It’s called the “hunger gap” – the time between the two annual harvests in the Sahel region of West Africa. Each June to September, water sources dry up and food supplies dwindle. At Selibaby Hospital’s Nutrition Center in Mauritania, open beds are few and far between – sometimes, the hospital runs out of space completely.
Most of the hospital’s patients are struggling with malnutrition and related diseases. Last year, the hospital treated 2,795 people – primarily children under five years old – for malnutrition, with inpatient treatment lasting an average of two weeks. Within the hospital’s Nutrition Center, which is run by Action Against Hunger, our team does everything we can to stabilize and help malnourished children recover, and we succeed far more often than not. But sometimes, children arrive too late.
In the middle of this heart-rending environment, one man’s kindness touches every mother and child he encounters: Pape Sall, a psychosocial worker who treats children as if they were his own. He organizes counselling sessions with mothers and children, hosts group play dates, and makes everyone around him feel more comfortable despite the trauma of battling a life-threatening condition.
Pape Sall’s work is crucial to helping mothers like Aminata, who carried her 18-month-old son, Ousmane, for days to reach Selibaby Hospital, desperate to save his life. Both mother and child arrived exhausted.
“Tell me, Aminata,” asks Pape Sall. “How many days ago did Ousmane start to have a fever?”
Aminata uses her fingers to indicate two, three, two days – she does not speak, but the despair is clear in her eyes. At 17 years old, Aminata is still a child herself. She has another child at home with her mother-in-law: she gave birth to her oldest when she was just 14.
Ousmane does not open his eyes: diarrhea, vomiting, and malnutrition have left him without strength. He is on the verge of fainting. Occasionally, he wakes up with the bursts of pain, but then he falls quiet again, as if surrendering.
“Action Against Hunger came to my community and referred Ousmane to the hospital. But it took me some time to get here. I live far away,” explained Aminata.
Nurses weigh and measure Ousmane and take his temperature. All the indicators confirm that the little boy suffers from severe acute malnutrition with medical complications. Then, treatment begins: F-75 milk formula and amoxicillin.
Aminata watches with painful concern, as her son’s eyes remain closed. The hours pass and darkness falls. They lie down together under a mosquito net on a hospital bed. In the same room, five other mothers sleep with their children. In the next room, three more women lie beside their babies.
The next morning, Ousmane wakes up lethargic, still with no appetite. The nurses give him more treatments of therapeutic milk and antibiotics.
Aminata’s mood finally improves on the third day, when Ousmane opens his eyes to ask for food – he is hungry.
"Since I left my village, at every moment, I thought my child was going to die. Only now, when I see his eyes open again, have I have found hope again,” says Aminata, who found support in the other mothers at the Nutrition Center. One mother has been of great help: "Her daughter’s case comforts me. If she – who was very, very sick – has recovered, Ousmane will, too."
By day four, Ousmane has a big appetite and starts a new phase of his treatment: the nurses give him Plumpy’Nut, the high-calorie, nutrient-filled ready-to-eat therapeutic peanut paste that will bring him back to full health.
Pape Sall organizes a play session where mothers and children gather on a carpet dotted with toys. He encourages Aminata to play with Ousmane, who becomes infatuated with a ball that’s nearly bigger than he is.
“We have to work on building up the trust of families,” explains Sall. “If the doctor asks ‘how are you?’, they will always respond ‘well’. But if parents feel that we truly care about them and their children, they will tell us how they really are. It is important to understand what lies behind each case to help them recover.”
Aminata opens up to Pape Sall, sharing that her in-laws help her with the children. Her husband, who does not have a regular source of income, has not yet learned that his youngest son is sick – he has been in Mali with their cattle. "For me, everything is a great burden. I would like him to be here to see how tired I am,” she says.
When asked about her young marriage, Aminata replies, embarrassed, "It was not my choice. I wanted to continue studying, but my parents forced me.” Hers is not an isolated case: in Mauritania, 32% of women marry before the age of 18. According to UNICEF, there is a clear relationship between malnutrition in children and maternal age: adolescent mothers are more likely to give birth to low-weight babies and grow up undernourished.
On the fifth day since their arrival, Aminata hears the joyful news: Ousmane is well enough to be discharged from the hospital.
"His recovery has been very fast," says Safiatou, head of the Nutrition Center. “In just five days, he has gained more than a pound, his fever has disappeared and, along with it, any medical complications. He can continue malnutrition treatment at home. Ousmane has come out of danger.”
Aminata, smiling, runs to collect her belongings, and they take a taxi home. On their journey, Ousmane falls quiet – he has overcome a tremendous struggle.
Arriving at his village in the desert, seeing his mud house, and his family waiting for him in the shade of a thatched roof, it seems as if Ousmane finally understands that he has been saved and begins to cry. It starts low, and then becomes strong – a victory cry.