On June 1, 2023, AlBatoul, 3, sits on her mother's lap in Dongola hospital, a UNICEF-supported facility in Sudan's Northern State, working through a packet of nutrient-rich Ready-to-Use Therapeutic Food supplied by UNICEF.
Emergency Response

What It Takes to Bounce Back from Severe Malnutrition: AlBatoul's Story

Violent conflict in Sudan has made it exceedingly difficult for aid workers to do their jobs — yet UNICEF teams remain on the ground inside the country, finding ways to deliver for children in need. Children like young AlBatoul, who is now recovering from severe malnutrition with UNICEF's support. 

This story is adapted from the original article by Bareeq Abdallah. 

All around the world, UNICEF strives to reach malnourished children with much needed treatment and care. That includes supplying Ready-to-Use Therapeutic Food (RUTF) to those who are suffering from severe acute malnutrition, or child wasting disease. 

It is one of the top priorities of UNICEF's emergency response in Sudan, where violent conflict erupted in mid April — sending malnutrition rates soaring as many families became displaced and basic services have shut down.

Dangerous conditions on the ground have made it difficult for aid workers to reach the most vulnerable children, but UNICEF is finding a way. 

A little girl receives lifesaving treatment for malnutrition

Children are always the ones to suffer first, and suffer the most, when there is conflict. The children in Sudan are no different. They are bearing the brunt of the violence, their families spending days on the road. Food is hard to come by.

Some 1.2 million people have been displaced. Another 400,000 or so have fled to neighboring countries, places like Chad where host communities, suffering their own deprivations, have little to offer and it is hard to find work.
Mahdia, 32, brought her 3-year-old daughter, AlBatoul, to the nutrition ward at a hospital in Dongola in Sudan's Northern State, because AlBatoul was vomiting and had diarrhea. The little girl, usually so bubbly, was quiet and sleepy and weak.

Mahdia, like many others, had recently arrived in Dongola having fled intense fighting around their home in Khartoum. It was a tough journey, with unfavorable road conditions and harsh weather.

At the hospital, AlBatoul was immediately screened for malnutrition. Found to be significantly underweight, and with her middle-upper arm circumference (MUAC) reading in the red, she was diagnosed with severe acute malnutrition with medical complications and admitted for treatment.

Gaining weight — and strength — after just a few days of treatment

After a few days of treatment with therapeutic milk, AlBatoul was strong and stable enough to take RUTF, a nutritious peanut paste, and has continued to gain strength. 

Mahdia is delighted as her daughter consumes the "packed meal" while seated comfortably in her lap, taking the occasional sip of water. She marvels at how easy the packets are to store and use — aspects that make RUTF so effective in times of conflict and other emergencies.

After only a few sachets, Mahdia says AlBatoul has bounced back. 

“Indeed, after she had this packet, her situation is much better and she looks better,” Mahdia says with a smile. “She is enjoying it. After these two days she has gained weight.”

A 3-year-old girl recovering from severe acute malnutrition sits on her hospital bed holding a packet of Ready-to-Use Therapeutic Food, provided by UNICEF.
After days on therapeutic milk, AlBatoul, 3, is stable enough to start on a course of Ready-to-Use-Therapeutic Food (RUTF). Despite challenges of operating in the middle of a violent conflict, UNICEF and partners have been able to deliver health and nutrition supplies to treatment centers across Sudan. More support is needed to help scale the emergency response. © UNICEF/UN0849669/Abdallah

With UNICEF's help, the hospital in Dongola has been able to maintain a sufficient stock of the peanut paste, as well as therapeutic milk, to treat children as they come in. UNICEF and partners have been able to keep delivering health and nutrition supplies by truck to malnutrition treatment centers across Sudan to meet the growing needs of displaced children and children in host communities. 

Nour-elhuda Abdallah Salih is a nutrition specialist at the Dongola hospital. She says she has seen an increase in the number of mothers seeking care and treatment for malnourished children, and an increase in return visits. Nutrition screenings and RUTF refill requests are also on the rise.

Salih says that while counseling mothers about best feeding practices, she also stresses the need for them to stick to a schedule during treatment and to bring their kids in for follow-up checkups to ensure a full recovery. 

With conflict comes fear that supplies could be cut off

As mothers adhere to her advice, many more children are beating malnutrition, Salih says. Still, she worries as conflict continues. “My biggest fear is interruption in the delivery of health supplies, because this will definitely impact the services we provide."

Success stories like AlBatoul's are what keep her going, Salih says. “When I treat a child, especially during tough conditions, is a great honor for me. Every time I save a child from a threatening disease, it warms my heart."

Nutritionist Nour-elhuda Abdallah Salih updates assessment records at Dongola, a UNICEF-supported hospital and malnutrition treatment center in Northern State, Sudan.
Nour-elhuda Abdallah Salih, a nutrition specialist at the UNICEF-supported Dongola hospital in Northern State, Sudan, says that helping children like AlBatoul recover from severe acute malnutrition is profoundly rewarding. Every time I save a child from a threatening disease, it warms my heart." © UNICEF/UN0849684/Abdallah

UNICEF needs more support to scale up the emergency response in Sudan

So far UNICEF has managed to deliver over 2,500 metric tons loaded with health, nutrition and water and sanitation supplies to states across Sudan, including states with active fighting, according to the latest situation report. These supplies will benefit at least 1.67 million children.

Continued ceasefire and uninterrupted humanitarian access are needed to ensure that the aid can keep flowing. 

UNICEF's appeal for support for the Sudan response remains 95 percent underfunded. 

UNICEF responds to hundreds of emergencies every year, meeting urgent needs of vulnerable children impacted by war, natural disasters and other crises. Donate in support of this mission. Every dollar counts.


TOP PHOTO: Mahdia, 32, fled fighting in Khartoum with daughter AlBatoul, 3, who is now recovering from severe acute malnutrition at Dongola hospital, a UNICEF-supported facility in Sudan's Northern State. AlBatoul was strong enough after two days on therapeutic milk to start on a course of nutrient-rich Ready-to-Use Therapeutic Food, supplied by UNICEF. © UNICEF/UN0849672/Abdallah

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