Combatting Malnutrition In Liberia In The Wake Of A Health Epidemic


Magazine article
Imagine a girl growing up in one of the world’s poorest countries. Born to an anaemic mother, she is underweight from birth. She does not receive the early breast milk she needs to prevent and fight illness, to grow and to overcome the nutritional deficiencies which she was born with. In the first two years of her life, she is often hungry and rarely gets the nutrients she needs.
Poverty, nutritional deficiencies, lack of clean water and proper sanitation mean she is often sick and her growth is irreversibly affected. Somehow she survives. She is lucky enough to attend school, but her undernourished brain and body makes it more difficult to learn, and she is the equivalent of two to three years behind her peers. When she is old enough to begin work, her diminished physical and cognitive development reduces her earning capacity by at least 20%, making it more difficult for her to feed her own children.
This is the tragic reality for thousands of children in Liberia.
Liberia has one of the highest child mortality rates and lowest GDPs in the world. It’s no coincidence. Over half the children there are malnourished and hunger kills 10,000 children every year. Of the children that survive, more than 40% suffer from chronic malnutrition, or stunting, and are unable to perform well at school. This can have a devastating impact on their futures, leaving them unable to earn a living or make a valuable contribution to their community in later life. Child hunger has effectively trapped Liberia in a vicious cycle of poverty.
Unicef UK President Lord Ashdown, my fellow Vice Presidents and I agreed this had to change. Working alongside the Liberian government, Unicef has developed a programme of high-impact and costeffective interventions that tackle the root causes of malnutrition and address Liberia’s unique challenges. Through the Liberia Initiative, Unicef aims to reach every child under five in Liberia in the next five years across 15 Liberian counties.
The first 1,000 days of a child’s life – between conception and their second birthday – are the most important in their development. Investing in nutrition during this crucial window can change the course of an entire nation. Children constitute over 50% of Liberia’s population and 100% of its future. The social return on investing in nutrition is astounding. It makes so much sense. Not only does good nutrition enhance a child’s chances of a better future, it promotes the country’s longterm economic growth. Investment now will mean generation after generation of healthy children will grow up to fulfill their potential, helping Liberia to an estimated 3% year-on-year increase in GDP – and a brighter, independent future.
The Government of Liberia has identified nutrition as a national priority and, working in partnership with Unicef, is committed to creating fundamental, lasting change in the country.
This commitment to getting Liberia’s health system back on track has never been so vital. Before the Ebola crisis, Liberia was making remarkable development progress. When Ellen Johnson Sirleaf became President in 2006, she generated political will to instigate change at the highest level, and committed to improving child nutrition. A rise in foreign investment led to a rise in the country’s GDP and increased resources meant Liberia could invest in basic social services. As a result, under-five child mortality rates were dropping.
Whilst the worst of the epidemic may be over, Ebola has undermined any progress the new government had made in the ten year’s since civil war ravaged the country’s economy and development opportunities. With Liberia’s scarce resources being spent on the deadly outbreak, one of the worst side effects has been the total breakdown of medical services. Treating malnutrition in children became an even greater challenge as infrastructure, resources, funding and staff were redirected towards combatting transmission of Ebola and providing life-saving treatment. The already underfunded and understaffed public health system has been overwhelmed by the recent crisis and weight of years of conflict.
There is a strong need to build back Liberia’s economy and infrastructure for the better, especially in rural areas. Building back better will increase the capacity and resilience of Liberia to deal with future epidemics like this.
To achieve this, Unicef is increasing the capacity of health facilities by training health workers, establishing new sites for treating mothers and babies, promoting behavioural change to increase levels of breastfeeding, and creating support networks for mothers during pregnancy. This is the first time services are being coordinated countrywide to ensure better service delivery. We hope to create a model that can be replicated in other countries so that nutrition-related stunting will be a thing of the past.
Despite Ebola, the programme is resuming as usual in eight of the 15 counties and we are working to get the other counties back on track. In many communities, nutrition screenings are being integrated with Ebola prevention, for example, by distributing therapeutic nutrition supplies in Ebola Treatment Units. Household visits are also being conducted to educate mothers to monitor the nutritional status of their children.
If malnutrition is left ignored, the potential of the current generation of children to reach its full potential will be irreversibly lost and Liberia will continue to be trapped in intergenerational poverty and deprivation.
For this country to focus on progress and development, rather than just stability, Liberia faces a long, challenging road ahead. Unicef’s initiative to reduce chronic malnutrition in children is a mechanism for achieving this, and for helping Liberia’s children build positive futures free from fear and danger.
This article first appears in Issue 8 of Philanthropy Impact Magazine, click here to download the article in printer-friendly PDF

Correction: This page has been updated to reflect Dr Michael Hasting's position of Vice-president