Madagascar has one of the highest rates of malnutrition in the world, with nearly half of all children affected by chronic malnutrition. As in much of Madagascar, most people in the Mandritsara region are reliant on small-scale subsistence farming, with rice being the main crop.  Farming techniques mean the harvest is heavily dependent on adequate rain, however, the weather can be unpredictable. The success or not of the rice crop is a source of great anxiety for many.  Madagascar is among the ten countries most vulnerable to natural disaster, with droughts, cyclones and floods all threatening food supplies.

However, food insecurity due to the climate is just one factor causing high levels of malnutrition.

92% of the population of Madagascar live in poverty (less than $1.90 per day).

A measles outbreak last year killed over 1200 children and left many malnourished. Poor sanitation leads to frequent diarrhoea, disease and worm infestation which exacerbate the problem.  Cultural taboos, social problems and poor weaning practices also contribute.

On the medical ward at the hospital we regularly admit children with acute severe malnutrition - this group represent the most severely affected and their risk of dying is 9 times that of well-nourished children.  We are thankful for the previous hard work that has been done to establish guidelines for the treatment of severe malnutrition at the Good News Hospital, including recipes to help families produce nutritious, calorie-rich foods.  However, the poverty and social difficulties that may have led to the malnutrition make treatment difficult - families often want to leave hospital and return to their villages before we feel their children are truly better.  Please pray for good relationships with these families, for perseverance with treatment and for gospel light to shine in the darkness.

The children who are admitted to the hospital represent just the tip of the iceberg.  Identifying those with moderate or chronic malnutrition can be challenging – with one in two children affected, your eyes get used to seeing poorly grown children and without conscientious screening, some will slip through the net.  Our out-patient nursing team plays a key role in identifying children with malnutrition and also in counselling families.  Thanks to a generous gift from a supporting church, we have recently purchased new scales and measuring equipment to help them in this task.  We are organising training and also hope to make some small changes to our facilities, to improve the way we welcome children to the hospital and to facilitate malnutrition screening. 

Please pray for this little project, that we would be better equipped to identify children in need of help and for the out-patient team as we work together with families for a better future.