Malnutrition: baby Nur’s story

At only 15 months of age, baby Nur has faced more hardships than most. When he was five months old, his mother Ayesha passed away from illness, leaving him and his brother in the care of their grandparents, Subura and Syed.

Weeks later, when he was six months old, a community nutrition volunteer visited their home in the Kutupalong refugee camp in Cox’s Bazar during a regular screening programme and noticed that he looked especially frail and exhausted. Using a mid-upper arm circumference (MUAC) tape – a simple color-coded measurement tool that allows health workers to quickly determine if a child is malnourished – the volunteer identified that he was severely malnourished after the MUAC tape reading was red.

“His [condition] was deteriorating rapidly. He had respiratory issues and cried often,” recalls Subura. “We thought he would not survive.”

After being assessed by the community nutrition volunteer, Nur was promptly referred to a nearby integrated nutrition facility for treatment. When his grandparents brought him to the facility, nutrition volunteers carefully measured his height, weight and MUAC to assess his nutrition status.

According to their measurements, Nur weighed a meagre 4 kg and his MUAC reading was red, confirming that he was suffering from severe acute malnutrition – the deadliest form of undernutrition – and was at risk of severe illness and death.

A Nutrition Emergency

A nutrition counsellor explains to Subura the types of diverse foods that she should feed Nur.

Child malnutrition rates run high in the Rohingya refugee camps. Based on 2023 estimates1, over 57,000 children under-five in the camps suffer from acute malnutrition.

Sajia Afrin Mesu, a nurse at the facility, sees around 30-35 children a day, with about 10-15 of them being diagnosed with acute malnutrition. She cites a lack of proper feeding and care leading to repeated bouts of diseases such as diarrhoea, fever and pneumonia as the root cause of malnutrition among most children.

When Nurse Sajia examined Nur, she determined that he had no other medical complications and was eligible for treatment for severe acute malnutrition in the outpatient therapeutic programme at the facility. She began treating him with ready-to-use therapeutic food (RUTF), an energy dense specialised food enriched with essential vitamins and minerals. The staff at the facility also provided nutrition counselling so that Subura learned how to better care for her grandson’s health and nutrition.

“I learned how to properly feed him RUTF and other soft diverse foods, which I did not know before,” Subura says, describing how she benefitted from the counselling. “And that I need to wash my hands before feeding him.”

The Road to Recovery

Nur is fed a banana by his grandfather Syed in the Early Childhood Care and Development corner of the nutrition facility.

Nine months after he began receiving treatment, Nur has started showing steady signs of improvement and has since been discharged from the outpatient therapeutic programme. During a recent visit to the integrated nutrition facility, he weighed 6.8 kg – almost 3 kg more than when he was first referred there for treatment. While he has not yet fully recovered, he is no longer severely malnourished and has graduated to receive support through the targeted supplementary feeding programme for moderately malnourished children.

Nur’s progress is also evident in his behaviour while he sits with his grandparents. In the Early Childhood Care and Development corner of the nutrition facility, his grandfather Syed can barely hold him as he energetically bounces around in his arms while playing with a yellow ball. His appetite has returned, and he eagerly eats a banana when offered one by his grandfather – a rare sight only a few months ago.

Between January and August 2023, over 4,500 children in the Rohingya refugee camps have been treated for severe acute malnutrition thanks to support from the US Agency for International Development (USAID). With this support, UNICEF is providing lifesaving treatment and care to children affected by acute malnutrition.

After a year and a half of tragedy and uncertainty, Subura is happy to see her grandson’s appetite and spirit slowly returning.

“I am grateful to the counsellor and the nurse for referring him to this facility. He is now very active and playful,” Subura says. “I hope one day he can become a Hafez (preacher) in our community.”

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1Source: Joint Response Plan (JRP) 2023