Malnutrition crisis in Chad: Bringing medical relief closer to communities

In a region where preventable childhood diseases aggravate malnutrition, hundreds of mothers are forced to travel many miles to give their babies a chance of survival.

First published September 5, 2023, by Doctors Without Borders/Médecins Sans Frontières

Chad 2023 © Johnny Vianney Bissakonou/MSF

Early in the morning, around 200 women gathered on mats spread across the courtyard of the N’doukouri health center in the Hadjer Lamis region of Chad. They were there to meet with medical staff from Doctors Without Borders/Médecins Sans Frontières (MSF) about the nutritional status of their children. Many were already enrolled in a nutrition program, while others were being screened for malnutrition for the first time.  

“This is the second time my son has fallen ill with malnutrition,” said Mariam Abdoulkarim as she held him gently in her arms. The child had already been diagnosed with malnutrition and was treated by MSF teams a few months ago. But in recent days, he has become ill with diarrhea again and is struggling to breathe properly.

Mariam Abdoulkarim. Chad 2023 © Johnny Vianney Bissakonou/MSF

“The harvests have not been good. We have nothing to eat, and I have nothing to feed my baby. That’s why he’s suffering from malnutrition for the second time.”

— Mariam Abdoulkarim, mother of an MSF patient

Some children have to be readmitted into the program within six weeks of being discharged. This is because the conditions at home that led to malnutrition in the first place are unlikely to have changed. 

MSF launched an emergency malnutrition response in September 2021 that has since evolved into a long-term project addressing recurrent nutritional crises in the Hadjer Lamis region. MSF teams support an inpatient therapeutic feeding center (ITFC) in Massakory provincial hospital and manage ambulatory therapeutic feeding centers (ATFCs) for 12 health centers in the district.  

MSF teams work to stop severe cases of malnutrition   

Every week, MSF teams arrive at N’doukouri health center to manage the MSF ATFCs in collaboration with the Ministry of Public Health and Prevention to treat cases of malnutrition in children under 5 years old. Once there, the teams set up for the day under a shaded area where they screen for and treat malnutrition, malaria, and other common illnesses. The teams refer complicated cases of malnutrition to the provincial hospital in Massakory, where MSF runs an ITFC with a capacity of up to 60 beds during the lean season. MSF teams also distribute soap for personal hygiene and mosquito nets to prevent malaria for children receiving treatment. 

In 2022, MSF treated almost 20,000 children for acute malnutrition across Massakory health district. This year, we have already treated more than 10,800 children with malnutrition.  

“The persistence of acute malnutrition in this health district is caused by poverty, the effects of climate change, difficulties accessing health care, recurrent measles outbreaks, childhood diseases (malaria, diarrhea, and pneumonia) and the lack of access to good quality drinking water,” said Dr. Christian Mwemezi, an MSF medical team leader in Massakory. “To this day, food security and nutrition responses remain insufficient throughout the region of Hadjer Lamis.”

Khaltouma Adam lives in N’doukoury, located 10 miles from Massakory. Her baby has received weekly treatment for malnutrition at the ambulatory therapeutic feeding center run by MSF. Chad 2023 © Johnny Vianney Bissakonou/MSF

Facilitating access to medical care for people in hard-to-reach areas

People living in remote areas face additional challenges because health care is often inaccessible to them. To address this problem, MSF launched an initiative in May 2023 to improve access by partnering with people within the communities so they can treat common illnesses closer to home, and with MSF guidance and expertise. Community health workers, with technical and material support from MSF, manage activities, referring patients in critical condition to the nearest health center or hospital if necessary. The program in Massakory is unique in that it also covers care for malnutrition, which is one of the most common childhood illnesses along with malaria, respiratory infections, and acute watery diarrhea. Within the first two months of its launch, 516 children have been treated across Massakory.

An MSF staff member assists two community health workers as they calculate the number of consultations and children treated or cured.
Chad 2023 © Johnny Vianney Bissakonou/MSF

In the village of Karkoure, located about 12 miles from Massakory town, community health workers—chosen by the community itself and supported by MSF—ensure people’s access to vital health care. “I have to sacrifice a whole day to get to the nearest health center, wait my turn for my baby to be seen, and then walk back home,” said Zara Oumar. For this mother, despite the immense challenges, it’s a great relief to have medical services available in her own village. 

In a community hut that serves as an examination and treatment room, community health worker Béchir Abdouraman administers first aid using medicines provided by MSF. Twice a week, an MSF team travels to Karkoure and sets up consultation tables in front of this hut, and children from surrounding villages come for care.  

For Younous Hissen Ahmat, chief of the village of Karkoure, this is a godsend for the people in his community. “We have a lot of problems with child malnutrition, malaria, and diarrhea in the community. It is the role of the chief to take care of his people, so if MSF comes to help us in this task, we can only be very grateful,” he said.

Béchir Abdouraman was chosen by his community to provide first aid to patients in his village. He received training and medicine from MSF.
Chad 2023 © Johnny Vianney Bissakonou/MSF

“There is a clear need for nutrition services in Massakory, but looking forward, we plan to strengthen our community partnership initiative, which we hope will address some of the challenges in accessing health care,” said Susanna Domeij, outgoing MSF project coordinator in Massakory.  

“People need a lot more help than we are currently able to provide to respond to hunger and malnutrition among children in Massakory,” she said, “Other humanitarian organizations are urgently needed to support water and sanitation, and hygiene services to reduce diarrhea, respiratory infections and other preventable illnesses, as well as agricultural and income generating activities to prevent malnutrition in the first place.”

Subscribe to the newsletter so that you never miss an uplifting story of medical humanitarians improving lives worldwide.

About Angels in Medicine

Angels in Medicine is a volunteer site dedicated to the humanitarians, heroes, angels, and bodhisattvas of medicine. The site features physicians, nurses, physician assistants and other healthcare workers and volunteers who reach people without the resources or opportunities for quality care, such as teens, the poor, the incarcerated, the elderly, or those living in poor or war-torn regions. Read their stories at

Interested in writing for Angels in Medicine? Know about an Angel we should interview? Drop me a note at

Leave a Comment