15 December 2017

Maria’s long journey to health

Over a million children in South Sudan are severely malnourished. Maria is one of 600,000 children treated since December 2013.

Two-year-old Maria John, from Juba, South Sudan, was admitted to the Al Sabbah Children’s Hospital suffering from severe malnutrition with medical complications. Her health improved steadily before she relapsed. Follow her journey from the initial treatment to her eventual full recovery.


© UNICEF/UN0152305/Gonzalez Farran

Two-year-old Maria John was admitted to Al Sabbah, a UNICEF supported inpatient stabilization centre in Juba, in October 2017, suffering from severe acute malnutrition, vomiting and diarrhea. She weighed just over 6Kg.

“There is nothing for us to eat at home,” said Gisma Augustino, Maria’s mother.
© UNICEF/UN0152299/Gonzalez Farran

At the hospital, a nutritionist works hard to engage Maria who turns away in shyness. Children are first seen at primary healthcare points close to their homes and then referred to the stabilization centre at Al Sabbah Hospital if they are found to be severe acutely malnourished with complications.

© UNICEF/UN0152300/Gonzalez Farran

Maria, too weak to walk, sits quietly with her grandmother, Victoria, while she is screened for malnutrition. Some 280,000 South Sudanese children are severely malnourished.

“I was so worried and I didn’t think she would become healthy without help so my neighbours advised me to come here,” said Maria’s mother, Gisma.
© UNICEF/UN0152301/Gonzalez Farran

A nutritionist at Al Sabbah Hospital prepares therapeutic milk for feeding Maria and other children at the stabilization centre. The therapeutic milk is rich in nutrients, easy to digest and quickly provides malnourished children with the energy they need to thrive.

© UNICEF/UN0152298/Gonzalez Farran

After Maria was admitted to the centre, she given a therapeutic milk formula called F-75, which is used to treat the most severely ill children. After she gained enough strength to feed herself she was provided with a different formula called F-100, the next step in the treatment process.

© UNICEF/UN0152302/Gonzalez Farran

Maria was then referred to a primary health care centre close to her home. The centre receives 200–300 patients per week. Maria and her grandmother sit patiently, waiting for Maria to be measured and weighed. She was given a weekly supply of Ready to Use Therapeutic Food (RUTF).

© UNICEF/UN0152303/Gonzalez Farran

Maria’s condition continued to improve, but after she developed a fever with a severe cold and cough, concerns for her health increased. A malaria test proved negative and she was treated with antibiotics. A severely malnourished child is nine times more likely to die than a healthy child.

© UNICEF/UN0152304/Gonzalez Farran

Seven-year-old Charlie Augustino comforts his niece Maria at their home in Juba, South Sudan. An economic crisis, with an inflation rate that has reached 800 percent, has plunged millions of people deeper into poverty and food insecurity, and left children vulnerable to illness.

© UNICEF/UN0152306/Gonzalez Farran

Maria’s family sometimes eats a meal of beans and rice. Extremely poor diets, very limited access to health services, disease outbreaks and poor sanitation have increased acute malnutrition across the country.

“I don’t make enough money to buy the right foods,” says her grandmother, Victoria.
© UNICEF/UN0152307/Gonzalez Farran

Maria’s family and friends had been preparing themselves for the worst and are grateful to have a healthy, happy child with them once more. “I can’t believe it,” says Maria’s grandmother.

“I saw Maria looking so weak we weren’t sure she would come home again.”
© UNICEF/UN0152308/Gonzalez Farran

Just over a month after diagnosis, Maria’s blank stare is now an infectious smile. Over the past 4 years, UNICEF and partners have treated over 600,000 children like Maria for severe acute malnutrition. Yet much more needs to be done to give every child in South Sudan the chance to live and thrive.


Read the report — Childhood under Attack: The staggering impact of South Sudan’s crisis on children.

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