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.
Photo: Samuel Hauenstein Swan www.sambronx-photo.com
Malawi’s HIV epidemic remains generalised and feminised. Although the country has recorded a significant reduction in new HIV infections and AIDS-related deaths; adolescent girls, young women and other key populations, particularly in urban areas, continue to bear the highest burden of the epidemic.
The HIV pandemic is worthing the poverty experienced by elderly. Orphans witnessing the death of one or both of their parents may be exhausted emotionally have no choice than turn to their grandmother and fathers for protection and upkeep. Not only does this increase the cost of running the households also the elderly grandparents must compensate for the loss labour on the frames for to the foreseeable future. The old have watched and grieved with dignity and dismay as one after another of their children died, leaving them without a traditional family support. ADIS left some families with only the old and the very young.
Malawi is a nation living in grief. Malawi’s communities are upholding human dignity and respect in circumstances that would daunt the most stout-hearted. Or as this woman told me the pandemic make everyone realises that strength lays in mutual community support and solidarity.
In 2016, Malawi had 36 000 (31 000 – 45 000) new HIV infections and 24 000 (20 000 – 31 000) AIDS-related deaths. There were 1 000 000 (970 000 – 1 100 000) people living with HIV in 2016, among whom 66% (62% – 70%) were accessing antiretroviral therapy. (UNAIDS 2017)
World Children Day
Today it is World Children Day lets give them what they most deserve dignity!
Behind each growing up child stands a loving mother, parents and the broader community, to give them the means to succeed.
Often I hear development for good change is about boosting agricultural technology, maximising value chain beyond the farm gate, better cash or food yields, etc. While I do not doubt any of these development focuses, first of all it is about sharing dignity throughout society. This must start with the weakest in society children.
This mother in Malawi told me how she has to struggle to manage her triple tasks: working on one of the large commercial tobacco farms for cash, tending to her plot of land for food and looking after her children’s needs.
Much of the commercial farmers produce nonfood items or maize destined for expert and getting foreign currency into its economy. This mother is no exception paid poorly the cash she earns is mostly drained for expenses such as transport, housing, schooling, health, and food. What she pays for full-time agrarian about is not nearly sufficent to feed the family. She as many smallholders has to cultivate on steep hillsides and other marginal lands, often with inadequate soil and water conservation, to substitute her purchased food from the mear day labor.
When her little boy fell ill with diarrhea, she had to make the impossible desition to drop either her wage labor or neglect her plot or both to tend her child and bring him to hospital. What should be the happy end to a worrying childhood disease quick moves on to the next concern, now she has missed a day at the commercial farm; her boss might have fired her meaning she lost her income.
Investing in peoples lives not merely a functioning of economic outcomes that results in growing exports and fancier technologies, but most of all must change the balance of social justice, hegemony and leading to dignity for all. No child should grow up in a household and community that is exploited to the great good of a few pushing the dignity of many in to second place
While choices in the political world are painted in shades of grey, the consequences of those decisions are often irreversibly black and white: the joy of a healthy childhood and family or the violence of poverty and hunger. Conceiving of and the implementing mechanisms to transfer control over peoples lives from the powerful actors to the families themselves is no small goal: above the technical obstacles, voluntary giving away dominance is not something that human beings do well. Development, defined as “good change (Robert Chambers)” must strive for nothing less than a real will for justice accessible at all levels even where it is in direct conflicts with the will to power and the few that hold this power.
Hargeisa, Somaliland – Vast regions of Somaliland, the autonomous territory that declared independence from Somalia in 1991, but has not been internationally recognised, are enduring one of their harshest droughts in two decades.
As the wet seasons have grown increasingly erratic and the rainfall more sporadic over recent years, thousands of herding families across the remote coastal Awdal and Galbeed territories have been pushed into crisis. link
Scenes of poverty are inescapable in a country like Bangladesh, where Western media and charities use them to generate outrage, sympathy and — sometimes — donations. That bothered Shehab Uddin, a former newspaper photographer in Bangladesh who knew there was more to the story than downtrodden people victimized by poverty, not to mention photojournalists.
Mr. Uddin not only asked permission to photograph poor people. He also moved in with several families and later had them help select the images that he would exhibit in their neighborhoods. read more
During the New York Times ‘Food for Tomorrow’ conference, Mark Bittman shares some of his thoughts in this video. He says, “The slogan should not be ‘let’s feed the world’, but ‘let’s end poverty’. That may not be profitable. But this isn’t about the business of agriculture, it’s about justice and political power.”
Niger has one of the highest child marriage rates in the world, according to Unicef. On average, one in three girls marries before her 15th birthday – and severe drought, poverty and hunger are pushing some parents to marry off their daughters at even younger ages.