Using simple tools for screening the basic nutritional status of their neighbors, trained health workers in Ethiopia ensure food aid goes to the families needing it most.
Fatuma Humad pulls out her measuring tape and wraps it around the upper arm—midway between shoulder and elbow—of a 2-year-old girl. Humad is looking at the girl’s mid-upper arm circumference, an indicator of nutritional status. She is pleased with the result: Until recent weeks, this young girl’s measurements indicated she was suffering from malnutrition.
Although she is glad to see improvement, Humad still has concerns for the people in her village, a remote, windswept and tree-less rocky hilltop village called Guhom in Ethiopia’s arid northeast Afar region. This part of Afar is suffering through an extended drought, diminishing the herds of camels and goats on which this village of roughly 5,000 people rely for their survival.
Lack of water and poverty are proving a dangerous mix in Guhom. “Infants and other children really need help” to avoid severe malnutrition, Humad says.
Neighbors helping neighbors
Humad is one of eight health extension workers trained by Oxfam’s partner in Guhom, the Afar Pastoralist Development Association (APDA). These volunteers, all women, learned how to help people suffering from acute malnutrition, particularly children and young mothers struggling to breastfeed newborn babies. They are among 40 health workers trained by APDA across Afar.
APDA, in collaboration with Oxfam, also provided three months of food to about 2,000 families in and around Guhom. The food included wheat flour, cooking oil, maize flour, chickpeas, and lentils. The families were selected based on data collected by the health workers, who go from home to home to monitor the mid-upper arm circumference (MUAC) and weight of children, pregnant women, and breastfeeding mothers. The project also supplied special high-calorie and nutrient rich ready-to-eat therapeutic foods for the most severely malnourished people.
Humad and the seven other health workers in Guhom had recently screened 560 children, 17 of whom needed urgent treatment for malnutrition. Of the 700 women screened, 238 needed treatment.
“We check their weight, and we give them food until they get better,” Humad explains. “We can only give the supplementary food to people who are really in need. We monitor their weight every day and check the MUAC.”
WHAT IS MUAC?
MUAC stands for mid-upper arm circumference. It is a measurement of the midpoint between the shoulder and elbow, using a measuring tape that is checked against optimal MUAC ranges by age to determine whether someone is malnourished.
- A 2-year-old’s MUAC measurement should be more than 11 centimeters.
- For older children, less than roughly 13.5 centimeters indicates poor nutritional status.
- A well-nourished pregnant woman should be more than 23 centimeters.
Crisis in Afar
In the middle of 2024, parts of the Afar region were facing a crisis due to multiple factors, including ongoing drought due to climate change, and fighting between Afar clans and those of the nearby Somali region. The drought and fighting led to a severe outbreak of cholera as people displaced by conflict and suffering from drought turn to unsafe sources of water.
Nearly half the 2.2 million people in this overlooked northeast corner of Ethiopia live in poverty, according to Mohamed Ahmed, deputy director of APDA. Providing them with crucial humanitarian assistance is a major challenge for the government and groups like APDA. “People have a right to basic nutrition,” Ahmed says. “We know Afar is the most malnourished region in Ethiopia. For many years we have been distributing food aid, but it has been reduced due to inflation.”
Food aid delivers better nutrition
One of the families receiving food aid and supplemental food in Guhom is that of Zahara Ega Ahmed. Ahmed says that recently, her daughter Aradi (not real name), the little girl Fatuma was measuring earlier in this report, was very malnourished. “She was really bad,” Ahmed says, as Humad finished her measuring. “I was also suffering.”
Humad acknowledged how difficult it was for both mother and daughter. “I could see Zahara was also suffering; both were in a lot of pain,” she says. Humad helped Zahara and Aradi find the supplementary food they needed, and watched their health improve. She credits the food aid delivered by APDA. “The food helped people; we saw significant improvements for the mothers,” Humad says. “And after I saw Aradi’s improvement, I was happy.”
“When I see improvements, I feel happy —especially in the children.”