Due to different reasons, the west of Côte d’Ivoire was strongly hit by different conflicts and harbours a large number of refugees. After an armed uprising in 2002, Côte d’Ivoire was de facto split in a northern, rebellion part and a southern, government-backing part until 2010. Man was lying in the northern part, with the demarcation line about 50 km south of the city. In November 2010, presidential elections were organised. The sitting president, Laurent Gbagbo, was declared defeated by the contender, Alassane Ouattara. However, Gbagbo did not accept the victory of Ouattara. A panel of the African Union tried to negotiate, but did not succeed, and further discussion about the outcome resulted in violence. About 3000 people were killed between January and April 2011, mainly in the western area of the country. In May 2011, Alassane Ouattara could finally be installed as new president. This long period of conflicts resulted in much damage and lots of internally displaced people, with infants and young children as main victims.
As part of the health& nutrition project, an important goal is the detection and support of malnourished children in the sanitary districts of Man, Bangolo, Duekoué, Guiglo and Blolequin, an area covering about 9000 km² with a population of approx. 800000. First, the community health workers, volunteers who support the health centers, have to be trained regarding the relation between food and malnutrition, and the importance of a varied food intake. It does not make sense to improve the children’s nutritional status with specially balanced high-energy food such as “plumpy nut”, if the mother does not change the composition of the food given to the child at home. This is not easy, as already mentioned in a previous blog, due to poverty, but also due to certain beliefs and habits. However, a varied and balanced food intake is also possible for people with limited resources, as a lot of plants and fruits are easily available in the region. Once the community health workers are trained, special days are organised for the search of malnourished children. The health workers visit the houses of their area, and based on the middle upper arm circumference (MUAC), they ask the mothers to come to a central point. There, the weight, height and MUAC are taken, presence of oedema checked, and the z-score calculated. In very severe cases, the child is sent to a specialized nutrition center (UNT), attached to a reference hospital, and for the severe or moderate cases, children are followed up locally in an UNTA. At each visit, mothers get explanation on the importance to give varied food to their children. In some health centers, they even organise cooking lessons, to practice the use of different ingredients.
In Yapleu, a small village south of Man, about an hour drive on bad tracks (piste) from the main road, we organised a screening to detect malnourished children between 6 and 59 months old. The community health workers were trained on how to perform the screening of malnourished children.
Bad roads to the village.
Training session with the community health workers.
The next day, the screening started. Here, children were weighed and measured.
The mothers with severely malnourished children did get an explanation on how to feed the “plumpy nut” paste.
Even fathers assisted.
Afterwards, a sensibilisation session was organised for the mothers about the importance of varied food intake and to encourage them to access the health center when their child is ill.
During this 2-day campaign, 80 children between 6 and 59 months were screened, of which 26 were malnourished (7 moderately and 19 severe). There is definitely still a lot of work to do!