Samuel Hauenstein Swan

Abshir Ali is 2 years old, 68cm tall and weighs 4.5kg. He is severely acutely malnourished. Average weight babies in wealthy countries reach such a weight within the first months of life. 

A hungry child may know no politics, but politics in Somalia and in the world at large - is really why that child is hungry ... Aid is simply not effective in the face of regimes that do not have to ensure the wellbeing of their subjects in order to stay in power. R. D Kaplan 

One year old Abny Ibrahim is in the bed next to Abshir. Heweighs 4.5kg and he too is malnourished. 

Acute malnutrition can kill directly but, more commonly, however, it weakens the immune system, increasing the chances of death from infectious diseases. Children who are severely malnourished are 9 times morelikely to die prematurely than well-nourished children.

Treatment must arrive quickly to prevent drained bodies being weakened further. Médecins Sans Frontières doctor Gigi Chan injects antibiotics to fight alife-threatening fever.

The long trek across arid land, often at night to avoid the armed gangs, exhausts not only children, but also their mothers. Deprived of water and food for days, breastfeeding mothers lack the energy required to produce milk, which results in a high number of babies under the age of six months old suffering from malnutrition.

All new arrivals are screened for illnesses and undernutrition on crossing the border into Ethiopia. 120.000 people so far have fled the conflict and famine stricken regions of Bay, Bakool, Hiraan and Lower Shabelle in central Somalia.

By August this year 123,000 people had fled into Ethiopia.  Hilowyen Campis one of 4 camps set up in recent months to shelter 17,816 refugees. Each family is allocated a tent and given access to water, latrines and basic health and nutrition services. World Food Programme (WFP) is providing general food distribution. The new camps have become the four biggest de facto towns in southern Ethiopia.

900,000 men, women and children have fled the conflict and famine zone in central Somalia. Another 123,000 have been displaced within the country. As many as 750,000 people are at a risk of death in the coming four months if efforts to respond to the famine are not scaled up [1]. 


[1] http://data.unhcr.org/horn-of-africa & OCHA bulletin 

Ellen van der Velden team leader in Hilowyen’s Médecins Sans Frontières hospital teaches amother of a severely acutely malnourished infant how to supplement her breastmilk by inserting a tube into the baby’s mouth whilst breast feeding.  

Two thirds of children and one third of the pregnant women arriving in the camp are malnourished, within three weeks of opening activities 1300 children and women.  

Diagnosing malnutrition and providing targeted nutritionaland medical interventions are essential in emergencies. Médecins Sans Frontières staff examine each child, adolescent and pregnant or lactating woman when upon arrival at theirfield hospital in the Hilowyen camp, which is home to 13.700 people.

Mohamed Ali and his family abandoned their home in Bakool after all their animals were either looted by militias ordied because he could not guide them to pastures made inaccessible by conflict.The family had to walk for many nights, avoiding settlements and roads for fear of being caught by armed gangs. 

For Nuria, his 2 year old daughter, the journey is not over. The water they found on the way left her with diarrhea causing severe weight loss. She is 6kg with a height of 74.8cm.

Low birth weight is one of the leading causes of under five child mortality in sub-Saharan Africa. Pregnant mothers are often malnourished themselves and lacking sufficient micro nutrition. They too receive therapeutic food to ensure they are getting the calories and nutrients necessary to producea healthy baby. 

Where malnutrition is very severe, the body can no longer absorb or retain energy, vitamins and micronutrients. Abshir Ali is given F75 therapeutic “milk” in order to restart his body functions and enable him toabsorb nutrients in the treatment. 

In particular, the lack of vitamin A weakens the children’simmune systems and makes them susceptible to infectious diseases. 

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