In one of the poorest regions of one of the poorest countries of the world, drought, lack of clean water, and destroyed crops threaten children with severe acute malnutrition.
EU humanitarian aid funding, together with support from UNICEF, helps children and their families in Madagascar deal with this threat. The support provides them not only with ready-to-use therapeutic foods, but also with follow-up monitoring of the children’s health.
Story by Abela Ralaivita, UNICEF.
Photos ©UNICEF/Andrian. All rights reserved. Licensed to the European Union under conditions.
Madagascar-fighting the nightmare of severe acute malnutrition_01In drought-ravaged Madagascar, UNICEF, with EU funding, helps families save children from severe acute malnutrition. 
Madagascar-fighting the nightmare of severe acute malnutrition_02Elysa and Elysette are 11-month old twins living with their parents and 6 siblings in the rural commune of Maroalipoty, southern Madagascar. The twins suffer from acute malnutrition. 
Madagascar-fighting the nightmare of severe acute malnutrition_03In a neighbouring village, Maho, 21 months also suffers from severe acute malnutrition. The little girl waits with her father for her mother to return from fetching water from a distant well. 
Madagascar-fighting the nightmare of severe acute malnutrition_04For years, droughts have affected Madagascar, mainly caused by poor rainfall and aggravated by the El niño phenomenon. Also, the south wind called "Tiomena" has ravaged agriculture. Clouds of dust now blow over the ravaged fields. 
Madagascar-fighting the nightmare of severe acute malnutrition_05Sambo, the father of the twins, is upset as he surveys his cassava plantation destroyed by the wind and sand. "Now we're buying cassava when we're supposed to be harvesting it," he says, overwhelmed by the situation. 
Madagascar-fighting the nightmare of severe acute malnutrition_06Sambo has to buy 4 kg of cassava per day to feed the 10 people in his household. To do this, he sells water, which has become a luxury item in many homes, or household utensils to other villagers. 
Madagascar-fighting the nightmare of severe acute malnutrition_07The whole family gets involved in the water collection, walking several kilometres to the nearest well. Everyone has a role to play in the family’s survival. 
Madagascar-fighting the nightmare of severe acute malnutrition_08Nearby, Maho’s mother, Toromasy, 20, cleans the pots and plates using the small amount of water she has just collected. 
Madagascar-fighting the nightmare of severe acute malnutrition_09Her child's malnutrition is caused partly by the consumption of non-potable water that has the colour of chocolate. It is one of the main factors causing diarrhoea and malnutrition. 
Madagascar-fighting the nightmare of severe acute malnutrition_10The 5 members of the household now have only cassava leaves as food. With many families turning to this last resort food source, the leaves themselves are disappearing. 
Madagascar-fighting the nightmare of severe acute malnutrition_11Thanks to EU humanitarian aid and UNICEF’s support, children are receiving treatment with therapeutic foods. "This situation is getting worse and worse, but fortunately we still have these products available to keep up," says Dr Tsida Randriatsiafara. 
Madagascar-fighting the nightmare of severe acute malnutrition_12At the health centre in Maroalipoty, women bring their children to be screened for malnutrition and to monitor their child's state of health. The twins are among those who arrived earlier, and Elysa is being weighed to follow-up on her recovery. 
Madagascar-fighting the nightmare of severe acute malnutrition_13Unfortunately, Elysa did not gain weight and the measurement of her upper arm still indicates red, a warning that she is still too thin. She will continue her treatment at the health centre until she reaches the target weight. 
Madagascar-fighting the nightmare of severe acute malnutrition_14"It makes me proud when a child is cured. I always insist that the parents follow up the treatment at the health centre," says Myriam, the head of the health centre. 
Madagascar-fighting the nightmare of severe acute malnutrition_15The whole family returns home with a sense of great relief. Despite their smiles, they say they still worry about what the future will bring.
