Photo: Ousmane, one-and-a-half year old boy treated by our staff in Mauritania. Lys Arango for Action Against Hunger.
Our communications officer, Lys Arango, was recently in Mauritania, where she met Aminata and her son, Ousmane. Here, Lys shares her story:
“Tell me Aminata,” asks the psychosocial worker, “how many days ago did Ousmane start to have a fever?” With her fingers, Aminata indicates two, puts up a third finger but settles on two. Her son, a year and a half old, does not open his eyes. Diarrhea, vomiting and malnutrition have left him without strength. He is on the verge of fainting. He wakes up with the bursts of pain at times, but then slumps again, as if surrendering.
The mother also has no energy left after carrying the baby from her village to the Selibaby hospital, in southern Mauritania. Aminata’s eyes seem do the talking for her, as if to say “please, do something for him, because I cannot anymore.”
The main enemy of this border region with Mali and Senegal is malnutrition, the medical name of hunger. Patients arrive at the hospital with infections or malaria, but generally, the real issue is the lack of food, which decimates immune systems. Once the children enter the Center for Intensive Nutritional Rehabilitation, supported by Action Against Hunger, the treatment lasts an average of two weeks.
Selibaby hospital received 2,795 cases last year. Sometimes they don’t have enough capacity to treat everyone, especially during the “hunger gap” from June to September, the time between the two harvests. The team does what they can – they try to stabilize and help their patients recover – but they do not always succeed. Some don’t make it. Despite the tragic environment, there is a man who radiates enthusiasm and optimism.
His name is Pape Sall, a psychosocial worker who treats patients as if they were his own children.
Aminata, is, in fact, another child. She is 17 years old. While the nurse examines little Ousmane, Pape Sall asks the mother if she has more children.
“Yes, I first gave birth at the age of 14.”
“Who helps you at home?”
“My mother in law.”
“Where is your husband?”
“He is away, doing the transhumance.” (Transhumance is the seasonal movement of livestock between pastures.)
“And how is it possible that you have not come to seek help before?”
“Action Against Hunger came to my community and gave me a paper to refer Ousmane to the hospital. But then it took me some time to get here. I live far away,” says the girl.
The nurses take care of the young child. They weigh him, they measure him, they take his temperature and once all the indicators confirm that Ousmane suffers severe acute malnutrition with medical complications, the treatment begins: F-75 milk and amoxicillin. Aminata observes with a painful concern that her son is still not opening his eyes. The hours pass, the evening gives way to darkness, and they lie down together on a hospital stretcher under a mosquito net. In the same room, five other women sleep with their children. In the next room, three more.
The next morning, Ousmane wakes up apathetic, without appetite. The nurses give him therapeutic milk and antibiotics, but the mood of Aminata only improves on the third day, when Ousmane opens his eyes to ask for food. He is hungry. “Since I left the village, at every moment he told me that my child was going to die. Only when I have seen his eyes again, I have recovered my hope,” says Aminata, who, little by little, is also opening up. She has made friends among the other mothers and she says one has been of especially great help: “The case of her daughter has comforted me. If she, who was very very sick, has gone ahead, Ousmane will also,” she says with a sincere smile.
On the fourth day, the child eats the therapeutic food, based on peanut paste, with great appetite. Then, Pape Sall organizes a group activity. In it, mothers and children gather on a carpet dotted with toys. He incites Aminata to play with Ousmane, who becomes infatuated with a big ball, almost bigger than him.
“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 they feel that we care about them and their children, they will tell us how they really are. It is important to understand what lies beneath each case to help them recover.”
Photo: Pape Sall, Aminata and Ousmane. Lys Arango for Action Against Hunger, Mauritania.
Aminata ends up sharing that her in-laws help her because her husband has no means. He is now in Mali with the cattle and has not yet learned that his youngest son is sick. “For me everything is a great burden. I would like him to be here to see how tired I am,” she explains. Then, asked about her early marriage, she replies, embarrassed, “It was not my choice, I wanted to continue studying, but my parents forced me.”
This is not an isolated case; in Mauritania, 32% of women marry before the age of 18 and we know there is a clear relationship between malnutrition and children born to adolescent mothers.
Thanks to funding from The State Department’s Bureau of Population, Refugees, and Migration, we are piloting a program in Mauritania, along with Bangladesh and South Sudan, on nutrition and gender-based violence (GBV) risk mitigation. As a part of the project, we are adapting technical tools and guidelines to integrate considerations for gender-based violence risk mitigation, along with training psychosocial workers like Sall on the signs of GBV.
On July 1, 2019, Ousmane is discharged from the hospital. “His recovery has been very fast,” says Safiatou, the head of the centre, “in just five days, he has gained half a kilo, the fever has disappeared, and with it, any medical complication.”
Aminata smiles. “He can continue the treatment against malnutrition at home. Ousmane is out of danger,” adds Safiatou. The mother, full of emotion, runs to collect her belongings. When the taxi arrives, they head towards it, almost flying.
On the journey to Zenyga, Ousmane goes terribly quiet. He is tired from this colossal struggle for his life. In his village in the desert, next to his mud home, his family is waiting for him in the shade of a thatched roof, relieved Ousmane is on his way back.
Photo: Ousmane returns home. Lys Arango for Action Against Hunger, Mauritania.