Biology 402, Spring 2012 Laura Paschall. Doctors Without Borders
DOCTORS WITHOUT BORDERS IN … MUAC BRACELET In a nutritional crisis, Doctors Without Borders teams...
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Ex eritiae quo consecea cones, volore nobitis coritatur ratempo rehentur aut quam, que apeliquis archil inus dis ipsandam quatendent faceatur aspel et ped maxim hilliqui delendandit ea am fuga. Undebit, seque quis explaborias voluptas esed quis non cone ma veniscia solori nobite sequis mo coneserument ut faciae eos reperibusae vendis ad qui untinvelenda necte nobitione sitat aut molumquaecta sequatestias eatur as eos nobitistibus con nis eos remqui acepellati consenient id magnam ipsunditatem labo. Cus apitiae quae prerfer feriatume quis amusciendam adis soluptam, consectus, ipicit que a consequam dolupta denis nis eius venis des maximenis ari corum ad ut autem es dolor sundit ut dolest quidusd aectem quam ea pa sunto eos eveleni hitasit re, asperep ratesequis re perunt accatquas dolorest, is debis porest, que doloria tquunt eiciligendi omnis soluptatquo quatius suntem fugitiorem harciat. Non conescia voloritate odit volorem autest quiaectium ernatem quid molest, temquiderias a nectus apiendelita vel molupta speditiam, et id quo id quae verorporum conesti nat ressit dolendae verovid erciet alia sit pre ommo quaerna tiurest prectis expliquae rere, sequid endigenet quis ex es adis aut aut mo coristorum eatusan daerfer natque dipsanim sequibus qui ulliaestem quatquas eaque nus, solesti sequisit, is cor aut et excerru mendere, simusam, cum hicitiatiur? Millab is excera doluptaquam nihiligendit laborum voluptiae. Nem rempore mporae perupta ectinctet int re magnam, quo blatius resteni magnimosant ab inuscillam nulliqui delestiatio bla proris dolupti corro eostesci con corporisi il earum vendae nis reste net venit alit expe namet et maiorru menectotaes et ut quodicaborae dolupta dolorerum es dente venimet, volorum faces minveli cienisqui consequam vercimpore omnimpo rerupti delit, que et endam quiam aut verspero occus se cum volupta tionet mi, culparum faciis escideri reptis expe volorum de renecto taturias aut te nienimp eliqui ut landio. Obis eic tem rem facculliquam quatur sum audi omniae quaessit quia cum nonserspis molupta tiumquo od quam ent alignient que cus vent. Rum quiaspel ipsandem quid que comnim est, sum ipsam reptatiate doloreprovid est voluptat ipidend aeperum restibus alit quiae poris alit ius nonet oditae. et et velessunt quo iducium dolore, nisque consequi apisti blaboriaessi odi assunt, volupta cullace atessequis quiaspi tatemperum esci doluptate nihilla vid eventi occata quo volorum eaque nis que sitas dias dolesciuscim expeleniste veriora temoluptatur as aut adio. Omnit venet invel molorep eratia il ipsape ventemo luptaspid ma Ex eritiae quo consecea cones, tis coritatur ratempo rehentur aut quam, que aspel et ped maxim hilliqui delend uis non cone ma veniscia ui untinvelend eos r mm mm 50 56 62 68 74 80 86 92 98 104 110 116 122 128 134 140 146 152 158 164 170 176 182 1 52 58 64 70 76 82 88 94 100 106 112 118 124 130 136 142 148 154 160 166 172 178 1 1 174 168 162 156 150 144 138 132 122 120 114 108 102 96 90 84 78 72 66 60 54 mm mm 50 56 62 68 74 80 86 92 98 104 110 116 122 128 13 52 58 64 70 76 82 88 94 100 106 112 118 124 13 12 120 114 108 102 96 90 84 78 72 66 60 54 1 2 3 4 With the help of our supporters, these are some of the tools we use to fight malnutrition. In areas where access to treatment centers and health care is limited, field workers travel to isolated communities to provide general check- ups, as well as nutritional health and hygiene education. © Benoit Huet / MSF The MUAC bracelet—a plastic band with a color-coded gauge—is used to quickly assess whether a child under five years of age is malnourished. © Seb Geo Every child that comes to a treatment center is registered upon arrival. A registrar writes down the child’s details, which may include their name and age, their mother’s details, and the name of their village. Severely malnourished children who are unable to eat on their own are given therapeutic milk in the treatment center, delivered through a nasal-gastric tube or syringe. THERAPEUTIC MILK © Benoit Finck/MSF Children who have severe acute malnutrition, or who also suffer from an infection or other disease, may need to be hospitalized to receive highly specialized inpatient care at one of our nutrition centers. INPATIENT NUTRITION CENTERS Moderately and severely malnourished children are weighed and checked for signs of edema, a symptom of malnutrition that causes swelling. CHECKING WEIGHT © Anthony Bourasseau / MSF Children who are moderately or severely malnourished also have their height measured to calculate their height-to-weight ratio. MEASURING HEIGHT © Sven Torfinn MOBILE CLINICS IDENTIFYING MALNUTRITION Ready-to-use therapeutic food (RUTF) is administered to children diagnosed with severe or moderate malnutrition, unless they are in such a serious condition that they need to be hospitalized. © Julie Remy READY-TO-USE THERAPEUTIC FOOD REGISTRATION As a preventive measure, children at risk of malnutrition can be sent home with rations of ready-to-use supplemental food. PREVENTION © MSF © Boris Revollo / MSF © Kate Ribet/MSF DOCTORS WITHOUT BORDERS IN ACTION—TREATING MALNUTRITION “When children are malnourished they don’t want to play, they don’t want to be touched by anyone but their mothers. They isolate themselves. When they get better, you can see that they start to run around and play with other kids.” — Amy Parsons, Field Nurse, Niger
Transcript of DOCTORS WITHOUT BORDERS IN … MUAC BRACELET In a nutritional crisis, Doctors Without Borders teams...
