"We could not plant anything at all": Children in southern Madagascar face chronic malnutrition after years of drought

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By Fanjaniaina Saholiarisoa Alida

VAHAVOLA, Madagascar – It’s 9 a.m. and the sun is already beating down on the village of Vahavola in Madagascar’s southern region. The temperature outside is over 35°C.

Vola Lambae sits with her seven children in the family’s small hut in the middle of a cactus plantation. It’s one of the few crops that still grows easily in the area. The nearest source of water is a river more than 3 km from the village, but it’s not safe to drink.

Around noon, the whole family prepares for what will be their only meal of the day: cassava leaves. The children are already frail from the lack of consistent food, vitamins and minerals. But this is all they have to eat.

"We can’t grow rice or other crops as the land is dry and the rain is scarce here. We could not plant anything at all. The cassava leaves come from other people's plantations, but they fill our bellies and help us sleep,” says Vola.

Vola’s youngest child, seven-month-old Mosa, is skinny and fragile. He is still breastfeeding, but Vola doesn’t produce enough milk because she herself eats so little, and she does not have enough clean water to drink.

A crisis of malnutrition

Vola and Mosa’s situation is reflective of a larger problem across Madagascar. Nearly half of all children under the age of five are stunted (low height for age) because they aren’t getting the nutrients they need to grow.

Children like Vola’s who aren’t getting enough food, both in terms of quantity and variety, are more susceptible to infectious diseases. They are also at risk of developing severe acute malnutrition – dangerously low weight and severe muscle wasting – which is a major cause of death for children under five.

Since 2014, the southern region has been particularly hard-hit by decreased rainfall, taking a toll on crop production. The ongoing El Niño weather phenomenon has compounded the drought, leaving 1.1 million people food insecure in 2018, including nearly 500,000 children. The number of children who are acutely malnourished is expected to rise in 2019.

Getting treatment before it’s too late

Today, community health workers are visiting Vahavola village. The UNICEF-trained staff travel to remote areas to identify children in the early stages of severe acute malnutrition. As soon as they see Mosa, they know he needs help. They decide to bring him to the Sampona health centre, the nearest health facility a 30-minute walk from Vahavola.

Once he arrives in Sampona, health worker Ericka Razafimbelo measures his weight and height. She also measures his upper arm with a special tool called a mid-upper arm circumference band. Mosa is in the red zone, meaning he needs urgent care or he might die.

Ericka gives Mosa ready-to-use therapeutic food, a tasty peanut-based paste that is designed to help children gain weight quickly. The paste is ideal for treating children in remote areas, not only because it provides all the nutrients children need to recover, but also because it has a good shelf life and isn’t water-based, so there’s little risk of bacterial growth and it doesn’t need refrigeration.

Ericka will send Vola and Mosa home with enough therapeutic food for a full course of treatment. She says that his situation is common in this area, but with continued treatment, he will be in good shape in few weeks.