In Pictures

‘Never seen a child like this’: Hunger takes toll on Chad’s young

Doctors in Chad working long hours to deal with growing malnutrition cases, exacerbated by country’s economic crisis.

Abdelkarim Djarnelim, a nurse at the Chad-China Friendship Hospital in N''Djamena for the past nine years, has been on secondment at the malnutrition section for the past three months. "I would like to — Abdelkarim Djarnelim, a nurse at the Chad-China Friendship Hospital in Ndjamena for the past nine years, has been on secondment at the malnutrition section for the past three months. 'I would like to contribute to the well-being of vulnerable children. I really came here by vocation,' he says. He says malnutrition is caused partly by ignorance and partly because of social problems. 'Many patients that come here have no means. Since Chad is underdeveloped, it is normal that we have so many malnourished children.' [Adrienne Surprenant/Collectif Item/Global News Insight]

Ndjamena, Chad – Since the fall in the price of oil in 2015, Chad has been struggling to deal with an economic crisis.

The main construction sites in the capital, Ndjamena, are abandoned, the market activities have suffered a slowdown and the salaries of state workers, including police and army officers, have been reduced as part of an austerity programme known locally as “the 16 measures“.

Chad’s health sector has been particularly affected – the national health budget was cut in half between 2013 and 2017, according to a report by Amnesty International. Doctors’ salaries have decreased from 517,000 to 317,000 Central African francs a month ($913 to $560).

The effect of the crisis is evident is hospitals and health centres, where medical staff face an increasing number of malnutrition cases.

A 2017 SMART survey found that the prevalence of severe acute malnutrition in N’Djamena stands at 4.9 percent, more than twice the emergency level set by the World Health Organization. Nationwide, an estimated four million people, out of 15 million, are food insecure. By the end of the year, the country’s health facilities are expected to receive more than 262,000 children, up to five years old, who suffer from severe acute malnutrition.

At the Chad-China Friendship Hospital, the number of malnourished children in need of treatment has doubled over the past 12 months.

“This year is exceptional,” says Veronica Ladangbe, who has worked as a nurse at the hospital for three years.

“At the beginning of June, we even had mothers on the floor, we could no longer enter this room. As the country is in crisis, it is hard for the poorest.”

At the Ndjari neighbourhood health centre, Awa Adan, 2 years old, has been sick for 6 months. Her mother Halila Hanoor, 25 years old says : "I myself am sick because I am disturbed by my child''s condi — At the Ndjari neighbourhood health centre, Awa Adan, two years old, has been sick for six months. 'I, myself, am sick because I am disturbed by my child's condition,' says her mother, Halila Hanoor, 25. She and her truck-driving husband began having financial problems when the cost of living went up. According to the centre's manager, Yvette Haiwanda, there has been an average of 40 to 50 new admissions a day since May. 'This year is too much compared to previous years, even before we reached the normal time of peak, there was already a big increase in cases,' says Yvette. [Adrienne Surprenant/Collectif Item/Global News Insight]

At the Ndjari neighbourhood health centre, Daouda Hawa (right), 22 years old, and her child Fatime Mohamat, 2 year old, await examination by health workers. Fatime has been sick for three months, her — At the Ndjari neighbourhood health centre, Daouda Hawa, right, 22, and her two-year-old child Fatime Mohamat await examination by health workers. Fatime has been sick for three months with symptoms of diarrhoea and fever, which have made her mother worried. [Adrienne Surprenant/Collectif Item/Global News Insight]

Mothers wait to be attended in Ndjari''s health centerm N''Djamena. — Mothers wait for a medical examination at the health centre in Ndjari. [Adrienne Surprenant/Collectif Item/Global News Insight]

A worried women arrives in ambulance to the Chad-China Friendship hospital. — A woman arrives in an ambulance to the Chad-China Friendship Hospital. [Adrienne Surprenant/Collectif Item/Global News Insight]

