Massiye Nyang’wa, a nurse working in Malawi, and Sister Eugénie Andrée Benga, a nurse working in Senegal, describe the effects of hunger on children.
Can you tell me about your work?
Massiye: We have health units and nutrition centres. If there are children under age five who are severely malnourished, we refer them to hospital.
There are two types of hunger in Malawi. The first is marasmus. The children look normal, but their skin is fragile and sometimes they have blisters on their skin. With kwashiorkor, the second type, they are totally lacking food—no carbohydrates, no protein, nothing. They are severely wasted. They look like an old person, and their skin does too—it’s wrinkled. Their eyes are sunken. They are irritable when you touch them. There’s no fat under their skin.
With hunger, the hair becomes soft and sometimes falls out. With hungry children, their eyes are dry and fixed. The eyes don’t move much. They produce little urine or stool.
Can they walk?
Massiye: Yes, they can walk.
But they feel faint, dizzy. They don’t see clearly. They don’t feel like playing. They just want to stay near their mother or someone they trust.
When they’re very hungry, they just sleep. There’s not a lot of movement.
Can you tell me about one child you remember?
Sister Eugénie: It happened in September 2012. It was a girl who suffered a minor burn. When she came to the clinic for care, looking at her, I felt something was certainly wrong–not only because of the burn, but also she was thirsty and hungry. Her parents were not giving her enough to eat.
I gave her milk, she swallowed everything in one gulp. By the time I was treating her wounds, she started licking the anti-burn cream that I spread on her body.
Those with her realized she was hungry. Given her condition, she could not eat solids. I continued to give her fluids. Unfortunately, she passed away in the evening when everything seemed back to normal.
What is the best way to feed a severely malnourished child?
Massiye: If you give them food, they will eat it fast and might vomit. You have to feed them slowly. We give them milk until they gain weight.
Sometimes they can’t open their mouths—their mouths are dry and their teeth are locked. We put a tube through their nose until the child becomes responsive. We’ve saved the lives of many malnourished children.
Severe malnourishment affects your brain. The brain needs food too. When malnourished children go to school, they can’t learn well. Their performance in school is poor.
With chronic malnutrition, you are getting food, but it is not enough. The children will be stunted.
What are some other effects of hunger?
Sister Eugénie: Hunger causes a disruption in the body, disturbances in all systems. Everything is in slow motion: there’s disrupted sleep, decreased muscle tone, decreased responsiveness to your surroundings. And disease develops more easily in the hungry, who do not have enough antibodies to fight it.
Have there been particularly bad years?
Massiye: In 2002, there was a lot of hunger here. It was very pathetic. They would stay it was like someone had taken off their stomach. With some people, right when we gave them food, they died. It was like they’d been waiting for that moment.
Sometimes we find elderly people who have died of hunger. There was no one to fend for them.
What does Caritas do to help?
Massiye: When CADECOM (Caritas Malawi) finds hungry people, we give them food and help them grow vegetable gardens, and things like ground nuts. We also help communities store food in food banks. And we distribute things like goats.
Sister Eugénie: In my area of Senegal, Caritas runs projects to fight malnutrition among children and pregnant women.
It also provides emergency relief, distributing food, especially after a poor harvest in late winter or during the lean period.
Caritas piloted many development projects in agriculture, sanitation, water, livestock, health and education, especially to help women. The goal is self-sufficiency and food security.
Malawi has good land. Why is there so much hunger?
Massiye: The first food that is harvested is used as a source of income. By July or August, there could be no food on the table.
We have a lot of water in Malawi. But there is hunger in places where the rains weren’t very good. I would invest in irrigation systems so there could be two harvests a year. Then people would have more maize and vegetables.
What are some other things people should know about hunger?
Massiye: When people with HIV have no food and take their medication, it makes them more hungry. The medicine is distributed through your body by the food.
Hunger in Malawi especially affects women. A woman trying to feed her children and husband will even turn to prostitution to put food on the table. Hunger becomes a gender issue.
Sister Eugénie: There can be a decline in productivity, begging, irritability, anxiety, aggression, theft.
There are places where you do not feel much the scourge of hunger–and that is due to solidarity, people helping.
By contrast in some circles, not having enough food is considered shameful. Many do not have enough to eat, but remain silent or give another impression so that others don’t know what’s going on. And the situation gets worse…