Archives du mot-clé malnutrition

SORTIR DE LA MALNUTRITION PAR LA PORTE DE LA VIE

par Martina Palazzo

Qu’est-ce que tu ferais si ton enfant avait la fièvre, vomissait et refusait de s’alimenter ?

Balkisa n’a eu aucun doute. Elle a amené sa petite Youssoura, âgée à peine de 21 mois à l’hôpital de Mao. C’était un jour de juillet, quand la fraîcheur des premières pluies soulageait les populations du sable au bon milieu de la ceinture sahélienne. Ici un enfant sur huit meurt avant d’atteindre l’âge de 5 ans pour des maladies  infantiles courantes, principalement le paludisme, la pneumonie et la diarrhée, avec la malnutrition comme facteur contributif majeur. D’ailleurs Mao est situé dans l’une des 12 provinces du Tchad qui présentent un taux de malnutrition aigüe global supérieur à 15%, seuil d’urgence pour l’Organisation mondiale de la Santé (OMS). Des chiffres* qui ne laissent rien à l’imagination, des numéros qui prennent la forme d’une sirène rouge appelant à l’alerte et à l’action.

Enfant gueri de la malnutrition
Balkisa garde dans son portable une photo de Youssoura quand elle était malade.
© UNICEF CHAD/2019/Palazzo

Youssoura était sévèrement malnutrie selon le diagnostic de l’agent de santé. Elle avait perdu du poids et n’avait plus de force. Son petit sourire n’éclaircissait plus son visage. L’action immédiate était de l’admettre dans le programme de prise en charge afin de sauver sa vie. C’est ainsi que débuta le traitement avec l’antibiothérapie et la réhabilitation nutritionnelle avec l’aliment thérapeutique prêt à l’emploi communément appelé le Plumpy Nut – 3 sachets par jour- dans une Unité Nutritionnelle Ambulatoire (UNA). Après quelques semaines de traitement, Youssoura avait repris le poids selon sa maman qui priait le bon Dieu d’avoir sauvé son enfant. Malheureusement, il s’en ait suivi 5 semaines plus tard une épisode de paludisme et de déshydratation qui conduit l’enfant et sa maman à l’hôpital de Mao encore une fois.

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Achta, infirmière de l’UNA de Mao Centre, nous montre une photo de Youssoura s’alimentant à travers la sonde. © UNICEF CHAD/2019/Palazzo

« Je pensais que j’allais perdre Youssura, mon seul enfant. Je ne pouvais plus travailler, car je ne la laissais une seule minute », nous témoigne Balkisa, jeune mère d’origine nigériane, vivant avec ses 2 coépouses et leurs enfants au centre-ville de Mao. Leur mari est parti un jour pour le Niger et n’est jamais rentré. Un accident de moto l’a arrêté, gravement blessé, sur le chemin pour son village natal où les funérailles de son père avaient eu lieu. Depuis lors, aucune nouvelle. L’absence de l’homme a fait de la famille matriarcale un soutien indéniable pour Balkisa. « Durant les deux mois et demi, faits de va et viens entre la maison et les services de santé, mes coépouses me consolaient, me préparaient à manger et survenaient aux besoins du foyer. Elles m’ont beaucoup aidé », continue Balkisa.

Enfant gueri de la malnutrition
Balkisa et Youssoura sont en compagnie de Zouwayra, deuxième coépouse, à la maison.
© UNICEF CHAD/2019/Palazzo

Deux mois et demi, cela a été le temps de maladie de Youssoura, le temps de descendre jusqu’au fond du puit et remonter vers la lumière du midi. Un clin d’œil pour un enfant qui a toute une vie devant, si et jamais, entre autres, ait la chance d’avoir accès aux services médicaux de qualité et à une alimentation adéquate, variée, et équilibrée.

Enfant gueri de la malnutrition
Balkisa donne du jus de fruit naturel à Youssoura. © UNICEF CHAD/2019/Palazzo

Youssoura mange tout maintenant et joue avec ses frères et sœurs à faire la cuisine.

Enfant gueri de la malnutrition
Youssoura prend son gouter. © UNICEF CHAD/2019/Palazzo
Enfant gueri de la malnutrition
Youssoura joue dans la cour de sa maison avec son frère et deux voisines. © UNICEF CHAD/2019/Palazzo
Enfant gueri de la malnutrition
Youssoura regarde sa maman préparer le feu pour la cuisine. © UNICEF CHAD/2019/Palazzo

«Je suis contente de voir un enfant passer par des complications médicales et ensuite retrouver la santé », nous dit Achta, infirmière de l’UNA de Mao Centre qui a suivi ce cas. «La maman de Youssoura m’a aidé pendant l’administration du traitement. Elle respectait les doses et écoutait mes conseils. Elle venait régulièrement aux contrôles. La réussite dépend aussi des mères et de leur rôle de protectrices à la maison où nous – les agents de santé- ne sommes pas présents. Balkisa est tellement collaborative, qu’elle nous aide à sensibiliser les autres femmes du village. » En effet, elle utilise l’histoire de sa fille pour convaincre et accompagner les mères à aller à l’hôpital dès qu’elles observent des signes inhabituels chez leurs progénitures.

