Gallery: Alarming malnutrition rates in Leer, South Sudan

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Alarming malnutrition rates are being recorded in parts of South Sudan. In Leer, a town nestled in the swampy marshlands that surround the White Nile river, Médecins Sans Frontières (MSF) is seeing this problem first hand.

Before the conflict, we used to have around 200 children admitted into the ambulatory therapeutic feeding centre (ATFC) at any one time,” says Grace Ayuelu medical team leader in Leer. She has been working in Leer hospital for almost a year. “But now, we have over 1,800 children. That is a big number.”

Fleeing conflict

Much has contributed to this situation. After the conflict that erupted in South Sudan in mid-December 2013, many people’s houses in Leer, as well as the MSF hospital, were looted and razed to the ground.

To escape the conflict people fled into the bush, going months without anything to eat other than wild roots and whatever else could be gathered from the land.

Now, with people returning to Leer, the partially destroyed MSF hospital is up and running again albeit at half the capacity.

Ambulatory feeding

Today, the busiest area of Leer hospital is the ATFC.  Here, children under five-years-old are brought to the hospital to assess their level of nutrition.

Taking measurements of their height, weight and mid-upper arm circumferences (MUAC) the majority of children who come through the ATFC are found to be moderately malnourished.

“In these cases,” says Grace, “they are sent home with a week’s supply of a ready-to-use therapeutic food called Plumpy’Nut, a peanut-based paste, and come back every week to be reassessed until they are back to normal health.”

Treating malnutrition

If children are severely malnourished, they have to be admitted into the intensive therapeutic feeding centre. Here, their feeding can be closely monitored and drugs can be prescribed to combat any other complications that can be a factor in recovering from malnutrition.

  • Photo: Nick Owen/MSF
    Carrying her son, 25-year-old mum Angelina arrives at MSF’s hospital in Leer, Unity state, South Sudan.
  • Photo: MSF/Nick Owen
    After walking five hours from her home village, Angelina spends little time waiting to be seen as MSF’s doctor, John Yonk Both, recognises that Gatluok’s condition is critical.
  • Photo: Nick Owen/MSF
    Before his consultation, Gatluok’s measurements are taken. The suspended baby scale shows that he weighs just 5.7 kg. The weight of a healthy boy his age should be 14 kg.
  • Photo: Nick Owen/MSF
    Gently lowered onto a measuring board he finds the situation distressing, like most children who go through this process. His height is recorded at 78 cm.
  • Photo: Nick Owen/MSF
    MSF nutrition nurse Charles Mpona Kalinde tries to comfort him as he, very carefully, carries Gatluok back to his mother after his measurements are taken.
  • Photo: Nick Owen/MSF
    He is then given the all-important MUAC test. His MUAC measures just 94 mm, well within the red area, indicating that he has severe acute malnutrition.
  • Photo: Nick Owen/MSF
    Gatluok and his mum are given a moment to recover after the measurements are taken. He reaches for the hand of an MSF clinic officer.
  • Photo: Nick Owen/MSF
    Gatluok is then taken for his consultation with MSF nurse Peter Bitoang Machar. Gatluok’s mum tells Peter of their situation at home, how her house was burned and their food stocks were looted, and how they had to flee into the bush.
  • Photo: Nick Owen/MSF
    During the consultation, Peter tests Gatluok’s appetite with some Plumpy’Nut. But, he won’t eat. Peter carries out another test and establishes that Gatluok has malaria and a high fever.
  • Photo: Nick Owen/MSF
    Despite being unwilling to eat, he is incredibly thirsty and eagerly drinks a rehydration solution.
  • Photo: Nick Owen/MSF
    Within half an hour of arriving, Gatluok is admitted into MSF’s intensive therapeutic feeding centre. But it will not be easy. His mum has no food at home and is also worried about her other child, who she had to leave behind in the care of her brother.
  • Photo: MSF/Nick Owen
    Now, one week after Gatluok was admitted, he has recovered from malaria and he has started eating again. It is hoped that within the coming days Gatluok will be discharged and will be followed up in the ATFC.

Read more

Press release
14 July 2014
Child malnutrition rates skyrocket in South Sudan
14 July 2014
Interview with MSF Project Coordinator in South Sudan, Sarah Maynard
4 July 2014
Video: Medical Care Under Fire in South Sudan
2 July 2014
This video shows the impact of the destruction of MSF’s Leer hospital compound in February 2014.
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