IWCG Job Number: 2011496 Project: MSF43824EI2 Nutrition Inforgraphic Insert Date: 09/18/12 Stage: Seventh Proof Component: Insert Size: 26x17 Stock: White Ink: 4CP/4CP
Médecins Sans Frontières Australia
ABN: 74 068 758 654
Postal address: PO Box 847, Broadway
NSW 2007 Australia
Reception: +61 2 8570 2600
1300 13 60 61
Email: [email protected]
Website: www.msf.org.au/malnutrition
Médecins Sans Frontières is a non-profit, private, international medi cal and humanitarian organisation.
Ex eritiae quo consecea cones,
volore nobitis coritatur ratempo rehentur aut quam, que apeliquis archil inus dis ipsandam
quatendent faceatur aspel et ped maxim hilliqui delendandit ea am fuga. Undebit, seque quis
explaborias voluptas esed quis non cone ma veniscia solori nobite sequis mo coneserument
ut faciae eos reperibusae vendis ad qui untinvelenda necte nobitione sitat aut molumquaecta
sequatestias eatur as eos nobitistibus con nis eos remqui acepellati consenient id magnam
ipsunditatem labo. Cus apitiae quae prerfer feriatume quis amusciendam adis soluptam, consectus,
ipicit que a consequam dolupta denis nis eius venis des maximenis ari corum ad ut autem es dolor
sundit ut dolest quidusd aectem quam ea pa sunto eos eveleni hitasit re, asperep ratesequis re perunt
accatquas dolorest, is debis porest, que doloria tquunt eiciligendi omnis soluptatquo quatius suntem
fugitiorem harciat.
Non conescia voloritate odit volorem autest quiaectium ernatem quid molest, temquiderias a nectus
apiendelita vel molupta speditiam, et id quo id quae verorporum conesti nat ressit dolendae verovid
erciet alia sit pre ommo quaerna tiurest prectis expliquae rere, sequid endigenet quis ex es adis aut
aut mo coristorum eatusan daerfer natque dipsanim sequibus qui ulliaestem quatquas eaque nus,
solesti sequisit, is cor aut et excerru mendere, simusam, cum hicitiatiur?
Millab is excera doluptaquam nihiligendit laborum voluptiae. Nem rempore mporae perupta
ectinctet int re magnam, quo blatius resteni magnimosant ab inuscillam nulliqui delestiatio bla
proris dolupti corro eostesci con corporisi il earum vendae nis reste net venit alit expe namet
et maiorru menectotaes et ut quodicaborae dolupta dolorerum es dente venimet, volorum faces
minveli cienisqui consequam vercimpore omnimpo rerupti delit, que et endam quiam aut verspero
occus se cum volupta tionet mi, culparum faciis escideri reptis expe volorum de renecto taturias aut
te nienimp eliqui ut landio. Obis eic tem rem facculliquam quatur sum audi omniae quaessit quia
cum nonserspis molupta tiumquo od quam ent alignient que cus vent.
Rum quiaspel ipsandem quid que comnim est, sum ipsam reptatiate doloreprovid est voluptat
ipidend aeperum restibus alit quiae poris alit ius nonet oditae. et et velessunt quo iducium dolore,
nisque consequi apisti blaboriaessi odi assunt, volupta cullace atessequis quiaspi tatemperum esci
doluptate nihilla vid eventi occata quo volorum eaque nis que sitas dias dolesciuscim expeleniste
veriora temoluptatur as aut adio. Omnit venet invel molorep eratia il ipsape ventemo luptaspid ma
Médecins Sans Frontières Australia
ABN: 74 068 758 654
Postal address: PO Box 847, Broadway
NSW 2007 Australia
Reception: +61 2 8570 2600
1300 13 60 61
Email: [email protected]
Website: www.msf.org.au/malnutrition
Médecins Sans Frontières is a non-profit, private, international medi cal and humanitarian organisation.
