© Charlotte Morris
I’ve just returned from two weeks in central Chad, a landlocked country in central Africa where the climate is hot and dry most of the year. Malnutrition among children is endemic here. Almost half of child deaths in the country are associated with the condition.
There are many reasons why there is a malnutrition crisis, but these include inadequate harvests, malaria and a lack of understanding about hygiene and nutrition, causing diarrhoea and in turn malnutrition. In addition, mums often stop breastfeeding babies when they're pregnant with their next child, and seek help from traditional medicine due to a lack of access to healthcare.
Below are stories from three women I met whose children were suffering from malnutrition.
Zara is 32 years old and from the capital of Chad, N’djamena.
When I met her she had been at the MSF intensive care unit in Bokoro town for four days. She was there with her granddaughter, Katalma who is two years old.
She had been visiting Bokoro to pay her respects to a family member who'd died, when her granddaughter fell ill.
“She hadn’t put much weight on for a while and then she started to get diarrhoea and her health got even worse. She hasn’t had any energy to be able to play with other children.”
“This is my daughter’s first child. She’s still in N’djamena but I’ve been speaking to her every day. She calls to ask about the health of her daughter. I say her daughter is getting better. MSF have gone above and beyond to help your daughter. They’ve worked really hard.”
She was an extremely strong woman who also had a two-year-old daughter of her own. “I would travel all the way to France for my children’s health," she told me. "I have given birth to 15 children. Seven of them have died and eight are still living. Two of them were twins and they died on the same day they were born. The others, I don’t know why, it was God’s choice.”
Amaboua is 22 years old and comes from a small village near Gambir in Bokoro, Chad.
Her youngest child, Ziham, is six and a half months old and has been coming to the MSF clinic for two weeks. She explained that Ziham has a night time fever as well as a cough. Amaboua says he’s been like this since he was born.
When I met her she was waiting on a mat at the MSF mobile malnutrition clinic in Gambir to be called by the MSF nurse. While she waited they'd asked her to feed her baby a nutritious paste that tastes like very sweet peanut butter, to check that he had a good appetite. If he doesn't, this is a sign of very serious malnutrition.
Amaboua has four children in total, all of whom have visited the MSF malnutrition programme when they were in their first two years of life. “All of them had a fever, diarrhoea and vomiting when they were little. So I have bought them all to the MSF clinic. It’s very good. All of my children have got better.”
Unfortunately, this is a common theme in Bokoro and suggests many mums don’t understand why their children are getting ill, making it difficult to tackle the causes.
Amaboua says “After my first son was born I noticed that from a very young age he fell ill. And the others have all done the same. I think at a certain age children find their health and then after that there aren’t many problems.”
Manoula is from Vale, a small village around an hour’s drive from Abgode in the Bokoro region of Chad. She doesn't know her age.
I met when she was at the MSF mobile malnutrition clinic in Abgode, waiting for an MSF car to leave and take her to the MSF intensive care unit in the nearest town.
She has twins who are 6 months old. One of them, Inde Adou, is much smaller than the other and has been suffering from diarrhoea and vomiting for the last month. It's the first time she has brought him to the clinic.
The MSF nurses told her that her baby needs to be transferred to the MSF therapeutic feeding centre.
"Since they were born I haven't had enough breast milk for both of them. I feed the little one with Nido" she says. Nido is a type of powdered milk and MSF staff are unsure whether it's suitable for babies under 6 months old although Manoula thinks that it is.
She decided to come to the MSF clinic today because other women in her village told her that MSF can help children if they're over six months old.
She is married with six children in total. At the moment, it is the wet season and her and her husband work in the fields. For the rest of the year she sells cakes to people in her village whilst her husband sells mobile phone credit. Their eldest son has come with her to the clinic today, and will also travel with her to the intensive care unit in Bokoro to help care for the twins.
Whilst they're in hospital her husband will look after the other children and her eldest daughter will prepare meals for the whole family. "I'm not worried. I'm following my child's health."