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Malnutrition killing Refugee Children in Cameroon 

By Jude Fuhnwi in Batouri
At the entrance into a therapeutic feeding centre in Kentzou, a town in East Cameroon, a 26-year-old refugee mother, Lisa Ngamanade, gets her own fair dose of the bitter pill, when news broke out that her only daughter, aged three, had died. 
The child who had survived the long and traumatic journey to Cameroon from the violence in the Central African Republic, CAR, died of chronic malnutrition. 
“I spent a lot to get her here. I travelled long distances with no shelter, food or water and now she has died. She was my last hope” said Ngamanade, tears rolling down her cheeks. 
“This baby really looked horrible when I first set eyes on her. She was suffering from stomach disorder and her feet were swollen” said a nurse, Melanie Takou, on whose arms the child had died, as they rushed her to the feeding centre. 
Malnutrition is taking what the body does not need or consuming food that does not have all the elements that the body needs to function normally in all its components. Ngamanade’s child had developed Kwashiorkor; a type of malnutrition characterised by not getting enough protein in the diet; as a result of severe protein deficiency. This child and other refugee children in Cameroon have died of malnutrition and others continue to die from it.
In Cameroon, up to 1 out of 3 refugee children from the Central African Republic suffer from malnutrition, a recent United Nations assessment has found.
Members of the assessment, who included experts from The United Nations Children’s Fund, UNICEF, the United Nations Refugee Agency, UNHCR, and the World Food Programme, WFP, reported seeing hospital wards with a lot of emaciated, sick children, two to three in a bed.
The risk of severe acute malnutrition, which can be deadly if left untreated, is particularly high. In the inpatient Centre of Batouri close to the border with CAR, the mortality rate in May 2014 alone exceeded 24 percent. 
“Children who have survived the horror in the Central African Republic are now at risk of dying from malnutrition and its complications and death is stalking these children,” said UNICEF Representative in Cameroon, Félicité Tchibindat. 
The UN assessment indicates that since the start of 2014, more than 100.000 Central African refugees, over half of them children, have entered Cameroon after walking and hiding in the bush for weeks or months.
Among them, between 20 to 30 percent of children aged below five, arrived suffering from malnutrition, a rate almost twice as high as the 15 percent considered “critical” in most emergency situations. 
“It is no exaggeration to say that this nutrition crisis has well surpassed the critical level, but WFP is implementing an aggressive response to ensure the absolute maximum nutrition support,” noted Gian Carlo, World Food Programme, WFP, Cameroon Country Director.
Press Reports say 3 to 7 deaths are registered per day among the refugees in Cameroon. The situation is particularly bad in the village of Ngaoui in the Adamawa Region and in the small Eastern town of Letta, where admission records in nutrition centres show that about 8 percent are infants less than six months old. UNICEF says malnutrition poses a “silent threat” to these children and is linked to poor hygiene, unsafe drinking water, diseases, lack of immunisation and improper feeding practices.
A nurse at a refugee arrival point in the small Eastern town of Letta, said malnutrition is an underlying cause of child mortality in the host communities, because it weakens the immune system, making children more susceptible to contracting diseases. Meanwhile, findings in the United Nations assessment also show that 1 out of 5pregnant and lactating refugee mothers also arrived in Cameroon malnourished, which puts their babies at increased risk. Whereas at least 17 percent of children admitted into inpatients facilities suffering from malnutrition are over 5 years old. 
According to statistics by UNICEF, 44 percent of children suffering from chronic malnutrition in the Central African Economic and Monetary Community, CEMAC, sub region are in Cameroon.
 For its part, the National Institute of Statistics in its recent study, published in October 2011, indicates that 33 percent of children less than five years suffer from chronic malnutrition while 14 percent of them are absorbed by severe malnutrition. 
Experts say Cameroon is a country with food sufficiency that produces enough to feed its population. However, poverty has stopped many in Cameroon from having access to a variety of nutritious and balanced diet.
The massive influx of refugees from the Central African Republic, Chad and Nigeria has added to the increasing number of people unable to access food in Cameroon. But access to healthcare is also a problem. According to an Inter Press Service, IPS, news agency report, 23 out of 43 health districts in the North and Far North Regions of the country are short of qualified personnel. The National Institute of statistics adds that the two regions have only 92 doctors for an overall population of 5.5 million inhabitants. These regions are the hardest-hit in the country. 
IPS further reports that in June 2013, the Garoua Regional Hospital’s Paediatric Feeding Centre in North Cameroon registered 31 malnourished children. Six died, one recovered and 21were transferred to other hospitals while three remained at the hospital for treatment.
Specialists also identify ignorance as a major cause of child malnutrition among the refugees in Cameroon. “The refugee mothers are ignorant of what they should eat to keep themselves and their babies healthy” noted a nutrition expert, Patricia Atem. Experts recommend exclusive breastfeeding as the best form of nutrition for children of zero to six months. Breastfeeding is considered the best source of energy and nutrition to babies. It reduces diarrhea-related death and child mortality caused by respiratory effects. During the period of exclusive breastfeeding, nutrition specialists have warned, no water, tea or any other kind of food or drink should be given to the baby.  
Working with partners on the ground, UNICEF, UNHCR and WFP are stepping up their efforts to provide refugee children and their families with the nutrition assistance they need. All children below the age of 10 are receiving supplementary feeding and ready to use therapeutic foods.
Mobile clinics are also providing nutritional assistance to malnourished children residing with host communities in the country.
According to WFP, since March 2014, more than 1.600 children with severe acute malnutrition were admitted in the therapeutic feeding centres available at the arrival points and refugee’s sites and hospitals. Another 9.000 children and 2.000 mothers received supplementary feeding. In total, over 50.000 people were provided with food assistance through United Nations Agencies and Non-Governmental Organisations, NGOs, according to the UN assessment.
However, despite the urgency of 9 million dollars requested for the nutrition response for Central African refugees in Cameroon in the Strategic Response Plan, only 2 percent has been received so far. Additional lives will be lost if the international community does not step up its support, WFP has warned.

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