DOCTORS WITHOUT BORDERS
Uganda: Karamoja faces major crisis of malnutrition
Dr.Wagner Paulon
2008
Design of MSF to treat malnourished children in the region should end in September, but should continue during 2009.
17/10/2008 - In Karamoja, malnutrition is chronic. However, this year, the remote region in northern Uganda is suffering its worst drought in five years, creating a humanitarian crisis.
The last two years recorded a drought after another, followed by extraordinarily heavy rains. The increase in the price of food makes the food available in the market is simply outside the scope of consumption. The rains ralas last year, and late this year, led to a late harvest and lack of peanuts and sorghum, and also the high numbers of deaths of animals.
Karamoja harbors a population of about one million, which is largely dependent on animals to sustain their way of life. The region is known for conflicts linked to invasions of herds. The styles of life and pastoral nomads and insecurity make it difficult for the population have access to few health posts in the region. The humanitarian crisis in Karamoja is characterized by high levels of food insecurity and acute malnutrition rates.
In response, Doctors Without Borders (MSF) opened a program of therapeutic feeding for children under five years in the districts most affected by hunger in Moroto and Nakapiripirit.
"The best way to help and treat children, the most vulnerable population, is traveling to the towns to find the children, providing rations for two weeks so that it can overcome the worst. We fear that the worst is yet to come , "Said Kodjo Edoh, head of mission for MSF in Uganda.
This is the best way to bring health as close as possible to the patients and reach the most vulnerable in traffic nomad population of Karamoja.
The nutritional intervention of MSF began in June 2008 and should end as early as September. Now, with almost 24 thousand children examined and 2.3 thousand of them severely malnourished, the program will probably continue until 2009. George Mbaluto, the Kenyan nurse responsible for the program, describes how the mobile clinics of the program of food are assembled: "the mothers come with the children to sit in the waiting room. Here we are informed about nutrition and personal hygiene."
Children between six months and five years are then examined with a bracelet called MUAC which measures the circumference of the arm.
"Any child whose arm measure between 11 and 35cm in MUAC has its thorough and measured weight. Those with measures under 11cm, as well as those that are with bilateral edema (swelling due to accumulation of fluid) are admitted directly and found severely malnourished" , Said Mbaluto.
All newly admitted child is tested for malaria and examined for other medical complications such as infections and diarrhea. In some areas, between 60% to 90% of children had malaria. Two nurses hold consultations, examine children and discard complications. They seek infections and low immunity. Children receive folic acid to prevent anemia, and vitamin A. To treat the complications, the nurses receive antibiotics and other drugs.
Children severely malnourished, but no other medical complications, will be treated on the spot. A child who is very sick, or no appetite, is conducted to the Hospital of St. Kizito in Matany, one of two hospitals in the district of reference. Here, MSF supports the unique therapeutic feeding center in the region. As soon as children are stabilized in the center, are released and sent to the mobile clinics closer to home.
In Karamoja, so devastated by chronic malnutrition, many families can not buy any food, much less the food right, and need to survive, cereal porridge, which lack the essential nutrients. MSF treats malnourished children with therapeutic food ready to eat, made to meet your needs.
"Here, we use Plumpynut, two sachet for children under 8 kg and 3 kg for those with more," said Mbaluto. "Soap and mosquito nets are provided to help with hygiene and prevent malaria. A supply of Plumpynut is given to mothers, who receive a recommendation to come back in ten days. We have not seen many problems, but great progress. Most children like of therapeutic food and is gaining weight. Depending on the location, we look around 60 or 70 patients a day. "
The team is encouraging community health agents to look for malnourished children visiting families. "Until now, mothers are coming regularly and the public this reaches 80/90% in most clinics. Still, in one or two of them, we are only looking at about 50%, then there is still some work to be done accordingly , "Said Mbaluto.
MSF believes that the challenge in the areas most devastated by malnutrition is not simply treat the most affected, but also prevent them reaching the terminal stage, ensuring that all children have access to food rich in nutrients.
? ? ?