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Ethiopian healthcare buckles under malnutrition crisis

Dubti Hospital, is the only national referral hospital in the Afar region, in northern Ethiopia, has seen admissions of severely malnourished children rise by 30% a month, and hospitals are seeing a mortality rate of up to 12%.

Here, because of the conflict, many hospitals or small health centres have been destroyed, writes Halima Athumani of SciDev Net’s Sub-Saharan Africa English desk, in the Sunday Independent, so many people travel to Dubti Hospital for treatment.

Malnutrition is a major issue, with doctors saying it’s one of the most significant disease burdens in the country.

It’s not just within Afar. It’s across Ethiopia. Constant hunger has been caused by the worst drought in 40 years, which has decimated agriculture and livestock.

Around 8m people have been affected, including another half a million who have been displaced in search of water, pasture and healthcare. While the violence in the north has recently calmed, the UN humanitarian affairs office says malnutrition rates are rising in the Afar Region, with a 30% increase in hospital admissions of severely malnourished children in March and a similar increase in April.

Dubti hospital is one of the most affected facilities. The corridors are lined with beds, with mothers and babies. Some of these women have been here for more than two weeks, some longer.

The UN says communities in northern Ethiopia need fertiliser and seeds for the upcoming growing season known as Mihir. They also need veterinary vaccines and treatment drugs.

More than 9m people countrywide need urgent assistance. But support organisations are desperately short of the fuel required to deliver food aid. And many have been forced to reduce or suspend deliveries since 8 May.

Dr Muhammad, acting CEO of the hospital, says: “We expect malnutrition in increments from March to the end of June because there is no rain between these months. About 90% (the population) are pastoralists. So they depend on their livestock. Whenever there is no rain and drought, the livestock’s products, like milk, are decreased, affecting the children.

“We have seen mortality rates of 12% for the past three months from the cases we have admitted. Most deaths were due to severe complications like shock and pneumonia. Also, malnutrition compromises the immune system.

“People go to traditional healers. After that fails, they come to health facilities. Some of the children we treat have burn scars. When we ask why, the parents say the traditional healer puts a heat meter on them, and some will give them grass or something like that as medication, but that won’t heal them.

“The condition worsens. Often, there is no health service available in their area. Then there’s no adequate transportation system either.”

Some patients die within 48 hours of their arrival.

“Most of these malnourished kids come with complications, especially shock, which is difficult to manage. Even though they are given fluids and anatropic drugs, some will not respond. Others come with a terminal or end-stage of the disease.

“This is the referral hospital within the Afar region for many of these patients. The problem is the health posts and health centres don’t function well. So if they go to the health centre, they will not find adequate service.

“And when these centres try to refer patients to hospitals, the ambulance is not available, causing another problem,” said Muhammad.

Supplies at Dubti Hospital were “adequate” for the treatment of the children, and when they recover, a letter is written to a health facility to register the child as an outpatient therapeutic-feeding patient.

“That health centre will supply them with nutrition, but in some of the health centres, they may run out. If the child is not the only one in the household, they may share it with him, which will cause a shortage. So we see relapse cases again and again.”

Do they advise mothers on what to do when they return home?

“We counsel them, but they say they will provide what is available in the house. So we say it’s better if you do this, this and this, and provide special attention for the younger children. They say they will do what they can. They are pastoralists. They don’t have money. They may sell their livestock. So after that they try to sustain their livelihood by providing a small amount of food.

“The root cause of malnutrition is sustainable agriculture in pastoralists’ lives. When I was a kid, we poured our milk on to the ground because there was too much. Everyone had extra milk. They wasted it. My father used to have 100 cattle. Now he has 12. That shows the extent of the drought in the Afar region for the past 10 years. And the worst drought is happening now. The last time this occurred was in 1994.”


Sunday Independent PressReader article – Ethiopian health system battles with severe malnutrition (Open access)


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Lactose-free/reduced-carb formula does not help severely malnourished children


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