Therapeutic milk and other nutrition supplies for malnourished children are free at Port Sudan Teaching Hospital, but the fluids and medicines many of them also need are not, a nutrition counsellor there told Al Jazeera. The supplies are provided with support from the World Health Organization and UNICEF. “However, intravenous fluids and medication remain a significant financial burden for many families,” said the counsellor, Maryam Gadalsid.
The cost shapes when children arrive. The hospital's paediatric director, Dr Ahmed Youssef, said families often bring children in only when malnutrition is advanced, because of financial hardship and fears about the price of treatment. Gadalsid said the 17-bed malnutrition unit now sometimes holds three children to a bed, which raises the risk of infections spreading.
Elsewhere the pressure falls on people who have been displaced. Sabri Adam, deputy head of the committee that runs al-Karama 3 camp in Damazin, in Blue Nile state, said recorded malnutrition cases there had risen from 1,800 in September to 2,116 in November. Al Jazeera does not say how the camp defines a case, and the hospital and camp accounts cover different places, so they show local pressure rather than a national trend.
The national picture comes from the UN-backed hunger monitor, the Integrated Food Security Phase Classification (IPC). In an alert on 12 October it warned of a growing risk of famine in parts of Greater Darfur and Greater Kordofan, where it said war, displacement, drought and too little aid were driving a rapid deterioration. According to UN News's report on the alert, across Sudan, only 26% of children expected to need care for severe malnutrition with medical complications had received it by August, and less than half of Sudan's humanitarian appeal had been funded by 8 October. The World Health Organization says it has supported all 161 operational nutrition stabilisation centres, which treated more than 26,000 children with complicated severe malnutrition between January and August. It also says 37% of the country's health facilities had stopped functioning.
Taken together, the reporting suggests that free supplies solve only part of the problem. A family can reach a ward with free therapeutic milk and still face the cost of fluids, drugs and the journey, and the cost can delay the visit until the child is sicker.