Clémence is holding onto her soft toy Dalmatian Puppy, her mother gave her for Christmas. Children all over the world hold on to their cuddly toys for comfort in unfamiliar places. Clémence is no different.
I meet her and her mother, Anita, in the intensive nutrition unit of the pediatric hospital in Bangui, the Central African Republic. 29,250 children under 5 years suffering from acute malnutrition are admitted for therapeutic care. The principal referral centre of the capital is crowded with children that have fallen ill with the most severe and deadly form of malnutrition. There is little noise from these children: too ill to play, too weak to express discomfort.
At two and a half years old and 5.5 kg, Clémence is barely above the weight of a new born baby. I learned how she came here as her mother, Anita, props her up in her lap. A few weeks back she was a strong and joyful little child playing in the streets near her home. All changed when she caught malaria and lost appetite fighting the fever. Weakened by illness, she developed diarrhea and quickly lost weight to the point that her parents got very worried and brought her into the hospital, where they learned their child was suffering from severe malnutrition.
Severe malnutrition is one of the greatest challenges to child survival in the world today. Affecting 16 million children worldwide and responsible for up to two million child deaths each year, it is the most lethal form of malnutrition.
Clémence is clinging onto her Dalmatian toy when the nurse tries to move it to take the temperature. Her breathing is very quick and she seems to drift in and out of sleep. She is unable to move her head up and look around. Having worked with ACF for many years, the intensive nutrition units are the hardest, saddest places to visit. No child should ever fall ill with Severe malnutrition. It is the epitome of an unjust world: a place that produces more food that it can eat and has the knowledge to treat infections these children can no longer fight.
However, nutrition units are also places of hope. Last year 87% of children brought to our nutrition clinics in CAR recovered and returned home. ACF cured more than three million children around the world last year alone. Effective community treatment, equipped with products like therapeutic foods, reach children living in the most marginalised and conflict ridden areas of the world. Where the illness is extremely severe and complicated by infection as it was with Clémence, inpatient treatment with the supervision of ACF doctors and nurses around the clock is the only option. CAR has experienced high levels of violence that have devastated its health system and increased poverty, so only few referral centres are available.
Talking to Anita, a law student, she was hopeful that the treatment was working and there were some signs that her child was getting better. Trying to feed her was not easy, as Clémence was spilling much of the therapeutic milk and having difficulties even swallowing. Feeding ill children is a painfully slow and delicate process as any parents know. Here it is an act of desperation to save a child. My presence was not helping as Clémence was distracted. I left the hospital where Anita was hopeful that her daughter would gain weight and get back her appetite so they could return home. I felt hopeful that Clémence’s mother was right.
Arriving back in the UK I had some horrible, sad news from Central African Republic. Clémence died from severe malnutrition only days after I left her bedside. Her mum was doing her best. In a country that has high rates of illness, only few health care workers are at hand to help her to detect the early signs of malnutrition and get treatment. This Mother couldn’t prevent her baby from getting regular bouts of malaria or the diarrhea that followed and weakened her little girl, and led to the severe malnutrition. She is one case in about 700 malnutrition-related deaths per year in CAR.
We do save lives in our projects every day. Sadly we failed Clémence. Despite our best effort, too many children still do not make it through severe malnutrition. In 2015 Action Against Hunger treated 1,560,000 children: more than any previous year. We have to do even more. Anita, her story and pictures serve me as a reminder to raise awareness of the unspeakable injustices of malnutrition so many children in CAR and worldwide, battle with day in day out.
Action Against Hunger are part of a massive scale up and work with communities, donors and doctors to find children long before they are severely malnourished, to expand treatment into many more health centers in order for malnourished children to stand the best chance to be cured. Referral centers such as at the Bangui paediatric hospital partner with us to deal with overwhelming numbers of malnourished children.