The food insecurity in the northeastern part of Nigeria has led to the increasing number of children dying from malnutrition in the last few months. A recent visit to Adamawa State by the Head of Investigation, KUNLE AKINRINADE, revealed the heartrending plight of some of the affected children and the need for urgent intervention.
It was noon in Mubi South Local Government Area, Adamawa State on June 26. Everywhere around the Malnutrition Stabilization Centre at the State General Hospital was hot. The heat from the scorching sun penetrated the interior of the facility established to rescue malnourished children from untimely death.
Right from its paved entrance, a repulsive smell welcomes a visitor to the facility. It stinks like rotten fish to the indifference of the inmates, who also contend with intense heat and birds that stray into the wards through broken glass windows.
Inside the facility are dozens of infants with sagging cheeks, spindle legs, distended bellies and mournful moans that graphically gave them away as distressed toddlers in need of healing.
Their mothers were not wearing a smile either. Cutting a pitiful look as she lay on a corner bed, Elham Shuaibu howled with the little breadth left in her. An innocuous touch by the reporter as an offer of sympathy further prolonged the wailing sound of the barely two-year-old. Even the lullaby rendered in Hausa language by her 20-year-old mother, Nafisat Usman, seemed to sound like a dirge to her hearing as she only raised the decibel of her cry in response. It had been four days since Elham was rushed to the centre after she lost weight and appetite rapidly and almost passed out.
“I could have lost her if she had not been rushed to this clinic,” Nafisat said.
“What I initially thought was manageable after she became feverish and started stooling turned out to be extreme malnutrition. She was admitted today (Wednesday, June 26).”
Elham’s condition stabilised after being attended to by medics at the facility who also gave her a therapeutic milk formula.
“She had lost weight rapidly. But she is responding well now after they gave her F-75 milk. Her condition is improving,” she added.
On the bed opposite Elham was one and a half years old Nusiba struggling with his mother, Hadza Hamzat, for a bowl of cereal, while he was being fed. The toddler succeeded in grabbing the bowl and packed a handful of the cereal into his puffy mouth, eliciting laughter from onlookers inside the ward. A week earlier, Nusiba was dying and his condition deteriorated and confounded his parents when his stomach swelled up.
“Nusiba was born after I had a delay in childbearing for 13 years. He has two siblings,” Hadza said.
“When his stomach swelled up last week and he suffered persistent diarrhea, I tried to manage his condition by feeding him with a popular infant formula but he declined.
“His stomach protruded further and I was left without any other option but to bring him to this clinic where he was diagnosed with acute malnutrition.
“His eating habit as you just witnessed is a result of the care and milky food given to him here.”
Like other distraught mothers, Godiya Harrison had sleepless nights over her two-year-old daughter, Patience, when she suddenly took ill in mid-June. She had passed off the girl’s condition for malaria until the reality hit her as her daughter could hardly eat, became emaciated, and stopped playing with her twin sister, Sabina.
“She could hardly eat when I brought her here on June 21,” Godiya said. “She regained her lost appetite when she was administered with a special kind of milk and she can eat anything right now.
“I am so happy that she could once again play with her twin sister right now, albeit she is still looking pale and gathering strength.”
Spread on a bed in the adjoining ward was Monday Malum, He had been laid back with severe malnutrition for days. His parents raced to the clinic when his condition defied self-medication and they were no longer at ease.
His mother, Aisetu, said her one-year-old baby boy rejected her breast milk and battled loss of appetite afterwards.
She said: “I brought him to this facility about one week ago. He stopped taking meals and had boils all over his body.
“At a point, I almost lost hope that he could overcome his condition because he was not responding to medications.
“However, his health is gradually stabilising following the treatment so far received at this clinic, especially the milk given to him.”
Alarming statistics on food insecurity, malnutrition
In northeastern Nigeria, many farmers have been unable to cultivate their lands over a long period due to the perennial violent clashes between herders and farmers. The evils of Boko Haram insurgency, banditry and cattle rustling have led to the displacement of farmers who have abandoned farmlands because of gangs kidnapping, extorting and in some cases killing them. Security restrictions are also placed on the cultivation of ‘tall’ staple cereals like sorghum to allow accessibility of troops deployed to contain insurgents.
