Triple burden on Ecop: measles, malaria and malnutrition | planet of the future

Ekapuan Elipan, a community health advocate in Lodakche, Kenya, gives a mother therapeutic nutritional supplements for her malnourished child July 26.Lucy Makori/MSF

The Ekope family lives in one of the villages of Lodakach in the Turkana district (Kenya). Its members bear the brunt of a triple burden: the measles outbreak that has hit the region again since March last year (there was another in 2022) and has already claimed eight lives, malaria and malnutrition. As of the day I am writing this, the Médecins Sans Frontières (MSF) team has conducted over a hundred medical consultations in the city.

The mother, Hellen Adir, comes to Lodakach’s office, where I am, worried. With her are two of her three children, two-year-old Ekidor Ekope and 10-year-old Abegno Ekope, who accompanied her to a medical consultation. Abegno looks weak during the sorting. The scorching sun makes the symptoms of fever and pain almost unbearable. A girl watches over the MSF mobile clinic team while one of my colleagues asks her mother about the little girl’s condition.

“He began to hurt his joints, stomach and legs. I came for medicine for her. I suspect it is malaria,” Hellen says. “I was restless for two weeks. Children get sick one by one. My five-year-old son Longham is at home, also recovering from measles and malaria. Last week I took him to the Lopur dispensary and he received treatment there,” he adds.

His joints, stomach and legs began to ache. I suspect it’s malaria

Hellen Adir, mother of Abegno Ekope, 10 years old

My colleague Nancy Gichiki, MSF Clinical Manager, checks Abegno’s temperature and sees that it is very high, consistent with what she has observed in children and adults during external medical activities. He also discovers a rash around Abegno’s ear and asks him to open his mouth to check for a sore throat. The symptoms confirm the measles, which likely reached Turkana, a community of shepherds who move from one place to another in search of pasture, after the return of some members from other parts of Kenya where there have been outbreaks. The next step is to check if he has malaria, as he also complained of pain in his body. The test is positive and treatment must be started immediately.

Abegno is one of 451 cases of measles and 1,475 cases of malaria found in Turkana West alone. These ailments have affected many people, from infants to the elderly. The suffocating sun did not stop them from going to the doctor. Some of them are sick and lie in the shade, escaping the heat, waiting for medical attention. Most older people complain of joint pain, but children under five are most affected.

The consequences of the drought

But that’s not the only struggle this pastoral community has suffered from the drought. Its dire consequences are manifested in the form of malnutrition among children, pregnant women and nursing mothers. As livelihoods are eroded by the loss of livestock, many villagers struggle to find food to feed their families.

Hellen’s 2-year-old son Ekidor completed a nutritional screening and just received a two-week therapeutic nutritional supplement for severe acute malnutrition from Finna Botta, my fellow nutritionist. MSF medical teams have conducted nutritional testing for the most vulnerable populations – boys and girls aged nine months to five years, pregnant women and breastfeeding mothers – both through mobile clinics and at health centers. We refer malnourished people to nearby centers where they are observed and their development is checked.

The mobile clinic team continues to ask parents the following question: “Are there children at home with symptoms of measles, malaria or malnutrition? Please bring it.” An upset father answers. “I did not have the strength to carry my second son, he is too heavy and at the same time very weak. At least I was able to carry another son on my bike,” he explains. The team listens to him and asks if he can take local health promoters to his home. Finally, they manage to get home and return with the child.

Two steps away, the distribution of mosquito nets continues. 8403 delivered to families with children under 15, pregnant and nursing mothers. The Ekidor family also received a mosquito net for the little boy and his recovering brothers.

MSF has been working with the West Turkana County team since June as part of a collaborative effort to tackle the dual threat of measles and malaria through mass vaccinations, integrated case management, treatment at two health centers, and teamwork by essential mobile doctors at the community level. It is a race to ensure that no child is left without a measles vaccine or malaria treatment.

A total of 26,862 children were immunized in a mass measles vaccination campaign that spanned a wide sub-district and covered villages over 170 kilometers away. This is accompanied by increased health promotion through community involvement, awareness and oversight. Bringing vital health services closer to the villages of Turkana has profound implications for those who live far from health facilities.

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