photo UNA
Balkisa et Youssoura vont à l’UNA de Mao pour une visite de suivi avec Achta.
© UNICEF CHAD/2019/Palazzo

Qu’est-ce que tu rêverais pour le futur de ton enfant, s’il/elle avait failli mourir de malnutrition ? Balkisa répond sans hésiter : « Je rêve qu’elle devienne doctoresse pour aider les autres enfants, comme Achta l’a fait pour elle au moment de la maladie ! »

Enfant gueri de la malnutrition
Balkisa, Youssoura et l’amour maternel. © UNICEF CHAD/2019/Palazzo

*Enquete SMART 2019/UNICEF Tchad

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Pour prévenir la malnutrition, assurer une prise en charge adéquate de la malnutrition aiguë sévère et éviter les rechutes, l’UNICEF soutien- grâce au financement d’ECHO -l’amélioration de l’accès aux services nutritionnels à travers le traitement des cas sévères, mais aussi le renforcement de la prévention par des approches novatrices comme l’approche communautaire sur les 1 000 premiers jours, la détection précoce des enfants malnutris et leur référencement vers les formations sanitaires, la prise en charge adéquate par le renforcement des capacités des agents de santé et l’appui en équipements et intrants nutritionnels, l’accès à l’eau, aux services d’assainissement et d’hygiène dans les centres nutritionnels, pour les enfants de moins de 5 ans. Le présent projet cible 40 000 enfants de 0 à 59 mois souffrant de malnutrition aiguë sévère (MAS), dans 16 provinces prioritaires du Tchad qui sont parmi les plus affectés par la malnutrition aiguë.

 

EU donates additional €4 million to UNICEF to combat child malnutrition in Chad

N´DJAMENA (Chad), 15 December 2016 – The European Union’s humanitarian department is strengthening UNICEF’s response to the nutrition crisis in the Sahel belt in Chad with an additional funding of Euro 4 million. This new grant will support the scale-up of Integrated Management of Acute Malnutrition (IMAM) for 40,000 children in 632 health facilities, and ensure that additional 350 health staff have the capacity to provide quality malnutrition treatment by the end of May 2017.

“Acute malnutrition is hampering the life of thousands of children in Chad. Developing integrated approaches to address it is a proven and high impact lifesaving intervention that UNICEF will continue to support,” stated Philippe Barragne-Bigot, UNICEF Representative in Chad. “We are grateful to the EU for its continued support to scale up such interventions in Chad, especially in the Sahel Belt.”

For years, Chad Sahel belt has been dealing with pervasive food and nutrition insecurity. It is estimated that over 4.3 million people in Chad are now food insecure. In addition, many of the neighboring countries – especially Nigeria, Central African Republic and Sudan- are facing political and security turbulences that lead to population movements which place an enormous burden on the already overstretched health system.

Recent surveys have revealed a Global Acute Malnutrition (GAM) rate of 11.7% with huge variations between regions. It is estimated that over six regions are above the emergency threshold of 15%. As a consequence, 558,000 children are estimated to be currently undernourished of which over 228,000 suffer from Severe Acute Malnutrition (SAM). Besides, chronic malnutrition is a public health problem and affects thousands of children across the country.

In partnership with different stakeholders, including the European Commission’s Humanitarian Aid office (ECHO), UNICEF aims to reach at least 200,000 cases of severe malnutrition to reduce morbidity and mortality resulting from recurring humanitarian crises in Chad.

« The European Union is renewing its commitment to address the urgent needs of malnourished children” said Olivier Brouant, Head of the European Commission’s humanitarian aid office in Chad. “Multiple crisis are impacting Chad, and children are the most affected. We are stepping up to help UNICEF provide life-saving assistance to the most vulnerable, to reinforce national capacities to provide quality malnutrition services, and to build the resilience of the affected communities.” The European Union is UNICEF Chad’s leading humanitarian donor and among the five most important donors of UNICEF in Chad.

In close coordination with governmental and non-governmental organizations, the project aims to implement and scale-up Integrated Management of Acute Malnutrition (IMAM) in 50 new therapeutic feeding centres. This will increase the coverage to a total 632 health facilities and ensure that these centres have the capacity to provide quality treatment of severe undernutrition.

The project will target 40,000 severely malnourished children in 15 priority regions, including refugee, returnee and sites for Internally Displaced Persons across the country. The provision of improved quality SAM services, stock management, reporting and information management will be reinforced through training and equipment of 350 health staff.

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Haoua Yunus and her daughter are nomads. Thanks to the EU support they have beneffited from improved SAM services.

About EU Humanitarian Aid and Civil Protection

The European Union together with its Member States are the world’s leading donor of humanitarian aid. Every year, the European Commission, through its humanitarian aid and civil protection department, helps over 120 million victims of conflict and disasters. Assistance to the most vulnerable is provided solely on the basis of humanitarian needs.

