Inside the African clinic fighting to keep hungry babies alive

Female children can end up worse, as some communities favor boys (Image: Armstrong Too / Plan International)

Just five months old, Haybe* lies motionless under a mosquito net, clinging to life.

He is small and desperately thin, and his mother Khadra* looks at his small body and is anxiously willing for him to recover.

When Haybe fell ill with diarrhea and vomiting, Khadra traveled for hours by road from the countryside to get him to hospital, where he stayed for several days. He was taken to the malnutrition clinic and given milk and injections to stop the vomiting, but his little system is struggling.

Years of drought in Somaliland, on the Horn of Africa, have left thousands of children like Haybe critically ill and dependent on milk and medicine to stay alive.

The mothers who bring their children here have thin eyes and hollow cheeks. Thin and exhausted, they are haunted by hunger, which threatens the family’s life.

Female children may end up worse off, as some communities favor boys, meaning girls have to make do with their brothers’ leftovers.

17-year-old Khadra says, “I feel hopeless; that I cannot do anything for my child. I hope God will change the situation and that my child will recover. And that life will change for the better.’

Khadra explains that her family are nomadic farmers in Somaliland’s Toghdheer region. They depend on their animals for survival, but in the midst of East Africa’s worst drought in decades, the land has become too barren for their stock to produce milk or bear young.

Khadra with her son

When Khadra’s 5-month-old son Haybe became seriously ill, she traveled for hours to get him to hospital (Image: Armstrong Too / Plan International)

This year is the fourth year in a row that the spring rains have failed. Most of Somaliland’s rural communities depend on livestock farming for their livelihoods, but since the parched landscape offers little pasture, animals are dying in large numbers, destroying livelihoods and severely impacting the amount of milk available for young children.

Strong figures from the clinic show that between January and May admissions for malnutrition almost tripled from 26 to 69, with two deaths recorded in April and May.

Khadra says she can no longer feed her family with milk or meat. Instead, they live on rice and Somali pancakes, sometimes eating only once a day. Where water is available, hungry families like the Khadras flock to the area, making them more vulnerable to diseases that flourish in overcrowded and unsanitary conditions.

“We live off livestock, but they are weak and thin, and the rest have died,” explains Khadra. “They cannot be sold. We depend on what our relatives give us. We have no other income. We cannot afford to provide milk and medicine for the child. Things are tough. Conditions are difficult.’

The small clinic her son is cared for is simple – with not even a fridge for medicines. Attached to the hospital, it has only two rooms with a total of 18 beds, all of which were full at the time of Haybe’s visit. In fact, over 30 children are cared for here by the 15 employees. Without their help, many more would die.

Inside the African clinic fighting to keep babies alive in the face of starvation

Without the help of staff such as nurse Hamda, many more children would die (Image: Armstrong Too / Plan International)

Nurse Hamda has seen a steady increase in mothers and children admitted with vomiting, diarrhoea, cough, anemia and fever. The 23-year-old says she is scarred by the infant death toll unfolding before her eyes.

“We’ve had children die from severe dehydration while in hospital,” she explains. “There was a child who was admitted to the clinic. We took them to the emergency room and tried to save them, but they died there.

“The child was vomiting for seven days, so when they were brought in they were severely dehydrated and died as a result.

“There was another incident with a child who was malnourished. When a child does not receive milk, they develop a deficiency of important minerals. So this child was admitted when he had a high fever, and died while his blood was still in the lab.’

Hamda does her best to help, even dipping into her own salary to help the hungry mothers who are desperate to eat.

“Sometimes I bring food to one or two, but the rest keep asking me,” she says sadly. “When there are about five or six of them, I can’t help them all, and I end up skipping breakfast because I don’t feel like eating.”

The work takes its toll on Hamda’s mental health, as she relives the horrors she has seen on duty.

“I came across an emotional mother with a small child who was paralyzed, and she asked me where she could leave her child,” she recalls. “I found out that she was hated by her family because of that child, she couldn’t afford basic needs like shelter, so she was desperate and willing to get rid of her child.

Inside the African clinic fighting to keep babies alive in the face of starvation

The work takes its toll on Hamda’s mental health, she says (Image: Armstrong Too / Plan International)

“I got emotional because I couldn’t help her. I advised her and told her that soon the child would get better, but she kept saying that the child would not get better. I still think about her. I ask myself whether she has abandoned the child or kept it.’

The women who attend the center have thin eyes and hollow cheeks. Thin and exhausted, they are haunted by hunger, which threatens the family’s life. Female children may end up worse off, as some communities favor boys, meaning girls have to make do with their brothers’ leftovers.

Saado brought her one-year-old daughter Sagal Ali to the clinic because she was life-threateningly malnourished and – like Haybe – suffering from vomiting and diarrhoea.

The 23-year-old mother of three says from the clinic: “I brought my daughter here to save her life. I kept her at home in a rural area for two months, but she was very sick, sometimes she went into a coma and sometimes she came out. She was malnourished, because our livestock cannot give milk anymore.

“It’s getting harder and harder. It is difficult for us, without milk from our animals. Some have died, while others are so weak that they cannot give milk. The drought is only getting worse and worse.

Inside the African clinic fighting to keep babies alive in the face of starvation

The future is bleak for mothers like Saado, who brought her little daughter here (Image: Armstrong Too / Plan International)

“We have suffered for a long time. It has now been nine months of malnutrition and our livestock is depleted. Some of our animals have died and some have become very weak. This [lack of milk and clean water] means that our children have fallen ill with diseases, such as diarrhea and vomiting.’

The future is bleak for Saado and many like her. The family’s animals are now too weak to sell and are worthless while inflation denies them even basic food supplies.

“I hope we can live a good life, and that our children get an education and that our lives get better,” she says. “I am very hopeful. But we need more support for our local communities, which are struggling to survive. With support, and if our children can be educated, things will be better for us.’

Across Somalia and the Republic of Somaliland, Ethiopia and Kenya, millions face life-threatening hunger. The UN has warned that 350,000 children will die needlessly in Somalia alone without urgent measures.

“East Africa is in the grip of the worst drought in decades, and in Somalia we are seeing extreme, widespread hunger, with pockets of the country at risk of famine,” explains Sadia Allin, head of mission in Somalia and Somaliland for the humanitarian charity Plan International. “The reality is that children are dying and loss of life on a devastating scale is now a very real risk.

“Families go to bed with empty stomachs, not knowing if they will have anything to eat the next day. Even more painfully, mothers go to bed knowing that their child is crying because they are hungry.

“Unless humanitarian aid is quickly scaled up, many thousands will lose their lives. Right now, Plan International is transporting water to drought-stricken communities and providing emergency funds to help families struggling with severe food shortages. But we urgently need more funds.’

With the drought in Somalia/Somaliland already decimating entire communities, 760,000 people have fled their homes in search of food and water this year alone.

Thanks to treatment, Sagal is now on the mend. But she is just one of a shocking 1.5 million Somali children under the age of five who could be malnourished by the end of this year, including 386,400 who are likely to be severely malnourished.

“She’s out of the coma,” says her mother Saado. “She is in better health at the moment. Her body is getting better. Thank God. I pray to God that we leave this place in good health.’

If you would like to make a donation to Plan International so they can continue to help the clinic and others affected by hunger, click here.

*The names have been changed

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