How to fight malnutrition in the desert
The hinterland of Lake Chad is a deserted, scarcely populated area. The climate is harsh with temperatures frequently reaching 45 degrees Celsius and little rainfall. The distance between villages is considerable, limiting trade and access to basic services, such as health and education. Although malnutrition is widespread, families cannot always seek treatment for their children.
In the Chadian province of Kanem, an invisible, irreversible and inter-generational scourge hinders development: malnutrition affects one in every four children. Zara Moustapha is a young mother from the village of Yoursoula, 45 kilometers away from the capital of the province, Mao, and eight kilometers away from Kekedina, the largest village in the area.
Three days after giving birth, she realized she was not producing enough milk to feed her baby. “She is my second baby and I was worried, but visiting the health center was not an option as it is too far away for me to walk”, she says.
Zara received counseling from two women in her community, the so-called maman lumieres (role mothers). Harmata Brahim and Kakay Choukou provide advice on hygiene, health, and nutrition to reduced groups of women with children suffering from moderate acute malnutrition.
“We have seen the number of malnourished children reduce significantly. When we started our group sessions, there were about 50 babies suffering from malnutrition in Yoursoula. Today, there are no more than 20”, explains Harmata.
This peer-to-peer model, known as FARNE (French acronym for Home delivery service on nutritional rehabilitation and stimulation) is becoming a widespread practice in the provinces of Kanem, Lac and Bahr el Gazel. Children from mothers in the group sessions suffer from moderate acute malnutrition, therefore awareness is combined with regular distributions of PlumpySup, a ready-to-use nutritional supplement. While encounters take place two times per month, maman lumieres conduct daily home visits to check on the babies’ evolution and provide individual care.
In a friendly atmosphere, women exchange experiences, fears and hopes. They learn about the importance of exclusive breastfeeding during the first six months of the baby’s life and play a card game that helps them identify different food groups that they can combine to prepare porridges for their children. Through the FARNE sessions, women from Kanem have discovered new ingredients, such as moringa, which they have integrated into the family diet.
“I don’t want my child to be malnourished ever again. I now understand that it is important for me to eat well while I am breastfeeding. My baby is already six months and I am starting to give her some food. I always wash my hands and the food I cook”, explains Zara. Her baby has almost recovered and she will soon leave the FARNE sessions.
Children in Yoursoula also become malnourished due to flawed cultural practices and beliefs. “Most communities in Kanem think that women should not eat chicken or eggs while they are pregnant. With the support of local authorities, we carry out large-scale awareness sessions in villages to explain that this is not true and that these foods have many nutrients which are beneficial for both mother and child”, explains Beatrice, working for the national NGO SECADEV. “When we arrive at a village, it is the men that first come out. When we explain that we are there to talk to women about nutrition, they generally stay. We prefer them to participate, as it is more likely that they will support changes this way”, she adds.
This innovative approach that combines treatment with community-led behavioral change communications is implemented by the United Nations World Food Programme (WFP) and its partners. It improves coverage and efficiency. “I am proud to support the women and children in Yoursoula. I provide advice to those attending the sessions, but also to other women in the village. I am always available and I like to host the FARNE sessions at my house”, explains Kakay, one of the maman lumieres.
In remote areas like Kanem, communities need to be part of the fight against this public health issue that has individual, social and economic impacts.
WFP’s programme to treat moderate acute malnutrition in Chad is made possible thanks to the support of donor countries. The United States of America (USAID/FFP) is WFP’s largest donor committed to this activity.