Relief assistance is an expression of European solidarity towards people in need around the world. It aims to save lives, prevent and alleviate human suffering, and safeguard the integrity and human dignity of populations affected by natural disasters and man-made crises.

For more information, please visit the European Commission’s humanitarian office website: http://ec.europa.eu/echo

About UNICEF

UNICEF works in 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit: www.unicef.org

To find out more about the EU-UNICEF partnership, visit http://www.unicef.org/eu/

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A major humanitarian crisis is unfolding in Africa’s Lake Chad Basin, an area that comprises parts of Nigeria, Niger, Cameroon and Chad, where violence and destruction have led to a dramatic increase in malnutrition. Local communities are doing what they can to help those in need. Download multimedia contents here: http://weshare.unicef.org/Folder/2AMZIFWEC7O

For further information, please contact:

Maria Fernandez I Chief of Communication I UNICEF Chad
+235 66 36 00 42 I mfernandez@unicef.org I www.unicef.org/chad

Isabel Coello, Regional Information Officer for North, West & Central Africa, Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO), Dakar, Tel. +221 33 869 60 92, Mob. +221 77 740 92 17, Isabel.Coello@echofield.eu

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Haoua and Halimé: A victory against malnutrition

By Badre Bahaji

In a beautiful, natural landscape, and under the watchful eye of the Queen of Guera, the mountain range and the region’s visiting card, we meet Haoua, a young nomad mother who waged a battle against malnutrition and malaria, which her daughter suffered from.

Haoua, 17, is married and has a 17-month old daughter (Halimé). She welcomes us to her nomad campsite in Kadam (Ferrique Kadam), where she has settled with her family. We are close to Niergui, a village in the Sahelian region of Guéra in Chad.

Haoua’s neighbour, Ismael, tells us that « this region is very popular with nomadic families that come here during the rainy season, because of its fresh and green pastures where they can feed the cattle ». « The cultivation of cereals (mostly sorghum and maize) is another activity that ensures the survival of many families during this time of year« , Ismael adds.

Haoua takes care of her daughter, does the household chores, and grows peanuts, millet, sesame, and other cereals, which contribute to the family income. Still, the lack of a proper diet and other deficiencies have put her baby in danger.

In regards to what took her to the Niergui Health Centre the first time, Haoua says: « I went with my daughter because she had severe diarrhoea« . Encouraged by her husband and advised by a community health worker who regularly visits the Ferrique Kadam, Haoua walked for several hours with her daughter on her back to be seen at the Niergui Health Centre, located 15 Km away.

« In addition to diarrhoea, he told me that my daughter was malnourished and had malaria« , Haoua recalls the words of the nurse that attended to them at the Niergui Health Centre. Halimé was admitted and began treatment for malnutrition and malaria.

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« After receiving medication, my daughter was cured in two weeks », the mother points out in Chadian Arabic. In later visits to the health centre, Haoua was given ready-to-use therapeutic food (RUTF) provided with support of partners such as ECHO and DFID, and took the opportunity to get therapeutic flour, which is also indicated for the replenishment of essential nutrients in children.

 « The problem is that mothers are unaware of the food needed to feed their babies and they ignore the importance of exclusively breastfeeding« , says Pambro Rigobert, the nurse who examined the nomadic baby. The nurse, who has also been head of the Niergui Health Centre since 2013, also comments on the « cultural constraints and bad habits » among the most common causes of malnutrition, recurrent in that area of the country despite the abundance of nutritious local produce.

Asked about the most common children’s cases in the Health Centre, Pambro Rigobert refers to cases of « malaria, diarrhoea, and malnutrition » coming immediately after acute respiratory infections.

In this context, the nurse stresses the importance of partners, such as ECHO and DFID,  in the reduction of child mortality, which « provide medication, food supplements, and mosquito nets impregnated with insecticide », among other materials.

These partners, the specialist continues, « also contribute in regards to the equipment used and the community health worker’s level of training – these are volunteer health workers who visit the villages to advise families and identify maternal and child health problems« . The community health workers play an essential role in providing health care to the families, both in terms of the population living in remote villages or with difficult access, and nomadic communities whose tradition dictates that a newborn should not leave the campsite during the first 40 days of life.

« We are delighted with the work of the community health workers« , says Ismael – Haoua’s neighbour – a nomadic shepherd and a father for the first time recently. Like Haoua, Ismael has settled with his family in Ferrique Kadam and grows cereals like sorghum and sesame.

Following the advice given by the community health workers, the baby is being breastfed and Ismael knows he can – and should – go to the Niergui Health Centre whenever necessary. « We are happy when we see the community health worker, we always welcome them with open arms« .

Dazzled by the scenery and the story of the triumph against malnutrition, we leave Ferrique Kadam while Haoua prepares a peanut-based porridge for Halimé who after a lot of playtime, cries out for food with a sleepy look.

The European Union’s humanitarian aid and civil protection department and the UK’s Department for International Development (DFID) are strengthening UNICEF response to multiple crisis in the Sahel belt in Chad with two grants of 4 500 000 and 350 000 Euro, which will support the treatment of over 45 000 severely malnourished children and the measles vaccination of close to 475 000.

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