Positive steps have been made toward consolidating peace in Côte d’Ivoire; however, hundreds of thousands of people continue to suffer the effects of the conflict that divided the country and forced more than a half-million people from their homes.
At least 566,000 people, representing nine percent of rural households in Côte d’Ivoire, are considered food insecure, and another 1.1 million, or 20 percent of rural households, are on the brink of this threshold, according to the World Food Programme (WFP).
Cote d’Ivoire’s Health Ministry estimates that 40,000 children under the age of five are malnourished in the country, although levels of malnutrition vary across the country.
The most affected region is Moyen Cavally in the southeast, with 43 percent of households living in a situation of food insecurity, and another 27 percent of households at risk of falling to that level, according to WFP.
Dr Gualbert Kouadio of the government’s National Nutrition Programme noted that lack of Vitamin A is a particular problem. The prevalence of Vitamin A deficiency is 68 percent in the north, 32.2 percent in the northwest and 40 percent in the south, he said.
Vitamin A is essential for proper functioning of the immune system. Good sources of Vitamin A are sweet potatoes, carrots, kale and mangoes. In places such as Côte d’Ivoire, where malaria is endemic, lack of Vitamin A makes people, especially children, more likely to succumb to the mosquito-borne illness. Health officials say that some 63,000 children under the age of five in Côte d’Ivoire die from malaria every year.
Another deficiency is Vitamin B1, or thiamine, which is found in whole grains, fish, poultry and leafy vegetables, among other foods.
The most notable levels of malnutrition occur among children under the age of two, partly because there is a very poor rate of exclusive breastfeeding up until the age of six months - it is four percent.
Côte d’Ivoire has been divided between a government-run south and rebel-held north since a failed coup in September 2002. Leaders in March signed a new peace accord that they have begun to implement, but aid officials say much needs to be done to rehabilitate the country on a humanitarian level.
Five years ago the poverty rate in Côte d’Ivoire was 38.4 percent, and by last year had risen to 48.8 percent, according to WFP. The nation, once a model of economic prosperity and stability in West Africa, now ranks 164 out of 177 countries ranked on the United Nations’ Human Development Index.
Healthcare has deteriorated considerably in the north of the country as most basic services have been left without staff or investment for much of the last four years.
“Côte d’Ivoire experiences serious challenges within the social and health sectors, with saturated and inadequate health infrastructure, an upcoming shortage of stocks of essential drugs and resources, shortages of potable water, poor sanitary conditions, and weak epidemiological surveillance systems,” said the international humanitarian Consolidated Appeal for 2007.
The appeal called for US$56.4 million to consolidate assistance to some four million vulnerable people in Côte e d’Ivoire, including $19 million for health and $3 million to support agriculture efforts. As the peace process unfolds, many of the country’s estimated 700,000 displaced people have begun to return home.
WFP attributes the high rates of malnutrition partly to a low level of food diversity. Poverty prevents people from being able to buy vegetables and protein that will diversify their diets, nutritionists say. Côte d’Ivoire is the world’s top producer of cocoa and a significant producer of coffee, but there is little food production.
Antoinette Allah, a nurse at the Mother and Child Protection Centre in the Abidjan suburb of Abobo said when she tackles parents about their sickly, under-nourished children, “they reveal that they do not have money to give them proper food”.
Many people in Abidjan, the main city, say they can only afford to eat once a day.
“In the morning, at noon and at night I eat [manioc-based] attieke,” said Armel Atse, a student. “I believe that it is the best because to wait at the house we only eat one time a day - at night. That is called a slow death.”
Dr Fokouo Kouadio said malnutrition needs to become a matter of "national urgency".
“For that to happen it is time to assure the necessary resources to fight against this phenomenon and avoid a catastrophe,” he said.
Several aid agencies, including WFP, have been working in Côte d’Ivoire to try to reduce the rates of malnutrition. WFP distributes food rations, provides food supplements to schools and offers food for work.