Fighting Severe Malnutrition One Child at a Time in Nigeria's North (REPORT/VIDEO)

- Words: HUMNEWS staff, with UNICEF
- Video: Courtesy of UNICEF Nigeria. Edited by Max Ramming; narrated by Maggie Padlewska 

(HN, July 31, 2011) - As government and aid officials fight to stem to tide of malnourished children in the Horn of Africa, on the other side of the continent, a proven method of quickly guiding children back to health is showing impressive results.

In Nigeria's dry north, a programme to endow individual communities with the ability to treat malnourished children has resulting in a sharp decline of cases.A weary mother brings her malnourished infant for the first time to a CMAM post near Katsina. CREDIT: M Bociurkiw

Malnutrition here, as well as in many parts of Africa, is not only due to lack of rain or climbing food prices. Aid workers say poor household feeding practices are also to blame: mothers either stop breast-feeding abruptly and too early or do not have the knowledge on how to prepare nutritious meals.

Dubbed the Community Management of Acute Malnutrition (CMAM), the concept is designed to nurse children back to normal over the course of about eight weeks. For the most part, children are treated at home with ready-to-use therapeutic food. It is a result of a close collaboration between the federal, state and local governments and communities, as well as UNICEF and the European Commission.

On a recent visit to a CMAM post in Katsina, mothers could be seen shepherding their malnourished children through a carefully-planned circuit. First come a check-up, then a consultation, and finally the mothers receive any needed drugs and anti-biotics, and food supplements, including the therapeutic food.

Careful records are maintained so that, over the course of eight weeks of rehabilitation, proper follow-up can take place. When the programme started, there were 100 cases a day treated; now, only about 20 mothers come in every day. "We are very, very happy with the results," said one health worker.

Midwife Fedosi Babendaga at the CMAM post. CREDIT: M BociurkiwThe programme is so finely-tuned that if a mother does not return for a follow-up visit, a trained community volunteer comes to knock on their door.

Midwife Fedosi Babengada says that, in addition to the case management, mothers are also offered nutritional advice on how to boost the health benefits of each meal.

Despite being one of Africa's most prosperous and populous nations, more than one million children aged five and under die of preventable causes every year in Nigeria. It has the fourth-highest number of underweight children in the world. This translates into more than two million children suffering from severe and moderate levels of acute malnutrition - most of them in northern regions.

CMAM reached about 54,000 severely malnourished children in seven drought-affected northern Nigerian states. It is funded by a 3 million Euro grant from the European Commission's humanitarian aid agency (ECHO).

The focus states border Niger Republic and the Republic of Chad - both of which appealed last year for humanitarian food aid following severe food shortages caused by the ongoing Sahel drought and climate change.

Apart from the effects of Sahel drought in Northern Nigeria, other major challenges in the region include poor child care practices - particularly low exclusive breastfeeding rates - as well as inadequate quality and quantity of complementary foods.

As Peace Takes Hold in Isolated Burundi, Donor Crisis Feared (REPORT)

Waiting for change in Burundi: According to UNICEF about 50% of the population is under 18 years old CREDIT: HUMNEWSBy a HUMNEWS Correspondent in East Africa

The global economic crisis and the drawing down of the emergency situation is translating into a decline in donor and humanitarian aid agency activity in Burundi - one of the poorest nations on the planet.

As the scarred nation struggles to emerge from four wars since independence in 1962 - between 1993 and 2006 some 300,000 people were killed - Burundi finds itself near the bottom of the UN's Human Development Index - with a GDP per capita of just $110. More than two-thirds of the population lives below the poverty line.

The health system is in a shambles and, according to UNICEF, almost 60% of children are stunted, a key manifestation of malnutrition.

On the economic side, the former Belgian colony has a very small tax base and is heavily reliant on external aid. It is set to miss most of the Millennium Development Goals (MDGs). One of the most densely populated places in the world, it has difficulties feeding its 8-million inhabitants. Quite the change from independence until 1993, when Burundi's economic performance was one of the best in Africa.

