Narratives Under Siege (4): Ard El Insan Child Nutrition Centre

"We receive 20-25 new
referrals every day, and we
see approximately three
hundred and fifty children
a week here at the centre.
Last year we treated
more than eight thousand
four hundred children
here in Gaza city, plus
another eight thousand
children at our centre in Khan Yunis.
All of them were under 5 years old,
and all of them were malnourished."

Najah Zohod is the Nutritional Director of the Ard
El Insan Child Nutrition Centre in Gaza city. The
centre works exclusively with malnourished
under-fives. Children are regularly referred
to Ard El Insan from the Gaza-based UN Relief
and Works Agency (UNRWA) which supports
some of the poorest communities in the Gaza Strip.
But many mothers self-refer, by simply turning up
at the centre with their babies and young children.
This morning Ard El Insan is crowded with women
and children queuing for assessments and treatment.
Most of the children are quiet, and some look thin and listless.

"Our target group is children suffering second and third
degree malnutrition" says Najah Zohod. "We weigh
every child who comes here, and take blood and
urine samples. Approximately half the children
are mildly malnourished. But 32% are suffering second
degree malnutrition - and the remaining 16% are
third degree malnourished." All those assessed as
suffering second or third degree malnutrition are
referred to the Nutrition Unit. "We give the children
nutritious meals here at the centre, and also train
mothers to feed their children a healthy balanced
diet" says Najah. "We usually serve the children fresh
meat, fruit and vegetables. But this week we cannot
serve the children any fruit at all, because of the closure."

Israel's ongoing siege and closure of the Gaza Strip is
chronically affecting every aspect of life in Gaza, including
access to fresh food and water. Fresh meat has been
scarce for weeks, and now there are also shortages of
fresh fruit. Meanwhile chronic power cuts across the
Strip have left fifty percent of Gaza households
(around 750,000 people) desperately short of fresh
drinking water, because there isn't enough fuel to
power their electric water pumps more than 4-6
hours per day. Despite the fact collective punishment is
illegal under international human rights and humanitarian law,
the Israeli Occupying Forces (IOF) continue to collectively
punish 1.5 million Gazan civilians. Many of the women
who come to Ard El Insan for help feeding their
malnourished children are now dependent on food aid
assistance from either UNWRA or the World Food
Programme (WFP). But WFP is currently unable to
provide 84,000 of its poorest beneficiaries in Gaza
their full aid rations, also because of the continued
closure. Some of the poorest families in the Gaza Strip
are struggling to obtain adequate food for their children.

In the Ard El Insan dining area, women are now feeding
their children fresh meat and vegetable soup, which the
centre provides free of charge. One of the mothers, 23
year old Fatma Mishrif, lives in Nuseirat refuge camp in
the central Gaza Strip. "When I first brought my
daughter here, she was 6 months old and very underweight,
and I didn't know how to make her more healthy"
she says. "But the centre has really helped me to help
her, and now my daughter is much better. This place is
very important for all our children." The centre also
offers mothers nutritionally-rich rations of dry food to
feed their children at home, donated by UNRWA.

Ard El Insan uses a holistic approach, offering mothers
ongoing support in child nutrition, breast feeding, and
other parenting skills. But the centre Medical Director,
Adnan Al-Wahaidi, is adamant the Israeli siege is
exacerbating child malnutrition in the Gaza Strip.
"The consequences of this siege and closure have been
very severe for babies and young children" he says.
"We have documented noticeable increases in recent
rates of child malnutrition, especially chronic malnutrition.
For example, there have been serious increases in child
stunting, which is a proxy for chronic malnutrition,
because it indicates prolonged exposure to malnutrition."

According to the Palestinian Central Bureau of Statistics
10.7% of Gazan children aged under five are now
suffering stunted growth due to chronic malnutrition.
Dr Al-Wahaidi describes the figure as "Shocking,"
pointing out that neighbouring Arab countries have
child stunting rates of less than 6%.

"One of the major problems in the Gaza Strip" he says,
"is that we do not have sufficient natural food resources.
We cannot grow the variety of fruit and vegetables that we
need in order to provide ourselves, and our children, a
well balanced diet. We are dependent on food imports, but
the food table in the Gaza Strip is now severely deficient
because of the siege and closure." Dr Al-Wahaidi
acknowledges that Gaza has become donor dependent.
"We have tens of thousands of families who now have no
options or alternatives to humanitarian assistance" he says.
"But if this siege is maintained, then current child malnutrition
interventions and preventions will not be sufficient.
Child morbidity and mortality will both increase.
We will not be able to cope."