Malnourished children are being treated in MSF facilities; no need for a major scale-up has been found
MSF's assessments of Haiti's nutritional situation have revealed small pockets of malnourished children, consistent with levels of chronic undernutrition found in the country before the recent hurricanes. However, none have shown high levels of malnutrition requiring a major scale-up of MSF’s nutritional programs.
Following a series of hurricanes and tropical storms in late August and early September, Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams have been investigating the nutritional situation through rapid screenings and surveys in three departments prone to malnutrition. Malnourished children were admitted to existing MSF medical facilities. While these assessments have revealed small pockets of malnourished children, consistent with levels of chronic undernutrition found in the country before the recent hurricanes, none have shown high levels of malnutrition requiring a major scale-up of MSF’s nutritional programs.
In the Artibonite Department a first round of nutrition status assessments were carried out by an MSF team in the Bas Artibonite area from St Marc to Dessalines, via Grandes Salines and Bocozelle in September. At that time, MSF teams carried out a MUAC (middle-upper-arm circumference) screening on 137 children while doing mobile clinics. This rapid screening process is used to triage the worst cases. Although it is an imprecise tool for determining the overall nutritional situation, it is helpful in providing preliminary indicators of potential malnutrition. In this region, the team found 8 percent global acute malnutrition (this is the total prevalence of severe and moderate cases of malnutrition) among the children screened. There were no severely malnourished children among the group .
In the North West Department, another area historically prone to food scarcity, a first assessment was carried out from mid September until early October. At first the MSF teams covered the area from Anse Rouge to Port de Paix, via Bombardopolis and Jean Rabel, just after the hurricanes. A second team returned later to Port de Paix and the area South and East of Port de Paix to carry out a height and weight screening. The nutritional status of 1,366 children between 6 and 59 months old were assessed. The teams determined a rate of 4.5 percent global acute malnutrition, and 4 cases of severely malnourished children were treated by the MSF team.
In November, a more comprehensive nutritional survey was carried out in the far west area of the North West Department and in the city of Port de Paix by Epicentre (the Paris-based epidemiological division of MSF). There are more than 35,000 children (below 5 years old) estimated to be living in the survey area. The preliminary results of this survey showed levels of severe acute malnutrition up to 2.8 percent and global acute malnutrition up to 8.8 percent . Once again, although the results do not indicate a critical emergency situation, MSF will continue to monitor the situation by carrying out a food security assessment and to treat the severest cases.
In the South East Department in early November, a pocket of acute malnutrition was discovered in the mountainous area of Baie d'Orange and Belle Anse, where authorities had reported child deaths related to malnutrition. MSF quickly established a therapeutic feeding center and about 100 children per day were screened. In the first two days of consultations 30 children were diagnosed as severely malnourished and 25 children as moderately malnourished. Some of the severely malnourished children were consequently referred to either the MSF clinic in Martissant, in the capital city Port-au-Prince, or to other hospitals in the country. Fourteen severely malnourished children were admitted in the MSF clinic in Martissant and one child has died. Three children are still hospitalized in Martissant.
More recently, screenings of children by our teams have shown much fewer critical cases and at present the situation in Belle Anse and Thiotte does not appear to be alarming. On a total of 1,495 children under 5-years-old screened in the last few weeks, 1.7 percent were in an acute malnutrition stage and 5.3 percent were facing acute and moderate malnutrition. Another assessment was carried out in the Jacmel area the week of November 24th, and showed 0.39 percent of acute malnutrition and 3.1 percent of global acute malnutrition.
There seem to be pockets of severe malnutrition but these conditions existed prior to the hurricanes and are endemic to the region. However, the teams continue to work throughout the country to investigate potential malnutrition hotspots and respond to reports.