Meet Maimouna

Meet Maimouna, a three-year-old farmer’s daughter living on the outskirts of the Central African Republic’s capital, Bangui.

In a country battling with high food prices and a decline in agriculture, many children, like Maimouna, are malnourished.

Maimouna arrives to a therapeutic feeding centre at Bangui Paediatric Centre after a 55 mile trek with her aunt, as her mother is too ill to accompany her. She is suffering from "kwashiorkor", a form of severe acute malnutrition. This type of malnutrition is characterised by the appearance of oedema: a swelling of the limbs caused by excessive water retention. A child suffering from kwashiorkor is at high risk of death and requires immediate treatment.

To celebrate World Food Day 2010, you can follow Maimouna’s day-by-day recovery.

25th September 2010

Once Maimouna arrived at the centre, Action Against Hunger staff members immediately take her measurements. Maimouna weighs a mere 10kg. This is grossly insufficient for her age and height. Her nutritional status is also checked by measuring her mid-upper arm circumference, known as MUAC

26th September 2010

Additional tests are performed and the doctor requests a chest X-ray because Maimouna suffers from a persistent cough. We discover that she has pneumonia; malnutrition is often induced, among other factors, by diseases such as pneumonia. Maimouna immediately receives medical treatment.

27th September 2010

Maimouna and her aunt meet again with the doctor. Daily monitoring is needed to properly assess her progress. It also allows her aunty to u

28th Sepetmber 2010

Maimouna has now been ill for a whole month. Before coming to the clinic, she was treated with traditional medicines at home, but there has been no improvement which her aunt brought her to the clinic.

29th September 2010

Maimouna receives therapeutic milk five times per day. The milk is rich in vitamins and minerals, but low in protein, sugar and fat. Maimouna is at the most critical and sensitive stage of her treatment, so our goal is to treat her medical symptoms and for her condition to stabilise, rather than focusing on increasing her weight.

30th September 2010

It is important that Maimouna is in a calm, stable atmosphere whilst she takes her milk. Maimouna’s aunt is there to softly encourage her. The milk must not be forced, so Action Against Hunger staff members advise parents and carers on the correct practice.

1st October 2010

Some of Maimouna’s fellow patients at the centre are suffering from another type of severe acute malnutrition, known as “severe wasting”. This type of malnutrition is characterised by a massive loss of body fat and muscle tissue and is recognisable by an emaciated body with a paunchy belly.

2nd October 2010

Maimouna’s condition is slowly improving. After five days, her oedema is disappearing and Action Against Hunger staff members refer her to the next phase of her treatment. In this so-called transition phase, Maimouna will receive a different therapeutic milk, however, she must still remain on antibiotics.

3rd October 2010

The daily monitoring of Maimouna’s weight continues. Good news! The curves show a drop in weight, which indicates that the oedema is fading.

4th October 2010

The therapeutic feeding centre not only treats severely malnourished children, but also holds regular information and awareness raising sessions for mothers and carers. A small change in care and feeding practices can prevent their children from relapsing into malnutrition.

5th October 2010

Malnourished child need specialist care by trained professionals; general paediatric nursing is not sufficient, therefore, our teams train local staff in the treatment of malnutrition. By working in close collaboration with local communities and training local staff, we are providing long-term solutions for the treatment of malnutrition.

6th October 2010

After a week at the centre, Maimouna is doing really well. She continues her nutritional treatment, and can finally play with the other children. Playtime cannot be underestimated as it is important to stimulate their development.

7th October 2010

Good hygiene at the centre is also crucial. All parents and/or carers receive soap and hygiene training when they arrive at the centre. Children are always washed at the hottest time of the day to avoid hypothermia.

8th October 2010

According to her latest health check, Maimouna is doing well and will now enter the final phase of her treatment.

9th October 2010

Maimouna receives ready-to-use therapeutic food, a nutrient rich, high protein treatment which will aid her recovery

10th October 2010

Whilst Maimouna gets stronger, more acutely malnourished children arrive at the centre. The Central African Republic has alarming malnutrition rates which not only affects a child’s life, but impacts upon the whole community.

11th October 2010

Another little girl, Kossi, is also at the centre today. She also suffers from acute malnutrition, but has maintained her appetite with no medical complications; therefore she does not need to stay at the centre. Instead she will receive a weekly amount of therapeutic food.that’s ready prepared for use at home.

12th October 2010

Depending on the situation, we also provide extra supplementary food to families to ensure that the family has enough food to feed all their children and the malnourished child receives the specialised therapeutic food needed for his or her recovery.

