Doctors Without Borders/Médecins Sans Frontières (MSF) teams have treated more than 450 severely malnourished children in its hospital in Qayyarah, around 35 miles south of Mosul, since March. Manuel Lannaud, MSF’s head of mission in Iraq, describes the scale of the childhood malnutrition problem in this region and how MSF is addressing it.
Who in the region is most affected by malnutrition?
We began treating severely malnourished children in our hospital in Qayyarah in March. Most are under the age of one, and 60 percent aren’t even six months old. Some of the mothers arrive from Mosul itself, but most live in camps. Over the past couple of weeks we’ve seen an increase in the number of malnourished children needing treatment. With the occupancy rate [in our hospital] at or over 200 percent, we are about to open a 30-bed unit where we can provide care to children suffering from severe malnutrition. Starting in July, mothers and their babies, who, up until now, have been accommodated in a 12-bed tent, will be cared for in the new extension.
What is causing malnutrition in the Mosul region?
It isn’t a problem of access to food. The malnutrition we see here is primarily due to the scarcity of infant formula. Obviously, adults and children in the besieged part of Mosul suffer from lack of food and, indeed, we see a lot of extremely underweight people arriving in the camps. Once they’re out of the city, the adults soon gain weight, but not the babies. Many Iraqi mothers don’t breastfeed, and the ones who do usually stop after two to three months. Conditions in the camps, combined with stress and exhaustion, make breastfeeding even harder.
There’s a political barrier, too. International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding ... and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition. MSF provides infant formula to children when they’re discharged from the hospital and during their follow-up care. We also encourage mothers and tell them how important breastfeeding is, but if they need formula, we give it to them. We also have to ensure that water in the camps is up to standard, and we inform mothers this is something they need to be aware of because it can pose a problem.
How does MSF treat malnutrition?
Children who’ve been hospitalized require close medical supervision. The number of readmissions to Qayyarah hospital is still relatively high. Mothers often want to leave the nutritional feeding center to get back to looking after their other children, but treating malnutrition takes time, sometimes as much as two or three weeks. Some mothers go against medical advice and then it’s hard for them to come back to the hospital—for lots of reasons, one of them transportation.
At the beginning of July, a preventive feeding program that includes follow-up care and malnutrition screening for children will open in one of the camps. More humanitarian aid agencies must get involved in this type of screening that is so critical to the process of preventing and managing malnutrition.