Nutritional “crisis” in Monrovia

Moderate hunger has been endemic in the Liberian capital for years, but as the effects of soaring global food and fuel prices have doubled rice prices, the aid agency Action Against Hunger (ACF) says thousands of city children are increasingly at risk of acute malnutrition.

ACF Head of Mission in Liberia, Berengere de Penanster, says a February 2008 survey showed “extremely disturbing” results that indicated a “significant nutritional crisis” in the Liberian capital.

"What we know and can't ignore anymore is that there are thousands of children at risk in Monrovia. Any lack of food, any disease can make them fall into severe malnutrition," he told IRIN.

ACF says 17.6 percent of city children weighed by its nutritionists are suffering from acute malnutrition. These figures surpass the 15 percent World Health Organization (WHO) threshold that defines a nutritional crisis, ACF says, citing lack of health facilities, difficulties of access for the poor and deplorable states of hygiene and sanitation in many areas as contributing factors.

Rising food prices are exacerbating the situation, de Pensanster said, estimating that Liberia is likely to be hit harder than its West African neighbours by rising global prices for rice and grains. The country imports 90 percent of its rice – the national staple – and in the last year, the price of a bag of rice has almost doubled.

"We know for sure that there is a link between food insecurity and malnutrition. It is considered as one of the main reasons for malnutrition according to a survey that ACF conducted last November and December,” he said.

“A large number of the caretakers of our beneficiaries give food insecurity as a main factor for the malnutrition of their children. So ACF is definitely worried about the current increase in prices and the consequence for a country like Liberia," de Penanster said.

The organisation supports a handful of outpatient feeding centres in Monrovia but says it now needs to open more. "The main obstacle is lack of funds. The Ministry of Health is conscious about [the situation] but does not have the means to act,” de Penanster told IRN.

“If we had enough funds we could open more feeding points in order to have a better coverage of severe malnutrition and we would be able to train the Ministry of Health staff, to increase the sensitisation of the population on good feeding practices."

Aid workers say relatively little has been invested in promoting good weaning practices in post-war Liberia. There is a common belief that once mothers regain an active sex life, breast milk is no longer safe for babies to drink. Small children are often served less nutritional meals than their parents; many are raised on rice alone, while meat and fish is reserved for adults. Some parents believe the smaller the child, the fewer nutrients he or she needs.

Liberia's 14-year conflict drove thousands of people from rural areas to Monrovia. The result is chronic overloading of city resources; almost half of Liberia's estimated 3.5 million people are thought to reside in the capital. While rural areas are more at risk from chronic malnutrition due to lack of food diversity, urban dwellers are threatened by stretched medical resources and fierce competition for jobs.

"People have left refugee camps to move back to the city hoping for a better quality of life, but they now find themselves confronted by mass urban poverty," explained Gilsel Stien, ACF Liberia's lead nutritionist. The agency says it is concerned that perceptions of development improvements in Liberia could mask the persistence of life-threatening conditions like malnutrition.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) warned in March 2008 that donors are under-supporting humanitarian programmes as they make the transition towards development-oriented projects. OCHA appealed for emergency donations of US$128 million.

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