By Shantha Bloemen
DORI, Burkina Faso, 16 May 2013 - After 35 days at Dori Hospital, 15 of them in a coma, 2-year-old Mariama now weighs 6.5 kilograms and is on the road to recovery. When she arrived, she weighed just five kilograms and was suffering from severe malnutrition with complications. Over the last two years, this referral hospital in the hot and dry north of Burkina Faso has seen a steady flow of such cases, as a large-scale nutrition crisis across nine countries of the Sahel region has left more than a million children at risk for or suffering from severe acute malnutrition.
A landlocked and poor country of 17 million people, Burkina Faso may be one of Africa’s biggest gold producers, but it remains one of its poorest. In the northern region, increased desertification has seen the expansion of the Sahara desert southward, while pressure from population growth has made the area increasingly fragile. Although reports indicate this year’s agricultural harvest has improved, estimates suggest that around 430,000 children will suffer from acute malnutrition in 2013, including 100,000 with severe acute malnutrition.
A mix of factors
Mariama’s story illustrates the complex mix of factors behind these numbers. When Mariama was just 14 months old, her 30-year-old mother, Aissato Hame, became pregnant again and stopped breastfeeding. The decision left Mariama without enough to eat. With four other young mouths to feed, and little food in their village, her parents started prospecting for gold. But the family was still unable to earn the 2,000 CFA a day (around US$4) needed to feed everyone. As a result, Mariama’s health deteriorated until her mother finally brought her to the hospital.
Now her mother has been taught how to make an affordable nutritious porridge with peanuts and has received a week’s supply of ready-to-use therapeutic foods, and Mariama can go home. The hospital, with support from UNICEF and Médecins du Monde, provides transport so she can return the following week for a check-up and receive another week’s supply of Plumpy’Nut, a high-energy peanut paste. Treatment will continue until her health is better.
From cure to prevention
Community Health workers Matrama and Amado Diallo go door-to-door in their village to educate parents and check for cases of children who may be suffering from malnutrition. One of their biggest challenges is not just the shortage of food, but also entrenched cultural attitudes that prevent children from getting nutritious food. “If children eat eggs, the father will leave you,” says one mother as she pounds sorghum into powder for porridge.
By educating families on good nutritious food practices, Matrama and Amado are starting to see a difference in the communities they serve. They say families are now aware of the link between nutrition and disease and illness. They can also identify the signs of acute malnutrition.
To help expand services like this across the country, a multi-sector Scaling Up Nutrition roadmap was adopted in May 2012, led by the Ministry of Health, with backing from UNICEF, WFP and NGOs, and supported by the European Union.
“This plan provides a way to get us to shift the focus to prevention of malnutrition, without losing sight of the need to treat new cases of acute malnutrition,” explains Marco Brero, a nutrition specialist with UNICEF Burkina Faso. “The focus is very much on building the institutional systems to deal with the crisis now, but also invest in the future.”
Homegrown solutions
Students from Foundation 2LE in Burkina Faso’s capital, Ougadogou, have built Inne Faso, a local factory to produce Plumpy’Nut. Just becoming operational, this franchise of Nutriset, the developer of Plumpy’Nut, is awaiting a final audit before it starts to sell its product locally, and eventually across the region. Managing Director Abdourazackou Sanoussi believes this investment will not only help address the high rates of acute malnutrition, but also create employment as well as a market for high-grade local peanuts.
For Burkina Faso, the hope is that with the right investments in education and resilience-building, acute malnutrition will be a thing of the past, and life for those living in the poorest parts of the Sahel will not be on the edge of survival.
Updated: 17 May 2013