A new survey reports very high levels of child malnutrition in Yemen's conflict-hit northern governorate of Saada, particularly in districts that have seen the worst of the fighting. The rate of malnutrition equals that of a survey in Southern Sudan earlier this year which attracted media attention as discovering “the hungriest place on Earth”.
A UN Children's Fund (UNICEF)-supported survey carried out by the Ministry of Public Health and Population showed that 45 percent of the 26,246 children aged 6-59 months who were screened in five districts in western Saada (the governorate has 15 districts in all) were suffering from acute malnutrition.
"In one area, the proportion was as high as three out of four children. Overall, 17 percent of the children screened suffer from severe acute malnutrition [SAM] and 28 percent from moderate acute malnutrition [MAM]," a UNICEF statement said.
Adding the MAM and SAM together gives a global acute malnutrition (GAM) figure of 45 percent for those children screened. This is the same figure as a survey done by NGOs Save the Children and Medair in Akobo, Southern Sudan, earlier this year which led to media reports calling it “the hungriest place on Earth”.
GAM and SAM are the principal indicators used in nutrition surveys. Prevalences of GAM and SAM are based on the proportion of children aged 6-59 months whose body measurements categorize them as acutely malnourished according to various statistical guidelines and benchmarks.
The survey covered only a third of one of Yemen’s 21 governorates, but other recent assessments and surveys from the camps for internally displaced persons (IDPs) and the host communities affected by the Saada conflict also show very high levels of acute malnutrition, according to Wisam Al-Timimi, a UNICEF nutrition and child survival specialist. The Saada survey used the Mid-Upper Arm Circumference (MUAC) methodology, UNICEF told IRIN.
"Malnutrition is the main underlying cause of death for young children in Yemen, and therefore this grim situation could spell disaster for the children of Saada," said Geert Cappelaere, UNICEF representative in Yemen. "As winter approaches, thousands of children are at serious risk if we are not able to act immediately."
Al-Timimi told IRIN the community-based surveyors for the July 2010 Saada survey were trained by UNICEF nutrition consultants and master trainers from Saada Governorate health office (part of the Ministry of Health).
"Food assistance not enough"
Intermittent fighting since 2004 is not the sole cause of the problem. In rural Yemen as a whole, there is lack of awareness about proper nutrition; bread and tea is a typical breakfast and dinner meal for both adults and children.
A projection based on 2003-2008 national data using weight, height and age indicators suggests that across Yemen, 15 percent of children aged under five suffer from GAM - that percentage already at the level the World Health Organization defines as constituting an emergency situation. But the protracted conflict in Saada between government forces and Houthi-led Shia rebels seems to have worsened the situation in the north.
"Several children come to us in an advanced state of malnutrition, and therefore their treatment becomes costly and takes several months. Parents don't give their ailing children the right food to remain healthy, nor do they take them to hospitals early enough," Shihab Mohammed, a doctor at the government-run al-Salam Hospital in Saada city, told IRIN.
Samia Mohammed, a former health awareness campaigner at al-Mazraq I IDP camp whose population mostly came from western Saada, said hundreds of children were already malnourished on arrival at the camp. "Their mothers were malnourished too," she said.
"Food assistance alone is not enough to address malnutrition," said UNICEF's Cappelaere, adding that major efforts are needed to support household food security, change existing feeding customs and ensure safe water, sanitation and hygiene for populations affected by the conflict.
Despite a ceasefire in February 2010, the extremely volatile security situation has impeded access, and limited the reach of humanitarian agencies.
"UNICEF therefore calls upon all parties to the conflict in Saada as well as the international community, including the Qatari mediation delegation currently visiting Yemen, to ensure that immediate access for humanitarian actors is granted to the entire governorate of Saada to ensure children can receive necessary life-saving assistance," Cappelaere said.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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