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According the GLOBAL HUNGER INDEX, 12,3% of Pakistan’s population is undernourished, and 37,6% of children under five are stunted.
These alarming numbers of undernutrition result from a fatal combination of food insecurity, lack of access to health care, high poverty rates, poor dietary practice, and access to clean water. The Covid-19 pandemic added further woes to the country’s long list of challenges, threatening agricultural production, employment and food security of its citizens.
Sindh was the first province with reported COVID-19 infections and the first to respond by instituting a lockdown strategy. In rural areas of Sindh, where Action contre la Faim teams primarily work, many families were trapped under strict confinement measures when getting enough food, selling produce, or receiving medical care was challenging due to transportation limitations. Besides, lack of clear communication spread rumors, discouraging families from coming to hospitals out of fear of contracting the new disease. Due to delays, Action contre la Faim stabilization centers have admitted many children in very critical conditions.
Kiran brought her 6-month-old baby girl Ruksana to the nutrition stabilization center at district hospital. Baby’s serious medical condition has pushed the parents to bring her urgently to the hospital: “We heard that if you sneeze or even cough, they suspect you of having coronavirus and take you away. We would not even consider visiting bigger cities, so coming here for treatment was a big deal for us”. Kiran shared with us that her daughter’s condition was so serious that she had no chance of surviving: “She was so sick that she would not drink milk or even cry. Here she is feeling much better, gained energy, and has color in her face”.
At the same time as Ruksana, a 2-years-old girl was also admitted to the stabilization center. Her mother Mala explained to our teams: “It’s been 3-4 months [since] my daughter was ill, but we haven’t visited a big city. We were not going anywhere out of fear of coronavirus”. Despite minor complications, the child has fully recovered and returned home.
Early admission can play a crucial role in children’s recovery and their further development. However, many families struggle to bring their children on time due to large distances and lack of public transportation due to lockdowns. Kausar Parveen traveled 100 kilometers with her 6-months-old baby-girl Zainab to get to the outpatient department at the rural health center in Bulri Shah Karim. “My daughter was getting weaker day by day. I took her for treatment to many places, but she was not getting better. A Community Health Worker told me about this center, that’s why I brought my daughter here, and she is much better now”.
Children diagnosed with severe acute malnutrition can receive medical treatment at more than 260 outpatient clinics in rural Sindh. Despite COVID-19 lockdown measures, Action contre la Faim teams worked against the clock maintaining nutrition services across eight districts of the
province. In addition to outpatient wards, nutrition stabilization centers remain open 24/7 admitting malnourished patients with serious complications. “We receive patients who are lean and weak, but after treatment, they are stabilized. On average, we keep patients here for 10-15 days. We make sure the children are completely stable before we let them go”, explains Dr. Sohni Laghari, medical officer at Nutrition Stabilisation Centre in Tando Allah Yar. “We were provided with safety kits including sanitizers, gloves, and masks to continue our work easily.”
By December 2020, Action contre la Faim teams treated 111,828 Cases of severe acute malnutrition among children. A large network of more than 2000 community health workers operates in villages and hard-to-reach areas to screen and identify malnourished children and conduct follow-up visits for recovering children at the doorstep of every household. They are in continuous contact with nutrition assistants, so children are followed up regularly and per their medical treatment.
Even though the global rate of child mortality decreases, a staggering percentage of 6,9% of children in Pakistan still die before their fifth birthday because of undernourishment. To bring this figure to zero, we must change how hunger is viewed and tackled among communities and institutions. Pakistan is subject to multiple disasters, such as drought, locust swarms, floods, and heatwaves that further fragilize rural populations, often disadvantaged and vulnerable. Ending undernutrition must be our joint struggle.
*Action contre la Faim implements the European Union funded “Programme for Improved Nutrition in Sindh (EU PINS)”. It has three components focusing on advocacy, undernutrition treatment (PINS 2) and prevention (PINS 3). The PINS-2 component is implemented in 8 districts namely Tando Allah Yar, Tando Muhammad Khan, Sajawal, Thatta, Shikarpur, Kambar Shahdadkot, Larkana, and Matiari.
**All interviews have been conducted in August 2020.
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