Malnutrition is not one of them. Already malnourished children who have their uvula cut can’t eat for at least a week, says health official Blague. When the child does eat, the open wound often gets infected. This worsens the malnutrition.
Because the infection can last several weeks, families believe their baby has simply contracted a different ailment. Chad’s government has never addressed these harmful practices. The issue remains extremely sensitive, in part because the healers claim their gift came from Allah and in part because many local officials were submitted to such practices themselves when they were children, aid workers say.
Hassane says in 30 years of practice, he’s never fielded any complaints from parents whose children became sicker.
‘‘If a child has fever or diarrhea, once he opens his mouth, I can instantly tell. If I put my finger on his gum and feel it, I can tell if it’s due to his bad teeth. Once we take out this bad tooth, the diarrhea stops,’’ Hassane says. ‘‘And if the child gets sick again, it’s because he had some other illnesses in his system.’’
Moussa Mahamat Ali, the chief of the healers in the town of Mao, the regional capital, claims that all the children who have come to him have been cured of malnutrition.
‘‘If the child is sick ... he has yellow hair, he doesn’t eat, he’s skinny, it’s because of the bad teeth,’’ says the 75-year-old Ali. ‘‘This is a treatment for malnutrition. No one has ever told me that this is bad.’’
By the time children do turn up at the United Nations-funded centers, they have already been through hell. Nearly every week, health workers here admit dangerously emaciated children with a foamy substance coming out of their mouths.
Malnutrition is the underlying cause for the deaths of 2.6 million children every year, according to a study published in the scientific journal, The Lancet. That’s a third of the global total for children’s deaths.
At the feeding center in the town of Mao, run by the French aid group Action Against Hunger, a mother has come in carrying a bundle in her arms. When she pulls back the sheet, the health workers gasp. It looks like she has brought in a skeleton.
The best predictor for the severity of malnutrition is the circumference of a child’s upper arm, the World Health Organization has found over years of responding to famines in Africa. Less than 115 millimeters indicates the child is at risk of imminent death.
This child’s arms measure just 80 millimeters around. She weighs 5.2 kilograms (11.4 pounds), slightly more than a healthy newborn. She is 3 years old.
It takes a moment for the health workers to realize that the little girl, Fatime, has been admitted before.
Fatime’s short history is a litany of the well-meant customs that get in the way of a child’s health, and possibly even her life.
She was born underweight. Women in Chad, including her mother, are discouraged from eating during pregnancy, in the hope that a small child will be easier to deliver.
Fatime’s mother stopped breastfeeding her when she became pregnant with her youngest child. She was told that pregnancy tainted her milk and could poison the child still nursing.
Zara Seid, the mother, collected the bitter chaff left over when women pound millet into flour, mixed it with water and painted it on her breasts. The bitter taste repelled the toddler, and she was weaned overnight.
Yet in a place where food is hard to come by, it meant that Fatime began her precipitous fall into undernourishment.
Malnutrition and disease work in a deadly cycle, and soon Fatime got sick with diarrhea and a fever. The lack of a proper diet weakens the immune system and makes childhood diseases more severe. The sick child then loses more weight, making recovery more difficult.
More than a year ago, Fatime’s mother brought her into the clinic.
Like many African women, though, her mother needed permission from her husband to leave her family and stay away. And she knew he was starting to get impatient.
Over the pleas of the health workers, she left the clinic only a week after she got there. And upon the advice of villagers, she went to the traditional healer, a one-day visit instead of a three-week hospital stay.
The medicine man diagnosed the child’s illness as the result of her baby teeth. He heated a blade in the fire and pulled them out.
‘‘I thought this would bring back my daughter’s health, so I took heart from that, even if it was hard to see her in pain,’’ says Seid. ‘‘After we took out the bad teeth, it seemed like she was getting better. ... Then she got seriously worse.’’Continued...