News / Africa

Study in CAR Links Mental Health and Malnutrition

A sick internally displaced Muslim girl sits next to her mother in a house in the town of Boda, April 15, 2014.
A sick internally displaced Muslim girl sits next to her mother in a house in the town of Boda, April 15, 2014.
Nick Long
Data collected at a hospital in the Central African Republic suggest that many parents of malnourished children have symptoms of post-traumatic stress disorder, according to the international aid group Action Against Hunger.  The group offers these parents psycho-social counseling in order to help the children recover.
 
Action Against Hunger treated 4,664 children with severe acute malnutrition in Bangui between last October and March. The NGO has data from interviews with about a thousand of those children’s parents.
 
The NGO says the data show that three-quarters of these parents were exposed to traumatic experiences and 60 percent described having symptoms suggestive of post-traumatic stress disorder, although they might not develop the condition.
 
It is known that young children whose parents have been exposed to severe trauma are at higher risk of developing malnutrition, but the high proportion of parents falling into that category in this case may come as a surprise to experts.
 
This kind of data has hardly ever been collected before in conflict zones, such as Bangui has been in recent months, so the links between violent trauma and malnutrition are not well documented.
 
Stephanie Duverger a psychologist who has studied the data, says that horrific experiences, fear and anguish often reduce parents' capacity to care for their children.
 
She told VOA about one father with a very young child whose wife had abandoned him, and whose neighborhood was attacked by rebels.
 
"So he had to escape, and on escaping and hiding in the jungle he saw a lot of dead bodies, the child also, and since then he said the child started losing his appetite completely and (he) himself, he became quite aggressive and he presented nearly all the post stress disorder symptoms," said Duverger.
 
The data collected from interviews also shows that 68 percent of the malnourished children had been refusing food.
 
Action Without Hunger is not suggesting that extreme poverty and lack of food are not the critical factors leading to malnutrition, but it is saying that young children often need emotional support as well as food in order to eat properly, and trauma can make it harder for parents to give that support.
 
Duverger says many parents the NGO counseled in Bangui had reacted roughly when their children had eating difficulties, and this may have made things worse.
 
"Also the study showed that lot of parents do not understand the symptoms as being a somatic [bodily] way to express distress.  They tend to think it’s a whim of the child, and they correct them quite violently in order to correct the symptoms which are in fact a way of saying help," she said.
 
Several parents VOA spoke to at the hospital said they hadn't understood why their children were not eating.
 
One mother had brought a six-year-old boy to the center, and Duverger says this boy initially screamed at any adult that approached him, including his mother.
 
The mother says that she gave the child food but he refused to eat, and sometimes he threw fits which she thought were just tantrums, so she started forcing him to eat.  But, she says, at the hospital she has learned that his fits were symptoms of stress as a result of what they had undergone after they had fled to the bush to escape violence.

Another mother with a child at the hospital had been exposed to extreme trauma.
 
She says that during the recent fighting her brother was killed in front of her, and fleeing to a displacement camp she saw lot of corpses, and so did the child, and those scenes keep coming back to her mind, and she thinks of the way they killed her brother.
 
She says that she had learned a lot at the hospital
 
Before coming here, she says, she thought malnutrition was simply because of lack of food, but here she has realized that in her child’s case it wasn’t just that - and that if a mother is depressed she can cause malnutrition in her child.  And another thing she has learned, she adds, is that playing with her child is also important for its healthy growth and development.

Duverger commented that it’s hard for many people to understand the importance of counseling in a conflict zone like the Central African Republic.
 
But other NGOs working here, including Save the Children and the medical NGO Emergency, told VOA they now want to include psycho-social counseling in their activities as they can see the need.

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