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Halima is two years old. Sitting on the knee of her grandmother, Sadia, she is wide-eyed, full-faced and curious. It is hard to believe that only four months ago, she was close to death.
Somalia is in crisis.
The twin perils of climate change and conflict have forced 3.8 million Somalis from their homes, severing their connection to land and livelihoods.
Leaving barren fields and dead livestock behind, they travel to displacement camps in the hope of finding food and water.
An estimated 1.8 million Somali children aged under five experienced acute malnutrition in 2023.
Halima was one of them.
Maryan was pregnant, and already a mother of five, when she and her husband divorced. As her family fell apart, her animals were dying, one by one. The rains had failed again, and the survival of her children was hanging in the balance.
A decision had to be made: Stay or go?
In Mogadishu, her mother Sadia was living in a makeshift shelter, one of an estimated 1.2 million displaced people living in the city. “I was displaced two years ago,” says Sadia, “after four consecutive failed harvests due to drought.” To survive, Sadia takes whatever work comes, such as washing clothes for the neighbourhood households.
Maryan decided to leave her small village in the Lower Shabelle region and take her children to Mogadishu.
Sadia and Maryan would survive together.
The European Union is supporting eight humanitarian organisations, including Concern, in providing emergency life-saving interventions in communities affected by drought and conflict in Somalia.
The Caafimaad Plus Consortium is providing food and nutrition assistance, water and sanitation services, healthcare, and shelter to vulnerable communities.
On the 24th of May 2023, a team of community health workers, trained by Concern, knocked on the door of Sadia’s shelter in a Mogadishu displacement camp. The team were conducting a routine door-to-door screening exercise, looking for possible cases of malnutrition.
Their attention was quickly drawn to Halima.
A health worker placed a Middle-Upper-Arm-Circumference (MUAC) band around Halima’s arm and pulled it closed. The length of the band was divided into three coloured sections: green, yellow, and red. Once fitted snugly around her little arm, it was clear that Halima was in trouble. The band had stopped at red, indicating severe acute malnutrition.
“I thought that everything was for a fee, and I couldn’t afford to pay a fee for medical consultation,” says Sadia. “When the community health worker came to my house, and saw my grandchild’s illness, they told me to take her immediately to the health centre, where I can get free treatment services.”
At this stage, Halima was very weak. Her hair was brittle. Her belly was swollen. She was feverish, coughing, and not eating or drinking. A nurse at the health centre quickly referred Halima onwards to the Banadir Hospital Stabilization Centre in Mogadishu, a facility supported by Concern.
She arrived weighing just 5.7 kg, less than half the normal weight of a child her age.
Halima was put on a diet of ready-to-use therapeutic food (RUTF): a high-nutrient paste made from powdered milk, peanuts, butter, vegetable oil, sugar, and a mix of vitamins and minerals.
After two weeks of treatment, Halima’s condition began to gradually improve, and her appetite began to stir. She was discharged from the Stabilization Centre, but continued her treatment as an outpatient.
“Halima was brought every week to the health centre for check-ups on her progress,” says Sadia. “The nurse regularly provided RUTF sachets, according to her weight. After weeks of visits, her weight gradually increased, and her condition improved.”
Sadia, who was Halima’s primary carer while Maryan was still pregnant, received support and guidance regarding infant nutrition and hygiene.
After eight weeks of treatment and supplementary feeding, Halima was discharged from care, weighing 9.5 kg. Her MUAC band was in the green, and her grandmother was relieved.
“Before I came here, my grandchild was unable to feed and play but now she is well and healthy, al hamdullilah [praise be to God].
Between April 2023 and September 2023, the Caafimaad Plus Consortium treated close to 10,000 Somali children suffering severe acute malnutrition, with 98% making a full recovery.
“I am very happy to see such a difference between her first day of treatment, and today,” says Sadia.
“Thanks to Concern. Thanks to Allah.”
