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“Before, she couldn’t bend her legs. Now she can sit normally.”

Inclusion Rehabilitation

Ruth is 15 months old. She suffers from malnutrition, which could irreversibly affect her growth. She is being cared for by HI.

© HI

Ruth was just 1 month old when her mother died. She was given into the care of her grandmother, Damaris, along with her two brothers, aged 8 and 5, as their father works in Kélo in southern Chad and is unable to look after them.

The siblings come from the village of Toukra, more than 15 kilometres from N'Djamena. Damaris takes Ruth to the nutrition centre by bus. Her transport costs are met by HI.
Damaris struggles to feed her grandchildren. Her main source of income comes from a small shop she runs in front of her house. She sells dried okra, cowpea seeds and peanut paste.

"If one of us falls ill, I don't have enough money to pay for a doctor and the medicines. We are hungry all the time. I find it very difficult to feed the three children and meet their other needs. Sometimes I don't eat so that they can."

She says.

Since she was 4 months old, Ruth has been receiving a weekly ration of Plumpy'Nut from Unicef - food bars formulated for the nutritional rehabilitation of children and adults suffering from severe malnutrition.

To complement Unicef's support, HI provides malnourished children with stimulation therapy sessions. The therapy comprises seven sessions designed to stimulate the psychomotor skills of children who have been severely affected by malnutrition. Ruth started her sessions at the beginning of the year with our physical therapist, Angeline.

"Before, she couldn't sit up. She would lie on her back all the time. She was very weak. Now she makes more effort to sit up. She tries to stand on her feet. She plays more and smiles more. She crawls, she picks things up...'                                   

Damaris, Ruth’s grandmother

Angeline, the physical therapist who ran the seven stimulation therapy sessions explains:

"She couldn't bend her knees or her arms the first time I saw her, at her diagnosis session. She was very weak. As the sessions progressed, she became much more mobile."

Stimulation therapy

Stimulation therapy complements emergency food aid. It is a set of activities that stimulate children’s motor skills and cognitive development. The therapist uses toys to encourage them to join in and gives them individual attention.

Each activity plays a specific role in development: holding a toy above a child's head will help with arm extension, while drawing with pens and pencils will help develop a better grip. Simple actions, such as kicking a ball or pushing a plastic car will help develop movement, interactions and reflexes.

Famine affects many families in Chad

In June 2022, Chad, the third least developed country in the world according to the UN, declared a "food emergency" due to the "steady deterioration in the nutritional situation". According to the UN, 5.5 million Chadians - more than a third of the population - needed "emergency humanitarian assistance" in 2021. The situation has been worsened by the war in Ukraine and its impact on the global grain trade.


The project is being supported by the German Federal Foreign Office (GFFO) until June 2024.


Date published: 04/09/23


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