Since March, MSF teams have treated over 450 severely malnourished children in its hospital in Qayyarah, 60 kilometres south of Mosul. Manuel Lannaud, head of mission in Iraq, explains the different causes and aspects of malnutrition.
Who in the region is affected by malnutrition?
We began treating severely malnourished children in our hospital in Qayyarah in March. Most are under the age of one and 60 per cent aren’t even six months old. Some of the mothers arrive from Mosul itself but most live in camps.
Over the past couple of weeks we’ve seen an increase in the number of malnourished children needing treatment. With bed occupancy often equal to or over 200 per cent, we are about to open a 30-bed unit where we can provide care to children suffering from severe malnutrition.
Starting in July, mothers and their babies who, up until now have been accommodated in a 12-bed tent, will be cared for in the new extension.
What’s causing malnutrition in the region around Mosul?
It isn’t a problem of access to food. The malnutrition we see here is primarily due to the scarcity of infant formula. Obviously, adults and children in the besieged part of Mosul suffer from lack of food and, indeed, we see a lot of extremely underweight people arriving in the camps.
But once they’re out of the city, the adults soon gain weight, but not the babies. Many Iraqi mothers don’t breastfeed and the ones who do usually stop after two to three months. Conditions in the camps combined with stress and exhaustion make breastfeeding even harder.
There’s a political barrier too. International organisations like UNICEF and the World Health Organization (WHO) promote breastfeeding – not only in Iraq – and provide infant formula, but only on prescription.
We believe distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalised for malnutrition. MSF provides infant formula to children when they’re discharged from the hospital and during their follow-up care.
We also encourage mothers and tell them how important breastfeeding is, but if they need formula, we give it to them. We also have to ensure that water in the camps is up to standard and we inform mothers this is something they need to be aware of because it can pose a problem.
What can be done to treat malnutrition?
Children who’ve been hospitalised require close medical supervision. The number of readmissions to Qayyarah hospital is still relatively high.
Mothers often want to leave the nutritional feeding centre to get back to looking after their other children, but treating malnutrition takes time, sometimes as much as two or three weeks. Some mothers go against medical advice and then it’s hard for them to come back to the hospital – for lots of reasons, one of them transportation.
At the beginning of July, a preventive feeding programme that includes follow-up care and malnutrition screening for children will be opened in one of the camps. More humanitarian aid agencies must get involved in this type of screening that’s so critical to the process of preventing and managing malnutrition.