Malnutrition rates among Yemeni children… 5 reasons for the sudden increase
Malnutrition is a serious threat to children in Yemen. This country witnesses a peak in the number of infections on a seasonal basis every year, as a result of the dry season caused by the interruption of agricultural production in rural areas. According to a report by Doctors Without Borders.
The report states that malnutrition was a threat to children before the conflict escalated in 2014, but the situation has further worsened as a result of years of war, which has contributed to worsening food insecurity, especially among the most needy.
Al-Taqri warns that Yemen’s high rates of child malnutrition are leading to preventable deaths, especially among children under the age of five.
Every year, MSF responds to seasonal increases in malnutrition rates, which have worsened this year, in various Yemeni governorates, particularly in the governorates of Hajjah, Al Hudaydah, Saada and Amran.
The organization notes that between January and October of this year, MSF facilities in Yemen received 7,597 children suffering from malnutrition.
That number, according to the organization’s data, represents an increase of 36 percent compared to the same period last year. While the number of casualties in Yemen often peaks between June and September each year, MSF teams have experienced an early peak this year, starting in April and May, and expect this situation to continue until the end of December this year.
The organization says that the peak of early-stage malnutrition, together with the large number of children suffering from malnutrition and its complications and the high need for hospitalization, has led to overcrowding in MSF-supported facilities.
Médecins Sans Frontières launched an emergency response to tackle a significant increase in cases of acute malnutrition and related health complications such as diarrhoea, pneumonia and anemia in some areas.
Doctors Without Borders emphasizes that the causes of malnutrition cannot be reduced only to lack of food, but there are five other reasons that aggravate the problem among children in Yemen.
Most families in Yemen are unable to purchase sufficient quantities of nutritious food or produce, even when available, due to skyrocketing prices fueled by the deepening economic crisis. There are also no employment opportunities for many people, and many have lost their homes during the eight years of war, either due to their destruction or displacement, adding to their suffering and worsening their financial situation, the organization said.
The Yemeni rial is experiencing a sharp drop in value, and the prices of food, transportation and fuel are rising significantly, which is an obstacle for the population to access sufficient quantities of nutritious food.
And about that suffering, Shuhra Muhammad, who brought her four-year-old grandson, Abdullah, to Abs Hospital in Hajjah, says, because of his malnutrition and other health complications, “We went to Abs Hospital several times, because his health condition improved, and then worsened again.” “Abdullah was last discharged from the hospital 20 days ago. We prefer to go to this hospital because the services are free. Abdullah’s father is absent. We are trying with his mother to provide him with food as much as we can, but we can hardly buy milk.” We have no way to reach nearby health centers that provide therapeutic nutrition for children.”
Primary health care services
Yemen’s health sector continues to collapse. Limited financial resources of health authorities, lack of supplies and equipment and non-payment or irregularity of salaries of health personnel have prompted many health institutions to close their doors in the organization.
It should also be noted that excessive fuel prices significantly limit people’s ability to access emergency medical care. These factors often delay receiving much-needed medical care, leading to additional health complications that could have been avoided with early treatment. Malnourished patients face the same challenge.
Since the end of May, MSF teams working in Amran province at Al-Salam Hospital in Khamer have noticed a significant increase in the number of patients suffering from severe acute malnutrition. The number of patients exceeded the capacity of the hospital’s therapeutic feeding area, so that in September 2022 the occupancy would reach 396 percent. At the same time, the number of emergency examinations increased by more than 20 percent. From January to September of this year, 31 patients died after being admitted to the hospital due to severe acute malnutrition, as most of them suffered from severe medical complications that, unfortunately, could not be treated due to late arrival at the hospital, according to the statement. MSF.
Most of the patients who go to Al-Salam Hospital suffering from severe acute malnutrition come from neighboring towns where there are health facilities, but they are only partially functional, according to the organization.
The organization notes that the scene is the same in Al-Hodeidah province, as MSF teams received 1,902 children suffering from malnutrition and health complications at the emergency department of Al-Dhahi Hospital between January and October this year.
Poverty and precarious living conditions
The organization says poor living conditions contribute to high rates of malnutrition, especially among the displaced. Abs Hospital in Hajjah province receives patients who come from the area around Abs, where many displaced people live in inadequate facilities and have limited access to food or income.
