For the majority of families in the Central African Republic (CAR), subsistence farming is their primary activity. They live a hand-to-mouth existence. Sometimes they can grow a little extra to sell at the market. “Before the conflict, we had lots of animals and we could grow our crops – corn, peanuts, beans and cassava,” says Frederic from Boungou village in eastern CAR.
However, the recent armed conflict, which occurred during the harvest season, prevented people from accessing their farmland and therefore disrupting livelihoods and a vital activity of CAR’s economy. This was compounded by the looting of cattle, seeds, tools, and already-meagre food reserves. Frederic continues:
“When the rebels came, they took everything. Now life is very difficult. Some people have started farming their land again but they can’t produce enough. They need more seeds but they have no money to buy them. There is a serious problem of food shortage; sometimes we only have one meal a day.”
CAR’s nutritional situation has been steadily deteriorating, with soaring food prices in the short term, food insecurity in the midterm, and devastating nutritional conditions for the most vulnerable in the long term. A recent Emergency Food Security Assessment by the United Nations’ Office for the Coordination of Humanitarian Affairs revealed that 484,000 people (10.5% of CAR’s total population) are at risk of food insecurity.
According to the World Food Program, 8% of children under 5 years old in CAR are malnourished, but this hides wide regional variations. International Medical Corps found a malnutrition rate as high as 15.8%, which is classified as ‘critical’ by the World Health Organisation, in parts of Haute-Kotto Prefecture in eastern CAR. Furthermore, the crisis impacted treatment services for malnourished children, as insecurity hindered humanitarian access and the transportation of vital food supplies.
International Medical Corps CAR’s Medical Director, Timothee Shelulabe, explains the lasting impact of malnutrition:
“Most of the damage caused by malnutrition occurs during the 1,000 days between conception and a child’s second birthday. Pregnant women who are malnourished are more likely to give birth prematurely or have an underweight baby. For the children that survive, a lack of nutritious food, combined with repeat infection or illness, affects the development of their brains and bodies. Even if a child’s diet improves later in life, the damage caused by malnutrition can be irreversible.”
International Medical Corps works in the Vakaga, Haute-Kotto, and Ouaka Prefectures of CAR providing primary health care and nutrition services to refugees, internally displaced people and conflict-affected communities. Regular malnutrition screenings for children under 5 and pregnant and lactating women are conducted at health centres and mobile clinics and through a network of Community Health Workers. Those identified with malnutrition are entered into a supplementary feeding program, an outpatient therapeutic feeding program or a stabilization center depending on the severity of the malnutrition and if the patients has any other medical complications.
Prevention is equally as important as treating malnutrition. During ante-natal and post-natal consultations, International Medical Corps midwives provide women with key health and nutrition information, such as good infant and young children feeding practices, including the benefits of breastfeeding, and the importance of good nutrition during pregnancy. Mothers and caregivers with children in our feeding programs receive information about how to prepare meals using local foods that are rich in vitamins and minerals.
In addition, International Medical Corps’ team of Community Health Workers conduct community outreach activities, discussing topics such as the early signs of malnutrition and what help is available. They also teach hand washing and good hygiene practices, which help to reduce a child’s susceptibility to infections or illnesses that can worsen or even cause malnutrition.