Action Against Hunger's nutritional surveys indicate alarming rates of malnutrition in Liberia's capital of Monrovia: more than 12,500 children under five years of age are at risk of severe acute malnutrition. Action Against Hunger, whose teams run and support nutritional activities in Monrovia, has launched an appeal for funding.

In Liberia since 1990, Action Against Hunger / Action Contre la Faim's (ACF) latest round of nutritional surveys shows extremely disturbing results that indicate a significant nutritional crisis in Grand Monrovia: of the 800 children weighed, measured, and examined, 17.6% (Z-score) were suffering of acute malnutrition. These figures surpass the 15% threshold that defines a nutritional crisis, and when extrapolated to the city's actual population, they indicate that 12,500 children under 5 years of age are subject to this life-threatening condition. While younger children are typically more vulnerable, the mortality rates uncovered in our field research are sufficient to trigger a worldwide alert, underscoring both the severity of the crisis and revealing a far broader public health crisis in Monrovia due to a general lack of health facilities, difficulties of access for the poor, and deplorable states of hygiene and sanitation in many areas.

Endemic Poverty in Monrovia

Despite Liberia's relative stability—peace accords were signed in 2003—the consequences of 14 years of war and conflict have ruined the country and its basic facilities. In the hope of rebuilding a better life, "the populations have left the refugee camps to move back to the city hoping for a better quality of life, but they now find themselves confronted by mass urban poverty," explains Ms. Stien Gilsel, Action Against Hunger's lead nutritionist overseeing the survey in February.

Moderate and severe malnutrition persist in Monrovia largely because government and private health structures have limited capacity to effectively manage treatment or initiate preventative action. Years of war have also disrupted the transmission of basic knowledge among families: several mothers, for example, no longer know how to feed or care for their children. And the fact that the youngest children are among the most affected indicates that poor weaning practices play a major role in the persistence of malnutrition.

Action Against Hunger's Strategy

Action Against Hunger has implemented nutritional programmes in Liberia in response to malnutrition from 1993 through 2004, providing emergency interventions while working to integrate our programs with local and national systems and carry out capacity building activities.

ACF was pushed to reactivate its emergency nutrition programmes in the capital after surveys uncovered alarming indicators in 2005—some 1,500 children under five years of age were estimated to be suffering from severe acute malnutrition in Greater Monrovia. ACF then re-opened programmes for the treatment of severe acute malnutrition in Monrovia in March 2006. The two-fold strategy was to respond to the needs and to progressively handover detection and treatment of acute malnutrition to Liberian actors, including the Ministry of Health and Social Welfare. At this time a local organisation, Aid for Needy Development Programme (ANDP), was running a Therapeutic Feeding Centre on the outskirts of Monrovia and two Supplementary Feeding Centers in town for the treatment of moderate acute malnutrition. Since 2005, ANDP has progressively expanded its activities in close collaboration with the Ministry of Health, with the support of UNICEF and Action Against Hunger —activities that included ongoing nutritional screenings in town and the administration of two Out-Patient Treatment Programmes since November 2007.reenings in town and the administration of two Out-Patient Treatment Programmes since November 2007.

Action Against Hunger has also pointed out in recent years that poor childcare practices and dysfunctional relationships between mothers and children have also had a direct impact on the health and nutritional status of children under five. To address these ills, Action Against Hunger implements psychosocial programmes that offer mothers and other caretakers access to preventative and curative activities in our nutrition centres and among at-risk groups in Monrovia—activities that are integrated into our treatment and prevention programmes addressing the root causes of acute malnutrition.

The Ministry of Health and Social Welfare, in collaboration with UN agencies and NGOs, is in the process of developing formal guidelines governing the detection and treatment of acute malnutrition in Liberia. In view of these ongoing efforts, and given the capacities of local organisations such as ANDP, Action Against Hunger's 2008 objective is to continue to help Liberian actors build capacity while working to transfer administrative responsibilities for our therapeutic nutrition programmes to local groups and government ministries. Only local capacity can sustain the types of integrated care practices and holistic treatment and prevention programme that can eradicate malnutrition in Monrovia over the long run.

Call for Action

Liberia is widely seen as a country in transition toward development, and indeed development projects have become much more prevalent than emergency relief interventions. That said, Action Against Hunger is concerned that perceptions of these broader improvements could mask the persistence of life-threatening conditions with the potential to trigger sudden relapses into states of nutritional crisis. Malnutrition continues to weaken the Liberian populace as a whole—especially children under five—but its urgency is often relegated to second-tier status behind the general emphasis on reconstruction and development.

Action Against Hunger is committed to carrying on the fight against acute malnutrition and poor healthcare in Liberia through our involvement with existing nutritional structures, the provision of support to local partners, and through our work with the Ministry of Health, but we cannot do it alone: Action Against Hunger has therefore launched an appeal calling on the international community to come to the aid of these threatened populations.

Notes to Editors:

ACF in Liberia: ACF has been present in Liberia since 1990 implementing nutrition, food security and water and sanitation programmes. In Monrovia, ACF is currently working in partnership with the local NGO Aid for Needy Development Programme (ANDP), founded by former ACF nutritionists, to implement nutrition and care programmes. Programmes include the treatment of severe acute malnutrition in children under 5 years old and the prevention of malnutrition via psychosocial activities. ACF also provides support to local actors such as the Ministry of Health and Social Welfare and the ANDP via capacity building activities with the aim of gradually handing over all nutrition activities to local partners.

Press Contacts

Lucile Grosjean Chargé de communication, ACF-France lgrosjean@actioncontrelafaim.org Direct: + 33 1 43 35 82 22 Offsite/Weekends: + 06 70 01 58 34 / + 06 70 01 58 43