to mitigate them. Supported health centers report on a weekly basis to Merlin and our staff conducts regular monitoring visits to every center.

Where We are Now

Although donor response was large for the Sahel, funding available for Chad has decreased to a point where it is threatening all the gains made during the 2012 food crisis response. Despite this, Merlin is developing longer-term, cost-effective programs to target the underlying causes of malnutrition but is aware that with limited donor engagement, gaps will increase during the next hunger gap. It is only with you further support can our successes in Chad continue.

 





 



Zafaya Health Center, Chad
Zafaya Health Center, Chad
Stabilization center in Massaguet, Chad
Stabilization center in Massaguet, Chad
Mar 29, 2013

DRC Emergency Response

Dr. Conde, Aiding at Nord Kivu Mobile Clinic
Dr. Conde, Aiding at Nord Kivu Mobile Clinic

Merlin’s Emergency DRC Vaccination Response

Merlin has helped vaccinate more than one million children against measles over just one week across seven provinces in North Kivu, DR Congo. In a country where health systems are weak, sadly people often die from easily preventable diseases such as measles. Vaccination programs can greatly improve the health of vulnerable people and help tackle the spread of deadly diseases.

“Measles kills, especially amidst insecurity. But this can and must be avoided,” said Dr. Félix Kabange Numbi, Minister of Public Health in DR Congo. “We know that vaccinations can save children’s lives.”

Since the Goma conflict flared up in November last year, people’s lives, especially those of children have been at great risk. People have been forced to flee their homes, often without any food or money. To make matters worse, diseases such as measles, diarrhea, flu and malaria have spread quickly throughout North Kivu taking the lives of many.

According to UNICEF, measles outbreaks were reported in all 11 provinces of the DR Congo and over 2,000 children died from the disease in 2012. The fighting in 2012 caused measles cases to be six times higher than the previous year.

Determined and undaunted since the beginning of the crisis, Merlin worked fast to set up mobile health clinics in camps providing life-saving care for internally displaced people. Each day, Merlin health workers have been treating up to 170 patients for diseases such as malaria, diarrhea and respiratory infections in DR Congo. We are also screening and treating children for malnutrition.

Without your help, we wouldn't have been able to give the urgent emergency vaccination that thousands of people in DR Congo need. Your help will save lives. To help us ensure vulnerable people in DR Congo are protected from preventable diseases.

Merlin response in Goma.
Merlin response in Goma.
Merlin Measles Vaccination campaign, Goma, DRC
Merlin Measles Vaccination campaign, Goma, DRC