Why are we there?
- Armed conflict
- Endemic/epidemic disease
- Healthcare exclusion
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Activities 2012
Combining Emergency Response with New Strategies to Prevent Malnutrition
Medecins Sans Frontieres/Doctors Without Borders (MSF) teams have been conducting nutritional surveys and needs assessments in several regions in Chad that have been projected to be the most severely affected by poor harvests, spikes in food prices, and trade disruptions resulting from the instability in neighboring Libya.
With little access to health care and a very limited local capacity for emergency response, the Chadian population is extremely vulnerable to malnutrition and epidemics.
Malnutrition treatment programmes
By the end of March, MSF had opened new emergency malnutrition treatment programmes in Biltine and Yao, where rates of acute malnutrition of as high as 24 percent and 20 percent, respectively, have been reported.
The Biltine program will include an intensive therapeutic feeding centre and treatment for critically-ill non-malnutrition patients. Outpatient therapeutic feeding centers in the outlying areas are also planned.
In Yao, in Batha region, MSF is providing inpatient and outpatient care, as well as primary health care and vaccination services. Health assessments are taking place in the regions of Hadjer Lamis, Abéché and Ouaddai.
Paediatric hospitals
MSF is continuing to run a 170-bed paediatric hospital in the town Massakory in western Chad's Hadjer Lamis region. The peak of malnutrition this year is expected in July, though from January through the end of March, 2,100 children have already been admitted, the majority of them for reasons related to malnutrition.
MSF is also conducting operational research aimed at developing strategies to lessen the impact of the seasonal peaks in malnutrition cases in Chad. In order to reduce the need for inpatient malnutrition care, MSF has started distributing ready-to-use supplementary food, an enriched peanut paste, with the intention of reaching thousands of children aged between six months and two years over the coming months.
Pre-empting malnutrition
A study is being carried out to evaluate the most efficient means of distributing these highly effective nutritional products in the effort to counter or even pre-empt malnutrition (which also involves simplifying protocols and decentralising management of acute malnutrition). Additionally, several immunization campaigns have been planned in an attempt to break the vicious cycle of disease and malnutrition.
Ultimately, the aim of this study it to define the best way of organising the distribution of nutritional supplements to reduce the number of new cases of severe acute malnutrition, decrease the need for costly inpatient nutrition centres to be established, and ease the treatment of malnutrition with outpatient structures. Mothers can provide the supplements themselves to their children. The results of the study, which are expected in 2014, will be shared and discussed with the Chadian Ministry of Health.
Measles vaccination in N’Djamena, Chad. © Mathieu Bichet/MSF
Meningitis outbreak
Besides opening malnutrition treatment programs, MSF teams are responding to a meningococcal meningitis outbreak in Chad. By the end of March, eight districts had surpassed the epidemic threshold for the disease and four other districts were placed on alert.
In the eastern Oum Hadjer region, the epidemic threshold was passed during the week of February 12, and by the end of March, a total of 252 meningitis cases and 10 deaths had been reported. In the southeastern Am Timan district, epidemic levels were reached during the week of March 18, and 147 cases and eight deaths have been recorded.
Meningitis has also reached epidemic levels, as measured by caseload, in the districts of Am Dam, Abou Deia, Lere, Dono Manga, Massakory and Bedjondo.
MenAfriVac vaccination campaigns
In response, MSF launched, in collaboration with the Ministry of Health, mass meningitis vaccination campaigns targeting persons aged one to 29 years of age in Oum Hadjer and Lere.
These campaigns are using the new MenAfriVac vaccine, which carries significant benefits when compared to vaccines used in the past. MenAfriVac lasts 10 or more years and is four times as efficient as earlier vaccines, thus conferring longer immunity to individuals and, as a result, protection to a wider section of a given population.
On April 1, MSF started a mass vaccination campaign in Oum Hadjer. After 15 days of vaccination activities, a total of 137,000 people had been vaccinated.
MSF is also providing quality medical treatment to meningitis patients; on April 26, MSF started its campaign in Lere, in the southwest of the country, with the goal of reaching more than 200,000 people. Additionally, MSF is providing treatment for people suffering from meningitis in these areas, as well as in Pala district.
At the end of 2011, MSF had 977 staff in Chad. MSF has worked in the country since 1981.
