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 granddaughter 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.”

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