September 2004

Darfur, SUDAN :: Fighting for Every Pound - Treating Malnutrition in the Kalma Camp Feeding Center

More than a million people in the Darfur region of western Sudan have fled their homes from attacks by government-backed militia. Some have been displaced more than a year ago, while others were forced to flee their villages only recently. Hundreds of thousands of displaced people are living in extremely harsh conditions in huge camps where there is a serious lack of drinking water, food, and medical care. And it is the children who are suffering most under these conditions.

In Darfur, Médecins Sans Frontières has set up a total of 15 feeding centers, providing food and medical care to more than 13,000 malnourished children and trying to nurse them back to health. Despite the intensive care, some children are still losing the battle against starvation and illness. The following is a photo essay on Médecins Sans Frontières' feeding center in the Kalma camp for displaced people.

Kalma camp, situated in the south of Darfur, is a pitiful displaced camp with makeshift shelters stretching as far as the eye can see. More than 70,000 people are living here in pathetic shelters made of sticks and plastic sheeting which offer little protection against the heat, wind, and rain. As many as seven people are often crammed into just a few square meters of living space. In Kalma camp alone, Médecins Sans Frontières cares for almost 600 severely malnourished children, who would have no chance of survival without special nourishment and continuous in-patient treatment. Two thousand moderately malnourished children receive supplementary feeding and come every two weeks for a check-up. As shown on the picture, they sit in their mothers’ laps awaiting their turn. The regular health check carried out on children by Médecins Sans Frontières as part of its outpatient nutrition program is necessary to diagnose illnesses at an early stage: "Because malnourished children such as three-year-old Safa are particularly susceptible to respiratory infections, diarrhea or malaria," explains Médecins Sans Frontières nurse Christine Shanahan. Just like all the other children, Safa is weighed to see if she has gained weight "on schedule". Little Halima was admitted to the in-patient department of the Médecins Sans Frontières feeding center ten days ago weighing just 2.5 kilograms - less than most babies weigh at birth. And Halima is 10 months old. Now her mother is feeding her almost continuously with special nourishment and she is slowly regaining her strength. The weight curve on her patient card is rising: she has already gained almost 400 grams. Saweida is also underweight for her age and is currently being treated as an in-patient. Four times a day in the nutrition centre the 18-month-old sips a special milk formula rich in calories and low in fat which is particularly easy for her little body to digest. But not all of the children have such a big appetite as Saweida. Some of the little ones are so weak that they no longer even have the strength to swallow. In such cases, they have to be fed through a tube to their stomach or put on a drip. Abdelazim is one of the children who didn’t make it, despite receiving intensive care: "We fed the little boy glucose through a tube to his stomach and also gave him an injection of fast-acting antibiotics," reports Christine Shanahan, an Australian nurse. "But his body was so weak he couldn’t keep up the fight against the chronic pneumonia." Abdelazim was only 13 months old when he died in his mother’s arms. As is the custom in Sudan, the parents buried the child before sunset. The cemetery bordering on Kalma camp is full of newly dug graves, most of which are very small. Thankfully, the results of Safa’s and her older sister Darassalam’s check-up showed that both children are healthy. Their mother received a ration of soya-corn-flour enriched with proteins and sugar for both girls, to last until the next check-up. They were also given soap to improve their standard of hygiene. Now she puts Safa on her back, takes Darassalam by the hand, and heads for "home". The three of them have been living in Kalma camp for almost two months now. Their real home no longer exists. They have traveled 200 kilometers from a village destroyed by militia attacks. Like most people here, their future is uncertain as the violence continues.

Stephan Große Rüschkamp

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