South Sudan: Plumpy'Nut and Messy Smiles!

In South Sudan, a dedicated team of parents and medical professionals are working together to bring malnourished children back to health...

After four weeks of critical illness, days spent in a coma, recurrent sepsis, severe diarrhoea and many tears, whilst her skin peeled off and regrew, Nyakuoth was now running around the ward, giggling as she kicked a plastic fire-truck back and forth with the other kids. She was ecstatic to be going home and her dad had promised to purchase a chicken for her to eat that afternoon.

An amazing team

For the last six months I’ve been lucky enough to work with the incredible team of mums (and sometimes dads), children, nurses, nurse aids, clinical officers, nutrition assistants and counsellors in the malnutrition unit in MSF hospital in Bentiu internally displaced persons (IDP) camp.

My first glimpse of the scale of the food crisis here came as I touched down on the tarmac of Juba airport. World Food Programme planes lined up next to the runway ready to orchestrate the delivery of food aid to over 1.8 million people that month.

Essential tools

I then boarded a small 14-seater plane and floated above the Nile and hundreds of miles of dense green vegetation. On landing on the dusty airstrip near the MSF hospital I spotted the distinctive crates of F75/F100 specialist feeding milks being lifted from the hold of the plane. These milks are an essential part of the careful refeeding regime for children with severe acute malnutrition.

Vicious cycles

Whilst all the children on the ward share the diagnosis of severe malnutrition, their journeys are all very different.

Some children are trapped in the vicious cycle of severe diarrhoea, recurrent infections, weight loss and just physically not having enough food to eat.

Other children are living with underlying developmental problems such as cerebral palsy and congenital heart disease.

A significant proportion of the children we care for are also living with HIV and tuberculosis.

Most children arrive on the unit critically unwell.

Life in the camp

The sanitary conditions in the camp are poor, with latrines overflowing and few safe spaces to play. Overcrowding in shelters makes for easy spread of tuberculosis.

Prevention of mother to child transmission of HIV is in its infancy with many individuals unaware of their HIV status and so miss the opportunity to prevent the chain of onward transmission.

Rations are basic and are limited to oil, lentils and sorghum (a type of grain).

Families living outside of the camp may not have access to safe drinking water.

Re-admissions to our unit are common.

Strong mums and long nights

Despite the malnutrition unit reflecting the huge degree of food insecurity faced by the community, it is a ward full of hope. Strong mums with the support of nutrition assistants and nurses stay up throughout the night to feed their children back to health whilst their medical complications are treated. 

We give the children meals of Plumpy'Nut, a special high-calorie peanut paste and porridge. It’s always a source of much happiness and relief during the ward round, when we see children like Nyakouth have regained the strength to sit up and grin as they tuck in.


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