Droughts in Grand Sud, Madagascar, have sharply increased in both frequency and intensity in recent years. Bearing the full brunt of the effects of climate change, families who live in this region have seen drastic impacts on their livelihoods and health.
In 2020, there were virtually no rains. Historically low rainfall levels depleted the few sources of clean water that existed in this chronically dry region. As a result, water-bourne illnesses such as diarrhea have increased sharply. And, without rain, there could be no harvests. Food insecurity and malnutrition rose.
“What little I produced in the past has been completely consumed. I don't know the dates, but it's been a long time since I had a harvest,” says Maliha, 38, a single mother of eight children. “Since the rain stopped, the children are not eating regularly. I give them whatever I can find, like cactus leaves. With this diet, they have diarrhea and nausea, but we have no choice. At least it doesn't kill them.”
Many families struggled to survive 2020, and hoped for a better year in 2021. Sadly, the rains have not yet come.
GRAND SUD ON THE VERGE OF FAMINE
“Kéré” means famine in Malagasy, Madagascar’s national language. It’s a term that too many families are familiar with, too often: periods of hunger come annually between harvests in Grand Sud.
This year, the lean period has been longer and drier than usual – and the hunger crisis more severe. Persistent drought and sandstorms have resulted in the second consecutive year of poor harvests. And, while food prices continue to rise, families have run out of what remained of their reserves and many cannot afford what’s in the market.
Right now, an estimated 1.14 million people in the Grand Sud are suffering from severe acute food insecurity, including nearly 14,000 people who are struggling to survive famine conditions. More than 135,000 are acutely malnourished, and more than 27,000 of those children are suffering from the deadliest form of hunger - severe acute malnutrition.
“The lean season comes every year, but right now, it is particularly hard. It has lasted the whole year. Before, the rain fell during the months of January, February, and March and allowed the cultivation of varieties of melons and pumpkins,” says Jean Delacroix Tsimanantsiny, Deputy Head of Programs for Action Against Hunger in one of the hardest hit districts, Ambovombe. "This year, the rains have never fallen and the population is suffering."
Mobile Teams Respond
Action Against Hunger’s 25 mobile health and nutrition support teams reach families that live furthest from health centers, targeting the areas with the highest numbers of malnourished children across nine districts.
When they arrive in a village, the mobile teams screen all children under five years old for malnutrition. A typical team includes a screener, who uses a color-coded arm band, height board, and scale to check a height, weight, and child’s nutrition status, and two nurses, who can provide treatment for malnutrition and other illnesses. If a malnourished child needs additional treatment, they are taken to a nearby outpatient center. The most severe cases, or cases where there are additional medical complications, are transferred for inpatient care at the local hospital.
“The situation has really deteriorated. Before, there were nearly 80 cases of children needing treatment at the health center, but now there are nearly 400 cases. That is why we must come – as reinforcements. The numbers are increasing both at the health center and in the villages,” explains Hamelo Lahimalio, who serves as a nurse on one of our mobile teams.
By working directly in the village, our teams are as close as they can be to the communities and can catch cases of malnutrition earlier, to reduce the need to visit a health center, which is far from home and often overloaded with patients in need.
After children are screened and rations of treatment are distributed to those in need, our teams work with mothers to teach them about what is causing malnutrition in their children. We also show them how to conduct an appetite test with their little ones using a packet of Ready-to-Use Therapeutic Food (RUTF), a special peanut paste. Often a sign of malnutrition worsening is a loss of appetite and interest in food.
“We cannot feed our children. This is what makes us suffer the most. There is no rain, so no harvests. The land is no longer arable and is abandoned. We eat plants - anything we can pick up.” says Donoe, a 40-year-old mother of six children. “This support helps us a lot. My child is now healthy after receiving the treatment.”
"We cannot feed our children. This is what makes us suffer the most."
Between October 2020 and March 2021, our teams have provided treatment to 8,727 severely malnourished children, 8,582 moderately malnourished children, and 9,611 children with other illnesses.
"I remember a child who had only skin and bones. The situation seemed without hope,” recalls Florentine Ramanampisoa, an Action Against Hunger nurse. “It was hard to think he could make it through, it seemed hopeless, but we never gave up. We told the mother to follow the treatment protocols carefully and, luckily, he recovered.”
The hunger crisis in Grand Sud threatens to drag on for months. Even if the rains come at the end of the year, farmers’ resources are depleted after such a poor harvest. And now, they lack the resources to afford fertilizer, seeds and other tools to plant their fields adequately. With the nutrition situation already more than alarming, our teams will continue their tireless work to help children and families who are suffering from hunger in the region.