At the Betesda health center, N''Djamena, Fadne Algoni, 17, is received with her 18-month-old child Abdoulaye Ahmat, who has generalized edema and kwashiorkor. Fadne is divorced, and lives with her fat — At the Bethesda health centre, N'Djamena, Fadne Algoni, 17, is received with her 18-month-old child Abdoulaye Ahmat, who has generalised edema and kwashiorkor. Fadne is divorced and lives with her father and 17 other family members in a four-bedroom house in Ndjamena. For a week now, her baby has diarrhoea and has stopped walking. 'This is the first time I've seen a child like this. I'm really worried,' says Fadne. [Adrienne Surprenant/Collectif Item/Global News Insight]

At the Chad-China Friendship Hospital, Noubalea Missikete, a nutrition assistant with ALIMA for 6 years, cares for baby Abdoulaye Oumar, 4 months old, and nurse Alima Guy Madjadoum, 31, makes his even — At the Chad-China Friendship Hospital, Noubalea Missikete, right, has been a nutrition assistant with the Alliance for International Medical Action (ALIMA) for the last six years. 'Here, we start treating patients around 4:15 in the morning because there are too many children. Otherwise we wouldn't make it,' he says. [Adrienne Surprenant/Collectif Item/Global News Insight]

Zara Ibrahim, 20 months old, is washed with Chlorexidine. His skin peels as a result from Kwashiorkor sickness. Four months ago, when his mother was pregnant from another baby, he fell ill. The mother — Zara Ibrahim, 20 months old, is washed with chlorhexidine. His skin peels as a result of Kwashiorkor sickness. Zara was taken to the hospital and treated for malaria after falling ill four months ago. [Adrienne Surprenant/Collectif Item/Global News Insight]

It is Naher Mahat Nour, 8 months old, 6th time at the hospital. He is sick since birth and his parents tried everything: classical pediatrics, traditional healer who prepared a concoction of bark to d — This is eight-month-old Naher Mahat Nour's sixth time at the hospital. He has been sick since birth and his parents tried everything: from classical paediatrics to a traditional healer who prepared a concoction of bark to drink. Two months ago, they brought Naher to the hospital for the first time. The father, Mahat Nour, 31, is a food salesman. 'There is not enough food left with the economic crisis. I only make small profits,' he says. He has struggled for two years to earn enough to feed his two wives and seven children. [Adrienne Surprenant/Collectif Item/Global News Insight]

Adama Bichara takes care of her first child Hawa Moussa, 5 months old. He was sick for two days before she brought him to the hospital ten days ago. Hawa suffers from severe acute malnutrition, febril — Adama Bichara takes care of her first child, Hawa Moussa, who is five months old. Hawa suffers from severe acute malnutrition, febrile gastrointestinal illness and severe dehydration. His father is in the military. For almost two months, he has been giving his wife less money to buy food, but he has not explained the reason. State workers' salaries have been cut by half because of the drop in the price of oil in 2015. [Adrienne Surprenant/Collectif Item/Global News Insight]

A doctor made a glove-toy for little Aboubakar Ahmad. — A toy made from a glove by one of the doctors for one of the young patients. [Adrienne Surprenant/Collectif Item/Global News Insight]

Abdoulaye Moussa, 3 months old, fell ill three days after birth. It started with pimples on his feet, then he lost weight. Her mother, Mariam Moussa, 26, was ill throughout her pregnancy, which she sp — Abdoulaye Moussa, three months old, fell ill three days after birth. It started with pimples on his feet, then he lost weight. His mother, Mariam Moussa, 26, was ill throughout her pregnancy, which she spent almost entirely in bed. "There's not enough milk in my breast. But even if there is nothing, I still give to the child," she says. Her husband grows millet, okra and beans in Masatari. In 2017, the lack of rain reduced their harvests, preventing them from having sufficient reserves for that year. [Adrienne Surprenant/Collectif Item/Global News Insight]

woman hangs her mosquito net overnight in the transition section before she leaves the hospital. The malnutrition section of the Chad-China Friendship Hospital had 80 beds, but as patients slept on t — The malnutrition section of the Chad-China Friendship Hospital had 80 beds, but patients slept on the floor due to this year’s overwhelming peak, so it increased its capacity to 150 beds at the end of June, with the support of ALIMA. [Adrienne Surprenant/Collectif Item/Global News Insight]

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