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EMERGENCY NUTRITION UPDATE ENU OCTOBER–DECEMBER 2010 ISSUE 8 ........................................................ In the Spotlight Emergency Nutrition in Large Scale Emergencies In this edition: • Latest highlights on recent research in emergency nutrition • Updates on changes to Nutriset F75 and F100 formula calculation • ey successes and challenges of undertaing emergency nutrition in large scale emergencies oth gloally and for orld ision • ringing hope in aistan – one mother’s eperience of ho is changing lies and as alays lots more important pieces to eep you updated on deelopments in emergency nutrition ithin orld ision and eyond L ¡UI¢£LIN£ & ¤£ £N¢IN The Latest Scoop! Nutriset has recently released updated guidelines on ho to calculate F75 and F100 used for seerely malnourished children in inpatient care Nutriset’s F75 and F100 therapeutic mils come in sachets of 10g and 5g and are mied using the folloing calculation: 1 sachet litres of oiledpotale ater litres of therapeutic mil In 00 in response to reuests for assistance in calculating and miing smaller amounts of mil Nutriset egan including a red scoop ith its therapeutic mils along ith instructions on ho much ater should e added per scoop of poder ince then these instructions hae een reieed and the folloing reised guidelines should no e used for smaller uantities of therapeutic mil using Nutriset’s red scoops red scoops specifically proided y Nutriset and containing Nutriset’s log on the handle: F100: 1 leel Nutriset red scoop ith 1 ml of ater F75: 1 leel Nutriset red scoop ith 1 ml of ater Nutrisets red scoops are included in all procurements for Nutriset therapeutic mil In order to assist the aoe process Nutriset is currently in the process of deeloping smallersie sachets orld ision note – o date orld ision’s noledge of the use of the Nutriset red scoop in field settings is limited If you hae eperiences using the Nutriset red scoop please email nutritioncoeiorg and let us no e are particularly een to understand hat the ey adantages and challenges you hae faced procuring measuring miing and deliering F75 hild in ¥aiti hoto y ¦on arren No 010 and F100 1 ........................................................ £NU LI¡¥ Submitted by Kaitrin Both, Nutrition Emergency Nutrition Advisor World Vision Australia and World Vision International in Large Scale Emergencies Large scale emergencies continue to tae ounded and ª million affected rior to Challenges place around the orld ranging from the emergency stunting as estimated to • UN capacity – he ¡loal Nutrition rapid onset such as most recently in ¥aiti e «¬ eclusie reastfeeding 1¬ and luster as running at one third and aistan to sloer onset such as in gloal acute malnutrition 5¬ s part of of capacity at the time the disaster Niger In most of these situations food the UN luster ystem for coordination occurred in part due to lac of funding and related nutritional concerns are a in emergencies the Nutrition luster UNI £F indentified an internal lac ma§or concern led y UNI £F as actiated ithin of surge capacity hile a disaster er time the aility of the UN and one ee of the eathuae striing response roster had een drafted N¡’s to respond to nutrition in ¤epresentaties from the UN prior to the disaster there as still emergencies has improed here has goernment and N¡s including orld significant need to dra on capacity een greater coordination through ision ere actie participants from other countries hich left gaps in mechanisms such as the UN Nutrition Highlights some countries losing ey staff luster as ell as deelopments • ¤egular meetings enaled sharing of • Implementing partner capacity – here in capacity uilding emergency information eteen UN ¡oernment as an indentified lac of implementing preparedness monitoring and sureillance and N¡’s hich assisted in partners for programming particularly hile acnoledging the adances identifying needs and aoiding oerlaps in the area of seere malnutrition responses in emergencies particularly Finding sufficient health staff as also in large scale emergencies continue to • ¤apid agreement and dissemination of difficult as many had een in§ured or face challenges including reaching affected a ¥aiti pecific UN interagency §oint died populations otaining accurate rapid statement on IF£ to all operational • Language Locating French or reole assessment data prioritising needs haing agencies speaing nutrition eperts as sufficient capacity including technical • ¤apid deelopment and dissemination particularly challenging logistical and monetary and monitoring of a UNI £F¥ technical note on • onflicts eteen needs and mandates and ealuating responses infant feeding in the contet of ¥I and – For eample the Nutrition luster Cluster Experience ¥aiti identified that there as a need for • ¤apid proision of demographic nutritional support to the elderly¯ recent reie of the ountry and readon proided y he entre for hoeer this conflicted ith UNI £F’s ¡loal Leel oordination eperience in ¢isease ontrol assisted in identifying mandate to or ith children only ¥aiti folloing the earthuae in ¦anuary needs and maing programming s such the luster had to adocate to 010 highlights some of the ey challenges decisions other groups ho could respond and opportunities for emergency • uccessful implementation of a range • Intercepting unsolicited formula 1 nutrition of actiities ithin the first month – here ere many groups ho ontet – In ¦anuary 010 an earthuae including a esite here all releant reuested and accepted unsolicited in ¥aiti measuring 70 on the ¤ichter information as accessile infant formula in reach of the scale damaged large parts of the country oneresponseorgnutrition mapping of International ode on areting including the capital ortau rince resources and gaps a draft response of reast il ustitutes racing y mid Feruary it as estimated that strategy and the startup of arious and addressing this proed ery time 17000 people had een illed ª00000 programmes consuming 1 Information for the £NU sumission piece has largely een dran from the folloing articles: • ¢olan & erers 010 eptemer he ¥aiti £arthuae ountry and ¡loal luster oordination £periences and Lessons Learnt Field £change Issue « p7 • Nutrition luster oordination eam and UNICEF ¥aiti 010 eptemer UNICEF’s perspectie on cluster coordination and programme response in ¥aiti 010 Field £change Issue « p7 2 ........................................................ ¥aiti hoto y ¦on arren No 010 World Vision’s Experience • £nsuring a nutritionally adeuate food fleiility to leae ongoing or to rapidly orld ision eperience and capacity ration for the eneficiaries respond in nutrition has continued to gro from ne challenge in particular has een nely adertised position the national office to gloal particularly oer repeatedly raised in recent responses¯ £mergency Nutrition pecialist ill the past fe years It’s interesting to note staff capacity has made ecellent strengthen the capacity of I to that many of the successes and challenges progress in scaling up nutrition staffing respond in a timely manner to nutritional faced y the UN luster ystem and capacity in the past fe years e hae needs during humanitarian crises his Nutrition luster ystem are not seen the estalishment of the ¡loal position ill sere 50¬ of their time as dissimilar to ’s on eperience ost ¥ealth entre including an £mergency part of the ¡¤¤ for deployment to recent responses hae highlighted that ¥ealth ¢irector¯ the formation of the largescale emergency anyhere in the hile has een ale to achiee a lot Nutrition entre of £pertise including orld here responds directly heir there remain areas for strengthening one £mergency Nutritionist disor remaining 50¬ ill e ased ithin position and the addition of a ¥ealth anada’s Nutrition and ¥ealth team Highlights and Challenges and Nutrition pecialist on the ¥iring is currently taing place for this ome of the ey challenges has faced ¡loal ¤apid ¤esponse eam In addition position in recent times and is oring hard to Nutritionists hae een employed in the arious ¤egions and one disor s emergencies continue to arise address include: has een hired for the frica region heir sees to continuously to reflect on and • £nsuring a ualified £mergency roles hae included assisting National improe its aility to prepare and respond Nutritionist is deployed at the onset of ffices and uilding capacity of staff in to emergencies through nutrition If you an emergency for Nutrition & ¥ealth areas such as and IF£ ¢espite hae suggestions on ays e can do this strategy and proposal deelopment this oerall increased National ffice e sure to share these ideas ith your • £nsuring adeuate monitoring & capacity the timely aailaility of staff for ¤egional Nutrition disor ealuation systems are included in deployment in an emergency has remained A special thankyou to Sarah arr and laire programme designs from the eginning a challenge due to staffing orloads and Beck or their contribution to this piece 3 ........................................................ N£ F¤ ¥£ FI£L¢ frica Update: ummary of Functional Indicators and Influencing Factors ept 200«ct 2010 Submitted by yprian uma – Arica A echnical Advisor e Country a ra Leone Sudan y er en S. K Ethiopia Somalia Zimbabw Nig EDRC WDRC Zambia MauritaniaSier Project Tonj Sth, areas / Tonj Nth 10 13 1 2 18 2 6 2 5 2 ADP’s & Gogrial covered West Project Up to Somaliland O in O in Phased status end of Up to end O closed. Lupane & O Masisi & O out. O O (O = 2011 of 2011 Puntland Rushinga Rwanguba Waiting ongoing) opened. for funds Poor – Poor – Poor – Food Poor - Very poor Very poor Poor – receiving Poor – receiving receiving Poor – security receiving – need – need receiving food aid receiving food aid food aid receiving Poor Poor situation food aid food aid food aid food aid in some food aid mainly mainly food aid areas due to due to conflict conflict Good – Poor - Poor - but can General cattle Poor - Generally Very poor Moderate sporadic change Generally security rustling cattle good – clan wars Good to good rebel rapidly good Good Good and clan rustling in Somalia attacks due to violence rebels activities Poor Good Access to Poor due Moderate Good due to Good Good Poor Good except Good Good population to rains insecurity during rains Total OTP=31 OTP= 66 OTP=61 OTP=39 OTP=11 OTP=47 OTP=17 OTP=21 OTP=16 OTP= number of SFP=31 SFP= 83 SFP=N/A SFP=33 SFP=11 SFP=52 SFP=0 SFP=0 SFP=16 22 sites SFP= 0 Number OTP&SC OTP= OTP= OTP= admitted =3096 4333 OTP= OTP= 1216 OTP= OTP= 1808 OTP= OTP= 524 NA OTP= since SFP= SFP= 6812 SFP= 10838 385 SPF= 2877 SFP= 1649 SFP= 969 SFP= 7 programme 9686 312734 SFP= N/A NA SFP= 7622 6467 SFP= 0 479 setup Number CV=265 CV=330 CV=560 CV=1692 CV= 210 CV= 1329 CV=333 CV= 89 CV=795 trained in MOH=10 MOH=53 MOH= MOH=11 MOH=23 MOH= MOH=14 MOH=53 MOH=36 DU DU CMAM WV=44 WV=82 173 WV=95 WV=4 282 WV=6 WV=11 WV=12 WV= 14 WV=16 Recovered 85% >80% 85% 82%* 70% 77.4% 90% 97% 85% Deaths in <3% <3% <3% <3% <3% 3.9% <3% <3% <3% programme Default 14% <15% 1.7% 9% 24% 13% 6% 2% 6% 53% Coverage 67.1% in 63% in 67% in 42.7% in >50% <44% in 76% 53% in Sinazonwe Tonj Sth Turkana Durame Burkahaba Maradi Lwambo & 67% Musele CV = Community Volunteers, OTP: Outpatient therapeutic programme, SFP: Supplementary feeding programme, ADP: Area development programmes, CMAM: Community management of acute malnutrition DU: Data unavailable CV: Community Volunteers MOH: Ministry of Health *Average figure between SFP& OTP 4
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