13th October 2010

While Maimouna and other children are treated at the centre, Action Against Hunger’s team is also implementing activities in villages aimed at preventing malnutrition, promoting its early detection and its management within the community. It is crucial to address the causes of malnutrition to prevent children from developing malnutrition.

14th October 2010

Her latest medical assessment shows that Maimouna has now regained her health! She no longer has any oedema, has reached her target weight, and no longer has medical complications. Her aunty is understandably relieved.

15th October 2010

Today Maimouna is well enough to leave the centre! She will be given ready to use therapeutic foods to prevent any relapse and her aunty is now fully aware of Maimouna’s nutritional needs. It is fantastic news that Maimouna has made a full recovery, but we must not forget the thousands of other children who need our help. Our fight against hunger will continue…

Humanitarian Emergency in Pakistan

Mohamed Mechmache, Action Against Hunger’s Emergency Field Coordinator, reports on Action Against Hunger’s response to the crisis


What is the current situation?



Pakistan was hit by the worst flooding in its history, affecting an estimated 20 million people. The flooding began in the north but has since moved south, washing away homes, bridges, roads, irrigation systems and some of the country’s most fertile and productive lands. In the southern province of Sindh, the Indus River has spilled over its banks, leaving fields and entire villages buried in muddy water. Millions are displaced and families have lost literally everything—their homes, their crops, their livestock and their livelihoods or small trades.





In 2009 over two million civilians in this area were already displaced by ongoing fighting, so this was another blow to families who have already suffered through a lot. The situation is much worse than the 2005 earthquake in Kashmir that left three million people homeless, in part because flooding in the northwest hit a population that was reeling from last year’s drought and conflict between the Pakistani Army and the Taliban insurgents. In 2009 over two million civilians in this area were already displaced by ongoing fighting, so this was another blow to families who have already suffered through a lot.


What are the biggest concerns?

In Pakistan, like other places that have experienced natural disasters, deadly water-borne illnesses can spread exceedingly quickly. The death toll from these diseases might exceed the current death toll from flooding itself (over 1700 have died) if we do not address this concern properly and rapidly. Water and sanitation infrastructure has been damaged and destroyed throughout Pakistan, forcing people to drink from contaminated sources and use the bathroom out in the open. I can’t emphasize enough how big a risk this is to public health, as thousands of cases of acute diarrhea and cholera have already been reported. Right now, we are very focused on stemming these kinds of illnesses.

How is ACF controlling water-borne disease outbreaks?


In the Khyber Pakhtunkhwa province in northwestern Pakistan, our teams are responding to the urgent needs of 52,000 people sheltering in temporary camps or returning to their villages. We have begun organising daily distributions of 32,000 liters of drinking water through a range of methods, including water trucking, installation of pumps and portable reservoirs, and the restoration of 100 water points and damaged irrigation systems. We’re constructing 600 emergency latrines, hand-washing stations and showers to help make sure conditions are sanitary in the camps and nearby villages. And to meet basic hygiene needs, we are distributing 7,500 kits with essential items like buckets, soap, detergent, sanitary pads and water purification tablets.



Our teams are responding to the urgent needs of 52,000 people sheltering in temporary camps or returning to their villages. We’re also training families on effective emergency hygiene practices and launching programmes to spray affected areas with insecticide. In addition, we are beginning a cleaning campaign to clear areas of dangerous, unsanitary debris through cash-for-work activities that will help community members select adequate food, improve their livelihoods and recover their autonomy.



In the Sindh province in southeastern Pakistan, where hundreds of thousands of people were recently evacuated because of surging floodwater, we are gearing up to deliver emergency programmes in water, sanitation and hygiene to help 80,000 people. Similarly, we’ll be trucking in water, repairing water points, distributing hygiene kits and constructing latrines, along with other activities to help make sure deadly diseases like cholera and diarrhoea don’t spread.

Our cash-for-work and fresh food voucher programmes are going to provide financial support to more than 10,000 families in the months to come. What other help will people get from Action Against Hunger?



As mentioned briefly before, our cash-for-work and fresh food voucher programmes are going to provide financial support to more than 10,000 families in the months to come. These programs are focused on helping restore their ability to feed themselves. In the same spirit, we will support hundreds of traders and small business owners, including women, through access to business restart grants while rehabilitating small scale community and market infrastructure. We’ve also identified the most vulnerable households in the areas where we’re working to receive cooking utensils, blankets, sheets, mosquito nets and mattresses so that they can slowly begin to rebuild their lives.

