To donate to the UNICEF Ireland Appeal for the Children of the Sahel, please visit our Sahel Emergency Appeal page

To donate to the UNICEF Ireland Appeal for the Children of the Sahel, please visit our Sahel Emergency Appeal page

The conditions are truly dramatic; more difficult than I have ever experienced. Temperatures of 47C is making travel very difficult. Without doubt Chad is a country in crisis. After 40 years of conflict and instability, it is poorly placed to deal with the food shortages it currently faces. To be a child in Chad today is a daily struggle for survival.

The population of Chad has doubled in the the last 20 years ballooning from 5 to 11 million. There is virtually no health system to talk about so if a child gets sick it is entirely dependent on agencies like UNICEF to help.

We’re currently on route to Abeche – a very remote area near the Sudaneese border. Throughout Chad’s Sahel belt, over 260 UNICEF-supported nutritional centres are operational, with plans to assist all 127,300 at-risk under-five children. – like this little child being weighed in a sling scale at a UNICEF-supported feeding centre in Chagoua Dispensary in N’Djamena, the capital.

Um Karim*, mother of seven, is one of the more recent arrivals in Al Faqiha. Her decision to flee across the mountains was made in one fearful instant, as clashes suddenly engulfed her neighbourhood.

“I just grabbed the children and ran,” she said. “We didn’t have time to take anything, not even our identity papers. We came through the valleys until we reached here.”
Her husband, a taxi driver, was unable to leave with the rest of the family. Um Karim has not heard from him since they fled.

Trying to cope

When she and her children – two of them toddlers, the eldest aged 14 – reached Al Faqiha, a local family offered them a single room to use. The room is sparsely furnished, and there’s no heating to warm them against the cold wind that sweeps off the nearby mountain slopes.

Ameera (name changed) stands in the Bekaa Valley, Lebanon. She fled Syria with her husband and child while their village was under heavy fire. She was badly bruised when she was thrown from a truck while escaping. UNICEF Image © UNICEF/NYHQ2012-0239/Kate Brooks

There’s not much to eat either. Um Karim points to a corner where a few plastic tubs contain rice, lentils, jam and other basic supplies

We’re missing a lot of things,” she said. “We can manage, but this is not the life we had in Syria. We thank God. We just try to cope.” Despite offers by Lebanese authorities to place Syrian children in local schools, but none of Um Karim’s children are currently attending class.

Fear for relatives back home

Stories like these, of stoicism and resilience in the face of hardship, loss and uncertainty, can be heard from Syrian families across the region. Latest assessments suggest there are now approximately 8,500 displaced Syrians sheltering in the Bekaa Valley. In total, there are more than 22,000 Syrians staying in Lebanon.

Some, like 24-year-old Ameera*, bear visible scars of their experiences. Her face is still badly bruised from when she was thrown out of a truck while she and others were escaping shellfire that descended on their home village.

For those who have been here longer, the task of making ends meet is the biggest preoccupation.

“Here, my husband has no work,” said Salwa*, a mother of three. “We are getting some assistance, like canned food. Some relatives provided me with furniture, but rent is very high and the house is damp. I managed to find work for my son. He earns $10 a day, which helps with the rent.”

Um Hashem*, who is in her 60s, has been in Lebanon for more than a year, and belongs to a support group for displaced Syrian families. Although she acknowledges life is difficult, her biggest worry is about the fate of her son and other male relatives still inside Syria.

“We thank the Lebanese for receiving us and for giving us rice and oil and other things,” she said. “But there’s not a day that passes when I don’t worry about what’s happening back home.”

*Names changed to protect refugees’ identities

UNICEF correspondent Kun Li reports on UNICEF’s efforts to treat malnutrition in the newly formed nation of South Sudan.

