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.

From Trickle to Torrent

A blog by Action Against Hunger’s Water, Sanitation and Hygiene Advisor, Nick Radin


"The road to Hombo is a muddy mess. When it rains in D.R. Congo, driving a few miles, even in a four-by-four vehicle, can take hours. I’m travelling to see our water installations in Hombo with Mamady Camara, who began working with Action Against Hunger seven years ago in his native Guinea, and now manages our water, sanitation and hygiene programmes in the zone. We’re also accompanied by two national staff, Congolese water technicians named André and Bonaventure, who grew up in the area and know it inside and out.

Over the last six months, the people of Hombo have taken in a wave of new arrivals coming to escape violence and seeking refuge with local families. Compared to surrounding villages, Hombo is perceived as relatively safe because of its close proximity to a base of U.N. Peacekeepers. This recent influx of displaced people has increased the village’s population by nearly 40 percent and put enormous pressure on local resources.

Before Action Against Hunger arrived, the only clean water source for all of Hombo was an unprotected spring - barely more than a trickle, really. You had to stand there for more than two minutes just to fill one 20-litre jerry can with water. This may not seem like a long time, but because there were 5,000 people that needed water every single day, they would sometimes have to wait in line for hours to get it.

Since each family was only permitted to fill one jerry can of water per day, not nearly enough for all their daily needs and far below minimum humanitarian standards, they were forced to draw much of their water from a nearby river.
This is the same river where people bathe, mothers wash their families’ laundry and animals drink and defecate. You can get a whole host of illnesses from drinking dirty water like this, including cholera, diarrhea and dysentery, which kill thousands of children in D.R. Congo every year.

We get out of our vehicle by the river in Hombo and are greeted by a group of women ecstatically whooping and hollering. They are gathering clean water from the tanks Action Against Hunger has installed by the river, and the joy on their faces is contagious.

In June, our teams set up a series of tanks to treat and fully decontaminate water that’s drawn from the river. The clean water from these tanks is then fed directly into a row of taps, where the women and children of Hombo now come to collect water each day. These taps provide more than enough water for the whole village, including the 2,000 newcomers that have arrived over the last few months, which means that all families now have access to as much safe water as they need.

I’m introduced to Bashige Dorcase, who, full of relief, no longer worries about having enough clean drinking water for all her children. Mamaday shows me the place near the river where our hygiene promoters are conducting sessions on practices like hand-washing, safe water handling and latrine usage. These are crucial steps in stopping the spread of water-borne illnesses that have ravaged communities across Congo, and they’re part of our integrated approach to fighting hunger and disease.

In addition to caring for her own children, Bashige has taken in her three young nephews. Full of relief, she tells me how she no longer worries about having enough clean drinking water for all her children. She also says that the residents of Hombo are getting along much better since they don’t argue any more over access to the limited water supply.

Bashige and her family aren’t the only ones whose lives have been changed. Two months after Action Against Hunger came to Hombo, the number of people seeking treatment for diarrhea at the local health centre was cut by more than half. There’s been a dramatic 95 percent drop in reported cholera cases, too.

My job takes me to villages across East and Central Africa just like Hombo. But seeing hope and gratitude on the faces of women like Bashige never gets old for me. At home in New York, it’s sometimes easy to forget how something as simple as a glass of clean water can make a world of difference. But today, it’s obvious. I hear it in the joyous shouts of the people of Hombo”

Action Against Hunger | ACF International is an international humanitarian organisation committed to ending child hunger. For more information, please visit: www.actionagainsthunger.org.uk and become a fan at http://acf-uk-facebook.tk/

HAITI: mother-baby tents established to protect the youngest survivors of the quake

Port-au-Prince - Amidst the camps for earthquake survivors in Port-au-Prince, Action Against Hunger | ACF-International has established multiple mother-baby centres specifically designed to provide a range of services to mothers with young children, including a safe environment for breastfeeding, as well as medical, nutritional and psychological support. Some 5,000 mothers and their infants will receive assistance in these makeshift tents.



