CARE Ethiopia CIDA funded Emergency Nutrition Intervention

Nutrition: a Lifeline for Mothers and Children in West Hararghe

Seated on the floor of the Kuni Town Health Centre, in Gemechis woreda, Halima Dawit
shared the tragic story of Khadija’s life. Six months ago shortly after Khadija was born, her
mother – Halima’s daughter – died. A happy event had turned to tragedy. Halima took up the
role of carer for her new granddaughter, but that was just the start of her struggle.

This year, the rains came late again in this part of Ethiopia. And when they finally began they
caused huge flooding which damaged many of Halima’s crops on her tiny quarter hectare of
land. What was not damaged by flood, was destroyed by drought.

This is what led them here, to the small room being used as a stabilisation centre for severely
malnourished infants. Khadija is one of nine inpatients currently admitted in the centre.
Halima had brought her to the health centre for an immunisation, and staff there immediately
realised the severity of her condition.

“I have so many problems; I don’t even have milk to give to my granddaughter.” she shared.
“They said she had a problem with malnutrition and they admitted her immediately. That was
three days ago.”

Like many of the mothers in stabilisation centre, Halima had travelled 80km to get there, this
great – sometimes impossible – distance, the reason why CARE, with funds from the
Canadian International Development Agency (CIDA), is supporting the Government to open
another two centres in West Hararghe alone, hoping to give as many children and families as
possible an opportunity to receive help.

Figure 1 (Left): Halima Dawit with Granddaughter, Khadija

The children in the centre, all under five years old, are
immediately put on a course of high-electrolyte milk, given
eight times a day, to stabilise their digestive system, and
then moved to a high-protein milk to help them to gain
weight.

As soon as Khadija gains weight over consecutive days, she

will be discharged and then treated in the Outpatient
Therapeutic Program (OTP) for the next two or three months
as she returns to a healthier weight. The children in OTP
receive weekly rations of Plumpy-nut, a nutrient rich ready to
eat therapeutic food with high caloric intake. It is an effective
means for restoring children to a healthy weight and nutrition
status.

Halima’s relief at receiving help is palpable, “I am so very glad to be here. I have learned how
to prevent malnutrition, and so far as it is possible, I will do my best to give my grand-
daughter the kinds of food she needs.”

Outside, a crowd of mothers gather with their children to be weighed. These children too are
severely malnourished, but well enough to be treated as outpatients. 45 children are expected
today.
There has been an increase in referrals since the Government carried out a screening across
the region a fortnight ago. But, many of the people here today have been referred by
someone in their community. A crucial part of CARE’s nutrition programme is training
community members to be able to identify severely and moderately malnourished children
who need treatment and link them government health services.

Engida Asha, CARE’s Emergency Programme Manager in West Haraghe explained, “there
are 162 Community Nutrition Volunteers in Gemechis woreda alone. Village leaders help us
to select them from the community and they are responsible for raising awareness and
identifying serious cases and referring them to our services.”

Many of the volunteers are traditional birth attendants, who help women too remote to get to
medical care, through labour and childbirth. With good knowledge of the communities, they
are well placed to spot families and children in need.

12-month old Nanti Ahmed is one of those. She was admitted as an outpatient three weeks
ago weighing just 5.1kg. She was given antibiotics and is now receiving a specially devised
high-protein food called Plumpy’nut to help her to gain weight.
Figure 2: Hawa Rahado with daughter Nanti
But, CARE doesn’t only target infants.
Chronically food insecure women, and pregnant
and lactating mothers in particular, are
especially vulnerable, which is why our
programmes specifically prioritise their needs.
When a child is referred, the mother is routinely
measured too, and this identified Nanti’s
mother, 20-year old Hawa Rahado, as also
worryingly underweight.
Hawa told us, “when I had this child, I had no
support because the father is not there, he has
migrated in search of work. I could not farm as I
had to care for the child. I had no harvest this
year. Nothing. I don’t have any food in the house to feed my children.”

Hawa has been receiving supplementary food, along with her child, for 3 weeks now.

“I was thinner than this before, and I am still improving. I am gaining weight. Though my child
still has diarrhoea and so is not yet putting on weight.”

For Hawa, as for thousands of ordinary Ethiopians, CARE’s nutrition programme is a lifeline.

As she put it, “I know if I had not come here, I would have died.”