By Jolien Carnel
With recent flooding and displacement in Malawi heightening children’s vulnerability, UNICEF has intensified its efforts to treat and prevent sickness and malnutrition.
CHIKWAWA, Malawi, 29 January 2015 – It’s a new day at Tizola Green Bank Camp. Those who managed to find a comfortable place to sleep have woken up hungry after another night. As children are particularly affected by the lack of food, the District Health Office organizes an under-5 clinic in the camp every morning.
The camp houses 1,470 inhabitants who have been displaced after Malawi experienced heavy rains and flooding on a scale not seen for over 20 years. More than half the camp’s population are children.
At the clinic, community health workers and volunteers carry out growth monitoring and nutrition screening. The measuring equipment scares some of the little ones, who struggle and cry when placed on the wooden height boards. Others have been here before, and bravely allow the Health Surveillance Assistant (HSA) to measure their length and weight, and check their middle upper arm circumference (MUAC) with the coloured tape.
Usually, children are monitored and screened once a month, but with UNICEF support the under-5 clinic is running daily. This enables health workers to follow up the children’s health and nutrition situation more closely, so sickness and malnutrition can be detected early.
Serious situation
This southern district of Malawi has some of the poorest communities in the country, mostly existing on subsistence agriculture, and often suffering food insecurity and poor diets.
“When I heard about the clinic, I rushed to have my daughter Elisa screened,” says Alefa Wilson, who found shelter close to Tizola Green Bank Camp. “Elisa is almost 2 years old and suffered minor diseases when the water came. As our house collapsed, we were trapped for three days, and her situation deteriorated,” Alefa recalls.
At the clinic, the HSA quickly noticed that Elisa’s situation was very serious. She was diagnosed with severe acute malnutrition and was immediately referred to the district hospital.
While Alefa accompanies little Elisa to the hospital, five other mothers receive therapeutic food and information on how to feed their malnourished children through the outpatient programme.
Malnutrition is generally a problem in Malawi, where 4 per cent of the children suffer from severe acute malnutrition and 42 per cent are affected by stunting (too short for age), which can slow physical and cognitive growth. Moreover, the diet of many Malawian children looks just about the same every day, depriving them of the variety of food they need to grow into strong adults. According to the Malawi MDG Endline Survey, only 26.6 per cent of children between 6 months and 2 years received foods from four or more food groups during the previous day.
Children in Malawi are thus already at risk for malnutrition, and being displaced after the flooding is making them more vulnerable. Many people at Tizola saw the water completely submerge their crops and belongings, leaving them without food and with a lot of worries. Without an adequate and diversified diet, it is projected that more children in the affected areas will become malnourished. The conditions in the camp also expose them to a higher risk of diseases such as diarrhoea and infections, making health and nutrition screening even more essential.
A tough task
In Tizola, 81 children have been screened on this day, including the 2-year-old twins Johanna and Joanna. Their mother Kenti is breastfeeding, but it’s difficult because she hasn’t eaten much herself. Kenti is in the camp with her four other children and husband. And feeding so many mouths is a tough task. “All our crops are washed away, and when the boat came to rescue us, we couldn’t take anything from our destroyed home. I literally don’t have anything. All I could rescue are my children.”
For now, growth monitoring and nutrition screening is being initiated in the camps in Nsanje and Chikwawa, where the flooding has hit hardest. UNICEF is supporting the daily clinics run by the district health and nutrition staff, as well as supplying the therapeutic food supplies needed to treat malnourished children.
When we visit Elisa the next day in the pediatric ward of the hospital, she is already doing better. She enjoys drinking her therapeutic milk and is visibly improving.
Background: Malawi suffered prolonged heavy rains in early January, leading to unprecedented flooding in southern and eastern districts. With at least 170,000 displaced, UNICEF is working through its teams on the ground in Blantyre and Zomba to deliver life-saving interventions to those in the hardest-hit districts: Nsanje, Chikwawa and Phalombe. Focused on displaced women and children, UNICEF is supporting its partners, including the Government of Malawi, to provide clean water and temporary sanitation, treat acutely malnourished children, and support mobile health clinics in the evacuation camps. UNICEF is appealing for US$9.3 million to provide emergency interventions for the next three months.