In Illeu, a small town in Eastern Equatoria State, Anorina Kabaka first had to bring a bucket full of sorghum grain to be ground into flour. While waiting for the sorghum to be ground, she plucked tamarind nuts, which she would soak in water to flavour the meal. Once she had returned home, she lit a fire, set a pot of water to boil, and mixed the flour into a thick porridge.

In spite of her efforts, meals like this barely sustain her family of nine children.

“What we cultivate in the garden is not enough to take care of these children,” said Ms. Kabaka. She wiped sweat from her face and continued. “Sometimes we go and cut firewood and take it to the market to sell. In case we get some money, we will buy food from the market. We don’t have any other work.”

Not enough to eat

Not too long ago, Ms. Kabaka’s 3-year-old daughter suffered from severe malnutrition. With treatment, she has recovered, but still needs follow-up care. That morning, Ms. Kabaka went to the local health post, which is also an outpatient therapeutic feeding centre, and collected more than 20 packages of ready-to-use therapeutic food (RUTF), her daughter’s treatment.

Anorina Kabaka holds tamarind fruits she uses to flavour her family's porridge in Illeu, South Sudan. It is a meal they eat every day. UNICEF Image © UNICEF South Sudan/2012/Li

Across South Sudan, the youngest nation in the world, hunger is a daily reality for many children. More than a quarter of South Sudanese children under age 5 are moderately or severely underweight, a result of food insecurity coupled with poor water, sanitation and hygiene, and unhealthy feeding practices. Moderate of severe stunting affects nearly a third of children under 5.

“Many children are malnourished because there is not enough food to eat around the house,” said Rachel Awadia, Director for Nutrition at the State Ministry of Health, Eastern Equatoria State. “Many mothers depend on wild fruits and vegetables to feed their families, which are not the ideal food to give to young children,” she added.

“There is also ignorance,” she said. “From the beginning of birth, babies are given water and food – exclusive breastfeeding is absent here. When the young mothers go out to search for firewood, water, and herd the cattle, they leave their children behind, often for hours, and the children suffer from starvation as a result.”

Suffering for too long

Nutrition programmes in Eastern Equatoria are being integrated into primary healthcare services. In hospitals such as Torit Civil Hospital, inpatient therapeutic feeding programmes are treating severely malnourished children with medical complications.

Due to the low capacity of the Government, “all these programmes, including training and supplies, are purely supported by UNICEF,” said Ms. Awadia.

Anorina Kabaka's daughter, 3, eats a ready-to-use therapeutic food at the local clinic in Illeu, South Sudan. She has been treated for severe malnutrition and is on the road to recovery. UNICEF Image © UNICEF South Sudan/2012/Li

Torit Civil’s brand new nutrition ward was just built by UNICEF, and will open shortly. For now, though, malnourished children are still being treated in the paediatric ward. There, a fragile 4-year-old girl named Susan is receiving treatment.

“I realized that there is something wrong with her when other children were all walking but she still couldn’t,” said Susan’s mother, Rose Iguri.

Like Susan, many of the children in the ward had been suffering from malnutrition for a long time, and they were all admitted far too late.

To tackle the problem at its root, UNICEF is also working with NGO partners to support mothers, nurses and midwives in ensuring malnourished children receive follow-up care at the community level. They are also disseminating key messages on infant and young child feeding practices.

The challenges are great, but hard work and commitment have begun showing results in the health and well-being of South Sudan’s youngest citizens.

Two-and-a-half year old Oumarou Seydou sits with his mother, Barira Saidou, at the nutrition rehabilitation centre at the Aguié town hospital in Niger. UNICEF Image © UNICEF Niger/2012/Adamou

AGUIE, Niger, 1 May 2012 – Two-and-half year old Oumarou Seydou sat motionless in his mother’s arms. He was not smiling or crying. He did not move.

That was four weeks ago, when we met Oumarou and his mother, Barira Saidou, in the UNICEF- supported intensive nutrition centre (CRENI, or ‘Centre de Récupération Nutritionnelle Intensive’) of Aguié’s town hospital in south-eastern Niger. Oumarou had just been admitted.

