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Thursday, 24th June 2021

Stories from the Field: Women of Resilience

By Luke Capper

Madagascar is facing a humanitarian crisis, which is escalating at an alarming rate. It has been estimated that COVID-19 has levelled nearly a decade of economic progress in Madagascar. With a GDP that decreased by 4.2% in 2020, there has been an increase in daily challenges for the country’s most vulnerable communities1. To make matters worse, southern Madagascar is experiencing its most severe drought since 1981, which has halted the agricultural planting season, a source of food and income for many2. The combination of these problems has played a major role in the decline of food security within the region and has caused serious public health concerns.

Of the groups which are suffering the most, women and children have been the worst hit. The number of children being admitted for treatment for severe acute malnutrition in the first three months of 2021 was four times the average from the past five years3. Struggling to find access to nutritious food, families have resorted to sourcing wild food, which is considered less edible and far more dangerous for pregnant and lactating mothers4. Traditionally, gender roles in Malagasy culture are rigid, with mothers as the primary caretakers of their families, their children, and their communities. With the onset of this humanitarian crisis, women are enduring one of the most challenging periods in recent history.

The number of children being admitted for treatment for severe acute malnutrition in the first three months of 2021 was four times the average

OCHA, 2021

SEED has responded to this crisis through the implementation of a food distribution programme, which targets seven rural community health centres and covers 41 villages in the south. Working alongside these community health centres, distributions of ready-to-use-therapeutic food (RUTF) are being carried out to treat children suffering from moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). In the worst cases, those children who are suffering from SAM with further health complications are provided transportation to the hospital in Fort Dauphin for emergency treatment. SEED is also supporting the families of all children suffering from MAM or SAM by providing each family with 16kg of rice, 10 cups of beans, and 1.75 litres of oil per month whilst their children are treated.

Since February 2021, SEED has been monitoring the progress of these children and supporting their families through food distribution at the local community healthcare centres. The team on the ground is constantly building relationships with the local communities and their healthcare providers. The majority of these encounters are with women who have endured hardships and constant challenges over the last year. These women have first-hand experience of the food insecurity in the region, especially its impact on young children and their local communities.

narovana.jpg

This is Narovana. Here she is with her six-month-old daughter, Valisoa, one of the now 138 children diagnosed with severe acute malnutrition in the region. Narovana, like so many women, has experienced first-hand the crisis afflicting southern Madagascar. As her only source of income comes from farming sweet potatoes and cassava, she has been deeply affected by the surging food insecurity in the region, accelerated by three years of drought. Her husband died shortly after the birth of Valisoa, and alone she supports her five daughters and one son in Soanierana - a commune which has seen the highest levels of MAM and SAM admissions out of the five communes which SEED is supporting. Her family has been left vulnerable to the challenges caused by COVID-19 and the drought. Sadly, Narovana is not alone.

SEED-trained community health workers approached Narovana and advised her to take her baby to be screened for malnutrition at Soanierana community health centre. It was there that Valisoa was diagnosed with severe acute malnutrition, the most serious type of acute malnutrition. Narovana is one of the many mothers whose family is enduring a daily struggle to provide food for her family. Valisoa now receives RUTF treatment, providing her with the nutrients she needs for healthy development. Her brothers and sisters have been receiving enough rice, beans and oil to sustain them while Valisoa undergoes treatment. You can find Narovana at Soanierana healthcare centre every Wednesday speaking with the staff and making sure that her daughter is nourished and in good physical condition. She has one less worry knowing that she can provide her family with nutritious food during a period of such uncertainty.

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Vaha Julie outside the community health recovery site

Vaha Julie tries to help people like Narovana on a daily basis. She is a community health worker based in Andramaka, one of the 41 villages which SEED covers through its food distribution programme. Julie manages a community health recovery site called Mahavelo, where community members can go to receive health information before being referred to the larger community health centres. She has been a Community Nutrition Officer since 2003 and was nominated and personally selected by her commune in 2010 to lead the Mahavelo site. Revered in the Andramaka community, they have described her as an honest person with a real desire to be of service to her community. If there is anyone who understands nutrition, it’s Julie.

