N’Djamena: Urgent need to increase treatment capacity for severely malnourished children
Nutritional centers throughout Chad’s capital, N’Djamena, are once again overwhelmed with an alarmingly high number of children suffering from severe acute malnutrition. The medical humanitarian organization, ALIMA (The Alliance for International Medical Action) is calling on the government, donors and other actors to quickly mobilize to support prevention activities and emergency medical response, by enhancing the capacity to treat malnourished children at all outpatient and inpatient health facilities throughout the city.
At the Chad-China Friendship Hospital (HATC), where ALIMA and its local partner Alerte Santé support the Intensive Therapeutic Feeding Center, there are normally just 80 beds. An additional 70 beds have been added in recent weeks, but it is still not enough to cope with the caseload. Doctors and nurses do their best to provide care to every patient, but this often means assigning 2 or even 3 children to the same bed.
“When you walk into the ward, you see many, many children,” said Dr. Ousmane Abdoulaye, an attending doctor with ALIMA/Alerte Santé at the HATC’s nutrition ward. “We are currently receiving about 30 new patients every day. As you complete your rounds, you must walk not only between beds, but also around mats, where some of the children and their parents have found themselves sleeping by default, due to a lack of bed space.”
A peak of malnutrition cases normally occurs in N’Djamena each year between July and October, coinciding with the lean season. This year it started early and health facilities are already reporting extremely high numbers of children requiring outpatient treatment or hospitalization for SAM. The number of children admitted to ALIMA/Alerte Santé’s SAM treatment programs between January 1 and mid-July this year, is 60% higher compared to the same period in 2017. And the number of children hospitalized for SAM with complications in HATC is 45% higher.
A number of factors could explain the higher rates of malnutrition this year, explains Dr. Moumouni Kinda, ALIMA’s program manager for Chad: “A decrease in agricultural production throughout the Sahel has led to an increasing number of people migrating from from rural to urban areas, where they live in precarious conditions. Additionally, an economic crisis, poverty and unemployment are affecting people’s ability to buy food or pay for health care,” he said.
To help health workers better face the high rate of admissions at HATC and Gozattor Hospital, ALIMA/ Alerte Santé reinforced our response in N’Djamena, where we support 2 Intensive Therapeutic Feeding Centers and 6 Ambulatory Treatment Centers. The organisation has deployed additional health staff, and are supporting the centers with additional beds, supplies, medications, and WASH (Water, Sanitation and Hygiene) activities.
"Despite all the efforts done by local health authorities, we need to scale up the response to face the emergency today, but also be prepared for the future because malnutrition in urban areas is a recurring and neglected problem in Chad," Dr. Kinda said.
ALIMA is calling on other actors, including the government and donors, to quickly mobilize to support prevention activities and emergency medical response, by enhancing the capacity to treat malnourished children at all outpatient and inpatient health facilities throughout the city.
ALIMA (The Alliance for International Medical Action) is a humanitarian medical organization that works hand-in-hand with a network of local medical NGOs to provide quality health care to the most vulnerable people during emergencies and chronic crises. Based in Dakar, Senegal, ALIMA has treated more than 3 million patients in 12 countries since its creation in 2009, and launched 10 research projects focusing on malnutrition, malaria and the Ebola virus.
ALIMA has been working in Chad since 2012, alongside the local NGO Alerte Sante (AS), to support regional health authorities in the capital, N’Djamena, as well as the health districts of Ngouri and Isseirom, providing free care to children suffering from severe acute malnutrition (SAM), offering both outpatient treatment for non-severe cases and inpatient care for cases of SAM with complications.
In 2017, ALIMA/AS launched, a training program to teach health workers to treat patients suffering from severe acute malnutrition with complications. In 2017, our teams treated more than 32,000 children for severe acute malnutrition, provided more than 15,000 children with routine vaccinations and treated more than 30,000 children as outpatients.
These activities are made possible thanks to generous financing from the European Commission's Civil Protection and Humanitarian Aid department (ECHO), The Start Fund, and The Bill and Melinda Gates Foundation.
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Photo © ALIMA/ Xaume Olleros -2017