Health workers in the Central African Republic are blaming poor family planning as well as high prices for worsening malnutrition in northern parts of the country. VOA's Nico Colombant reports from a feeding center in the small northern town of Bossangoa in this the third part of a series on neglect and challenges in the mostly lawless Central African Republic.
The market in Bossangoa is full of vegetables, meat, water and fruit, but just a few steps away, free milk distribution is taking place at an overfilled center for malnourished children.
Each child gets a different amount of milk depending on how severe his or her status is.
The center was built for 16 beds, but now there are more than 60 children with their mothers here, forcing most to sleep on mattresses outside.
The surrounding area has lush land and a small population, but at the malnutrition center, it is a cacophony of cries, which is getting worse, according to Action Against Hunger aid worker James Batende.
"It is very hard now because when we started the program in January and February, there were few beneficiaries in the program here and now they have been increasing. They increase every day," he said.
At the entrance of the center, mothers sit on a wooden bench holding their children with distended bellies and tiny wrists and ankles, waiting for them to be measured and weighed to see whether they qualify for the program.
One mother, Leontide, explains to an aid worker she is bringing her fifth child to the center. She is 38, and she says she can only feed her children vegetables from her small plot of land.
Leontide says with higher food prices she cannot afford anything in the market anymore. She says her husband is a retired schoolteacher who left two years ago to go to the capital Bangui to sort out his retirement papers so he could get a pension, but she says he has yet to return.
A local aid worker, Thierry Aurel Issa, tries to talk to a girl, Mouna, six years old, who has just arrived at the center, her eyes glazed, flies buzzing around her face, her bones piercing through her angular frame.
The aid worker explains that since her case seems very serious, she will be given a glass of sugary water and rushed to have a medical consultation.
The director at the center, Nicole Kotigbia, says more severe cases are coming in as it is the harvesting season, and she says parents often abandon their children at home while they work in the fields.
She says adults often treat their children like adults, thinking they can survive on very little during hard times, but that is not the case.
She says high prices in markets mean poorer families just save enough money to buy soap and salt but cannot afford anything else.
She also blames bad family planning. She says many mothers come to the center pregnant with another child, even though they cannot feed the children they already have. She says many times they do not know any better. She says they do not know how to count between their menstrual cycles and forget which days they are more susceptible to getting pregnant.
Kotigbia says at a low economic level it is very dangerous to have a child less than two years after the previous one.
Some of the mothers also come from outlying areas where there are road bandits who attack pedestrians and kidnap them, making many people fearful to walk to their fields, compounding an already bad situation.
But there are success stories, here, or at least, stories of hope. A small girl, her cheeks filled up again, uses an empty package of malaria tablets as a toy.
Twenty-year-old widow and mother of two, Christina, says after 15 days at the center her three-year-old daughter, Antoinette, is beautiful again.
As other women start preparing food with donated supplies, in the center's courtyard, Christina adds she is ready to start a new life. She says she knows it will be very difficult, given that life in the Central African Republic is a daily battle for survival, but she says, she will try her best to make sure her daughter is never malnourished again.