However, the lean season that comes with the rainy period, the period between harvests that lasts from May to August, also significantly contributes to the low levels of household food stocks, less pasture for livestock, and households typically depend on different types of coping strategies to meet their food needs for the period, leaving many households and families to ration meals.
In its latest report, the International Rescue Committee (IRC) and its partners estimated that around 16% of Nigerians will face severe food insecurity or hunger between June and August 2024.
Also, the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) noted in a statement that malnutrition rates are of great concern. The report projected that approximately 700,000 children under five would be acutely malnourished over the next six months, “including 230,000 who are expected to be severely acutely malnourished and at risk of death if they do not receive timely treatment and nutrition support.”
A recent data released by the United Nations Children’s Funds (UNICEF) estimates that 2 million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected is currently reached with treatment. The report pointed out that seven per cent of women of childbearing age also suffer from acute malnutrition.
The Acting Representative of UNICEF Nigeria, Dr Rownak Khan, said: “UNICEF is deeply concerned about the escalating food security and nutrition crisis in the Borno, Adamawa and Yobe (BAY) states.
“The alarming rise in severe acute malnutrition among children underscores the urgent need for immediate action.
“This year (2024) alone, we have seen around 120,000 admissions for the treatment of severe acute malnutrition with complications, far exceeding our estimated target of 90,000.
“We must ensure that lifesaving nutrition commodities reach every child in need.
“This is not just a call to action; it is a race against time to save lives and protect the future of millions of vulnerable children.”
Starving mothers, malnourished children
Life has become nightmarish for mothers like Nafisat in the last few months. Nafisat’s husband, Hassan, fled from Boko Haram attacks in Madagali to Mubi, where he has had to rely on rented farmland which is not big enough for the large-scale farming he was used to.
“My husband doesn’t have enough farmland to cultivate food crops for us to feed us, talk less of selling.
“Before, at Madagali, where he hails from, he had big farmlands and enough cash crops to sell and bring for us to feed.
“But since we came to Mubi, his income from farming has reduced because he has no vast farmland to cultivate.
“The current season comes with low harvest.
“What we do now is to ration the little foodstuff at home, and this has affected our child too. I breastfeed my child while I am hungry when we are left with nothing to feed on.
“Health workers have told me that a starving mother’s breast milk lacks the vital nutrients needed to nourish a baby. I believe that this might be the reason for my child’s malnutrition.”
Hadza shared the same plight as Nafisat. Her husband’s farming activities have been largely affected by the lean agriculture season with little yields. “The little food my husband gets from his farm and sometimes from his farmer friends is what we have been surviving on,” she said.
“Most times, we eat twice in a day and the meal is meager. Yet, I have to feed my child with breast milk as health officials advised, even when I don’t have enough strength to suckle.
“The moment my child’s ill health began, I had the premonition it could be due to insufficient feeding, and my fear was confirmed by doctors at the Malnutrition Stabilization Centre.”
Godiya also shared her travails arising from food scarcity, saying: ”It is almost a hopeless situation every day of the week. Harvests have been meager these days and we have no enough food to eat. Most times, I feel dizzy when breastfeeding my child because I do not eat very well.”
The underlying cause of 45 per cent of all deaths of under-five children has been attributed to malnutrition, with Nigeria having the second highest number of stunted children in the world, with a national prevalence rate of 32 per cent of children under five on a national scale.
A 2020 report published by an international humanitarian agency, Action Against Hunger, pointed out that the link between starvation in women and breastfeeding could lead to malnutrition in infants.
The report stated: “All people, whatever their gender or age, need different types of food in their diet to keep them strong and healthy.
“Women are often more vulnerable to malnutrition. They generally have smaller and less muscular bodies than men and need about 25% less energy per day.
