At 14 months old, Aisha Ibrahim had a fever. Then the diarrhoea followed, and she lost fluids for weeks.
Her mother Sadiya never attended any antenatal clinic while pregnant. Aisha has had only one vaccine her entire life. Any hospital was hundreds of kilometers away.
Mother and daughter were stuck in their village of Kirapa, Sokoto state. And Aisha was dying gradually, from severe acute malnutrition.
“I spent N1,000 to get here,” Sadiya says weeks later. Here was Gidan Dahala health centre, one of six centres where Sokoto government and its partners manage severe acute malnutrition.
And the N1,000 her weaver husband provided for the long ride to Sokoto saved Sadiya’s baby.
“If not for my husband, I would not have been able to come. He gave me the N1,000,” she narrates quite happily.
Red zone
Aisha fell into the red zone of a tape to measure the circumference of mid-upper arm – less than 11cm.
Every Thursday, an average 13 children are admitted into the malnutrition treatment programme at Gidan Dahala in Sokoto city, and the numbers are growing.
Up to 2 million children aged less than five suffer SAM, and two out of every three of them are unable to get the treatment that could save their life across 11 most-affected northern states in Nigeria, according to the Emergency Nutrition Network.
The United Nations Children’s Fund, which helps malnutrition-treatment, says without any intervention, up to 72,000 children could die this year alone from SAM – that’s nearly eight children every hour.
“What do we do with these children?” said Paul Mudzongo, nutrition specialist at UNICEF.
“They don’t have the voice to sit at tables where decisions are made.”
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Malnutrition treatment in 11 states is paid for by international partners. Getting states to cough up money could sustain the treatment for more children
Scrambling and unsure
Malnutrition is a big enough problem, but it got even bigger as military force liberated enclaves previously held by Boko Haram terrorists across the northeast.
States are both scrambling and unsure how to deal with thousands of children currently living with SAM.
Saudatu, 21 months, was losing weight and had diarrhoea when her mother brought her to Gidan Dahala.
“Some tests were done, and they confirmed it was malnutrition,” says Saudatu’s young mother Sadiya Nura.
Since community management of acute malnutrition piloted in Kebbi and Gombe in 2009, the programme has been pushed into Sokoto, Zamfara, Adamawa, Bauchi, Borno, Katsina, Yobe, Kano and Jigawa.
It works by identifying children with SAM and placing them on “plumpy nuts” or “power food”— a high-protein paste of peanut butter, milk, vegetable oil and mineral vitamins.
In weeks since starting on a diet of power food, Saudatu is getting better, her mother says. “Indeed, there have been plenty of improvements,” she adds.
Without treatment, up to eight children could die every hour from severe acute malnutrition, according to estimates
“It is my hope she gets better”
At least nine out of 10 children placed on power food recover from SAM—that’s almost 830,000 so far, according to figures from UNICEF.
The power-food programme costs around N31,840 for weeks-long treatment for a single child, and the paste takes almost 60% of the total cost.
Since Sokoto started malnutrition programme in nine of its 23 council areas, UNICEF has paid for the power food, flown in from South Africa. Seven years later, Sokoto is considering putting up money for power food.
“The government wants to use its money to start buying, and to start producing locally,” says Mohammed Alhamza, Sokoto state nutrition officer.
Sokoto is optimistic about signal from Dangote Group, which has bankrolled philanthropic donations for routine immunisation in three northern states, to push local production of power food, ending a dependence on imports from South Africa.
Kaduna buys power foods for its children. Zamfara and Kebbi, which was among pilot states for community management of acute malnutrition, are works in progress. No other state does.
Khadija, 2, needs the power food that’s pulled her from the brink of malnutrition-related death. “It is my hope she gets better,” says her mother Fatima Nura.. “I am hoping so.”
Khadija is at Gidan Dahala, but her age mate Aisha, also 2, is ready to be discharged after weeks on being on the programme.
Sadiya hopes the same for her own Aisha. Then at least her husband’s N1,000 sacrifice would have been worth it. If “it” is her daughter’s life.
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