Phil's first blog in aid of Blog Action Day 2010- Water and Malnutrition

I work with Action Against Hunger as an emergency nutrition coordinator and am lucky enough to see firsthand the impact that jointly tackling water and malnutrition together can have. Action Against Hunger works with an ‘integrated approach’ to help people suffering from hunger and malnutrition, and we believe we can only be effective at this by acknowledging water, food and health are tightly interlinked. If we only provided food and ignored the essential right people have to access clean drinking water, we would undoubtedly fail in our mission!



The causes of malnutrition can be complicated, but we can consider two broad immediate factors: lack of food and disease. Water-borne diseases can cause dehydration, lack of appetite and alter the body’s metabolism. These factors in turn can cause malnutrition and start the vicious cycle whereby malnutrition reduces immunity and increases the risk of further infection. This is why in Chad Action Against Hunger is working hard to reduce the impact of cholera outbreaks, and in Haiti and Pakistan we focused the first relief efforts on providing clean water.



Once clean water is provided for communities it provides the platform for other food and nutrition-related projects to take place more successfully. You can find out more about our work on www.actionagainsthunger.org.uk

Addressing Malnutrition in Bangladesh By Nichola Connell, Nutrition Advisor in Bangladesh

11 August 2010 - "Located not far from Cox Bazaar, a seaside resort boasting one of the longest beaches in the world, I found myself in the small village of Kutupalong in the South-East corner of Bangladesh, a stone’s throw from Myanmar across the Naf river. In stark contrast to the beautiful nearby beaches, Kutupalong is an overcrowded and resource-poor area struggling to cope with the added burden of a large refugee population.


Kutupalong hosts one official refugee camp which, together with one other official camp an hour south, is home to 22,000 UN registered refugees who arrived from neighbouring Myanmar in the early nineties. However, another 200,000 to 400,000 unregistered refugees have arrived since then living in two unofficial camps, the largest of which is in Kutupalong, as well as in the surrounding villages. Bangladesh is the second poorest country in the world. With its own population struggling with access to clean water, food, health facilities and education, the country is unable to provide any assistance to the unregistered refugees, leaving them in an extremely vulnerable situation.



As a nutritionist, my job was to take over the running of the nutrition programmes in a newly opened Action Against Hunger Emergency Operation centre in Kutupalong. These are programmes aimed at helping children under five years old suffering from moderate or severe acute malnutrition, as well as pregnant and lactating women. In addition to the nutrition interventions, Action Against Hunger also implements water, sanitation and hygiene programmes and psychological support activities for the population.


I particularly enjoyed my work at the outpatient treatment centre for severely malnourished children under five years of age. Often these children would arrive completely listless and full of infections as well as with a very low weight for height. With a lot of effort from all the staff and volunteers they would grow from strength to strength as they received therapeutic food provided by Action Against Hunger and routine medication from the nurse.



This was certainly the case for Mohammed, a 12 month old boy who arrived severely malnourished. After just 6 weeks he was nearly up to his target weight and his mother Rashida had participated in hygiene promotion sessions aimed at promoting adequate hygiene practices that can help reduce the occurrence of illnesses and relapses into malnutrition. His father came to thank me personally for everything we had provided for his son which enabled him to recover - they had been resigned to the fact he would not live much longer.


One of the severest cases I dealt with involved treating 21 day old twin girls who arrived one day in December. They were brought in by their grandmother as the mother had passed away a few days after giving birth. The twins had not received any breast milk for 15 days. Consequently they were severely malnourished and very hungry. Many people are not aware that it is possible to relactate, enabling grandmothers to breastfeed their grandchildren if needed. Since breastmilk is very important for young infants, we used the Supplementary Suckling Technique which involves stimulating breastmilk production and providing therapeutic milk to the babies at the same time. The grandmother was able to breastfeed the twins on her own after a few days and the condition of the babies stabilised. The twins went on to make a full recovery. Their recovery shows what a huge difference our work can make. By giving just a small amount of advice and guidance, lives can be saved.


The good work of Action Against Hunger continues today in Bangladesh with new nutrition programmes being planned for the Bangladesh people in the surrounding villages, as well as providing continued support to the refugees. Having seen what life-threatening problems people there face every day, it is essential this work continues, to give children such as Mohammed and the twins a better chance in life. We should not forget how lucky we are in the UK to have access to good quality food, water and good advice: such simple things that literally mean the difference between life and death in Bangladesh."