15 September 2016

In July 2015, MSF opened an emergency nutritional project in Bokoro in southwestern Chad. Since 2010, MSF has carried out four nutritional interventions in this drought prone area in the central Sahel region in an attempt to tackle the growing malnutrition emergency. The Bokoro project is part of MSF’s wider malnutrition strategy in Chad.

Since June, and in partnership with the Ministry of Health (MoH), MSF teams in Bokoro have administered specialised food for malnutrition, reinforced the national health services already available and increased from 10 to 15 health centres in the region.

Elizair Djamba from Chad, a Supervisor of MSF distribution project in Bokoro, talks about his experience working for MSF.


Mariam Ahian is 35 years old and from Gama. Today is the first time she's been to the MSF mobile malnutrition clinic. Photo: Charlotte Morris

It’s my third year working with MSF. I saw what MSF does on the ground in Chad and I wanted to work for them. MSF is by nature a medical organisation and I was concerned I wouldn’t have anything to offer, but I’ve studied hard and now that I’ve been given the opportunity to work here I bring all of the skills and experience that I can. Currently I’m a supervisor for MSF’s distribution programme in Bokoro where we’re hoping to stop young children getting malnourished.

The children who come to our distribution sites should be healthy, but are at risk of getting malnourished. For the first time in Bokoro this year, we’re giving these children rations of specially formulated supplementary food and giving them a chance to stay healthy.

I’m responsible for managing a team of 20 people and ensuring they’re well motivated and well trained so that all of our beneficiaries receive the care and products they need. I’m also responsible for managing the stock and making sure we don’t run out of soap, supplementary food and mosquito nets.

It’s a really varied project so we have nurses measuring the upper arm circumference of all the babies, triaging people and looking after any of the babies that turn up ill. But ultimately, it’s a prevention project so this means there are a lot of non-medical tasks too such as distributing the soap, mosquito nets and supplementary food. Mums also receive a short education lesson about hygiene and nutrition.

The work is hard. We have to travel a lot and long distances and the state of the roads often aren’t good. When we arrive, the women and their babies are always waiting for us so we make sure we’re out of the MSF base by 6.30 am every day. We can’t leave people waiting in the heat, so this also means there’s no time to take a lunch break. We arrive in the villages early and we keep working until all the mums have everything they need.


Mothers from the village of Abourda and surrounding area, who have young children at risk of malnutrition, receive a short education lesson from MSF staff at the distribution site. Photo: Charlotte Morris  

Now we’re in the rainy season and often we arrive at the sites and it starts pouring with rain. We can’t leave the women and babies in the rain either so we have to be out in the rain with them, showing them that it’s important and worthwhile to be here. On top of this, the local village leaders expect a lot from us.

One day a grandmother turned up at the distribution site with an 18-month-old child who was really ill. He was very malnourished and had diarrhoea and vomiting. The child’s dad had died three days earlier. We took the child to MSF’s intensive care unit in Bokoro and a couple of days later the mum also died. I couldn’t believe it. The grandmother stayed with the child in hospital but she was very old and had a lot of health problems herself. I was really worried about what the child’s future was going to look like and I made the most of our relationships with the local community leaders to see whether there was anyone in his village who could adopt the child.

The child recovered from his illness and was discharged from the MSF hospital. This was so good to see but I still call the community leaders occasionally to check the child is doing ok. Recently I haven’t had any news. I’m really hoping that one day we can find the child again because I want to make sure they get registered in our distribution programme. Sometimes women travel long distances to come to our sites and travel between villages so I’m always on the lookout for them.

Find out more about MSF's work in Chad.