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When no tears come

Ethiopia, October 12, 2011

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  <span class="field-credit">
    Bija Gutoff/Mercy Corps  </span>
    Ali Mohamed, head of Mercy Corps sub-office in Gashamo (left), with Hali Yosuf, 27, and her six-month old, Samia Mohamud. Photo: Bija Gutoff/Mercy Corps

There was already a crowd at the mobile health site when we arrived. The veranda was a colorful swirl of fabric. Most of the women had a bulge at their side, belly or back that turned out, when unwrapped, to be a baby.

I made my way through the crowd and began taking photos. I asked the moms what was wrong, what brought them to the clinic today. These normally shy people – many of the women and girls I’ve met on my trip through drought-stricken regions of Kenya and Ethiopia have refused to be photographed – quickly held up their babies for me. They wanted their children to be seen. They peeled back a t-shirt, lifted a pant leg, pointed to an eye. They pressed a finger to a foot to show the telltale imprint of edema, a symptom of severe malnutrition.

The Mercy Corps team – working in partnership with the Ethiopian government, and now transitioning the program to local hands – rotates among 12 sites every two weeks. Communities know where the team will be on a given day, so they can show up at the clinic near their home. Mercy Corps targets the communities where the need is greatest.

The nurses and community health workers who assess and treat patients see lots of malnutrition. The signs are all too common: dry reddish hair, edema, skin conditions, sub-normal measurements (as measured by the circumference of the mid-upper arm). And the cause is easy to trace. No rain means no grass, which means cows, goats and camels produce less protein-rich milk, the main food of pastoralist children here.

My travel companion, Mercy Corps health and nutrition manager Siyat Moge Gure, told me the saddest thing. “When a child has severe malnutrition,” he said, “they cry – but no tears come.”

Take Hali Yosuf, whose daughter Samia Mohamud is six months old. “My child has many problems,” said Hali. “She is not taking enough food, she has stopped breastfeeding, and she is malnourished.” Samia doesn’t wiggle much in her mother’s lap. She doesn’t babble or coo the way a healthy baby her age should. I can see why Hali looks so worried and scared. Her baby is sick, and she needs help.