Yet the landlocked, East African country hardly registers on the radar of major donor countries.

And crises elsewhere in the world means that cash-strapped agencies like the UN's World Food Programme (WFP) are scaling down their operations here.

"Maybe donors need to be told that they need to invest in Burundi to prevent another crisis," said a European diplomat. "You can either spend $100 now to treat a mildly ill patient or $1000 later to treat a severely ill patient."

However one main challenge, experts agree, is the provision of good governance. Diplomats say the current leadership is extremely inexperienced and lacking vision. "They are narrow-minded and introverted and are only interested in looking after their own constituencies," said one diplomat.

Periodic violence by armed bandits remains a problem in Burundi. Earlier this week gunmen in police uniforms killed five people.

The humanitarian arm of the European Community (ECHO) is shuttering the doors of its Burundi head office all together next year. Other UN agencies are also expressing fears about the cash situation a year or two up the road.

Part of the challenge in drawing donor attention is generating more media coverage, aid workers say. Few of the major western news agencies have a bureau in the capital Bujumbura, preferring instead to send correspondents from the East African media hub of Nairobi.

A man dries his coffee beans next to a highway near Gitega. Coffee exports represent about 90 percent of Burundi's export earnings. CREDIT: HUMNEWSRelatively peaceful and credible elections last year won the Maryland-sized country international applause. But rampant corruption, low capacity and frequent changes in the cabinet makes the shift from the emergency phase to long-term development difficult, experts say. Recently, western ambassadors wrote a scathing letter to the Government complaining of an escalation in extra-judicial killings.

After President Pierre Nkurunziza, an avid golf player, won the election last year, opposition figures have either fled the country or gone undercover.

A 2006 USAID-funded study recently found that what is needed is diversification of the economy - away from an over-reliance on coffee growing, which accounts for some 90 percent of export earnings. However landlocked and with the nearest seaport well over 1200 kilometers away in Dar-es-Salaam - via poor roads and customs barriers, connecting Burundi to the outside world is not a simple matter. Indicative of the lack of economic activity is that Bujumbura's lakeside port is operating a just a fraction of its capacity.

A Nairobi-based Western diplomat who follows Burundi said the country's only, long-term hope is to take advantage of the opportunities that can come from regional integration. He pointed to the small neighbouring country of Rwanda, which has recovered from its multi-year conflict much better and is even now boasting a tourism sector and functioning stock market.

Said the diplomat: "The Government will have to position itself to benefit fully from regional integration. Instead what we are seeing is a squandering of one opportunity after another. I'm seeing very little political will to open horizons.

"My message is to focus on integration. It will be a catastrophe if they don't."

One glimmer of hope is the prospect of new mining operations in the country. A Canadian mining company is said to have obtained exploration rights for gold deposits. Another is improving yield on coffee exports: the Seattle-based company Starbucks is said to be looking at Burundi as a market for beans.

And in another positive development to further integrate Burundi into the global economy, Seacom Ltd., a closely held company that operates a fiber-optic link off East Africa, said this month it plans to extend the high-bandwidth fibre-optic cable to Burundi.

The USAID study suggests development of the tourism sector as part of an economic development package. But Burundi's sandy beaches - it sits on the clean and majestic Lake Tanganyika - international-quality hotels and guest houses are little known to the jet-setting public. For visitors, it's possible to arrive at Bujumbura International Airport - one of the cleanest and most efficient in Africa - and be sitting on the beach drinking a can of locally-made Primus beer less than one hour after touchdown.Burundi already has some international-standard tourism assets, including a good international airport and the Bora Bora Beach Resort in Bujumbura (shown above). CREDIT: HUMNEWS

International air links are limited, but that may improve later this year with the addition of service by South African Airways. Sadly, deforestation and a decline in the wild animal population doesn't give the countryside the appeal of other East African countries. The part of the country with the most exotic vegetation and wildlife - bordering Congo and Rwanda - is still regarded as a security risk.