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Ivorian bribes and stalemate causing hunger

child's legs being measured by health workers

By John James
BBC News, Mankono

We arrived at the tiny hospital in Mankono an hour after nine-month-old Aminata, but the tiny Ivorian baby had already passed away.

She had arrived severely dehydrated and malnourished and a weight of 5kg.

The reason why people are malnourished is mainly not due to a lack of food... food on the market is expensive
Merlin's Eric Gerard

There was little doctors could do.

"If she'd been referred here a week ago, perhaps we could have done something," said Doctor Gaousou Toure.

Mankono is a small town at the centre of what was once West Africa's richest country, until a civil war in 2002 split the country in half.

There was little actual fighting and Ivory Coast is still one of Africa's major agricultural exporters - around 40% of the world's cocoa, and more rubber and cashew nuts than any other country on the continent.

But despite these cash crops, Ivory Coast has large regions suffering from malnutrition.

A recent survey showed that malnutrition was now at emergency levels among children under two years old in two regions in the north-west, Bafing and Worodougou.

child eating a fruit
Food costs soar because of demands for bribes during transportation

A third of children nationally suffer from chronic malnutrition.

This is not a country facing a famine, but a series of factors has left large numbers of the population struggling to grow and buy enough food.

"The vulnerability of this population is pretty bad," says Eric Gerard, the country director for the British health charity, Merlin.

"Seeing these figures which are just below the threshold of a crisis, another hit will definitely generate a drama in the country because these populations are too weak now.

"If a second hit occurs we are really afraid of seeing a very serious crisis."

Orchards

With health workers from Merlin, we travelled out of Mankono to visit some of the remote villages where the charity carries out regular check-ups for children under five.

child sitting on a branch
A third of children nationally suffer from chronic malnutrition

We see very few vehicles as we pass the endless cashew nut orchards and fields ready for the new cotton crop.

There are few sounds of life outside the occasional village; collections of round mud houses topped by thatched tepee-style hats.

The flamboyant trees are in full blossom setting alight the scrubland with their scarlet flowers.

In the village of Dandougou, women are lining up with their children outside the village health centre.

The children scream with terror as a health worker from Merlin, Kouamane Kouame, measures their height and weight, checking for signs of severe acute malnutrition.

"Since we've been here we've had lots of cases, but at the moment we have four remaining patients with severe acute malnutrition," he says.

"But following our screenings this morning there's a chance we'll have lots more cases among these children."

Like elsewhere in West Africa, these are the "hungry months" between the end of stocks from the previous harvest the coming crop.

Bribes

A checkpoint is a sudden reminder the entire northern half of Ivory Coast remains under the control of ex-rebels, who have been in charge since a failed coup d'etat in September 2002.

If the elders want you to use traditional medicine, you can't disagree, even if you don't think it will help
Maryam Coulibaly, mother of two

The fighting quickly ended, but the legacy is a country that remains split in two with presidential elections repeatedly postponed.

According to the International Monetary Fund, the poverty rate rose from 38% to 49% between 2002 and 2008.

Despite a peace deal signed in March 2007, the ex-rebels have yet to hand over control and their demands for bribes from goods vehicles adds to the cost of food at the market.

"The reason why people are malnourished is mainly not due to a lack of food, but mainly due to accessibility issues due to poverty," says Mr Gerard.

"The food on the market is expensive and farmers have to travel with their harvest along road-blocked roads."

Earlier this week, the president of Ivory Coast's Chamber of Commerce said at least $300m (£200m) was paid in bribes at checkpoints each year, and the total amount could be as high as $600m.

Stunting

Further along the road, we meet Maryam Coulibaly, the mother of two young girls.

mothers and children waiting to see health workers
Special food supplements are given to the malnourished children

Along with tens of other mothers, she is waiting in-line under in the shade of a large tree to see the visiting health workers.

The high levels of stunting among adults - estimated at 40% in this region - is evident.

Children showing severe signs of malnutrition are given specially designed food supplements.

Ms Coulibaly tells us that children with malnutrition do not always get the help they need because of the cost of modern medicine, the lack of the health facilities close by and also certain cultural beliefs.

"You might believe that the white man's medicine can heal you, but if the elders want you to use traditional medicine, you can't disagree, even if you don't think it will help."

Ivory Coast was once called the "economic miracle" of Africa, with rapid growth in the first two decades after independence from France in 1960.

But the current political stalemate is keeping investors away and blocking the effectiveness of a government focusing on elections, now five years late.



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