People in Madagascar are experiencing an exceptionally acute food and nutrition crisis that is leaving thousands of children severely ill and pushing families into extreme poverty. Since March 2021, Doctors Without Borders/Médecins Sans Frontières (MSF) emergency teams have been setting up more and more mobile clinics to deliver humanitarian and medical assistance in several of the country’s districts. We have now begun distributing food and recently opened an inpatient therapeutic feeding center in the hospital in the town of Ambovombe, on the southern tip of the island.
After years of back-to-back droughts, the prospects for the harvest—which in a normal season would now be well underway—are extremely poor. According to the Famine Early Warning System Network (FEWS NET), food production is expected to fall up to 70 percent below the last five-year average. Though there may be variations between districts depending on climate, irrigation, and availability of aid, the situation is catastrophic in the region where MSF works—and the crisis could worsen with the onset of the lean season in October.
Food distributions
“We’re seeing malnourished children struggling to regain weight after weeks of treatment in our mobile clinics,” said Bérengère Guais, MSF head of emergency programs. “The medical care we provide and the half-rations different organizations have been distributing are not enough to reverse the trend in a setting where there is so little access to food. A massive increase in emergency food assistance is an absolute priority.”
In addition to treating malnutrition and its medical complications, in June MSF began distributing food rations to the families of malnourished patients to help restore their access to food. One ration contains approximately 145 pounds of rice, beans, oil, and salt, which is enough to cover a family’s needs for one month. Our teams have already distributed 1,588 rations (around 104 metric tons of food), and distributions will continue for the next few months.
Mobile clinics
Mobile MSF clinics screen for and treat acute malnutrition at more than 15 sites in the Anôsy and Androy regions (14 in Amboasary district and three in Ambovombe district). Our teams have treated 4,339 people suffering from moderate or severe acute malnutrition since they began providing medical assistance at the end of March.
The condition of malnourished children is exacerbated by a number of associated diseases, principally malaria, which affects 22 percent of our young patients, respiratory infections (18 percent) and diarrheal diseases (14 percent).
In southwestern Madagascar, other needs assessments and malnutrition-screening initiatives are being conducted and will be extended to Androy and Atsimo-Andrefana regions in the coming days.
Inpatient care
Working in partnership with the local authorities, six weeks ago MSF began construction of an inpatient therapeutic feeding center in the hospital in Ambovombe to scale up inpatient care for critically ill malnourished children. The 40-bed center is now open to patients, and an extension is already underway to double capacity.
On June 21, 2021, the first three patients were admitted accompanied by their mothers and, by the end of the first week after opening, 28 children had received treatment.
Improving access to water
A third of the malnourished children we treat in our mobile clinics in Amboasary district also suffer from either diarrhea or parasitic diseases, indicating a lack of access to clean water.
Since March, MSF has distributed about 50,000 gallons of water, 2,872 jerry cans, and 3,870 bars of soap. Our teams have also repaired 11 hand pumps at existing water points and seven more will be back in service soon. Construction of nine new hand pump wells has begun and should be completed in July and August. We are also looking into installing boreholes in 24 locations.
