Yemen: Five reasons why child malnutrition is surging
Malnutrition is a persistent risk to children living through Yemen’s brutal civil war.
Each year, the country sees a regular rise and fall in malnutrition cases. This is linked to the so-called ‘lean season’ between harvests and often peaks between June and September – a pattern that was seen even before the conflict escalated in 2014.
However, the situation has worsened due to the direct and indirect effects of the prolonged violence, exacerbating food insecurity for already vulnerable people.
In 2022, Médecins Sans Frontières / Doctors Without Borders (MSF) teams working across Yemen reported a rise in malnutrition cases as early as April, and now predict the peak to continue into December.
In total, we’ve seen a 36 percent increase in patients from January to October and so far treated over 7,500 children for malnutrition.
However, there is more to this malnutrition than food insecurity. Here are five major factors, reported by MSF teams working across Yemen:
1 | Food is less affordable
Families in Yemen are unable to afford enough food, let alone nutritional food, as Yemen’s deepening economic crisis has caused prices to soar.
Many people do not have access to paid work or have lost their homes in the war due to destruction or displacement. The value of Yemen’s currency, the Riyal, is depreciating, and food and transportation costs (including fuel) are rising.
“We came to Abs Hospital several times and he was improving,” says Shohra Mohamed, who brought in her four-year-old grandson, Abdullah, to the MSF-supported facility suffering from malnutrition and other complications.
“The last time he was discharged was 20 days ago. We prefer to come here as the services are free of charge.
“Abdullah´s father is away. We try to feed him with what we have, but we rarely can afford to give him milk. We don’t have access to health centres that provide therapeutic food nearby.”
2 | The healthcare system has collapsed
The healthcare network across Yemen continues to crumble.
There are limited financial resources, shortages of supplies and equipment and either no or irregular payment of salaries to medical staff. All of which have caused many healthcare facilities to close.
Along with the high cost of fuel, these factors limit urgent access to medical care. Patients can then face delays when they need emergency care, leading to complications that could have been prevented if treated sooner. This includes conditions like malnutrition.
MSF teams working at Al-Salam-Khamer Hospital have seen a steady increase in the number of patients with severe acute malnutrition since the end of May, with their feeding centre at 396 percent capacity in September 2022.
In the first nine months of the year, 31 of these patients sadly died. Most had arrived too late with complications that were too severe to treat. In fact, many patients arriving with severe acute malnutrition had come from surrounding areas where healthcare facilities were only partially functioning.
3 | People are living in poverty and unstable conditions
Poor living conditions, especially for people who have been displaced, also contribute to the rise of malnutrition.
Abs Hospital in Hajjah treats patients from the surrounding areas where many internally displaced people live without proper shelter and with limited access to food or income.
From January to September 2022, the MSF- supported feeding centre here admitted 2,087 children with malnutrition and related medical complications, most aged between six and 23 months.
“Most of the displaced people don’t have a regular income due to difficulties in accessing employment opportunities,” says Saddam Shayea, an MSF health promotion supervisor at Abs Hospital.
“Another issue is the lack of access to clean water. This increases cases of diarrhoea, in addition to the lack of hygiene materials that are essential to reduce the risk or limit the spread of some diseases.”
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4 | Pregnant women are missing out on crucial care
There's an urgent need to increase health education and promotion for antenatal care and post-natal care, which are directly linked to malnutrition.
Limited access to this crucial medical care is leading to complicated pregnancies and greater risks for mothers and newborns. For example, in Abs Hospital in 2022, more than 50 percent of mothers in the maternity department were suffering from malnutrition.
Antenatal consultations are usually an opportunity for malnutrition to be identified and patients referred for treatment. However, the MSF team in Abs previously reported a very low level of women in the maternity ward who had also received antenatal care. In 2021, only 10 percent of women who gave birth in the hospital had attended at least one consultation.
Added to this, there is limited awareness in the community about the importance of breastfeeding and routine vaccinations for children. Parents also don’t have access to information about identifying the initial symptoms of malnutrition.
5 | There are gaps in the humanitarian response
This year, funding cuts have caused many primary healthcare facilities (such as community healthcare centres and clinics) to discontinue services or work with limited supplies.
"I have four children who were all suffering from malnutrition,” says Ahmed Abu Al Ghaith, a father who brought his one-year-old daughter to Ad Dahi hospital.
“I took them to the nearest malnutrition treatment centre in the area. But they had to choose and prioritise among my children whether to give them some therapeutic food as there was not enough.”
As well as some healthcare services closing down or providing only limited care, there are also gaps in nutrition and food assistance programs, and inadequate water, sanitation and hygiene projects that help prevent waterborne diseases.
Combined, all these factors increase the risks of malnutrition and its complications.
MSF and malnutrition
Around 45 percent of all deaths in young children are linked to malnutrition.
When children suffer from acute malnutrition, their immune systems are so impaired that the risk of death is greatly increased.
The critical age for malnutrition is from six months – when mothers generally start supplementing breast milk with other foods – to 24 months. However, children under five, adolescents, pregnant or breastfeeding women, the elderly and the chronically ill are also vulnerable.