Combating Acute Malnutrition: Detecting and managing cases

Miss Oscar, nurse, completes the register

Miss Oscar, nurse, completes the register. © Maxence Bradley

UNICEF supports early detection and management of acute malnutrition in the departments most affected by Hurricane Matthew. Join us as at a screening session with our partner, the Foundation for the Development and Support of the Haitian Family (FONDEFH).

Dame Marie is a city located at the extreme south-west of the island. I recall the name from the first reports of UNICEF teams as they arrived in the area “Dame Marie, Anse d’Hainault, Les Irois, destroyed”, confirming the initial observations of United Nations helicopters. From Port-au-Prince, the capital of Haiti, it’s difficult to fully understand what these words mean. Today, almost two and a half months after the hurricane, I can clearly see the extent of the damage yet I can only imagine the distress these children and their families must have felt as Matthew struck their land, their roof, their lives.

Acia and her daughter Israéline

Acia and her daughter Israéline. © Maxence Bradley

When we arrive at the Dame Marie High School on 21 November 2016, we find there are about 65 families, including 130 minors, living in the school. “Families came initially seeking refuge from Matthew and those whose homes were destroyed have found shelter here since then. Some have started moving into small houses or hangars, others are rebuilding their homes,” says Edouard Aya, 58, a field animator and public crier for the Dame Marie hospital. He is also a farmer and fisherman, and now he is coordinator of the shelter. “I volunteered to coordinate the shelter,” he said, “I wanted to be useful.

In this shelter, Plan International provides for children and MSF Belgium delivers drinking water three times a week. UNICEF partner, FONDEFH, is here screening for acute malnutrition by measuring the upper-arm circumference with a plastic ribbon marked in centimeters. It is a quick, simple, yet very effective tool to identify children who are too thin and at high risk of mortality.

Rachel 16 years old and her daughter Loica 2 years old

Rachel 16 years old and her daughter Loica 2 years old. © Maxence Bradley

The children patiently wait their turn, while those who have already been examined walk with a lollipop in hand or are cradled in their mothers’ arms.

Acia is 18 and her daughter, Israéline, is 2 years old. Since the passage of Matthew, they have been living in this high school with Acia’s mother, her father, and her older sister; their house was totally destroyed by the hurricane.

Israéline has been diagnosed with severe acute malnutrition after being screened by FONDEFH. This means that she is suffering from excessive weight loss that is dangerous to her health. The team make an appointment for Acia to go to the Health Center of Dame Marie on Monday, to receive appropriate nutritional care and treatment for her daughter. For the next 1 to 2 months, she will need to return to the Health Center every 15 days for treatment follow-up, and to receive packets of ready-to-use therapeutic food that will help Israéline to regain weight. Her progress will be monitored closely until she is cured. Acia hugs her child and tells me that her most cherished wish is for her daughter to be healthy.

Guerline, nurse is measuring the arm of a child.

Guerline, nurse is measuring the arm of a child.© Maxence Bradley

There is concern that the nutritional status of these children will deteriorate due to several factors that could lead to a corresponding increase in the number of cases of malnutrition. On the one hand, an increase in infectious diseases, particularly diarrhea caused by a lack of access to safe water, and on the other hand, a lack of nutritious food due to crop destruction (70-100% of crops have been destroyed in the affected areas), and compounded by significant loss of livestock and livelihoods.

Rachel, 16 years old, holds her daughter Loica, 2 years old, in her arms. They, as the others, live in Dame Marie High School with Rachel’s father, mother, and husband. FONDEFH has made a Monday morning appointment at the clinic for them, also, because Loica has a fever.

Rachel’s friend, Belony Celna, joins her with her one-year-old son. His name is Numa Wilsherson. He is suffering from diarrhea. Miss Oscar, a nurse at FONDEFH, gives Belony oral rehydration salts (to dilute in water), and micronutrients (a powder composed of 15 vitamins and minerals to be added to the porridge of the little boy) for Numa to receive treatment at home, and schedules a follow-up appointment for him at the clinic for Monday morning

Jameson is making kites

Jameson is making kites. © Maxence Bradley

“The screening for malnutrition carried out by FONDEFH is also an excellent opportunity to detect other illnesses in children such as diarrhea, respiratory infections or dermatoses. These are the diseases encounter most frequently during our consultations,” explains Guerline Dodin, a nurse at FONDEFH for 6 years.

UNICEF provides technical and financial support for the early detection and management of acute malnutrition, focusing now on the two departments most affected by the hurricane, South and Grand’Anse. In the department of Grand’Anse, 16 of the 26 nutrition centers existing before the hurricane are now operational again, and in the South department, 28 of the 38 nutrition centers are once again active.[1] In areas where centers are inactive, UNICEF partners like Médecins du Monde are providing essential health and nutrition services through mobile clinics[2] until routine health services are restored.

UNICEF Haiti - 70th Anniversary video shooting with Jean Jean Roosevelt

© Maxence Bradley

In a shady corner of the schoolyard, Jameson, 14 years old, and his friends, are busy. He is the “chief” of a kite-making workshop. “I hope to return to school very soon.” he whispers to me before running off to join his comrades in flying their kites.

 

Julie Harlet

UNICEF Haiti communication

[1] UNICEF Haïti- Hurricane Matthew Factsheet Nutrition au 5 December 2016.

[2] See our article on interventions of Mobile clinics ‘’The 4-wheel drive clinic that cares for communities in remote areas’’ on                     http://timounyo.com/5685/?lang=en

This post is also available in: French