The International Rescue Committee is scaling up health and nutrition programmes in Chad and dispatching emergency experts to Mali as millions of people in these countries and across the drought-ravaged Sahel region face a growing humanitarian disaster. IRC media and information manager Sophia Jones-Mwangi recently visited the hard-hit Bahr el Gazal and Guéra regions of Chad and shared this and other updates on the humanitarian situation and the IRC's response.
Article and photography: Sophia Jones-Mwangi
Mongo District, Guéra – Tuesday 17 and Wednesday 18 April – I arrived in Mongo town, an hour’s flight southwest of N’Djamena, Tuesday afternoon with Felix Leger, IRC’s country director in Chad, and Dr. Charles Ido, who will be leading our emergency nutrition response here. The first thing that struck me as the plane began its descent were the mountains and hills surrounding the town which, like its tree-lined streets, are in stark contrast to the desert plains of the Sahara. The picturesque nature of this area belies the fact that Guéra Region, which encompasses Mongo District, is severely affected by drought.
Mongo, in particular, is prone to food shortages. In 2011, 57 percent of all cases of malnutrition in children in Guéra came from this district—the reason that the IRC will start providing emergency nutrition to children under five and to pregnant and new mothers in the coming days.
Whenever the IRC begins work in a new area, we meet with government representatives and local officials. On our first night in Mongo, Felix and Dr. Charles made a courtesy call to Ouedingue Asse-Assoué, the regional governor, who thanked the IRC for coming and stressed that malnutrition in Guéra is a major problem.
The next morning, they met with Dr. Ramat Abdoulaye Abderamen, head of Mongo Health District, who warmly welcomed the IRC. “The arrival of any partner is always a plus,” he said. “We have limited means, and it’s often thanks to the presence of partners such as yourselves that we get qualitative results.”
According to Dr. Abderamen, the drought has people looking for food and neglecting their health. “Some mothers are hesitant to go to the health centres because they don’t receive food there,” he said. “Only a few people in the community use the health centres. This is partly because there are only 17 for a population of 200,000. People prefer to go traditional healers.”
After meeting with Dr. Abderamen, we drove in the sweltering heat through a valley surrounded by giant boulders and hills. We passed women riding donkeys with babies strapped in baskets. Goats and camels munched on whatever shrubs they could find. When we arrived at Banda Health Center, it was closed. A group of women and children were waiting under a tree.
“This centre should be open,” said Dr. Charles. “This is one of the major problems here. If there is only one nurse working and he or she has to go somewhere or has a meeting, the centre will close for the day or part of the day.”
I spoke with the women waiting under the tree, who told me that there were far too many people at the clinic yesterday and the nurse was unable to see them all.
“One of our priorities in coming here will be to support and strengthen human resources in the area through training, as well as to get the community actively involved in nutrition screening,” said Dr. Charles. “When there are community health workers and community health committees, a centre like this will not be closed.”
Zenaba Abdullai sat patiently in the meagre shade with her two-year-old son. “I don’t know what is wrong with him,” she said. “He has been complaining of stomach pains. He is very weak and I’m worried that he is not developing.” I asked her how she is coping in this lean season. “Because of the lack of rain, there is no food, we can’t give the children anything,” she lamented. “We have lost weight and we are very weak.”
Banda is a farming community—beans, peanuts and millet. The last harvest was in September. Only millet can be found in the markets, but it is extremely expensive, available to but a handful of people. Even those selling it ration their portions because they don’t know when they will need it for their own use.
Like Zenaba, Jimir Yunis doesn’t know what is wrong with her one-year-old son, so has come to the health centre to find out. She too is worried about the lack of food. A farmer, Jimir had a poor havest and no surplus to sell. That was five months ago. “It is finished,” she said of her food stores. “There is nothing.”
Dr. Charles noticed that many of the children in Banda were weak and drowsy and possibly anemic. They showed obvious signs of malnutrition, their stomachs distended. “There are children with stomach pains, too—this can be a sign of worms. It is important that we intervene to provide medicines for deworming, iron for the anemia and therapeutic food for the malnutrition.” In addition, Dr. Charles stressed the value of awareness-raising programmes to help mothers prevent disease in children.
Both Charles and Felix believe that Mongo District presents a huge challenge. “We really don’t know how many children have malnutrition, because the children screened here in the district are only those who come to the health centre,” said Felix. “I’m sure if we would screen all the villages in Mongo, we would find many more.”
The IRC plans to establish outreach teams in each of the 17 health centres in Mongo and strengthen the network of community health workers and community health committees, which at the moment is almost nonexistent. “These teams will screen all children from six months old to 59 months,” Felix explained.
In addition, the IRC plans to establish an outpatient therapeutic programme for malnourished children under age five who don’t have medical complications. Dr. Charles will lead a team of nurses who will visit all 17 health centres weekly, supplying therapeutic food provided by IRC partner UNICEF.
The crisis in the Sahel is nothing new. Many of the people whom I’ve met these past days have been coping with drought and food shortages for many years. Felix believes that long-term solutions need to be made at by the government. “Otherwise, we are condemned to continuously act as a band-aid to the problem,” he says. “We are here to support the Ministry of Health. It is important that the state helps its population by assisting them in finding different ways of planting crops, for example. There is also a huge need to establish strong health services.
“Now we are addressing the emergency but we must help people in the long term,” Felix continued. “This is all about increasing their resilience to drought in the future. If the rains are not good in June and July, then the harvest in September will be bad. In such a case, IRC will most likely advocate to donors to continue for another year in this area beyond the nine months that we are committed to.
“If the rains are good and the harvest is good, this will give families the breathing space they need. We may think about staying and helping people to be better prepared for the next drought, which is inevitable.”
The IRC’s emergency nutrition programme in Chad receives support from the European Commission’s Humanitarian Aid Department (ECHO) and the U.S. Office of Foreign Disasters Assistance (OFDA).