Genete Mohammed carries her 18-month-old daughter Iman to the Belina Arba Health Post in drought-affected Fedis District in Eastern Ethiopia for the weekly UNICEF-supported outpatient therapeutic programme (OTP).  Field report by Indrias Getachew. BELINA ARBA, FEDIS, 25 July 2011

VIDEO: 11 July 2011 – UNICEF correspondent Chris Niles reports on UNICEF efforts to treat malnourished children in eastern Ethiopia.

“Iman’s body was swollen – on her face and shoulders,” recounted Ms. Mohammed. “I took her to the hospital and they told me to bring her to the health post where they would treat her.”

Tackling malnutrition

Drought has resulted in high levels of malnutrition among children in affected districts like Fedis, with an estimated 312,740 severely malnourished children requiring urgent life-saving treatment.

“Malnutrition here has never been as bad as this year,” said Ms. Lemlem Worku, one of two health extension workers assigned to the Belina Arba health post, who has been working in Fedis District for the past four years. “Perhaps its because the rains were delayed, but malnutrition has never been this bad.”

Ms. Worku begins the session with a discussion on nutrition and gives advice on the kinds of locally available foods that the mothers can use to feed their children. Then, one at a time, she calls the mothers to her table where she measures the children’s mid-upper arm circumference (MUAC) and checks on bipedal oedema, a good indicator of nutrition status, after which she weighs them, registering their results on their OTP cards.

UNICEF provides support

This is Iman’s third visit to the life-saving programme and her progress is encouraging.

“When Iman first came she weighed 5.5 kgs,” said Ms. Worku. “She needs to weigh 6.3 kgs before she can be discharged. Today, on her third week, her weight has reached 6 kgs. The oedema swelling is gone and she is getting better.”

Satisfied with Iman’s weight gain since her last visit, Ms. Worku advises Ms. Mohammed on how to properly wash her hands, before leading her to a quiet corner and handing her a sachet of ready-to-use therapeutic food (RUTF) for Iman’s appetite test. Iman reaches for the familiar packet and has no trouble eating the life-saving therapeutic food. Having passed the test, a week’s ration of RUTF and a bottle of amoxicillin antibiotic to fight infections is given to Ms. Mohammed, after which mother and child head back home, a short walk from the village health post.

UNICEF has supported Ethiopia to increase national capacity to treat severe acute malnutrition in drought and food insecure districts like Fedis from almost nothing in 2004 to 8,800 sites today. Additionally, UNICEF has assisted the Ministry and Regional Bureaus of Health with the training of health extension workers in outpatient therapeutic feeding. UNICEF also provides the RUTFs, nutritional supplements, medicines and other inputs such as weighing scales and MUAC tapes that are required for the programme.

Improvements in jeopardy

Families with malnourished children don’t have to go far from home to receive life-saving interventions provided by health workers from their local communities. In fact, in most cases, children can be treated at home – unless they have complications like fever or diarrhea. This enables parents to continue working on their farms without having to leave their other children unattended.

Child survival rates in Ethiopia have improved significantly in recent years with advances in child nutrition playing a major role. In 1990, more than twenty per cent of children would not survive to reach their fifth birthday, with malnutrition being an underlying factor in more than half of all under-five child deaths. By 2010 this number had been cut by half.

The on-going drought emergency is, however, threatening these child-survival gains. Systems that have been put in place to save children’s lives are now stretched as a result of the drought.

Waiting for the harvest

It has started to rain again in Fedis bringing with it hope for a harvest in a few months time. Meanwhile, community-based therapeutic feeding programmes are ensuring that children survive the crisis. UNICEF is appealing for an immediate $10 million to respond to emergency humanitarian needs in Ethiopia over the coming three months.

“My wish is for my child to get better and for us to get out of these hardships,” said Ms. Mohammed. “Right now we are waiting for the harvest, but we are not sure if there will be hunger or plenty – we are just not sure.”