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Sudan: "Clipboard Ali" helps keep children alive in Darfur

11-05-2007 Feature

One of 69 nutrition monitors working for a Red Cross feeding centre at a sprawling camp for displaced people in Darfur, Ali goes from tent to tent, watching out for babies at risk. Leigh Daynes of the British Red Cross reports.

   

  ©BRCS/ICRC/sd-e-01246    
 
  Gereida, Darfur: the Red Cross feeding centre aims to keep young children alive and well.    
     

Armed with little more than a battered clipboard and a bamboo cane, Abdullah Ali is helping to keep children alive in South Darfur.

Around the remote town of Gereida more than 100,000 people, many of them women and children, have been displaced to a dusty, rubbish-strewn camp .

Their number has increased eight-fold in the 30 months since the camp was opened, as a steady stream of people poured out of the bush, fleeing armed clashes. For now, the numbers have stabilized – but the spectre of life-threatening conditions like malnutrition constantly stalks the camp's children.

It's a reality Abdullah knows only too well. The tall, handsome 30-year-old is a father himself and was displaced by the violence.

“I live here in the camp with my wife and three young children, who are all aged under 5,” Abdullah explains. “We have been here for nearly three years. Life here is different from the one we had at home. Then we were happy because it was easier to find work and we were free to come and go. Here our movement is really restricted.”

 Fear of attacks  

 

Many in the camp share Abdullah’s feeling. But the fear of further attacks keeps them holed up under plastic makeshift shelters in the searing Sudanese heat.

Abdullah’s parents recently decided to leave the camp to try and make a new life somewhere else. He says that it is too unsafe for them to return to his home village. And for now he will stay put because he has found work as a Red Cross nutrition monitor.

Every day he tours the camp in search of children who are at risk of malnutrition. For those he has already referred for treatment, he checks on their progress.

One such referral, and Abdullah's first house call today, is frail Shima Ahmed, aged 2. She was accepted onto a therapeutic feeding programme being run by British and Australian Red Cross teams in the camp.

 Peanut paste  

Hawa, Shima’s mother, listens intently as Abdullah reminds her that, if she is to recover, Shima must continue to eat the nutritious peanut-based paste she has been given. On Abdullah’s clipboard is a list of points to check that will reveal whether or not Shima has developed medical complications.

He also keeps an eye on attendance records at the feeding centre. It is not uncommon for mothers to leave the camp, sometimes for hours at a time, in search of wood and grass. Young children are left alone and often miss health care appointments. In a culture where it's the women who do this kind of work, there is invariably no choice.

Abdullah completes his house call by marking Shima’s progress on his checklist and reminding Hawa to be careful about hygiene and weaning; inattention here adds to the risk of malnutrition.

He moves on to measure the height and arm circumference of other children in the neighbourhood. Using his cane that has notches denoting various heights, he can spot potential malnutrition cases and refer them immediately to the Red Cross feeding centre for treatment.

 Keeping malnutrition under control  

    

This kind of preventive outreach work, supported by three small satellite clinics dispersed throughout the vast camp, is helping the Red Cross keep what might otherwise be rampant malnutrition rates under control. There are 69 nutrition monitors like Abdullah watching over some 21,000 children aged under 5 in the camp.

 
Mothers will take their sick child to a traditional healer who will scratch its throat with a stick to make it bleed, believing this helps treat malnutrition. In reality, it kills... 
 

Like Shima, malnourished 18-month-old Nawal Mohammed was receiving the peanut-based paste – but just over a week ago, things took a worrying turn when she stopped eating. Umbaram, her 25-year-old mother, brought her straight to the feeding centre for help.

Nawal’s life hangs in the balance, says Red Cross nurse Penny Connley: “Since February, Nawal has been constantly losing weight,” Penny explains. “She’s down to 6 kilos now and has been refusing to eat and drink.

" It’s a real concern because she doesn’t have worms or malaria, which might explain the problem. We’re doing all that we can to encourage her to drink specially formulated milk, but for now we’re having to feed her through a nose tube.”

 Hospital the last resort  

If things don't improve, the infant will have to be referred to the nearest hospital – a gruelling five-hour drive north, which Penny knows has to be the last resort.

Frequently mothers will take their sick child to a traditional healer who, for a fee, will scratch the child’s throat with a sharp stick to make it bleed. It is widely believed that this mystical curative is effective in the treatment of malnutrition. In reality, it kills.

Nawal's mother still places her trust in nurse Penny. “We want Red Cross to help and feed us,” she says. “I hope my baby gets better again. I want to go back home, to my village – it is about one day away on a donkey cart. "

That is what everyone in this camp wants. But until a solution is found to their plight, displaced families throughout Darfur will continue to rely on the life-saving help provided by the Red Cross.