On the 16 November, UNICEF reported that the number of children suffering from severe acute malnutrition (SAM) across the Sahel has reached a 10 year high. More than 1.3 million received emergency treatment in 2018. The SAM rates in the Northern Regions of Cameroon are distressing, with The North and Far North Regions being the hardest hit.
This situation is caused by poor eating habits, inadequate sanitation facilities, poor sanitation practices, and the lack of health and social services. Additional factors such as Boko Haram, climate change, and droughts with shorter periods of rain and soil deterioration, have exacerbated the local situation and have lowered access to food particularly during the lean season. As a result, malnutrition in the region has increased by 1% per year during the last few years. It has affected the lives of many Cameroonians. People like young Oumar Youssouf.
Oumar Oumar Youssouf
Aged at 8 months, and under the care of his grandmother residing in Mawak neighbourhood in Kousseri, Oumar will never know his mother Hadje Heoua, who died at the young age of 24, only a couple of months ago due to ill-health.
Oumar was brought to the Malnutrition Management Centre (located in the periphery of Kousseri) by his grandmother for a consultation. Oumar presented symptoms of acute malnutrition. His weight had drastically dropped from 6kg to 3.5kg compared to his last visit. When the Health Officer wrapped the Mid-Upper Arm Circumference (MUAC) band around Oumar’s arm to determine if he was too thin, the tape showed he was clearly in the red zone (see the video below). His MUAC showed a decrease from 113mm to 82mm, and his temperature stood at 38.4ºC. He had diarrhea but no oedema.
The case of Oumar is one amongst many that caught the attention of the PRESEC team who are working to reduce malnutrition in Kousseri in the Far North. Death in the family led to additional vulnerabilities. There are many factors that led to Oumar’s situation. Although emergency treatment of SAM is important, his case can only be prevented from reoccurring or deteriorating if the underlying factors are addressed. Livelihood programmes need to be supported and resilience need to be improved to prevent shocks from economic or climatic events. Additional support is needed for the more vulnerable households, such as Oumar’s family.
Building preventative measures and strengthening the management of malnutrition.
The EU-funded PRESEC project implemented by SNV in collaboration with two local NGOs (CADEPI and APROSPEN) is actively involved in engaging key actors from health and agriculture extension services in eleven councils in Adamawa, North and Far North Regions to build a sustainable system to prevent malnutrition. Local governance structures have been created to serve as advocacy platforms to bring about change in the target population (refugees, IDPs and host communities). The project coordinates nutrition action across sectors. PRESEC supports livelihood programmes by increasing local resilience through agriculture: The project supports diversifying local food options for families by promoting homestead gardens, small animal husbandry, fish ponds and improved climate smart practices. Vulnerable households are given additional support, and the common thread throughout the programme is community based nutrition education. The aim, is to prevent cases like Oumar.
The integration of acute malnutrition treatment in the PRESEC project is critical, as there is a strong need for emergency care. The Malnutrition Management Centre, includes a space to provide nutrition counselling to caregivers, so that mothers and caregivers can discuss how to support their infants in recovery. In May 2018 in Kousseri, the PRESEC team gathered health personnel from the centre for a three day training on case management of acute malnutrition. They received training on early detection, screening and treatment of infants with SAM, and how best to support the children during their stay and help them recover more quickly. The trainers discovered that the Malnutrition Management Centre faced a number of problems including lack of appropriate weighing scales, and inaccessibility of potable water and electricity. Recommendations were made by the PRESEC team to the centre’s authorities on protocols for prevention, early detection and referral of malnutrition, to mitigate the risk of death due to SAM. Through the governance platform, established by PRESEC, the needs of the Centre will be discussed.
More investment in prevention measures is needed. Although many children have been reached with treatment, programmes like PRESEC are critical to create conditions for communities to become self-reliant and better prepared against recurring SAM. The case of Oumar must not become the norm in 2019 and beyond.