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In Djibouti, screening by Doctors Without Borders/Médecins Sans Frontières (MSF) teams in the first half of 2011 revealed a rise in the number of children suffering from moderate levels of malnutrition. Over the course of the year, staff saw a 60 percent increase in the number of children admitted to the inpatient therapeutic feeding center: from 1,029 in 2010 to 1,735 in 2011. Teams also treated more than 2,200 children for malnutrition in six health centers on the outskirts of Djibouti City.
A situation of chronic malnutrition
The nutritional situation in Djibouti is critical, but it is unchanging. In order to focus on emergency activities, MSF is handing over its services in Djibouti. In August, the outpatient program was transferred to the Ministry of Health and other longer-term, non-governmental organizations.
Staff continued to see a large number of children in the program who were also suffering from tuberculosis (TB): 81 tested positive, and after completing treatment in the feeding center, were referred to the national TB program. The inpatient feeding program will be handed over to national authorities in April 2012.
Lobbying for change
A hot, dry climate means there is little capacity for crop cultivation in Djibouti, and this has recently been further diminished by a regional drought. In Djibouti City, where some 60 percent of the country’s population live, food supplies are under strain. A ‘floating population’ of migrants passing through the country adds to the pressure.
MSF petitioned the UN and the government to take steps towards preventing further deterioration of the situation, and advocated the use of nutritious ready-to-use food. This ready-to-use food has an animal protein base and contains all the nutrients that are vital for a growing child, unlike the corn-soy blend of fortified flour that is more commonly used to supplement children’s diets. The Ministry of Health is in the process of revising the national protocol for the treatment of malnourished children under five to include nutritious ready-to-use foods.
Responding to cholera
Cholera – a water-borne bacterial disease that causes profuse, watery diarrhea – broke out in July and August, and MSF supported the health authorities’ response by treating 190 patients. When a smaller outbreak occurred in October, MSF again provided assistance.
At the end of 2011, MSF had 134 staff in Djibouti. MSF has been working in the country since 2008.