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Malnutrition Devastates Horn of Africa Drought Areas

A Turkana woman holds a young child as both are examined for malnutrition by a World Vision nurse at a feeding and treatment center in Lokori, Kenya, July 28, 2011

A Turkana woman holds a young child as both are examined for malnutrition by a World Vision nurse at a feeding and treatment center in Lokori, Kenya, July 28, 2011

Malnutrition rates are skyrocketing in certain areas of the Horn of Africa, which is experiencing the worst drought in decades. To treat malnutrition, aid workers choose from an array of powders, pastes, biscuits and other supplements loaded with micro-nutrients, depending on the recipient’s circumstances.

Lokor Locmel is three years old. But her shrunken face, stick-thin limbs, and weak cry make her seem like a child half her age. She weighs almost 5.6 kilograms, but should be at least double that weight, at 11.5 kilograms.

Lokor is registered in the out-patient program at Makutano Clinic, in a village about an hour’s drive from the northern Kenyan town of Kakuma. The clinic, which serves a population of 8,500 people, has seen a dramatic spike in malnutrition as the drought rages on. In January, the clinic had 21 cases of severe malnutrition; in July, there were 68 cases.

Nutritional foods are ready to eat

In the out-patient therapy program, Lokor receives 45 grams a week of a peanut paste fortified with a range of micro-nutrients such as vitamins, calcium, potassium, and folic acid. There are several types of paste. The one Lokor uses is called Plumpy’Nut.

Head nurse Jimmy Loree is Lokor’s caregiver. He said Plumpy’Nut is doing its job.

“Swelling of the legs, the hands, has gone. She is not looking like an old man, but now she looks shiny. And the weight also is increasing, meaning there is some good improvement in the child,” said Loree.

Plumpy’Nut and other pastes fall under a category called “ready-to-eat foods.” These are specialized therapeutic foods containing vegetable fats, dry skimmed milk and other ingredients. They are used primarily in emergency operations to prevent or treat moderate to severe malnutrition in children and to produce the greatest weight gain in the shortest time.

Packed with micronutrients, calories

Severely malnourished children and adults also are admitted to the hospital and are given intensive nutritional treatments, such as drips and milk. Another type of emergency food is high-energy biscuits.

“Fortified biscuits are also used as a ready-to-eat food that is high in nutrients and calories, and that is for people who are moving or who do not have the ability to be able to cook, then this is a very important kind of product for immediate nutritional support,” explains World Food Program spokeswoman Challis McDonough.

Other products available are compressed food bars and micronutrient powder that is sprinkled on food.

Hospitals, aid workers scramble to help

Stable populations not facing an immediate emergency situation receive supplementary rations from the “fortified blended foods” category. These are powders that are mixed with oil and water and cooked as porridge. They also contain a host of micronutrients, and are used mainly in supplementary feeding and mother and child health programs.

It is distribution day at Kakuma Mission Hospital, which happens twice a month. More than 300 women and their children line up under a hot sun to receive cooking oil and a supplement known as Corn-Soya Blend.

Thomas Ekai, the administrator of Kakuma Mission Hospital, said, "The normal ratio per month is actually 7.5 kilograms [16.5 pounds] and the oil is 0.75 [kilograms], so it is one-tenth of the other food. That is what they are given if they are found to be malnourished and they do the OTP [out-patient therapy] there. That means they get the food and they go home. It is done twice a month and it is mixed here. They go with the food mixed - they may not actually go there and do the mixing as required. ”

Kakuma Mission Hospital, and most other health-care facilities and food distribution sites, get their rations and therapeutic nutritional treatments from the U.N.’s World Food Program. Once WFP delivers the food aid to the site, aid agencies typically distribute the food.

Fighting starvation

To determine who is malnourished, health-care professionals follow a number of procedures, including measuring the thickness of the upper-arm, comparing someone’s weight with their height, and looking at an area’s overall food security situation. Those eligible for food aid are then registered and monitored, so that they can begin their long journey back to health.

Some 12 million people in the Horn of Africa face hunger and starvation due to the drought that has ravaged the region over the past several months.

The nomadic herders of Kenya’s Turkana districts have been hit particularly hard. Some 30 percent of households in the area rely on food aid to survive, while at least half of the households consume only one meal a day. Almost half of Turkana’s children are moderately or severely malnourished, and in need of life-saving emergency nutrition services.