Blog - ECHO in the field

Fighting Acute Malnutrition in Djibouti

“Two trainees nutrition agents study the statistical table that enables a monthly overview of the children admitted to Nutrition programmes, including details on how many, their individual status, whether they recovered, been referred or quitted the programme. With these statistical tables reliable data on Nutrition can be gathered.

Two trainees nutrition agents study the statistical table that enables a monthly overview of the children admitted to Nutrition programmes, including details on how many, their individual status, whether they recovered, been referred or quitted the programme. With these statistical tables reliable data on Nutrition can be gathered.

20/12/2011 – This year, the European Commission Directorate General for Humanitarian Aid and Civil Protection (ECHO) has provided €2.6 million towards humanitarian aid projects in Djibouti. Two implementing partners: UNICEF and Action Against Hunger (Action Contre la Faim – ACF) have already begun putting €1 million of this funding to work. In partnership with the Ministry of Health, ACF has launched a national capacity building exercise aiming to tackle malnutrition across the country. Camille Biet of ACF tells us more about it.

It is rare that Djibouti makes the news headlines. However, this small country in the Horn of Africa, is everything but ordinary. Bordered by Somalia, Ethiopia and Eritrea, Djibouti is a relatively peaceful haven in a region where turmoil seems to be the norm. Its strategic geopolitical location has enabled it to develop a thriving trade industry.

But apart from trade, which benefits only a few, Djibouti is all about stones and dust. In this dry and hot land, burnt by the scorching desert sun, the country is unable to produce any basic commodity. About 80 percent of the food consumed in Djibouti is imported. Prices follow the fluctuation of the market, while 74 percent of the population lives on less than US$3 a day. Many people in Djibouti cannot afford to buy food everyday.

While food security is deplorable, getting access to clean water is also a daily challenge for many families. In this context, the underlying risks of malnutrition are great. In 2010, UNICEF and the Ministry of Health estimated a 10 percent rate of Global Acute Malnutrition.

Although there are some public sector nutritionists in the country, a major capacity gap remains. Indeed, the exact state of malnutrition in the country remains ambiguous. In partnership with the Ministry of Health, ACF has launched a national capacity building exercise to fill the knowledge gap and tackle malnutrition at the national level.

Training Health Workers

In November 2011, ACF and the Djibouti Ministry of Health started training sessions for health workers. Two ACF trainers, assisted by one member of the National Programme on Nutrition, provided the training. The sessions included a basic course on what Global Acute Malnutrition is, how to diagnose it, and how to treat it. The course also covered how to manage nutrition centres, stocks, distribution and how to collect data to generate useful medical statistics.

“The level of knowledge is very different from one session to another,” says Gwenaelle Garnier, a trainer from ACF. “A lot depends on where the team we are training works, their previous experience in managing malnutrition, and of course their willingness to learn.”

Trainings started during the first week of December in Ali Sabieh, in the southern part of the country. Seven training sessions have been conducted so far, benefiting 104 health workers in Djibouti Ville.

Improving Knowledge and Self Confidence

Faizal Adbi is a nurse working in Balbala 2, a health community centre on the outskirts of Djibouti City, where malnutrition rates are very high. Abdi, who works on a programme for the Integrated Management of Childhood Illness, participated in one of the nutrition training courses provided by ACF in collaboration with the Ministry of Health.

“I see a lot of malnourished children at the centre and now I am the one referring them,” says Abdi. “The training has improved my knowledge on malnutrition in general and on anthropometric methods. Now I know how to take the child’s weight, height, etc… I did not have enough knowledge before. I did not even know how to position the child when you take their weight,” adds Abdi.

“I also gained skills to do statistical analysis. This will be very useful for me, especially if one day I become responsible for the centre. I will have to monitor the work of the nutrition department and I’ll have the necessary knowledge to correct mistakes,” explains Abdi.

On the Job Supervision

As a follow up to this training, Action Against Hunger (ACF) and the National Nutrition Programme of the Ministry of Health will assist trainees in the field and supervise their work.  “I hope to see the results of the training on the ground once we start with the supervision,” says Gwenaelle from ACF. “I know the result will not be immediate, but I’m hoping to see small changes, tiny improvements that, when taken together, will bring about more effective management of malnutrition.”

This participative approach will benefit a total of 390 health workers in Djibouti City and in the south of the country. ACF is planning to scale up these activities next year in the northern region thanks to the support of ECHO and thus cover the entire country.

Camille Biet
Action against Hunger
Djibouti, December 2011

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