International Rescue Committee (IRC)

FOOD FOR THOUGHT: Malnutrition's Insidious Impact on Children

If they can escape slaughter, endure rape and survive outbreaks of infectious diseases, the thousands of young people uprooted by ethnic conflict in Sudan’s Darfur province still face food shortages that threaten to stunt forever the physical and intellectual growth of their formative years.

The sheer immediacy of the moment in Darfur—the scene of one of the great humanitarian crises of the post-Cold War era—overshadows what could be the lifelong consequences of malnutrition on a generation of displaced youngsters.

“We focus on the emergency, but look at the long term,” said Richard Brennan, M.D., director of health programs for the International Rescue Committee, after a recent eight-day tour of camps in North Darfur state. “You have malnourished children who will never reach their full physical and mental potential because of this.”

Children’s bone and tissue cells have greater needs for nutrients than those of grownups, and are more sensitive to deficiencies.  The lack of vitamins, minerals and proteins can stunt bone and muscle growth and have a negative impact on the victim’s IQ.  Studies have shown increased risk of stroke, hallucinations and depression, not to mention early death. 

While adults wage war, a consistent concern among younger people in the camps for the displaced is the lack of proper schooling, Brennan said.  “You sit down with the young people in the camps and listen to their frustration over their future.  They all say the same thing: Can you get me to school?”

The IRC’s North Darfur office in El Fasher oversees programs in the nearby Abu Shouk camp, which has about 46,000 internally displaced people; and the Kassab camp 80 miles northwest in Kuttum, which has 45,000.  The IRC runs sanitation and primary healthcare programs at both camps, but the needs of the displaced have been overwhelming. 

While the Abu Shouk camp’s conditions are among the best of the roughly 150 settlements in the province, they are still bad.  Brennan said 39 percent of the children there suffer from acute malnourishment.  There have been outbreaks of hepatitis and dysentery.  A measles epidemic killed 23 children.

“We are on the razor’s edge in terms of mortality,” Brennan said.  “The best camp has 40 percent acute malnutrition and it’s had outbreaks of measles and hepatitis.  We can infer that the places where we don’t have good data, it’s worse.”

Since the outbreak of civil war in Darfur in 2003, the UN refugee agency, UNHCR, estimates 1.2 million people have been uprooted in Darfur and another million have fled to neighboring countries.  Tens of thousands have died.

Brennan said 80 percent of the deaths have been due to violence during attacks by the Janjaweed militia, but that infectious disease and malnutrition have been the main cause of death in the displaced persons camps.  

Poor security, bad roads, short staffing and lack of safe vehicles—along with erratically imposed government restrictions—are preventing aid from reaching large populations of displaced who are presumed to be in even worse shape than those in the camps.  The U.S. Agency for International Development has estimated that only 40 percent of people in Darfur have access to health services, while the World Health Organization puts the number at just over half.  USAID estimates that 2,000 people are dying each day from the effects of malnutrition and disease in Darfur.

Violence seems to have tapered off in the northern regions of Dafur in proportion to the increase of international organizations in the region.  But bloodshed remains high in South Darfur.  Among the most volatile camps is the one at Kass, where militias stage almost daily incursions that usually include rape, according to IRC field coordinator Bob Kitchen.  The camp hosts 40,000 people.

Camp curfews from 10 p.m. to 8 a.m. make round-the-clock health care impossible.  “If a woman is hemorrhaging from childbirth at 10 o’clock at night you need an ambulance to take her to the hospital,” Brennan said.