War's silent killer - Death by malnutrition in Central African Republic
War's silent killer - Death by malnutrition in Central African Republic
UNOCHA, 16 Mar 2016
URL: https://unocha.exposure.co/36e4dae3838a9f016403a62118a02efd
Three years of conflict in the Central African Republic (CAR) has forced over one million people from their homes and left two and a half million struggling to meet their basic needs. But it has also led to a less visible deadly outcome: the number of young children dying from malnutrition has risen since the conflict began and the number of people going hungry has doubled, according to recent assessments.
At Gordil health centre in the remote Vakaga region in the north-east, mothers wait in the sweltering heat for their babies to be screened for malnutrition. Rakia Ahamath, 36, sits quietly while she tries to breastfeed tiny Abdul, the youngest of her seven children. But the six-month-old boy cradled in Rakia’s thin arms gets no nourishment from his mother. “I had not much to eat and so I had no more milk. We have been unable to be self-sufficient for the past years. It’s a big problem,” said Rakia.
DOCTORS FLED HEALTH CLINICS
The biggest killers of children in CAR are not bullets, but malnutrition, malaria, respiratory infections and diarrhoea. The mortality rate of children under age 5 is now above emergency levels in 11 of CAR’S 16 prefectures, as well as in the capital, Bangui, marking a significant increase since pre-crisis levels, according to NGO International Medical Corps (IMC). In these areas, one in six children is acutely malnourished, according to IMC, which is the only NGO running a nutrition programme in Vakaga, despite the total lack of functioning health clinics there.
Acute malnutrition rates peak annually during the April-to-November lean season, but the combination of conflict and severely restricted access to food has caused a sharper spike than in previous years, said Dr. Sambo Souley, a Nigerian doctor who runs a nutrition programme in Vakaga with IMC. Health workers have fled violence, leaving clinics empty, while parents are bringing in their sick children too late because they are displaced or cannot safely access a clinic, said the doctor. It took Aisha Zakaria and her family one month of walking to flee from Bangui to their home village. They had little to eat along the way and two of her children became malnourished.
“Malnutrition is closely linked to the conflict in the region, while the absence of a State presence and doctors are worsening it,” said the doctor. “Inter-tribal conflicts and conflict with the State have made the few qualified health agents in the area flee.”
The pre-crisis malnutrition levels of children under age 5 were already extremely high in CAR. This was due to a variety of factors including widespread poverty, a fragile health system, lack of access to clean water and sanitation, and poor infant-feeding practices. Vakaga has just three water sources to meet the needs of 5,000 people.
HUNGER LEVELS DOUBLED
Population-wide hunger levels are also staggeringly high with one in two people across the country unable to access sufficient food, according to the latest food security assessment by the World Food Programme (WFP). This is double the rate in 2015. Conflict-related harvest losses and high food prices, as well as poor rains, have led to exceptionally poor crop yields. “Three years of crisis have taken a huge toll on the people of CAR,” said Guy Adoua, WFP Deputy Country Director. “People not only lack enough food but are also forced to consume low-cost, low-nutrient food that does not meet their needs… WFP is extremely concerned by this alarming level of hunger.” According to Dr. Souley the staple diet has become manioc and beans, consumed just once per day. “A child cannot survive on manioc alone,” said the doctor.
Families have been forced to sell their assets, pull their children from school and resort to any measures they can, including begging on the streets to buy food. “This is not the usual run-of-the-mill emergency. People are left with nothing,” said Mr. Adoua. Families urgently need immediate emergency food assistance in the form of food distributions, cash handouts, food-for-work schemes and school-meal programmes, says WFP.
In the longer term, farmers will need seeds and tools to plant next year’s harvest, while investment to stem CAR’s crumbling public services, widespread poverty and mass unemployment are needed to keep children alive once stability returns. If not, children and their families will continue to live with the menace of hunger and malnutrition for years to come.
At Gordil health centre in the remote Vakaga region in the north-east, mothers wait in the sweltering heat for their babies to be screened for malnutrition. Rakia Ahamath, 36, sits quietly while she tries to breastfeed tiny Abdul, the youngest of her seven children. But the six-month-old boy cradled in Rakia’s thin arms gets no nourishment from his mother. “I had not much to eat and so I had no more milk. We have been unable to be self-sufficient for the past years. It’s a big problem,” said Rakia.
DOCTORS FLED HEALTH CLINICS
The biggest killers of children in CAR are not bullets, but malnutrition, malaria, respiratory infections and diarrhoea. The mortality rate of children under age 5 is now above emergency levels in 11 of CAR’S 16 prefectures, as well as in the capital, Bangui, marking a significant increase since pre-crisis levels, according to NGO International Medical Corps (IMC). In these areas, one in six children is acutely malnourished, according to IMC, which is the only NGO running a nutrition programme in Vakaga, despite the total lack of functioning health clinics there.
Acute malnutrition rates peak annually during the April-to-November lean season, but the combination of conflict and severely restricted access to food has caused a sharper spike than in previous years, said Dr. Sambo Souley, a Nigerian doctor who runs a nutrition programme in Vakaga with IMC. Health workers have fled violence, leaving clinics empty, while parents are bringing in their sick children too late because they are displaced or cannot safely access a clinic, said the doctor. It took Aisha Zakaria and her family one month of walking to flee from Bangui to their home village. They had little to eat along the way and two of her children became malnourished.
“Malnutrition is closely linked to the conflict in the region, while the absence of a State presence and doctors are worsening it,” said the doctor. “Inter-tribal conflicts and conflict with the State have made the few qualified health agents in the area flee.”
The pre-crisis malnutrition levels of children under age 5 were already extremely high in CAR. This was due to a variety of factors including widespread poverty, a fragile health system, lack of access to clean water and sanitation, and poor infant-feeding practices. Vakaga has just three water sources to meet the needs of 5,000 people.
HUNGER LEVELS DOUBLED
Population-wide hunger levels are also staggeringly high with one in two people across the country unable to access sufficient food, according to the latest food security assessment by the World Food Programme (WFP). This is double the rate in 2015. Conflict-related harvest losses and high food prices, as well as poor rains, have led to exceptionally poor crop yields. “Three years of crisis have taken a huge toll on the people of CAR,” said Guy Adoua, WFP Deputy Country Director. “People not only lack enough food but are also forced to consume low-cost, low-nutrient food that does not meet their needs… WFP is extremely concerned by this alarming level of hunger.” According to Dr. Souley the staple diet has become manioc and beans, consumed just once per day. “A child cannot survive on manioc alone,” said the doctor.
Families have been forced to sell their assets, pull their children from school and resort to any measures they can, including begging on the streets to buy food. “This is not the usual run-of-the-mill emergency. People are left with nothing,” said Mr. Adoua. Families urgently need immediate emergency food assistance in the form of food distributions, cash handouts, food-for-work schemes and school-meal programmes, says WFP.
In the longer term, farmers will need seeds and tools to plant next year’s harvest, while investment to stem CAR’s crumbling public services, widespread poverty and mass unemployment are needed to keep children alive once stability returns. If not, children and their families will continue to live with the menace of hunger and malnutrition for years to come.