Between January and September, the MSF-supported therapeutic feeding center at Abs General Hospital received 2,087 children suffering from malnutrition with health complications. Many patients come from Al-Khamis, a sub-district of Al-Hodeidah province, south of Absa, and they are most of the time in the late stage of the disease. The most affected age group are children aged 6 months to 23 months.
In this regard, Saddam Al-Shaya, supervisor of health awareness activities at Abs Hospital, says: “Most displaced people lack a regular source of income due to difficulties in finding jobs. They also live in unhealthy environments, and suffer from a lack of clean water , which increases the risk of diarrhea.” For example, with the lack of hygiene items that are necessary to reduce and reduce the risk of spreading some diseases, which increases the risk of malnutrition.”
Lack of community health awareness
There is a great need to strengthen health awareness services dealing with prenatal and postnatal care, as it is directly linked to malnutrition, according to the organization. In this context, the limited availability and unavailability of prenatal care leads to complicated pregnancies, which creates negative effects during childbirth on mothers and newborns. In 2022, the MSF team discovered that more than 50 percent of mothers in the maternity ward at Abs Hospital were suffering from malnutrition.
The MSF team noticed that very few women were receiving antenatal care. In 2021, only 10 percent of the total number of women who gave birth in a maternity hospital received one prenatal care.
The prenatal care consultation is an opportunity for mothers to find out if they are malnourished and to treat it by referring them to the appropriate nutritional services. This step improves birth outcomes and reduces the risk of infant and newborn malnutrition.
Moreover, there is no community awareness that emphasizes the importance of breastfeeding and adherence to a routine vaccination schedule for children. Parents also do not have enough information to recognize the initial symptoms of malnutrition, which delays the diagnosis and treatment of the condition.
Lack of humanitarian response
This year, funding cuts have halted services in some primary care institutions or resulted in drug shortages, according to MSF.
“I have four children who are malnourished. I took them to the nearest malnutrition treatment center in the area. There they had to choose between my children in order of priority to give them therapeutic food, because there is not enough of it.
In addition to the poor state of the health sector, gaps in nutrition and food aid programs and the lack of adequate water, sanitation and hygiene services have increased the risk of malnutrition with health complications, which are more severe when associated with water-borne diseases.
A response to the increase in the number of malnourished people
MSF works in 13 of Yemen’s 21 governorates. In most of the organization’s facilities, MSF teams have witnessed an alarming increase in the number of children suffering from malnutrition with medical complications.
This led to an increase in the bed occupancy rate to more than 100 percent of the capacity of the hospital’s therapeutic nutrition centers. In order to deal with the increasing number of cases of malnutrition and reduce morbidity and mortality rates among the most vulnerable, our teams are working to increase the response capacity of our programs, especially in hospital therapeutic feeding centers and other departments, and are working to increase support to primary care centers and intensify community health awareness service.
In Amran province, Al-Salam Hospital launched an emergency plan in the pediatric ward from June 2022 to deal with the increasing number of malnutrition cases. The capacity of the hospital was increased to 213 beds, and until now it was 113 beds.
In the same context, and to urgently address the significant increase in cases of severe acute malnutrition in the Dahi district of Al Hudaydah province, MSF expanded access to basic services for malnourished people by establishing a 70-bed therapeutic feeding center and providing free referrals from health centers to the hospital for children under the age of 5 who are malnourished and meet the referral criteria.
In November of this year, 282 patients with malnutrition and other complications were admitted to the new hospital center. Monitoring of the nutritional status of the population in the Daha area is also being stepped up to ensure early reporting of symptoms of malnutrition and other disease outbreaks, according to the organization.
In Hajjah province, after the bed occupancy rate reached 180 percent, the team at Abs Hospital greatly increased the capacity of the hospital’s therapeutic nutrition center, as the area allocated to the Ministry of Health was used to deal with the arrival of a large number of malnourished children. On the other hand, we started providing support to the health center in Al-Khamis district in Al-Hodeidah, including malnutrition treatment services.
However, malnutrition remains a major threat in Yemen, causing preventable deaths, particularly among children under the age of five. In this context, health authorities and humanitarian and health actors must ensure a comprehensive response aimed at increasing the scope and effectiveness of nutrition monitoring throughout the country.
MSF emphasizes the need to strengthen the primary health care network to ensure rapid access to care and to help raise community health awareness of the risk of malnutrition, as this can detect early signs of malnutrition at an early stage.
The organization also points out that the response should include expanding vaccination campaigns across the country, especially among children under the age of five who are the most vulnerable.