I just got this letter from Stephen Flanagan, a Doctors Without Borders Emergency intervention nurse in South Sudan.
Thanks to everyone who bought the Mouthtronica albums, we raised nearly £600. If you would like to make a further donation to MSF, please head to their website: MSF.org
Thank you for your donations from the Shlomo Mouthtronica project towards the work of Médecins Sans Frontières (MSF). I am currently working as part of our outreach team near Leer in South Sudan, where the numbers of children being admitted to our feeding programme has dramatically increased over the last few months. I wanted to thank you for your support because it is your donations which have allowed us to respond with additional staff, medicine and therapeutic food. Our work in south Sudan is just one example of the work that you are supporting and I would like to tell you about some of my patients.
“It’s red” my colleague calls out to me, so I make another tally mark on our data sheet where ‘red’ results are increasingly becoming the norm. We walk to the next house and find another red and then another some moments later. After we had assessed over 300 children, we decided to take a break away from the south Sudanese heat – it was 46c and only 11am.
For those children who have a Mid Upper Arm Circumference (MUAC) scoring of red, it means that they are severely malnourished and as a result, are at a significant increased risk of dying. MUAC measurements are a quick and simple process whereby a measuring band is placed around the upper arm. A reading is then made which indicates the severity of their nutritional status.
We continue throughout the day, walking from house to house and assessing every child in the village. That was until we came across one small girl who clearly needed admitting into our in-patient feeding programme. The girl, 4 years old is quietly listless in the arms of her mother, who has only a hopeless glare on her face. I take the measurement of the child’s arm. It reads a circumference of 98mm – clearly, another red and clearly at risk of dying.
You can see for yourself just how malnourished this child was with the enclosed MUAC tape. Thread it through the middle slit and make it into a circle until you reach the 98 mark. What you have in front of you is the upper arm circumference of this 4-year-old girl and you do not have to be an expert to know that this arm is far too thin.
Understandably, the mother initially refuses for her child to be admitted into the hospital. She has three other children so who will look after them? After some negotiation, she agrees and the child is taken to the MSF hospital in Leer where MSF provides for special feeding.
The next day we left by 4×4 and head to a remote area that we know has experienced food shortages before. However, it is not long before swampy ground forces us to abandon our vehicle and continue on foot. It takes us most of the day before we arrive at our destination, set up camp and rest in preparation for more long days ahead…
After two weeks, having assessed 12,000 children, we sit eagerly awaiting the analysis of our results, although we know in the back of our minds what it will be…
Arriving back in Leer, we supported the staff in the in-patient feeding facility. Over 20 patients are critical and, if they were in Britain, would be in an intensive care unit. One small child arrives, dehydrated and limp. We start initial emergency treatment but for this 2-year-old the complexities of his condition are just too much and the child died shortly after arrival. I have worked in a feeding programme before and have always asked myself if it becomes any easier seeing a child die because of hunger. In reality, you are just too busy to think about it.
There are positives working here, it’s not all doom and gloom. There is nothing better than seeing a bouncing, lively child discharged home after watching them improve from a condition were they are so weak they are unable to stand. And there are many, many children who go down this route.
From Jan –April this year there has been a 200% increase in the number of children admitted into the programme as compared to the same period last year and it was here in Leer that alarm bells first began to ring. Children were, and still are, arriving at an increasing rate each day. I checked the attendance figures this morning and there are over 500 children admitted in the programme – 6 weeks ago when I first arrived it was 205. Apparently the other feeding programmes run by MSF in Lankien and Nasir are both seeing similar increases.
Malnutrition is complex. Although now is the start of the traditional hunger gap in southern Sudan, the situation has been compounded by an even worse than usual harvest plus sporadic insecurity following recent elections. Food prices in the markets have increased by over 100% since January and people here are helplessly doing what they can to manage.
Thanks to the support of individuals such as you, we have increased our capacity drastically in Leer to care for these children already. But, following our assessment there is a clear need for intervention now and more so in the coming weeks and months. Without the specialist feeding care we can provide the situation will only be much worse. And that’s the next challenge, plans are already under way to access these areas and intervene. That is what I like most about MSF, individual gifts such as yours allow us the freedom to be able to see the problem then get stuck right in and get on with the job. Thank you for helping us to do this.
With grateful thanks,
Emergency intervention nurse
From the 4 – 28th August 2011 I’m performing my super-fun one man show Mouthtronica at the Edinburgh Fringe.
Every night I perform a spontaneous improvised collaboration with a different guest artist. The next day you will be able to download the MP3 of each collaboration in aid of the international medical charity MSF.