High malnutrition rates in slums “alarming”

With malnutrition rates as high as 25 percent in some areas, the UN Children's Fund (UNICEF) is alarmed at the condition of children under five in Djibouti's slum areas.

"This is a chronic but silent emergency," Georges Gonzales, the acting UNICEF representative in Djibouti, told IRIN. "It is an emergency which requires not only short-term intervention to save lives but also calls for long-term solutions to develop a food security strategy."

He said drought and high food prices, which were beyond the means of most poor people, had combined to create the poor nutritional status of Djibouti's infants and children.

The UN World Health Organization (WHO) considers a global acute malnutrition (GAM) rate of 15 percent critical.

Aristide Sagbohan, a UNICEF nutrition specialist, told IRIN that up 25,000 children in the country were malnourished. He said the GAM rate in Djibouti was 17 percent.

"In the north-west the figure is 25 percent," Sagbohan said. "These kinds of rates are normally found in countries in a complex emergency."

Slow improvements

However, Sagbohan said a national nutrition project launched in January 2006 by the government and its development partners had helped reduce mortality rates among the severely malnourished from 20 percent to less than 5 percent within two years through therapeutic and supplementary feeding programmes.

Despite this slow improvement, the government and its partners needed to continue to support this sector.

The current strategy was "successful in helping avoid and reduce death but does not reduce the vulnerability of the population. You also have to address the causes of malnutrition," Gonzales said.

Malnutrition was highest among children between 12 and 24 months, mainly because that was when they are weaned off the breast and exposed to contaminated water and food.

Photo: Abdi Hassan/IRIN
Georges Gonzales, acting UNICEF representative in Djibouti

Screening programmes

Community-based organisations were also involved, being trained by UNICEF to work within the health system. These community groups, mostly women, do simple screenings to identify children with malnutrition symptoms and are trained to provide ready-to-use therapeutic food.

"They are our first line of defence," said a medical official.

In one of the health centres supported by UNICEF, with WFP and WHO and support from USAID, dozens of women with malnourished children come for feeding and screening, said Madina Ali, a doctor.

"They are given weekly rations to take home but once a week they must come to the centre to be weighed and tested," Ali said.

She said in the poor Arhiba neighbourhood, where the centre is located, more and more malnourished children were coming to the centre.

Zahra Hussein, a mother of three, brought her 30-month-old son to the centre for feeding, weighing and testing. "If it were not for this, he would be worse," she told IRIN.

She said her husband, a labourer, was unemployed. "We sometimes have one meal a day and sometimes we don’t.”

Gonzales said those affected were mostly from families who had migrated from the rural areas because they lost their livelihoods due to the drought, or from neighbouring countries.

The Famine Early Warning Systems Network (FEWS Net), however, stated in January 2009 that large-scale food aid distributions countrywide had alleviated food insecurity for the time being, although the primary drivers - poor pasture and water availability in addition to high food prices - remained.