The piercing wail of a mother who has lost her baby to illness and hunger is the little heard national anthem of the world’s poorest countries.
And Central African Republic, with more than half its population starving, is no stranger to that dreadful song.
I was woken from my sleep at 4am on a dark, dark Thursday night in March as the young mum’s cries filtered through the air leaving no one in doubt of her despair.
The many miles she had walked to Bossembélé Hospital in a bid to save her child - a wasted journey.
She was bereft, her sorrow untouchable and tragically hers is not a lone story.
In just one week in the country with charity Concern Worldwide I met dozens like her.
Women with no say in their own lives, left burdened with the care of children they don’t have the means to feed or buy medicine for after their husbands left to find work.
Isabelle Ingele, 28, is one such woman.
Her husband works in the mines and she had not heard from him in months.
She has seven children and five of them - Farikou, 10, Didda, eight, Yaouba, five, Etienne, two and nine-month old Abaker Dimanche - suffered from acute malnutrition when we met them, three of them severe.
We spoke to the young family at Yaloke Hospital in Ombele M’Poko where they had been admitted for treatment.
The hospital treated them for malaria but despite being a government run facility they got no food and Isabelle had to rely on the goodwill of others to make sure they didn’t go hungry while she slept on hard concrete floor by their hospital bed at night.
She said: “I don’t know what to do, I just put my trust in God. If I had the means things would be better and my children would be healthy.
“We came to the hospital because two of my children were malnourished - they checked the other three and they too were admitted.
“We have just received some medicine but nothing else.
“I always worry because there is no one to help me take care of the kids.
“God knows I am living a very hard life.”
Some miles away at Pama Health Clinic an unpaid health worker was trying to help children and mothers but much of their medicine had expired or run out.
They had some tools to measure levels of malnutrition in children with MUAC bands, weigh and measure them - but little else.
Mum of eight, 34-year-old Anice Zongo, walked two hours to get help for her seven year-old daughter Lydia, who struggled to walk after suffering polio, and her sick four-month-old Samedia.
Lydia’s running nose and straw coloured hair were a beacon of just how unwell the little girl was but her mum had many more mouths to feed and her youngest, still a baby, was also ill.
Anice told us: “My baby has recently had diarrhoea and has been coughing for the past few days.
“Lydia does not go to school because she got sick.
“I am not happy, I am just waiting for help for my kids. I just want them to be treated.”
It’s hard not to question humanity amid such heartbreak.
But there was nothing the largely unqualified staff at the clinic could do for them and so mums like Anice often turn back towards traditional medicine and the advice of shamans, which can often do more harm than good.
At Concern supported clinics elsewhere in the region - it was a very different story.
Food, medicine, malaria tests and equipment were provided in upgraded facilities where hygiene was emphasised, records kept and children treated for their illnesses.
Six-month-old Elvige and her three year old sister Natacha were diagnosed with malaria at the mobile health clinic in Gwabi, which serves around 3,000 people, the week before we visited.
And because of Concern they were able to get the help they needed.
Mum Daniella Wazilo, 24, was back at the clinic the day we visited, picking up the next batch of peanut paste, which was getting her baby to a healthy weight.
She said: “I came last week because my daughter had a fever and was vomiting. I didn’t know what was wrong with her.
“My other child Natacha, who’s three, sometimes gets sick and I have to give her medicine. They discovered she had malaria last week along with Elvige.
“I am relieved that they know what the problems are and they are receiving treatment and will improve.
“I’m very thankful for this clinic of Concern.”
The charity also spends money in the region training midwives and health centre staff to help support and educate women to take care of their little ones.
This could come in the form of medical intervention, helping them give birth, vaccinations against preventable conditions and even breastfeeding advice.
Many mothers we met gave their babies dirty water and fed them leaves, resulting in illness.
Health workers like Nelly Lessene, 32,, and matron and immunisation coordinator Emielliene Mapouka, 39, at Concern-supported Bekadili Health Facility advise them to breastfeed alone until the child is six months old - advice that has had some success.
The women also help to deliver between 15 and 20 babies each month and help out at mobile clinics elsewhere in the region.
Emielliene said while they have had some success they would like to help even more mothers.
“Before this the women were giving birth at home,” she explained.
“Some still give birth at home but then they bring the baby to us. Some are still not coming here but we would like them too.”
With your help, Concern could reach even more mothers, babies and children under five. They could vaccinate many more against preventable conditions like polio and save them from deadly diseases like malaria by supporting more clinics and hospitals throughout CAR.
The ongoing crisis has all but collapsed the country’s healthcare system, leaving even dying children with few places to turn to for help.
In Bossembélé, where Concern is working, over a third of health clinics are not supported – this means that even though staff members are incredibly dedicated and do their best to help, services are often unreliable which is ultimately costing precious lives.
THE FACTS
Central African Republic is ranked lowest on the 2018 Global Hunger Index
- 66.3% of the population live below the poverty line on just 97p a day
- 61.8% of population are estimated to be undernourished
- 46.2% of children under five are estimated to be stunted
Concern has so far equipped 13 health clinics and 13 mobile health clinics reaching thousands, trained 173 healthcare staff and 128 outreach workers to deliver healthcare in remote areas
This autumn, you can support Concern to help children break free from hunger in some of the world’s poorest places. As part of its Free from Hunger appeal, all donations made before 24 December will be matched pound for pound by UK government to help make sure that mums and children in the Central African Republic get the food, nutrition and healthcare they need to survive and grow up strong.
CLICK HERE for more information.
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