"I have seen so many cases where you discharge them and ... then they come back with the same condition" - Mohamed Dahiye
WAJIR, Kenya (AlertNet) – Mohamed Dahiye was careful not to show his frustration as he administered life-saving drugs to malnourished children in Wajir District Hospital in drought-stricken northern Kenya.
A decade of working as a nurse in the only hospital for miles around had shown him, he said, how emergency treatment was in many cases little more than a temporary sticking plaster for patients in one of Kenya's poorest regions.
"I have seen so many cases where you discharge them and they will be away for three weeks to one month. And then they come back with the same condition," Dahiye said, tending to a woman who had just arrived with her emaciated baby.
"The mother might tell you she cannot go back home because there is nothing to eat. They prefer to stay in the hospital. But we cannot keep them. Once they get cured, they have to be discharged."
The number of malnourished children being admitted to Wajir hospital has been rising steadily since January, when the effects of prolonged drought started to bite. They occupy about half of the 25 beds in the paediatric ward.
The highest number of admissions for malnutrition so far this year was 32 in May, staff said. Even in a good year, it rarely drops below 10.
Many children don't make it to the hospital, a neat white building constructed by Italian prisoners of war during World War Two. The shade of its cool verandas and rustling trees provide respite from the dusty, heat-sapped town.
"Most of the deaths happen at the community level because they don’t get a referral in time. Cases just go undisclosed and they die there," said Dahiye.
The hospital largely depends on Save the Children’s twice weekly outpatient therapeutic feeding programme, where children are assessed and treated for malnutrition in local clinics, to refer and transport dangerously malnourished children to its ward.
In the paediatric ward, five children have died since January, mostly recently a two-year-old girl called Safia.
Despite his good job and regular income, Dahiye does not think he is immune from the problems facing his community and makes a point of regularly assessing his own two-year-old daughter for malnutrition.
"I weigh her, I take her Middle Upper Arm Circumference (which shows the level of malnutrition) to see whether she is coming to these levels," the affable nurse said.
"Because once they reach this state, it’s very hard to bring them up. This child will have learning problems later even if he survives. It’s a lifelong disability."
BECOMING AID DEPENDENT
Malnutrition is so common that it is not enough to earn sick children a place in the hospital. Only those with medical complications, such as malaria or vomiting, are admitted.
Children who are just malnourished are given Plumpy'nut, a nutrient rich paste made from peanut and milk, to eat at home.
"A child might be in the therapeutic feeding programme but he is not responding because the whole family is using the little ration that was meant to upgrade him," Dahiye pointed out. "It is very hard to get those children cured because the food is being shared."
In May, 28.5 percent of children in Wajir South District were suffering from malnutrition, according to the Kenyan government.
"Lack of food at all is the basic cause of this malnutrition. If there is no money and the animals are not there, what will the child be fed with?" asked Dahiye. "Poverty is the major blame here."
Dahiye's patients are ethnic Somali herders who make the best use of this parched land, bordering Somalia, by leading their cows and goats to fresh grazing lands when the dry season melts into heavy rains.
Increasingly frequent droughts, deforestation and growing populations are making this way of life untenable without substantial investment, aid experts say.
"We should sit and look for long term solutions. The short terms are these small ones you can see now, but this will not take us forward," Dahiye said.
Many families no longer own livestock as their herds have been decimated by repeated droughts. They are known locally as 'drop outs' from pastoralism, having moved to the outskirts of towns hoping to get casual work or food aid.
"Instead of looking for the root cause, we are mostly being fed with the relief food. People became so dependent on this," Dahiye said. "Some families have been on (the government's) General Food Distribution for more than 10 years."
(Editing by Katie Nguyen)
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