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CARE Ethiopia CIDA funded Emergency Nutrition InterventionNutrition: a Lifeline for Mothers and Children in West Hararghe

Seated on the floor of the Kuni Town Health Centre, in Gemechis woreda, Halima Dawitshared the tragic story of Khadijas life. Six months ago shortly after Khadija was born, her mother Halimas daughter died. A happy event had turned to tragedy. Halima took up therole of carer for her new granddaughter, but that was just the start of her struggle.

This year, the rains came late again in this part of Ethiopia. And when they finally began theycaused huge flooding which damaged many of Halimas crops on her tiny quarter hectare of land. What was not damaged by flood, was destroyed by drought.

This is what led them here, to the small room being used as a stabilisation centre for severelymalnourished infants. Khadija is one of nine inpatients currently admitted in the centre.Halima had brought her to the health centre for an immunisation, and staff there immediatelyrealised the severity of her condition.

I have so many problems; I dont even have milk to give to my granddaughter. she shared.They said she had a problem with malnutrition and they admitted her immediately. That wasthree days ago.

Like many of the mothers in stabilisation centre, Halima had travelled 80km to get there, thisgreat sometimes impossible distance, the reason why CARE, with funds from theCanadian International Development Agency (CIDA), is supporting the Government to open

another two centres in West Hararghe alone, hoping to give as many children and families aspossible an opportunity to receive help.

Figure 1 (Left): Halima Dawit with Granddaughter, Khadija

The children in the centre, all under five years old, areimmediately put on a course of high-electrolyte milk, giveneight times a day, to stabilise their digestive system, andthen moved to a high-protein milk to help them to gainweight.

As soon as Khadija gains weight over consecutive days, shewill be discharged and then treated in the Outpatient

Therapeutic Program (OTP) for the next two or three monthsas she returns to a healthier weight. The children in OTPreceive weekly rations of Plumpy-nut, a nutrient rich ready toeat therapeutic food with high caloric intake. It is an effectivemeans for restoring children to a healthy weight and nutritionstatus.

Halimas relief at receiving help is palpable, I am so very glad to be here. I have learned howto prevent malnutrition, and so far as it is possible, I will do my best to give my grand-daughter the kinds of food she needs.

Outside, a crowd of mothers gather with their children to be weighed. These children too areseverely malnourished, but well enough to be treated as outpatients. 45 children are expected

today.

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There has been an increase in referrals since the Government carried out a screening acrossthe region a fortnight ago. But, many of the people here today have been referred bysomeone in their community. A crucial part of CAREs nutrition programme is trainingcommunity members to be able to identify severely and moderately malnourished childrenwho need treatment and link them government health services.

Engida Asha, CAREs Emergency Programme Manager in West Haraghe explained, thereare 162 Community Nutrition Volunteers in Gemechis woreda alone. Village leaders help usto select them from the community and they are responsible for raising awareness andidentifying serious cases and referring them to our services.

Many of the volunteers are traditional birth attendants, who help women too remote to get tomedical care, through labour and childbirth. With good knowledge of the communities, theyare well placed to spot families and children in need.

12-month old Nanti Ahmed is one of those. She was admitted as an outpatient three weeksago weighing just 5.1kg. She was given antibiotics and is now receiving a specially devisedhigh-protein food called Plumpynut to help her to gain weight.

Figure 2: Hawa Rahado with daughter Nanti But, CARE doesnt only target infants.Chronically food insecure women, and pregnantand lactating mothers in particular, areespecially vulnerable, which is why our programmes specifically prioritise their needs.When a child is referred, the mother is routinelymeasured too, and this identified Nantismother, 20-year old Hawa Rahado, as alsoworryingly underweight.Hawa told us, when I had this child, I had nosupport because the father is not there, he hasmigrated in search of work. I could not farm as I

had to care for the child. I had no harvest thisyear. Nothing. I dont have any food in the house to feed my children.

Hawa has been receiving supplementary food, along with her child, for 3 weeks now.

I was thinner than this before, and I am still improving. I am gaining weight. Though my childstill has diarrhoea and so is not yet putting on weight.

For Hawa, as for thousands of ordinary Ethiopians, CAREs nutrition programme is a lifeline.

As she put it, I know if I had not come here, I would have died.