MALNUTRITION: KENYA: Kakuma camp cuts child malnutrition

NAIROBI, 22 June 2010 (IRIN) - Aid workers in a camp for some 80,000 refugees in northwest Kenya have in six months slashed acute child malnutrition rates by doubling the provision of nutritional supplements, scaling up feeding and adopting community feeding programmes. The number of acutely malnourished children in the camp at Kakuma has fallen from 1,800 in November 2009 to fewer than 1,200 in June 2010, according to John Burton, the UN High Commissioner for Refugees (UNHCR) health coordinator in Kakuma, a decline from 17 percent of the children to 7.9 percent. According to Kakuma Medical Unit, 70 percent of acute malnutrition cases reported in December 2009 were among the 13,100 Somali refugees relocated from Dadaab, in northeast Kenya, at the beginning of the same month. A medical employee told IRIN: "Acute malnutrition tends to happen over short time changes, as opposed to chronic malnutrition which results from year-round lack of life-enriching nutrients. Children, newly arrived, were probably debilitated from all the movement, first from their home country, later from Dadaab to here. "Also, due to the sudden congestion of the camp and consequent lack of safe drinking water and adequate sanitation facilities, waterborne diseases and an outbreak of cholera were recorded inside the camp, highly affecting children and causing sudden weight loss." During the intervention, new growth standards for children were introduced, lowering the threshold, in terms of middle upper arm circumference, for what is considered acute malnourishment. The new standards would thus place more children in the category of "acutely malnourished". "Together with our nutrition partners in Kakuma - IRC [International Rescue Committee] and other NGO partners - we have doubled the distribution of Plumpy'nut from 400 cartons per month to 800 since February," said Burton. Plumpy'nut is a ready-to-use therapeutic food with a peanut paste base that is high in protein and energy. A new approach The intervention also included introducing community feeding programmes (technically known as community therapeutic care), designed to care for malnourished children with greater community involvement and limiting the length of stays in therapeutic stabilization centres. Traditionally, the programme was tailored for moderately and severely malnourished children in stabilization centres where children could be admitted for as long as possible till they improved. The new concept involves limiting their stay so that after about a week, the child is discharged to an out-patient programme. Every morning children are given therapeutic food under the supervision of nutrition nurses. In addition, mothers are trained and supported in how to feed their child and linked to a mother-to-mother support group. After the child has started improving, and the mother is well versed in how to look after it, visits to the treatment centre are reduced to once a week and the mother is given one week's supply of therapeutic food to use at home. UNHCR sources told IRIN that budget cuts in the past two years had cut funding for the camp from US$1,180,018 in 2008 down to $967,679 in 2009 and with the influx of Somali refugees from Dadaab in November, some extra funding allocated to Kakuma was immediately channelled to the cholera and malnutrition outbreak through special programmes and hiring more staff. "That funding allowed us to respond to respond to the emergency, but sustainability is key to success, and our healthcare system inside the camp is far from that," said a Kakuma medical unit employee.