GAO, 10 August (IRIN) - Emaciated baby Jibril is
lucky. If he hadn't been carried by his mother from their village
in eastern Mali, to the main hospital in Gao on Wednesday morning,
doctors say he would have been dead by Thursday.
Jibril's mother coddles the limp child in her lap as nurses bustle
about mixing life saving formulas and recording vital statistics
- height, weight and age - that will be monitored over the four
weeks they expect it will take for him to recover.
The doctors estimate Jibril must be about a year old, but he weighs
in at only 4.3 kilos. His target weight before he can leave the
ward is 6.2 kilos.
Within an hour of arriving at the hospital Jibril's been cajoled
into drinking a plastic cup full of rehydration formula teaspoon
by teaspoon, and is accepting some specially enriched milk, the
first real food he has had in days.
"This is a typical case of severe malnutrition, if he was
any worse than this, he would be dead," said Clara Marti Mashooka,
the paediatrician for French NGO Action Contra la Faime working
at Gao main hospital.
According to government figures 1.1 million Malians are short of
food this year after a severe drought and a plague of locusts ravaged
crops and animal herds.
Children are the hardest hit, particularly those between six months
and five years, who are no longer breast feeding and prone to malnutrition
as they don't get the protein and vitamins they need from their
meagre diet, explained Mashooka.
Jibril is so wiped out with hunger that his body is limp and even
focusing his huge eyes on his mother takes too much effort. He has
the face of a wizened old man. His skin hangs from his tiny frame
in folds. It can be pinched and twisted on his belly where it stays
in a tight knot.
"When it doesn't spring back like that, it's a sign of severe
dehydration," explained Mashooka.
But within an hour, his skin is already regaining some of its elasticity.
Recovering muscle tissue that will enable Jibril to sit up, will
take a few more days of intense care and food every three hours.
After about a week, Jibril should be able to stand with help and
have enough energy to take an interest in things around him that
includes reaching for offered milk rather than being teased and
coaxed into accepting it.
"It's very satisfying seeing the rapid progress that the children
can make," said Mashooka, "but it requires intensive care."
Jibril's mother, Sidi Boukoum Adama, set out for the hospital on
foot from her village of Tondibi, some 50 km north of Gao on Tuesday
morning. She walked through the heat of the day, and took a boat
over the Niger River resting the night at a relative's house in
town before going to the hospital.
"My husband told me to bring him to the hospital when he refused
food," said Sidi. She and her husband are from the Songhai
ethnic group. They are sedentary rice farmers.
But this year's rice stocks were decimated by last year's locust
swarms, and though the rains are falling, the new harvest has not
yet been reaped and bellies are growling with hunger.
Sidi doesn't know her age but the nurse guesses she is in her twenties.
She has had four other children, though one of them died last year.
It is not clear whether that too was due to malnutrition.
It's also not clear whether Sidi has made the association between
her child's condition and his diet.
"It's an illness of God," Sidi tells the nurse, who translates
into French.
Most of the children that arrive at the hospital will recover.
But of the 60 or so that have been treated so far, three have died.
One child died on Friday. "We got her too late," explained
Mashooka. The two-year old had wasted away to only five kilos.
Yet the child was not brought in from some remote village, but
had lived in Gao town within a short walk of the hospital and the
shady maze of Gao market where oranges, yams, rice, fish and meat
and much more are all on sale.
Of the 17 severely malnourished children in the pediatric ward
on Wednesday afternoon, eight or nearly half of them, live in Gao
town.
"Word is getting out that the treatment is free, so now more
mothers are coming," said Mashooka. But that doesn't solve
the problem that there are people in town too poor to buy the food
they can see on the market.
Touwa Walett Eglas is one such mother. She's at the hospital for
the first time with her youngest child, Hamamata, who's severely
malnourished. She's had six children in all, but three of them died.
She didn't take them to hospital.
"Hospitals are always so expensive," said Touwa. She
is a black Touareg, one of the poorest and most marginalised groups
in Mali. Traditionally they are a slave cast, indentured to lighter
skinned Touareg families that roam the desert with their animals.
But Touwa, her husband and two surviving children abandoned their
nomadic lifestyle last year, after the last of their herd of a dozen
goats died. The locusts swarms that ravaged West Africa in 2004,
stripped all vegetation leaving nothing for their herd to eat.
"There was nothing there for us, so we came here for a better
life," said Touwa who has transported her thatch and weave
nomad tent to Gao's downtown district of Chateau.
"But the problem is my husband only knows how to live in the
bush, he doesn't know the ways of the city." He can't find
steady work and she never knows where the family's next meal is
coming from never mind money to pay hospital bills.
However, after her positive and free experience at the hospital,
Touwa says she would come again if any of her children fall ill,
but not before visiting her traditional healer, or marabout.
"If you get good traditional medicines, they are very good
and better than the hospital," she said.
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