Sudan: fighting the double burden of child malnutrition
Humanitarian agencies and their partners in Sudan are taking a holistic approach to supporting Government efforts to beat malnutrition and food insecurity, with programmes that include sanitation, education and agricultural elements as well as nutritional supplements.
Child malnutrition rates in eastern Sudan’s Red Sea, Kassala and Gedaref States are the highest in the country, with an estimated 30 per cent of children under the age of five moderately or severely malnourished. Throughout Sudan, some 750,000 children suffer from Severe Acute Malnutrition every year, putting them at high risk of death. The children who survive face problems that can last a lifetime, from stunting and wasting to behavioural and developmental problems, chronic health conditions such as diabetes, and emotional problems like anxiety and depression.
Tackling child malnutrition in Eastern Sudan
To meet this challenge, the Sudanese Government and humanitarian partners have stepped up their treatment of children suffering from severe malnutrition. The number of under-fives treated has increased from 27,000 children in 2009 to 102,000 children in 2012 and an estimated 132,000 in 2013.
“Child malnutrition represents Sudan’s most solvable problem,” says Susan Lilicrap, UNICEF’s Chief of Nutrition in Sudan. “The Government’s strategic plan to tackle child malnutrition is thorough and effective. It is simply a matter of resources that prevents us from taking those final steps towards ensuring no Sudanese child suffers from the injustice of malnutrition.”
In eastern Sudan, the UN is working in partnership with the Government to provide vital food assistance to children under 3 years old. A supplementary feeding programme has been established at malnutrition centres across the region, providing extra food and basic health treatment for children at risk. Mothers who bring their children to these malnutrition centres receive PlumpyNut, a high-energy peanut-based supplement that can be given to a child regardless of how severely malnourished they are. Six to eight weeks of PlumpyNut, supported by quality health treatment, is usually enough to treat malnutrition.
An integrated response to child malnutrition
However, beating malnutrition is not this straightforward.
Sudanese mothers are seen as solely responsible for the welfare of their children. Anecdotal evidence suggests that they often share the PlumpyNut ration among all their children, rather than giving the whole packet to one malnourished child as instructed.
In eastern Sudan, conservative customs often prevent women from leaving the home unaccompanied by their husband or a male family member, so they may not be able to bring their children back to the malnutrition centre for vital follow-up treatment.
The response to child malnutrition should therefore include efforts to educate women in basic healthcare, and to empower them to act on behalf of their children. Mara Nyawo, a Nutrition Specialist with UNICEF in Sudan, says it should go further, involving sanitation and agricultural programmes.
“We need to move beyond the mindset that the problem of malnutrition is simply the domain of nutritionists,” Mara says.
“We need to bring on board a range of other responses to ensure that sanitation services are adequate enough to prevent diarrhea; to ensure women receive the vitamins and nutrients essential for a smooth pregnancy and healthy newborn; and to ensure that farmers are producing good quality, nutritious crops.”
The WFP, FAO and UNICEF have launched a joint programme aimed at enhancing the resilience of communities in eastern Sudan, for example, by supporting small-hold farms in the production of nutritious foods.
But more needs to be done to integrate the whole humanitarian community in initiatives to combat child malnutrition, which poses a serious threat to the future of Sudan in terms of healthcare costs and lost productivity.
“If we do not prevent malnutrition among children, the development of Sudan will take a lot longer,” says Mark Cutts, Head of OCHA in Sudan.
“Child malnutrition affects every stage, every facet of human life,” he adds. “Eliminating child malnutrition in Sudan requires that the humanitarian community sees the bigger picture and addresses the multiple issues that have made it so pervasive.”