Sitting at a small clinic in the Talangai area, north the Republic of Congo’s capital Brazzaville, Elise Diamba holds the hands of her malnourished two-year old grandson.

"Gérard’s mother stopped breastfeeding him when he was seven months," the 61-year old grandmother says. "He hadn’t even started walking. Since then, his health has not been good."

Like many Congolese children, Gérard was left to the care of the grandmother after his biological mother could no longer feed him properly. Now diagnosed with kwashiorkor – a condition that results from inadequate protein intake – he is in desperate need of medical attention.

However Diamba, like the majority of the 3.1 million Congolese who live on less than a dollar day, has struggled to raise the Fcfa 50,000 (US $100) required for his treatment.

"I know I have to save the child," Diamba says. "But the doctor needs to first cure him and then I’ll pay."

Gérard, who has a dozen other siblings, was just one of the children waiting for treatment at the clinic that morning. "I receive on average five cases of children suffering from malnutrition each month. We often manage to save them, but the treatment takes a long time and is expensive," explains Hermann Amboulou, who runs the small clinic.

Rampant malnutrition

According to the UN Children’s Fund (UNICEF) representative to Congo, Koen Vanormelingen, seven percent of Congolese children are malnourished – a condition that affects their growth.

"These are children who do not have enough to eat; they are very poor. They have sometimes lost their mother and therefore cannot be breastfed," he says. "There are poor people in urban and in rural areas. Malnutrition is a clear sign of poverty."

Breastfeeding, he says, is key to reducing the number of malnourished children: "The most important factor is to sensitise mothers and young women to provide more breastfeeding to their children."

In the last decade Congo’s socio-political problems, including conflict and political instability, have exacerbated food shortages and increased malnutrition rates. According to the UN, there are at least 100,000 displaced persons and thousands of ex-combatants in the country, including numerous child soldiers.

A 2005 UNICEF study found a significant lack of vitamin A and iodine in the population’s diet, while 58.6 percent of pregnant women were anaemic. "The deficiency in iodine affects 10 percent of school going children: 14.6 percent of boys and 6.3 percent of girls," says Vanormelingen.

Apart from goitre (characterised by neck swelling) and cretinism, a condition characterised by severe brain damage in early life, iodine deficiency can also lead to learning disorders responsible for poor school performance, reduced intellectual ability and impaired work capacity.

According to the UN Food and Agriculture Organization (FAO), in spite of its enormous agricultural potential and nearly four million inhabitants, the Congo is considered a low-income food-deficit country.

"A national programme of food security that touches the whole of the country would change the situation," said FAO Director Jacques Diouf during a trip to Brazzaville in July 2007. "With the peace and the democratic process that has started, we will be able to restart a national programme and to have an economic impact throughout the country."

The case of the Pool

The 2005 report ‘le Pool, une crise humanitaire négligée’ said the Pool area – which includes the capital city Brazzaville and has seen most of the country’s armed conflict – had the highest rate of malnutrition.

Remnants of civil war militias are still active in region, where basic human services and infrastructure such as schools, roads and health centres have crumbled. During the last major conflict that affected the Pool – which is also referred to as the country's 'granary' – more than 50 percent of farmers lost their tools, seeds and approximately 75 percent of their livestock, said FAO.

"Agriculturalists and pastoralists have limited themselves to self-consumption agriculture," the UN Office for the Coordination of Humanitarian Affairs said. "The Pool, which used to export agricultural products, now has to import food."

Farmers in the region are also recovering from the effects of the cassava mosaic disease, which devastated the crop in the region.

According to the UN, only two percent of Congo's arable land is exploited. Food production is insufficient to meet national requirements, and this has resulted in a heavy reliance on food imports.

The way forward

Congolese authorities have been working with development partners to improve the country’s food situation.

Between 2003 and 2007, the government, the FAO and about 30 Vietnamese experts have been developing a pilot project on food security. Officials plan to take this countrywide after approval from ministers and the allocation of funds.
 
Using a US$17 million loan from the International Fund for Agricultural Development, the government will implement a seven year scheme targeting 50,000 farmers in the northern areas of the Plateaux, the Cuvette, and the Cuvette Ouest. There are also plans to build a modern fishing harbour in Pointe-Noire on the Atlantic coast.