COMMENT | Malnutrition: Dire reality must change for our children

COMMENT | Picture having a 10-month-old daughter who, for the past two weeks, has been battling a fever, cough, diarrhoea, and vomiting. In the last four days, she has struggled to breathe.

Clutching her in your arms, you hop onto a motorbike, crisscrossing multiple hospitals, only to be turned away due to a lack of available beds.

Fearing for your baby's life, you plead with hospital staff for admission, but even if they agree, the financial burden seems insurmountable.

This scenario was a heartbreaking reality for Aisha (not her real name), reflecting the unfortunate experiences of many mothers in Nigeria.

Aisha finally reached the Doctors Without Borders hospital in Maiduguri, the capital of Nigeria's Borno state. It was evident that her baby was severely malnourished, grappling with breathing difficulties, and unable to feed properly.

After a thorough test, a Doctors Without Borders medical team diagnosed the baby with severe acute malnutrition compounded by pneumonia, as such children are highly susceptible to infections due to weakened immune systems.

Immediately, the team admitted the baby to our inpatient therapeutic feeding centre, initiating the first stage of treatment. Here, the team managed medical complications, provided nutritional treatment with eight meals per day, and introduced a nasogastric tube for feeding, along with antibiotics.

Remarkably, within three days, signs of recovery surfaced. After four days, the baby no longer required oxygen support. Ten days later, she transitioned to our outpatient therapeutic feeding programme, receiving four to six meals daily.

Twenty-eight days after admission, the baby was discharged, having fully recovered. Aisha’s baby was one of the 20,156 malnourished children treated in the Doctors Without Borders feeding centre in Maiduguri in 2022 - a staggering 84 percent increase from 2021.

Despite significant strides in science and technology, malnutrition - a preventable condition - remains a formidable impediment to social and economic progress, sustaining an unyielding cycle of poverty.

This global health challenge transcends age, borders, and socioeconomic boundaries, with the alarming reality that the prevalence of malnutrition is steadily increasing worldwide.

Millions affected

In 2022, Doctors Without Borders treated more than 500,000 children for malnutrition. However, this number is merely a drop in the sea, with Joint Child Malnutrition Estimates (JME) saying around 148 million children worldwide, or one in every five under the age of five, suffer from stunted growth due to chronic malnutrition.

Additionally, about 45 million children under five were wasted (excessively thin for their height), with 13.7 million severely wasted in 2020 due to acute malnutrition.

In 2023, JME revealed a worrisome state in the global fight against malnutrition. Progress toward the 2025 World Health Assembly (WHA) nutrition targets and Sustainable Development Goal (SDG) target 2.2 is significantly lagging.

The inter-agency group disclosed that only a third of all nations are making progress to cut the incidence of stunting in children by half by 2030.

Effectively addressing malnutrition is a complex challenge that goes beyond simple, linear solutions.

It's a nuanced issue influenced by a web of interconnected factors, including poverty, food insecurity, poor diets, inadequate clean water and sanitation, conflict, displacement, natural disasters, and the compounded impact of the Covid-19 pandemic.

Recent reductions in funding for humanitarian initiatives are poised to worsen the risks of malnutrition, particularly for vulnerable groups such as refugees in camps.

“By the time a child is admitted to our hospital with malnutrition, it’s not something that food can fix,“ said Charity Kamau, a Doctors Without Borders project coordinator in Bentiu, South Sudan, where Doctors Without Borders runs a hospital in the internally displaced peoples (IDP) camp.

The conditions in the camp, which houses those who fled the country’s civil war, have worsened in 2022, with catastrophic floods cutting off road access and essentially making the camp an island. None of the 112,000 or so people who live here can leave to grow crops or travel elsewhere to buy food or find work.

Kamau revealed the team in the hospital saw malnourished children in critical conditions daily.

“Sick and malnourished children need more care and more time to recover than children who are well-nourished, and they are more likely to get sick again.

“Here in Bentiu, we see how often the whole family is affected - even as one child is being treated in hospital, one of their siblings will arrive needing urgent care.

“For us as a team, the challenge is to provide these children with the treatment they need, while bringing in enough supplies of therapeutic food by plane - the only way to reach the area until the floodwaters subside,” she said.

Kamau shared that while the medical care and therapeutic food Doctors Without Borders provides its young patients are lifesaving, some children still suffer permanent damage.

“Malnutrition can affect children’s growth, both physically and developmentally. I have encountered children who have lost their ability to walk because of malnutrition.

“That’s why, wherever we can, we provide physiotherapy to help children regain their strength, and psychosocial support so they can start to play, learn, and interact with other people again.”

Ongoing efforts

In crisis-ridden and underserved areas like Nigeria, South Sudan, Afghanistan, and Yemen, Doctors Without Borders has been a linchpin in battling malnutrition.

The medical organisation’s interventions are meticulously tailored, evidence-based efforts aimed at breaking the malnutrition cycle and fostering resilient communities.

Key nutritional support initiatives by Doctors Without Borders encompass therapeutic feeding programmes for severe acute malnutrition, delivering life-saving treatment with specialised, nutrient-rich foods, and Ready-to-Use Therapeutic Food (RUTF), a fortified, peanut-based paste pivotal in therapeutic feeding.

Supplementary nutrition for vulnerable groups, especially pregnant and lactating women and young children, combined with nutritional education, forms a crucial aspect of their strategy.

Doctors Without Borders’ approach extends beyond direct interventions, encompassing community outreach, nutritional assessment, capacity building, global healthcare access advocacy, and raising awareness about the devastating impact of malnutrition.

Despite grappling with challenges such as insecurity, limited resources, and sustainability issues, Doctors Without Borders stands unwavering in its commitment to combating malnutrition and offering essential care to those in need.

However, addressing the widespread consequences of malnutrition globally and achieving enduring improvements in community health and well-being necessitate continued support and heightened awareness.

To support Doctors Without Borders in their battle against malnutrition, consider donating here.

DOCTORS WITHOUT BORDERS is an international, independent medical humanitarian organisation that delivers emergency aid to people affected by conflict, epidemics, healthcare exclusion and natural or man-made disasters.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.