Julie’s job entails visiting local villages, which fall in areas with high rates of malnutrition, and investigating any health concerns amongst villagers with regards to nutritional health on a monthly basis. She provides education and information on healthy nutritional practice and the causes of malnutrition in the community. Each day she witnesses the problems that her community, family, and friends face as a result of the drought, COVID-19, and food insecurity, and every day she works to ensure that her expertise can make a difference. SEED is incredibly grateful to have someone like Julie working alongside the team as a community health agent, supporting the communities which our project serves.

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Haova and her family

Unfortunately, not everyone is lucky enough to have a Julie in their village. Haova’s story is one of deep sorrow. At seven months pregnant, Haova takes care of her two-year-old daughter Manampolily and provides for her six other children in the village of Andramanaka in Tsagnoriha. Haova is the victim of sexual abuse and not one of her seven children has a father that helps support her or her family. During this period, her family rejected her and showed no support for her or her children. She is one of an estimated 25-50% of women who have experienced an increase in gender-based violence in 20215. On top of this, the rice and cassava crops, once her primary income, have been impacted by the drought currently devastating the south. In the face of this, Haova alone proved her strength as a mother by persevering to support her children and providing for her family as best she could. She taught herself how to weave and her low but vital source of income is now generated by weaving mahampy, a reed that is often found in local wetlands. Her story, like so many of the women in this region, is one of resilience.

Through SEED’s intervention, Manampolily was diagnosed with moderate acute malnutrition and has since been receiving treatment of RUTF from the community health centre in Mahatalaky. Haova and her family are able to enjoy the rice, beans, and oil that they receive from SEED. She has spoken of the nutrition education which she has received alongside food distributions and has incorporated what she has learnt into her family's diet to ensure that nutritious foods are protecting her children. Haova thanked members of the team and the community health care facility for supporting her family and the vulnerable children in her community at such a critical time in their lives.

2021 Food insecurity in Madagascar
1.5 million

people at risk with not enough food to eat

 
138

children diagnosed with SAM in Anosy so far

 
£0.25p

daily cost of malnutrition treatment

 
£10

weekly cost to feed an entire family

To have little does not mean to have nothing, and these women prove their strength and resilience every day as they jump over hurdle after hurdle. SEED hopes that these women, along with their families and communities, can continue to be supported by the food distribution programme. With the situation in the south continually worsening, the number of children admitted with acute malnutrition is on the rise. As a result of the current loss of funding impacting the international development sector, the future of SEED’s Food Distribution programme is uncertain. Rising cases of malnutrition have already forced SEED to reduce the portion size of unprepared food rations by half, just so SEED can continue supporting all of the families with children currently undergoing treatmenti. It seems unfair that women like Haova, Narovana, and Julie, who have endured such personal hardships, should continue to watch their own children and communities suffer. Malnutrition treatment - which can save a child’s life - costs only 25p a day, with an entire treatment course costing only £15. Feeding an entire family with rice, beans and oil to ensure a nutritious diet for a month, costs just £10 per week. Sometimes, a little can go a long way.

As the situation in the surrounding areas grows worse with far greater numbers of malnutrition, expansion of the food distribution project into these areas is unattainable until additional funding is secured.



Notes

  1. Unprepared food rations decreased from 30kg of rice, 20 cups of beans, and three litres of oil to 16kg of rice, 10 cups of beans, and 1.75 litres of oil per month.

References

  1. The World Bank. “Madagascar Economic Update: Setting a Course for Recovery.” The World Bank, Dec. 2020.
  2. OCHA. “Madagascar: Humanitarian Snapshot - March 2021 - Madagascar.” ReliefWeb, 31 Mar. 2021, reliefweb.int/report/madagascar/madagascar-humanitarian-snapshot-march-2021. Accessed 14 May 2021.
  3. OCHA. “Madagascar - Grand Sud Humanitarian Key Messages.” OCHA, 6 May 2021.
  4. FEWS Net. “FEWS NET Madagascar Food Security Outlook February to September 2021.”, Feb. 2021.
  5. OCHA. “Madagascar - Grand Sud Humanitarian Key Messages.” OCHA, 6 May 2021.