In Chad, a season for all diseases

The changing of seasons affects the lives of people differently throughout the world. For most of my life the changing of the seasons brought forth a sense of excited anticipation for whatever the upcoming season might bring. In Chad the seasons can be divided by the weather, or by the epidemic.

Massakory, Chad

The changing of seasons affects the lives of people differently throughout the world. For most of my life the changing of the seasons brought forth a sense of excited anticipation for whatever the upcoming season might bring.

In Chad the seasons can be divided by the weather, or by the epidemic. There is the meningitis season, the cholera season and the malnutrition season – all of which overlap to some extent. In late April, the meningitis season is here, and the peak season for malnutrition is slowly approaching.

At Medecins Sans Frontieres’ malnutrition project in Massakory, the signs of the changing of the seasons surround us, and the excited anticipation formerly brought forth by the changing of the seasons seems to evade me.

The numbers in Massakory’s malnutrition program grow progressively each week. Not only are the admission numbers increasing, but the types of admissions are changing. In the past month we started to see a growing number of children returning to the program. We can cure a child of malnutrition, but we don’t seem able to cure the country of the problem – children leave the program and go back home to the same problems that caused the malnutrition in the first place.

This week I met 22-month-old Abdoulaye and his mother. Abdoulaye had been in the malnutrition program last summer. He was “cured” in September, only to become sick with diarrhea in January. He and his family live a two-and-a-half-hour walk from the nearest health centre. As his mother had to tend the fields to ensure that the family had food to eat, she was unable to take Abdoulaye to the health centre.

He progressively got sicker, until he became malnourished again. He re-entered the ambulatory malnutrition program in February. This week when I met him at the malnutrition centre he had met his target weight and was yet again considered “cured.” When we told Abdoulaye’s mother that he was now healed, and she would not have to return the following week she became angry. “And what now – wait until he gets malnourished again?” she asked.

MSF is conducting operational research in Massakory, on the use of Plumpy Doz. It’s a variant of Plumpy Nut, a supplementary food aimed at preventing malnutrition in children between six and 24 months of age. For the next year, in the region where Abdoulaye lives, there will be monthly distributions of Plumpy Doz in the villages for every child that fits the age criteria.

Mothers receive four pots of Plumpy Doz a month, and are instructed to give their children three spoonfuls, three times a day. I reminded Abdoulaye’s mother of the Plumpy Doz. This did not diminish her anger. “And when the Plumpy Doz distributions are done, when you are done studying us, what do we do? Wait until our child gets sick and becomes malnourished again?” I had no answer. What is the answer?

The discussion took me back to Djibouti and the first time I encountered mothers it seemed might intentionally be starving their children to be able to get access to free medical care. It reminded me of the mothers in Niger who seemed to keep one of their children constantly malnourished so they could receive a weekly ration of Plumpy Nut, with which they fed the rest of their children. I was reminded of the mothers in the Congo who had to make the unimaginable decision of whether to go harvest in their fields, where they would be raped, or to stay at home, not get raped, and have their families starve.

The causes of malnutrition are complex, as is its treatment. Clinically it is not complicated, but socially, politically and economically it is extremely challenging. Plumpy Nut and all of its brothers and sisters are not the long-term answer. When leaving the centre with her final week of Plumpy Nut ration, Abdoulaye’s mother bade us farewell and cynically, yet realistically, called out, “See you in a few months.”

It reminded me of the end of the summer camp season when I was young. There would always be tears and the shared hope that we would all see each other again the following summer. The beginning of the peak malnutrition season has barely begun but I already know that by the time the end appears, many tears will have been shed and I will hope, with every ounce of optimism, that we will not again have to see the children that we have already treated this season.

I can hope, but hoping has its limits.

Tricia Newport is a nurse who lives in Whitehorse. This is part of a series of dispatches from Chad.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Dr. Brendan Hanley, Yukon’s chief medical officer of health, speaks at a press conference in Whitehorse on March 30. Hanley announced three more COVID-19 cases in a release on Nov. 21. (Crystal Schick/Yukon News file)
Three more COVID-19 cases, new exposure notice announced

The Yukon’s Chief Medical Officer of Health, Dr. Brendan Hanley, announced three… Continue reading

Yukonomist Keith Halliday
Yukonomist: COVID-19 strikes another blow at high-school students

They don’t show up very often in COVID-19 case statistics, but they… Continue reading

The Cornerstone housing project under construction at the end of Main Street in Whitehorse on Nov. 19. Community Services Minister John Streicker said he will consult with the Yukon Contractors Association after concerns were raised in the legislature about COVID-19 isolation procedures for Outside workers at the site. (Crystal Schick/Yukon News)
Concerns raised about alternate self-isolation plans for construction

Minister Streicker said going forward, official safety plans should be shared across a worksite

The Yukon’s Chief Medical Officer of Health Dr. Brendan Hanley, pictured at a press conference in October, announced three new cases of COVID-19 on Nov. 20 as well as a new public exposure notice. (Crystal Schick/Yukon News file)
New COVID-19 cases, public exposure notice announced

The new cases have all been linked to previous cases

Beatrice Lorne was always remembered by gold rush veterans as the ‘Klondike Nightingale’. (Yukon Archives/Maggies Museum Collection)
History Hunter: Beatrice Lorne — The ‘Klondike Nightingale’

In June of 1929, 11 years after the end of the First… Continue reading

Samson Hartland is the executive director of the Yukon Chamber of Mines. The Yukon Chamber of Mines elected a new board of directors during its annual general meeting held virtually on Nov. 17. (Joel Krahn/Yukon News file)
Yukon Chamber of Mines elects new board

The Yukon Chamber of Mines elected a new board of directors during… Continue reading

The Yukon Hospital Corporation has released its annual report for 2019-20, and — unsurprisingly — hospital visitations were down. (Crystal Schick/Yukon News file)
Annual report says COVID-19 had a large impact visitation numbers at Whitehorse General

The Yukon Hospital Corporation has released its annual report for 2019-20, and… Continue reading

Whitehorse City Hall. (Joel Krahn/Yukon News file)
City hall, briefly

A look at decisions made by Whitehorse city council this week

City council was closed to public on March 23 due to gathering rules brought on by the COVID-19 pandemic. The council is now hoping there will be ways to improve access for residents to directly address council, even if it’s a virtual connection. (Crystal Schick/Yukon News file)
Solution sought to allow for more public presentations with council

Teleconference or video may provide opportunities, Roddick says

Megan Waterman, director of the Lastraw Ranch, is using remediated placer mine land in the Dawson area to raise local meat in a new initiative undertaken with the Yukon government’s agriculture branch. (Submitted)
Dawson-area farm using placer miner partnership to raise pigs on leased land

“Who in their right mind is going to do agriculture at a mining claim? But this made sense.”

Riverdale residents can learn more details of the City of Whitehorse’s plan to FireSmart a total of 24 hectares in the area of Chadburn Lake Road and south of the Hidden Lakes trail at a meeting on Nov. 26. (Ian Stewart/Yukon News file)
Meeting will focus on FireSmart plans

Riverdale residents will learn more details of the City of Whitehorse’s FireSmarting… Continue reading

The City of Whitehorse is planning to borrow $10 million to help pay for the construction of the operations building (pictured), a move that has one concillor questioning why they don’t just use reserve funds. (Crystal Schick/Yukon News)
Councillor questions borrowing plan

City of Whitehorse would borrow $10 million for operations building

Most Read