Nutrition in Emergencies

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Nutrition in Emergencies
Spices condiments
A source of micronutrients - Blended food
Dr. Mariam Alwaili In-charge of clinical
nutrition MOH
Protein rich food Peas, beans or lentils
Source of fat - Vegetable oil
A staple food - Cereals
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Conceptual Framework for the Causes of
Malnutrition in Society
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1. Protein-Energy Malnutrition

2. Micronutrient Malnutrition Vitamin A
Deficiency (VAD) Iron Deficiency Anemia
(IDA) Iodine Deficiency Disorders (IDD) 3.
Communicable disease 4. Non-communicable disease
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Omani code
Guidelines
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Programme Interventions in Emergencies
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Overview of Programs

• General Food Distribution
• Selective Feeding Programs
• Supplementary Feeding Programs
• Therapeutic Feeding Programs
• Food Security Interventions
• Disease control measures

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Overview of Feeding Programs

• General Feeding Programs
• - For populations dependent
• - Full or partial food basket
• - Wet or dry rations

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The Food Basket

• For an initial emergency period and/or for a
  population entirely dependent on external food
  aid.
• 2,100 kcal/person/day
• 10-12 of total energy from protein
• At least 17 of total energy from fat
• Recommended micronutrient intakes

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Overview of Feeding Programs

• Selective Feeding Programs
• Supplementary Feeding Programs
• Therapeutic Feeding Programs
• Usually target vulnerable groups
• Malnourished children and individuals
• Pregnant and lactating women
• TB/HIV/other chronically ill patients
• If general ration or food intake not sufficient
  to meet special needs

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Disease control measures

• Reduce the demand for micronutrients
• infection prevention and treatment
• reduction in measles/TB, hookworm
• improve hygiene
• immunization
• deworming
• malaria control
• Availability of ORS
• increased exposure to sun
• Increase supply of micronutrients in the diet
• or by supplementation
• THESE SHOULD HAPPEN SIMULTANEOUSLY
  
  

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Overview of Feeding Programs

• Food Security Interventions
• gardening/income generation, etc
• Support for gardening projects, income
  generation, etc.
• Improve access to micronutrient rich foods by
  growing, trading, purchase, etc.
• Increase dietary diversity

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What Are the Characteristicsof an Adequate
Ration?

• Meet the populations
• minimum nutritional requirements

• Diversified

• Acceptable and broadly familiar

• Fit for human consumption

• Easily digestible for children

• Economic in terms of fuel requirements,
• preparation time and waste

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Distribution systems should be

• Equitable
• Regular
• Accountable
• Transparent
• Secure

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Minimum response in every emergency
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What must I do to protect and support safe and
appropriate IFE?
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Offer safe places for breastfeeding and feeding
support
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Prioritise pregnant and lactating women for
shelter, food, water and security
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Make sure every newborn initiates breastfeeding
within 1 hour of birth
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Ensure access to safe and adequate complementary
foods, appropriate to needs and context
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Locate technical capacity
Wet nurse relactates an abandoned baby (Myanmar,
2008)
Unaccompanied infants with no source of breasmilk
(Rwanda, 1994)
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Do not seek or accept donations of BMS, bottles
teats

• Donated (free) or subsidised supplies of
  breastmilk substitutes (e.g. infant formula)
  should be avoided.
• Donations of bottles and teats should be refused
  in emergency situations.
• Any well-meant but ill-advised donations of
  breastmilk substitutes, bottles and teats should
  be placed under the control of a single
  designated agency.
• Operational Guidance on IFE, v2.1, Feb, 2007

But Gov should special cases
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Key priorities

• Scale up existing life saving treatment of acute
  malnutrition programs
• Capitalize on high impact low cost interventions
  such as breast feeding, complementary feeding and
  Vitamin A supplementation
• Building capacity of national institutions in
  nutrition emergency preparedness, response and
  mitigation
• Targeting under 5 children, pregnant and
  lactating women, and vulnerable groups (elderly,
  disable people etc.)

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Standard Guidelines for designing and monitoring
feeding programs

• SPHERE
• UNHCR/WFP Guidelines for Selective Feeding
  Program in Emergency Situations

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NUTRITION PREPAREDNESS IN EMERGENCY
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How to Prepare Individual

• Be prepared to be self sufficient for at least
  72-Hours.
• Food
• Water
• Shelter
• Medications
• Hygiene items
• Keep it together, updated/rotated and accessible.

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EXAMPLE OF 4-PERSON 72-HOUR KIT
Sheets, blankets, towels, pillows
5 gallon bucket with hygiene items
Water
Ready made Dried food
Propane heater
Dishes, pots pans
Canned food
Sleeping bag
Battery lantern with batteries
Propane Lantern
Camp stove misc. items (rope, tools, matches,
propane)
Propane
Charcoal
Extra BBQ Propane tank
Tent, cots, sleeping bag.
Tarps
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Key priorities

• Scale up existing life saving treatment of acute
  malnutrition programs
• Capitalize on high impact low cost interventions
  such as breast feeding, complementary feeding and
  Vitamin A supplementation
• Building capacity of national institutions in
  nutrition emergency preparedness, response and
  mitigation
• Targeting under 5 children, pregnant and
  lactating women, and vulnerable groups (elderly,
  disable people etc.)

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Group work

• 1. What information on nutrition needs do you
  need to know of affected people?
• 2. With whom would you need to coordinate to
  find out more about the situation?
• 3. What information did you got from risk
  assessment study
• 4. What intervention measures would you make
  based on the information that you have?
• 5. what is your contingency plan.
• 6. What is your recommendation

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Coming together is a beginning
Keeping together is progress
Working together is success!