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 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.
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.
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.
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.
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