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Treating malnourished children at home
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Every year, 5 million children die worldwide as a result of malnutrition. It is one of the leading causes of death among children under the age of 5.

Agnes Nakut:

The way things are now, most of my children will be malnourished

Especially my youngest, Emmanuel. He's not growing as he should.

I heard that I could get free help from MSF. So I decided to take him to their clinic.


Médecins Sans Frontières, MSF, treats over 150,000 children for malnutrition every year worldwide.

Kodjo Edoh, Doctor and head of mission:

We are in Moroto, Karamoja region where MSF is implementing an ambulatory therapeutic feeding centre for severely malnourished children.

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Over the last few years, MSF has made a significant change in its treatment approach. In the past, malnourished children were admitted in a feeding centre or hospital for several weeks. But now, most children are treated by teams going out with mobile feeding clinics.

Kodjo Edoh:

The set-up of the mobile clinic is to have 2 experienced MSF nurses supervising the local team. Moreover, our link with the community is through our national staff that is recruited on the spot: nurses, and nursing assistants, that are recruited on the spot, speaking the language and also living in the community, so being a testimony of what is happening in that community.

In the morning, the mothers are gathered under a tree for health education and then they are channelled through this point where they have to go under this. Because we don't know the birth certificate and the birth date of the children and so, we use the height to select them.

So when the height is less than 110 centimetres, they are supposed to be under 5 and then they are screened with the MUAC. If the MUAC is green, it means the child is healthy. Then it's the end of the road for that child, he's sent home. But if the MUAC is yellow or red, then he is sent for weight and height, which is the next step.

At this point, the children are weighed, and then the height is taken. Those 2 components are very important to decide if they are in the programme.

So to summarize, you have the yellow and red MUAC that are coming here. The weight and height are taken and then according to the criteria, they are entered in the programme. Once they are entered in the programme, they come to the registration point, where they get a card. This card will be used later.


If children are malnourished, but not seriously ill, the parents are given plumpy'nut. This is a concentrated paste made from peanuts, milk, oil and a mix of vitamins and minerals, all essential for growth and development.

Kodjo Edoh:

So this is the consultation point, where the child is screened for any medical condition. Like respiratory infection, like malaria, like any other disease that needs to be treated.

After this process, a prescription is done and the child will go to the next point. Next point is the dispensary point, with the card and the prescription, the mother comes to this point and then the dispenser gives the drugs and the plumpy'nut.

At the same time, he explains how the plumpy'nut should be taken and also how the other drugs should be taken. And then he explains when is the next appointment.


Only children who are so severely malnourished that their lives are in danger are admitted for inpatient treatment. The majority of children however, can be treated through these mobile clinics. This way, mothers can give their children the therapeutic food at home. They only have to return for a medical check-up and a new supply of plumpy'nut the next time the MSF team comes again. This approach allows many more children to get care.

Médecins Sans Frontières cannot prevent malnutrition, but it does everything it its power to assist people. It treats patients, but also lobbies international donors and other aid organisations for better treatment.

(MSF via China.org.cn December 1, 2008)


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