therapeutic feeding centre project: Liberia
1. Humanitarian Challenges & Needs
After recovering from 14 years of violence and civil war, Liberia has now been relatively peaceful for nearly 7 years. The period before the war had also seen very little development in the country. A democratic government is now in place following the general election in 2005, and this is currently doing its best to meet the challenges and needs facing the population in this post-war country. However, the destruction of facilities and infrastructure during the war has severely reduced the functioning of the government departments, public services, and subsequently access to these basic services.
This has been compounded by a huge lack of experienced, qualified, and skilled personnel, such as teachers, with the relevant technical knowledge, to help rebuild the new infrastructures. As such, poor urban populations remain highly vulnerable to major crises and sudden shocks, whilst the rural populations are widely spread out and are isolated, and thus difficult to reach.
As such, these poorer communities both remain equally vulnerable to chronic crises due to a lack of appropriate facilities and services, which would normally serve as a ʻsafety netʼ, for the most disadvantaged communities. One of these major problems is malnutrition, often caused by a lack of access to food, mostly due to poverty, or loss of livelihood following the civil war.
Despite the relative stability in the country recently, many international aid agencies have stopped treating malnourished children (especially under-5ʼs), and government services and private facilities are non-existent. Liberia still remains one of the poorest and least developed countries in the world, ranked at 169 out of 182 in the United Nations Human Development Index.
The Problem of Malnutrition
Malnutrition is a major problem, especially in the capital city of Monrovia. However, whilst nutrition is a key part of the Liberian Ministry of Healthʼs Basic Package for Health Services (BPHS), the government is not yet in a position to provide services to tackle the problem. This is mainly due to a lack of funding, a lack of facilities, as well as limited skills and capability within the government. For example, there are no specific health departments or public services dedicated to deal with the countryʼs malnutrition.
With a lack of public services, ACF and our key Liberian local partner organization ANDP have formed a partnership to tackle malnutrition in the country. ANDP (Aid for the Needy Development Programme), are technically qualified and skilled in running nutritional programmes and operations. However, this depends on funding being available for ACF and ANDP to be able to continue this critical work, until a time the government becomes self-reliant and capable. In the meantime, ANDP has essentially taken over from the government, in the treatment of malnutrition in Monrovia. ACF also continues to guide the malnutrition prevention activities, and is working with key aid agencies towards a way to promote long term sustainability within the government for tackling acute malnutrition.
Action Against Hunger & ANDP Experience
With the lack of skills and expertise to deal with acute malnutrition within the government, and until a time the government is able to take charge, ACF and ANDP have essentially taken over in addressing acute malnutrition in Liberia, especially in Monrovia. As a result, ACF established 1 in-patient Therapeutic Feeding Centre (TFC) and 7 Out-patient Treatment Programmes (OTPs) which have gradually opened since April 2007. The first OTP that opened was run by ACF, while the next six were run by ANDP. However, in February 2009, the TFC caseload was transferred directly to ANDP, who are now the only organisation involved in the direct treatment of acute malnutrition in the region. As such the skills, capability, experience, knowledge, and continued presence of ANDP is absolutely vital in tackling malnutrition in Liberia.
Funding is thus desperately required for ANDP to continue this critical work within the Monrovia area. Funds would enable the treatment of up to 1200 children (within the TFC and 5 OTPs), as well as up to an additional 3,360 children in the 5 Supplementary Feeding Centres (SFCs). This would reach almost 4,560 children over a 12 month period. In addition, ANDP and ACF would also provide support and advice for the Liberian Ministry of Health, allowing their government health centre staff to also develop and learn the key technical skills and management methods for acute malnutrition for a time in the future when they are able to take over.
2. Project Objectives & Activities
The project will target and primarily benefit children under-5 years of age specifically, along with their caregivers, such as mothers and grandmothers, as well as ʻat-riskʼ groups (such as, those with HIV/AIDS, disabled, elderly, etc) and the approach has two main components;
1. Treatment: of severely acutely malnourished children under 5 years old within the Therapeutic Feeding Centre (TFC) and Outpatient Therapeutic Programmes (OTPs). This includes hygiene, health and nutritional education and care practices activities aiming at creating healthy mother and child activities and relationships. Key activities would include;
- Continued operation of the Therapeutic Feeding Centre (TFC) and Outpatient Therapeutic Programme (OTPs)
- Expansion of activities at the TFC and OTPs to benefit greater numbers of malnourished children.
- ACF to reinforce, train, and build greater skills and expertise within ANDP in the treatment & prevention of malnutrition.
2. Prevention: of malnutrition through awareness raising, counselling, and educational care practice activities for the most vulnerable ʻat-riskʼ groups within the communities. Providing health information in an easy to understand way to help prevent malnutrition. Key activities would include;
- Activities to promote & raise awareness of malnutrition for caregivers, such as mothers, to prevent malnutrition in the community (e.g. community events, leaflet distribution, door to door visits, radio adverts etc).
- Training & support for Liberian Ministry Of Health staff in charge of nutrition programmes.
Unfortunately, as Liberia is one of the poorest ʻleast developed countriesʼ in the world, the Government itself has little in the way of money to support this work, and international donors do not seem to demonstrate a high level of interest on malnutrition issues. This lack of funding seems to persist despite ACFʼs own research into the potentially serious increase in malnutrition if the situation is left unchallenged. This has also been confirmed by the UNICEF Nutrition Survey (March 2009). Therefore, ACF will continue supporting ANDP, and carry on trying to seek funding from donors worldwide for ending malnutrition. Whilst not the main aspect of the project, nevertheless, ACF understands the need to build skills in the Liberian Government, and will also help the Ministry of Health in the best way it can until it can take over itself and become self-sufficient and skilled enough in the treatment & prevention of malnutrition.