Action Against Hunger is targeting mothers with children under six months, who are vulnerable to malnutrition, as well as diseases resulting from contaminated water supplies and poor hygiene. Breast-milk contains a high concentration of antibodies and helps protect young children from infection. The centres are also designed to provide a sense of security for mothers and children recovering from trauma.



“Breastmilk is vital for a baby’s health, especially in an acute crisis situation such as this” said Lucile Grosjean, a spokesperson for Action Against Hunger in Haiti. “It is the best way to ensure a child is nourished and feels safe and protected. Breast milk contains a high number of antibodies and helps protect young children from infection. The centres are also designed to help mothers relax under these difficult circumstances.”



A woman named Helene arrived this weekend at one of our breastfeeding centres in the devastated Canape-Vert district of Port-au-Prince. Her baby was born in the street without any medical support. Due to the unhygienic conditions, the baby quickly developed conjunctivitis. Helene is now living in a makeshift tent with her 13 day old baby and her other children but is struggling to deal with a newborn in such difficult conditions. Upon arrival, Julie, a trained psychologist who runs the centre alongside her colleague Pierre, immediately performed a quick medial assessment and provided Helene with clean drinking water, food and a mat to lie on. With around-the-clock care, Helene’s baby is now recovering and Helene is breastfeeding her child successfully.



Before Action Against Hunger established these centres, Chantal, another young mother, scavenged for food and water for her three-month-old baby Cassandra among the rubble-strewn streets of Port-au-Prince. Now, she has a place to rest while she breastfeeds her child and receives additional nutritional support and hygiene instruction.



Action Against Hunger encourages mothers to visit these tents daily or as needs arise. Soon the centres will transform into nurseries where mothers can play with their children, engage in soothing activities like sewing and basket making, and embark on the long road to recovery.



Our team of nutritionists make regular visits to each of the nursing centres. “These centres are a real help to mothers in a crisis situation like this,” said Uwimama, Action Against Hunger’s nutrition coordinator. “In an emergency situation, young infants need special care. In addition, the bond between a mother and her child is really important for the child’s development and well-being. Mothers are traumatised so it is crucial to give them support and a feeling of security.”

Action Against Hunger extends programmes to towns outside Port-au-Prince

Port-au-Prince – One week since the devastating earthquake struck Haiti, it is now a race against time to provide access to clean, safe drinking water to the survivors. Action Against Hunger | ACF International is already providing safe drinking water to 40,000 individuals in the neighbourhoods of Champs de Mars and Canape-Vert while finalising the setting up of additional water reservoirs in the stadium and the Croix de Pres district. The organisation’s teams are also finalising preparations to set up water reservoirs and rehabilitate water points in Leogane, 30 kilometres west of the capital. The water network in the region had already been seriously damaged during the cyclones of 2008, and with 80% of the city destroyed, some 125,000 quake survivors are in desperate need.



“Our 120 strong-team is working with local communities to manage the security and effective distribution of water at all water points,” said Action Against Hunger’s Lucile Grosjean in Haiti. “Four community members are nominated to join each water management committee, in charge of running the distributions. By involving local volunteers, Action Against Hunger ensures the effective delivery of water to those in desperate need.”



Meanwhile, the organisation’s teams in the neighbouring town of Gonaives, which has seen a massive influx of people from Port-au-Prince, have started to distribute water to hospitals and health centres. “Not a single drop of water is currently available in the K-Soleil hospital,” reported Lucile Grosjean on Tuesday. “Doctors and nurses have no water to wash their hands and patients are desperately thirsty. Relatives are trying to buy water in the streets, but with little money available and prices doubling in most regions, it is nearly impossible to find drinking water.”



Action Against Hunger is also finalising preparations to launch food distributions, despite facing severe logistical problems, including fuel shortages and the hugely congested airport. 45 metric tons of protein biscuits to provide for the nutritional needs of 18,000 children under five years old are currently being transported from Santo Domingo to Port-au-Prince, and will be distributed from tomorrow onwards.





Action Against Hunger has launched a public emergency appeal. Call 08456 003618 or click here