This World Humanitarian Day, Dexter Chagwena, a Research Nutritionist from the University of Zimbabwe, and Rufaro Charity Madzima, an independent Nutrition Consultant, reflect on acute malnutrition in Zimbabwe, how the condition is becoming increasingly prevalent during periods of stability and what needs to be done to make efforts more sustainable.
Zimbabwe is no stranger to humanitarian crises. Over the past few years the country has experienced sporadic cholera outbreaks. Parts of the country are particularly prone to droughts and floods. Earlier this year the Tokwe-Mukosi dam flooded in Chivi– a rural district in Masvingo Provincean in south-eastern Zimbabwe – displacing 4000 villagers when their homes were submerged.
Masvingo province is located in the low veld of the country where rainfall is minimal and uncertain. Most parts of the province are drought prone, therefore, are generally unfit for agriculture. Villagers, therefore, make their livelihood through cattle ranching. Last February, when the dam flooded, villagers did not just lose their homes, but their cattle and sole form of livelihood. In the weeks that followed, malnutrition rose as many families could no longer afford a single decent meal and were left severely food insecure. As a result of the sudden lack of nutritious food and increased risk of disease, many children experienced a rapid loss in weight – a condition known as acute malnutrition.
This condition can quickly result in death without treatment. Thankfully, treatment is available. Cost-effective and high-impact approaches to treatment have revolutionized the fight against acute malnutrition. Through community-based approaches it is possible to identify and treat more children than ever before. Energy-dense, micronutrient-enriched foods —known as RUTFs —can effectively treat children in a matter of weeks, without needing to be admitted to hospital.
Acute malnutrition has been prevalent in many African countries for decades – affecting 13.2 million children in Africa alone. In Zimbabwe, like many African countries, young children tend to be the most vulnerable to this condition. Zimbabwe has made tremendous strides in tackling acute malnutrition over the years – today around 3% of children under the age of five affected, down from 7% in 2005-06. This has been, in large part, due to the support provided by humanitarian assistance to decenralise the community based management of acute malnutrition (CMAM) to almost every district of the country.
As a resource-limited country, Zimbabwe has achieved “tremendous successes under difficult conditions.” Recently, at the initiative of the Ministry of Health and Child Care, Zimbabwe has migrated from community based services to a more institutional based, integrated management of acute malnutrition (IMAM). This initiative is aimed at improving the previous CMAM approach to a more unified response in the management of acute malnutrition between health institutions and communities. But there is still room to advance our efforts and reduce the rates of acute malnutrition even further. To do this Zimbabwe, and other countries, need more sustainable approaches in fighting acute malnutrition in non-emergency settings.
While acute malnutrition does occur during humanitarian crises, it in becoming increasingly common in stable settings. Humanitarian efforts are crucial and must continue to provide life-saving support when incidents like the Tokwe-Mukosi flooding occur. But much more needs to be done to advance our efforts and provide a more sustainable approach in fighting acute malnutrition in non-emergency contexts to ensure that children who are at risk during times of stability are also able to access this life-saving treatment.
The supply of life-saving RUTFs is often restricted to periods of crisis. As a result, clinics can suffer from regular stock-outs – a major barrier to accessing treatment. Repeated stock-outs can contribute to community-based SAM treatment services as being perceived as unreliable, leading to significant increases in length of stay, absenteeism and children defaulting from treatment.
Globally, a staggering 1 million children die each year from this condition, despite the fact that it is preventable and treatable. If we hope to make a dent in this number, and safeguard the futures of millions of children, then more needs to be done to bridge the gap between short-term humanitarian funding and long-term sustainable development funding.
What can you do?
Sign the Generation Nutrition petition calling on leaders all over the world to take urgent action to reduce the number of children suffering from acute malnutrition and safeguard the lives of millions of children.
Dexter Chagwena, Research Nutritionist, University of Zimbabwe, College of Health Sciences
And Rufaro Charity Madzima, Independent Nutrition Consultant, JIMAT Development Consultants, Harare, Zimbabwe. www.jimatconsult.co.zw