“However, they require the same amount of nutrients, which means they need to eat more nutrient-rich foods than men. But this is often unaffordable as foods rich in nutrients, fruits, vegetables, and protein, are the most expensive.
“When pregnant and breastfeeding, women need to consume foods that are even richer in nutrients to maintain their energy and nutrition levels.
“Lack of access to a healthy diet puts pregnant women at greater risk of complications during pregnancy and birth.
“Many infant and young child deaths in developing countries are the result of the poor nutritional health of their mothers. Teenage mothers and their babies can also be particularly vulnerable to malnutrition.”
Influx of children, vanishing therapeutic food
In Adamawa, UNICEF said that children in the State are experiencing Chronic Food Poverty. It estimated that the number of Severe Acute Malnourished children (SAM) 0-59 months to be admitted during the lean season is 44,567, noting that exclusive breastfeeding occurs only among 53.3 percent of newborns while only 11.8 percent of children aged 6 to 23 months in Adamawa receive a minimum dietary diversity.
In March, UNICEF commended the state government of Adamawa for prompt payment of a sum of N100 million as a counterpart fund to tackle the challenge of acute malnutrition at the launch of the Adamawa State Food Nutrition Policy and State Multi-Sectoral Strategic Plan of Action for Nutrition – 2023-2027, where the UNICEF Chief of Field Office, Dr. Tushar Rane, reiterated that children in the state still suffer from chronic food poverty.
As of May this year, no fewer than 73 malnourished children were admitted for treatment at the Malnutrition Stabilization Centre in Mubi South Local Government, according to its Chief Medical Officer, Dr. Mark Malgwui. Magwui told the reporter, that the figure as of June 26 was 54, with more children expected to be admitted before the end of the month.
Malgwui pointed out that the influx of malnourished children to the centre has created a burden on the limited number of F-75 and F-100 therapeutic foods used in the treatment of children at the centre.
F-75, a life-saving therapeutic milk, is specially formulated to stabilise patients during the starting point of treatment for severe acute malnutrition while F-100 therapeutic milk is for the nutritional rehabilitation from severe acute malnutrition, according to the management protocols established by the World Health Organisation (WHO).
“The high peak of admission is around this month. As of last month (May) we have about 73 patients. This month(June) we currently have about 48 patients on admission for Severe Acute Malnutrition while about five patients have been discharged bringing the total number of patients for this month to 54 .
“The lean farming season is responsible for the increasing number of malnourished children. Some of them are brought for diarrhea and vomiting, among others.
“We used to have challenges of water and light but solar light and borehole have been provided by the International Committee for Red Cross (ICRC).
“The effect of this is the burden on the limited number of F-75 and F-100 kinds of milk we normally use to treat and stabilise the children.
“This centre is largely supported by international humanitarian organisations, especially the International Committee for Red Cross.
“We may run out of therapeutic milk if the upsurge in number of malnourished children persists.
“It is a disturbing reality that the milk is running out (of stock) while the number of malnourished children in need of it for treatment keeps increasing.”
Calling for help and support from humanitarian organisations, the Nutrition Focal Officer of ICRC at the State General Hospital, Mrs. Grace John Madanya, said there was a need for additional support to make the centre habitable for infant patients.
“We give the centre food intervention and support including provision of qualified personnel. The number of malnourished children on admission at the centre goes up during the rainy season or lean season because of low harvest and scarcity of food. The children are admitted for one week upwards and discharged as outpatients.
“Some of the challenges facing this Centre is the lack of playground for children and dilapidated glass windows that allow birds to stray into the wards to disturb patients.
“The waiting room also leaks and allows rain to drop on people, while the heat here is also very severe.”
She also noted the limited number of F-75 and F-100 therapeutic milk in stock, urging intervention from partnering humanitarian organisations as cases of children on admission rise.
“The International Committee for Red Cross (ICRC) has been supporting the Centre with therapeutic milk (F-75 and F-100). But we need more support as the milk might go out of stock in the next few months, as the number of children battling malnutrition increases,” she said.