He is among the nearly 394,000 children in Niger who are in need of treatment for severe acute malnutrition, a life-threatening condition. Their plight is part of the nutrition crisis gripping the Sahel region of West and Central Africa, the result of drought, poor harvests and rising food prices.

Seeking life-saving care

Ms. Saidou first brought Oumarou to the outpatient nutrition treatment centre in Kona, near their village, after he had begun experiencing diarrhoea and his feet and ankle started swelling. The staff in the centre referred him to the hospital for inpatient treatment.

At the hospital, a nurse evaluated Oumarou’s weight-to-height ratio. He weighed only 7.2 kg; a child of his height should weigh 8.8 kg. The result confirmed that he was suffering from severe acute malnutrition.

Oumarou was additionally diagnosed with anaemia, oedema, malaria, diarrhoea and respiratory infections – complications of the malnutrition. All these indicators determined that Oumarou should be hospitalized for intensive care.

Oumarou Seydou sits with his mother, Barira Saidou, in the nutrition rehabilitation centre in Aguié, Niger. Oumarou was discharged from the centre after four weeks of treatment for severe acute malnutrition. UNICEF Image © UNICEF Niger/2012/Adamou

Week one: During the first four days, Oumarou received Formula 75, a kind of therapeutic milk, to restore his metabolic function. He was placed under strict a feeding schedule and was also given malaria drugs, zinc, antibiotics and other medicines to treat his complications.

At the end of the week, Oumarou slowly started to stabilize, with tests showing that his oedema had begun to disappear and that he was beginning to recover from the malaria. But Oumarou’s weight had dropped to a shocking 6.4 kg, a result of the fluid loss from his body. He looked wasted, with his skin stretched over his tiny bones.

Week two: Nine days after he was admitted, Oumarou began the transition phase of treatment, in which he was switched to Formula 100, another therapeutic milk, and ready-to-use therapeutic foods (RUTF), which contained all the essential nutrients he needed. The nurse closely monitored his adjustment to the change. The results were promising: At the end of the second week, Oumarou had gained 0.8 kg.

Week three and four: Oumarou continued to receive six doses a day of RUTF, gaining an additional 0.8 kg. Ms. Saidou was thrilled to see her son feeling well and recovering. He was discharged from the CRENI, with plans to continue treatment at home using the RUTF.  Arrangements were made for Oumarou to receive outpatient treatment at the centre in Kano.

“I never thought my son would make it. I already saw him dying,” said Ms. Saidou. “I was hopeless, but decided to give him the chance. We honored all the instructions the nurse gave and his condition has improved significantly.”

Two-and-a-half year old Oumarou Seydo sits with his mother, Barira Saidou, during the second phase of his treatment for severe acute malnutrition. UNICEF Image © UNICEF Niger/2012/Adamou

Committing to Oumarou’s future

Oumarou’s parents are dedicated to ensuring he makes a full recovery – and that he stays healthy.

Ms. Saidou had travelled 55 km to bring her son to the CRENI. While there, she attended sessions on appropriate child feeding practices, how to prepare nutritious foods, the importance of exclusive breastfeeding, improved hygiene practices, and the proper use of malaria nets.

“I am committed to put the lessons into practice and follow-up the outpatient treatment until my son is fully recovered,” she said before leaving the hospital.

Ms. Saidou stayed in the CRENI for four weeks, leaving her other three children behind in the care of her husband, who visited Oumarou at the CRENI five times. “If it is not for his support, my son wouldn’t have survived,” said Ms. Saidou.

UNICEF urgently requires additional funding to procure enough essential medicines and therapeutic food and milk and to hire the extra health staff needed to save the lives of children at risk.

