By Athanas Makundi for the UNICEF Blog
Hargeisa, Somaliland March 2015: Hasha Abdi Abdullahi was desperate. She was living in a makeshift camp for the displaced in Hargeisa with her seven children after being forced to leave her home, 50 kilometres away, because of drought. She was heavily in debt and her three-year-old son, Abdisalam Mustafa Farah had started to refuse all food and showed signs of being malnourished.
“His hair turned orange,” says Hasha. “He likes being with his friends but when he stopped playing with them, I realized his condition was getting serious.”
She tried giving him medicine but his condition did not improve. Some days later, a community worker recommended that she buy a ‘Super Fariid’- a micronutrient powder that is sprinkled onto a cooked meal.
“If we hadn’t intervened at that stage Abdisalam would have become malnourished,” says Koos Dahir a community health worker, who goes from house to house educating mothers on the use of micronutrients powder for children. “At the same time we encourage mothers to improve their home diet by buying food with iron, and vitamins like vegetables.”
“This worked like magic.” exclaims Hasha as she cuts open the sachet and sprinkles the powder onto her son’s meal. “I gave him the powder and my son got his appetite back and as you can see he is now much better.”
Another mother, Halimo Hassan Ahmed had a similar experience after her ten month old baby Abdi Rahman failed to thrive despite continued breastfeeding. Halimo had been attending sessions on Infant and Young Child Feeding (IYCF) at a nearby health clinic to learn about feeding her child and providing proper nutrition.
“I know how to prepare a proper balanced diet,” says Halimo, a mother of three children, whose family was displaced from Ethiopia after losing everything to drought.
“The problem is that I cannot afford to buy all these nutritious food, I’m told my baby needs. My husband is jobless, so we eat what we are lucky enough to find and my baby eats that too.”
Recently, while at the IYCF session, Halimo and her friends were introduced to ‘Super Fariid’ and encouraged to use it to enrich their children’s food.
“I sprinkle one sachet a day on his food and I have seen a big change,” says Halimo proudly. “I find that ‘Super Fariid’ is cheap and even with a little cash you can still afford one sachet for the day.”
Micronutrient deficiency comes from diets lacking essential vitamins and minerals and can cause illness, blindness, impaired mental development and susceptibility to infectious diseases A micronutrient study conducted in Somaliland and Puntland regions by FSNAU and supported by FAO and UNICEF in 2009 revealed high levels of iron deficiency which can lead to impaired physical growth and mental development and lack of vitamin A which is essential for the immune system, especially among women and children.
Lack of micronutrients is one of the key causes of malnutrition among children. Across Somalia it is estimated there are about 203,000 acutely malnourished children of whom about 38,000 children are severely malnourished and need medical treatment and therapeutic food to survive.
“This lack of crucial nutrients in the body is what we refers as ‘silent hunger’,” says Awan Shahid, UNICEF Nutrition Specialist based in Hargeisa. “Most women cannot afford to buy the kind of food that makes up a proper diet for the family, and therefore their children miss out on the essential nutrients for growth.”
The ‘Super Fariid’ sachets are available at a subsidized rate through selected pharmacies as part of a UNICEF-supported project to improve the nutrition of children aged from six months to five years. One sachet of the powder, which has iron, vitamins A and C, zinc and folic acid, is the right amount for one child for a day. It can be sprinkled and mixed with food while cooking or into food that is ready to eat.
The brand name was chosen for Somalis to identify with. The Somali celebration known as Fariid which takes place when a baby is 40 days old. Symbolically, the baby is placed onto the shoulders of the strongest and intelligent child in the community and it is believed that the baby will grow up strong and healthy as that child.
With UNICEF support, its NGO partner PSI buys the sachets from UNICEF-approved suppliers, brand and package it and make it available through the largest pharmacy wholesaler in Somaliland and their community retailers. The pharmacies which sell the micronutrients also provide additional information on how to use it. It is currently available in four regions of Somaliland and discussions are underway for expansion into Puntland.
The pharmacists in Somaliland say the product, which is the first of its kind available locally, is selling well. They are supplied to pharmacies and community workers at a subsidized cost. A small box containing 7 sachets costs 2,000 Somaliland shillings around USD$0.35 USD – and a month’s supply is estimated to cost about one percent of the amount an average family spends on food a month. In addition, free distribution aimed at the lowest socio-economic group will be scaled up through health facilities in 2015. Pharmacist Maulid Abdi Hassan sells about 2800 sachets a month.
“It is good business so far,” says Maulid. “I think the demand is high because the product is new and it is advertised regularly.”
UNICEF also supports PSI to carry out social marketing to raise awareness of the powder using adverts on the television, radio and road shows. With the current limited reach of the public healthcare system, working through pharmacies means that the product is far more widely available.
“We didn’t want to give the product away for free,” says Donato Gulino, PSI Somaliland Country Director. “We want to create value for the product. This simply means, if you buy the product, there is a high chance that you will use it.
“We want to eventually change the behavior of the people. Our main goal is to educate the community on the right nutrients that meet the nutritional needs of the children and the entire family.”