Thiers is an escape from death to death. They trekked for four months, eating primarily leaves, milk and meat from their own animals – animals they slaughtered on the road when they became too weak to continue.

Now, they have reached Cameroon, the final destination, but sadly, malnutrition is killing their children. The pathetic ordeal of Central African refugees living in Cameroon as captured by The Cameroon Journal's Arison Tamfu.

In Cameroon’s economic capital Douala, there is an abandoned dilapidated building at the notorious New Bell neighbourhood where cockroaches and rats usually rally for merriment. That is where I have come to meet Alima Fatima, a refugee from Central African Republic (CAR). She lives in the building with her only surviving child and five other refugees.

“This is better than the streets. At least, we are far away from the noise, cold and mosquitoes,” she tells me with evidence of despair.

Fatima is 38, but has a countenance of an old granny. Today, like every day, she and her daughter, Amina, leave for ‘work’- begging on the streets of Douala.

“Most often, we have nothing to eat and begging is our main source of living. It has kept her alive” she says referring to her daughter, Amina, a scrawny-looking kid with a swollen stomach. Though malnourished, Fatima is determined to keep her alive and healthy.

“She will never experience what my other children experienced” she says vehemently.

What her children experienced is heartbreaking. In 2014, she decided to escape her country, Central African Republic (CAR) after a bloody conflict escalated between the Séléka rebel coalition and government forces. She says it was a long arduous journey, made on foot.

“We left everything behind – we didn’t take anything with us. Sometimes we will go for three days without even a drop of water.” She explained.

Over 200 villagers made the journey with her. It was a real ordeal for them but their children paid the greatest price. Fatima was nine months pregnant. She gave birth just one week after they started the journey.

“My new born baby died one week after birth because I could not feed her,” she says with tears rolling down her cheeks.

“I lost three out of my five children, a girl and two boys and my sister also lost two of her children – two boys. The first one of mine was two years, second four years and the last, one week old. I know more than 60 children who died because of malnutrition in the course of the journey” she adds.

Early July 2014, they arrived in the East region of Cameroon after trekking for over one month through dense forests. Fatima breathed a sigh of relief when they met other refugees eating in a camp in Batouri. But it did not take long for them to discover that, although they had escaped from the violence, they were now going to face trauma- malnutrition for their children.

Malnutrition is lack of proper nutrition, cause by not having a balanced diet and lack of enough food to eat.

“Malnutrition remains one of the greatest humanitarian concerns for refugees and children are disproportionately affected,” says Dr. George Tamufor. “Children under five years old have not developed substantial immune systems, especially if they are malnourished and have been since birth. As a result, disease tends to target these groups hard and fast.

Children at such young ages have no resistance to starvation and malnutrition. Therefore, mortality rates in this demographic are inordinately high. Additionally, those who survive such malnutrition can often have lasting brain damage and face other health complications” he added.

In the inpatient center of Batouri close to the Cameroon-CAR border, the mortality rate in July exceeded 24 per cent when Fatima and her two children arrived.

“Children who have survived the horror in the Central African Republic are now at risk of dying from malnutrition and its complications,” said Félicité Tchibindat, United Nations International Children’s Emergency Fund (UNICEF) Representative in Cameroon. “Death is stalking these children. It is alarming to see entire families undernourished – including older children and women.”

UNICEF reported that some 1 out of 5 pregnant and lactating refugee mothers arrived in Cameroon malnourished, which put their babies at increased risk. It added that 1 out of 3 refugee children from Central African Republic suffer from malnutrition.

Members of the mission, who included experts from UNICEF, the United Nations Refugee Agency (UNHCR) and the World Food Programme (WFP), reported seeing hospital wards with a lot of emaciated, sick children, two to three in a bed.

As a result of the devastating situation, Fatima lost one of her children in the camp and decided to leave the East region for Douala where she now lives in the dilapidated building.

“Maybe things have changed in the camp but I prefer to live and die here,” she says.

It’s been two years now since UNICEF declared malnutrition was ‘alarming’ among refugees in Cameroon but things have not changed; refugee children are still starving and dying in camps and streets of Cameroon. The humanitarian crisis in the Far North region of Cameroon where Boko Haram insurgency has displaced thousands continues to deteriorate. The increasing number of refugees and Internally Displaced Persons (IDPs), on top of the pre-existing nutrition crisis and increasing food insecurity is resulting in a complex humanitarian emergency according to UNICEF.

According to UNHCR there are over 500,000 registered refugees in Cameroon who have escaped from civil war in CAR and Boko Haram in Nigeria and Far North Cameroon.

Relief Efforts

Working with partners on the ground, UNICEF, UNHCR and WFP are stepping up their efforts to provide children and their families with the nutrition assistance they need. All children below the age of 10 are receiving supplementary feeding and ready to use therapeutic foods.

In 2015, UNICEF admitted over 60,000 of children under 5years old with acute malnutrition to therapeutic care. More children are being admitted.

“It is no exaggeration to say this nutrition crisis has well surpassed critical level,’ stressed Gian Carlo Cirri, WFP Cameroon Country Director. “WFP is implementing an aggressive response to ensure the absolute maximum nutrition support.”

Gaps

UNICEF is requesting more assistance as refugee children continue to die of malnutrition in Cameroon especially those that have been abandoned in the streets of the country. Fatima and her companions in Douala have lived and are living the agony.

“Fifteen of us came here in Douala with 11 children but we have already lost nine children because we could not feed them” she says.

Humanitarian access to people in need remains highly difficult in the Far North Region and in some areas close to the border with Central Africa Republic due to the security situation. This results in difficulties for UNICEF and humanitarians partners to procure assistance to people in need, a release by UNICEF said.

Dr. Tamufor has been voluntarily teaching refugee mothers on how to recognise early signs of malnutrition in their children.

“Since health centers are often few and far between – and women may lack the time or motivation to bring their children to the doctor until it is urgent – having an eye on the child’s health at home is key” explains Dr. Tamufor. “Teaching mothers to watch for symptoms like listlessness and swollen stomachs enables them to bring their children to the doctor at the first sign of trouble”

Here, they can obtain therapeutic food programmes that provide treatment and protein earlier when they are more effective, he says.

“I might have lost my dignity and respect as a mother, but I am pleased that my child will not go through what I went through” says Fatima after Dr. Tamufor announced he would offer Amina decent accommodation and therapeutic treatment gratis.

I ask Amina what she wants to be in future.

“A medical doctor. I want to treat children that are suffering like me” she says smiling.