Twelve-year-old Oumar Soumana sells frozen juice in Niamey, Niger. He sends his earnings to his parents so that they can afford food in their home village. UNICEF Image © UNICEF Niger/2012/Tidey

Only a few months ago, 12-year-old Oumar Soumana was happily living with his family in Damana, in south-western Niger. But when the village’s food stocks were depleted – a result of the massive food crisis occurring throughout the Sahel region of Africa – he was forced to leave school and travel to the capital in search of work.

On a recent, sweltering day, Oumar walked down the dusty streets of Niger’s capital, Niamey, carrying a cooler on his shoulder. Inside were ‘appolo’, small plastic bags filled with iced fruit juices, which he sells for a few CFA francs each.

“It is a painful job for me,” he said. “I spend the whole day walking. I do not really rest because I have to sell and bring the money back, otherwise my salary will be reduced, so I prefer to do the maximum.”

Oumar’s boss is a civil servant who makes fruit juices to supplement her income. “She pays me 10,000 [CFA francs, or US$20] at the end of the month,” he said. “She is the one who ensures that I will have my breakfast, my lunch and my dinner.”

Oumar is not alone. According to Niger’s Ministry of National Education, Literacy and Promotion of National Languages, 47,000 children have already left schools this year due to reasons linked to the food crisis. Schools in the regions hardest-hit by the food crisis reported the highest number of dropouts. In Tillaberi, a region in south-western Niger that is one of the worst-affected, nearly 22,000 students have dropped out of school.

Oumar Soumana, 12, sits outside the makeshift tent he shares with his sisters in Niamey, Niger. UNICEF Image © UNICEF Niger/2012/Tidey

Many are forced to leave school because they are too weak to attend or because they must follow their parents as they migrate from villages to towns in search of work. Sometimes the children are put to work to earn extra money to support their families.

Crisis forces children to work

Niger is among the countries worst affected by the Sahel food crisis, a disaster caused by drought, failed harvests and rising food prices. According to Niger’s National Survey on Household Vulnerabilities, nearly 5.5 million people, more than half of whom are children, are currently estimated to be food insecure, representing nearly 35 per cent of the country’s entire population. UNICEF and partners estimate that nearly 394,000 under-5 children are at risk of severe acute malnutrition, a deadly condition, if adequate funding is not made available to provide treatment.

When Damana’s food stocks were almost empty, Oumar and other boys his age left to find work in the capital. There, Oumar was reunited with his two older sisters, who had previously left the village for the same reason. They are now employed as domestic workers.

Oumar and his sisters live together in a makeshift tent in an improvised camp where displaced families have gathered in the suburbs of Niamey. The camp has no running water or sanitation.

The money they earn is sent to their parents in Damana so “they can eat,” Oumar said. They keep only a small amount of money to sustain themselves.

“Here I have to look for food myself, with the risks that I face outside. Some people do not pay and run away, some people threaten me, some people insult me,” Oumar said. “For me, this is not a nice life, and I wish I was in the village with my parents.”

Putting children back to school and preventing dropouts

Back in his village, Oumar had been enrolled in school, and dreamed of becoming a teacher. He knows what he has lost by dropping out and leaving home.

Oumar Soumana, 12, sells frozen juice in Niamey, Niger, to send money back to his family so that they can afford food in their village. UNICEF Image © UNICEF Niger/2012/Tidey

“Through education, it is possible to find a good job and to have a better life,” he said.

UNICEF and its partners are launching ‘catch-up classes’ for children who have left school to help them make up for the missed lessons so they can continue their educations in the next school year. The classes will offer meals to ensure that children are fed and that parents are motivated to have their children attend.

Preparations are also underway to open an additional 500 temporary school canteens targeting schools in the regions worst-affected by the crisis, helping to keep students in school. Children protection measures are also critical for UNICEF, which is strengthening the capacity of social services to identify vulnerable children and provide psychological and other supports for those who are victims of violence.

When the rainy season finally arrives in June, Oumar hopes to go home and work with his father in the fields. “It will be better than selling in the streets and everything. I am suffering here,” he said..