Ex eritiae quo consecea cones,
volore nobitis coritatur ratempo rehentur aut quam, que apeliquis archil inus dis ipsandam
quatendent faceatur aspel et ped maxim hilliqui delendandit ea am fuga. Undebit, seque quis
explaborias voluptas esed quis non cone ma veniscia solori nobite sequis mo coneserument
ut faciae eos reperibusae vendis ad qui untinvelenda necte nobitione sitat aut molumquaecta
sequatestias eatur as eos nobitistibus con nis eos remqui acepellati consenient id magnam
ipsunditatem labo. Cus apitiae quae prerfer feriatume quis amusciendam adis soluptam, consectus,
ipicit que a consequam dolupta denis nis eius venis des maximenis ari corum ad ut autem es dolor
sundit ut dolest quidusd aectem quam ea pa sunto eos eveleni hitasit re, asperep ratesequis re perunt
accatquas dolorest, is debis porest, que doloria tquunt eiciligendi omnis soluptatquo quatius suntem
fugitiorem harciat.
Non conescia voloritate odit volorem autest quiaectium ernatem quid molest, temquiderias a nectus
apiendelita vel molupta speditiam, et id quo id quae verorporum conesti nat ressit dolendae verovid
erciet alia sit pre ommo quaerna tiurest prectis expliquae rere, sequid endigenet quis ex es adis aut
aut mo coristorum eatusan daerfer natque dipsanim sequibus qui ulliaestem quatquas eaque nus,
solesti sequisit, is cor aut et excerru mendere, simusam, cum hicitiatiur?
Millab is excera doluptaquam nihiligendit laborum voluptiae. Nem rempore mporae perupta
ectinctet int re magnam, quo blatius resteni magnimosant ab inuscillam nulliqui delestiatio bla
proris dolupti corro eostesci con corporisi il earum vendae nis reste net venit alit expe namet
et maiorru menectotaes et ut quodicaborae dolupta dolorerum es dente venimet, volorum faces
minveli cienisqui consequam vercimpore omnimpo rerupti delit, que et endam quiam aut verspero
occus se cum volupta tionet mi, culparum faciis escideri reptis expe volorum de renecto taturias aut
te nienimp eliqui ut landio. Obis eic tem rem facculliquam quatur sum audi omniae quaessit quia
cum nonserspis molupta tiumquo od quam ent alignient que cus vent.
Rum quiaspel ipsandem quid que comnim est, sum ipsam reptatiate doloreprovid est voluptat
ipidend aeperum restibus alit quiae poris alit ius nonet oditae. et et velessunt quo iducium dolore,
nisque consequi apisti blaboriaessi odi assunt, volupta cullace atessequis quiaspi tatemperum esci
doluptate nihilla vid eventi occata quo volorum eaque nis que sitas dias dolesciuscim expeleniste
veriora temoluptatur as aut adio. Omnit venet invel molorep eratia il ipsape ventemo luptaspid ma
mm
mm
505662687480869298104110116122128134140146152158164170176182188194200206212218224230236242248254260266272278284
52586470768288941001061121181241301361421481541601661721781841901962022082142202262322382442502562622682742802276 270 264 258 252 246 240 234 228 222 216 210 204 198 192 186 180 174 168 162 156 150 144 138 132 122 120 114 108 102 96 90 84 78 72 66 60 54
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5056626874808692981041101161221281341401461521581641701761821881942002062122182242302
5258647076828894100106112118124130136142148154160166172178184190196202208214220226222 216 210 204 198 192 186 180 174 168 162 156 150 144 138 132 122 120 114 108 102 96 90 84 78 72 66 60 54
Médecins Sans Frontières Australia
ABN: 74 068 758 654Postal address: PO Box 847, Broadway
NSW 2007 AustraliaReception: +61 2 8570 2600
1300 13 60 61
Email: [email protected]: www.msf.org.au/malnutrition
Médecins Sans Frontières is a non-profit, private, international medi cal and humanitarian organisation.
Ex eritiae quo consecea cones, volore nobitis coritatur ratempo rehentur aut quam, que apeliquis archil inus dis ipsandam
quatendent faceatur aspel et ped maxim hilliqui delendandit ea am fuga. Undebit, seque quis
explaborias voluptas esed quis non cone ma veniscia solori nobite sequis mo coneserument
ut faciae eos reperibusae vendis ad qui untinvelenda necte nobitione sitat aut molumquaecta
sequatestias eatur as eos nobitistibus con nis eos remqui acepellati consenient id magnam
ipsunditatem labo. Cus apitiae quae prerfer feriatume quis amusciendam adis soluptam, consectus,
ipicit que a consequam dolupta denis nis eius venis des maximenis ari corum ad ut autem es dolor
sundit ut dolest quidusd aectem quam ea pa sunto eos eveleni hitasit re, asperep ratesequis re perunt
accatquas dolorest, is debis porest, que doloria tquunt eiciligendi omnis soluptatquo quatius suntem
fugitiorem harciat.
Non conescia voloritate odit volorem autest quiaectium ernatem quid molest, temquiderias a nectus
apiendelita vel molupta speditiam, et id quo id quae verorporum conesti nat ressit dolendae verovid
erciet alia sit pre ommo quaerna tiurest prectis expliquae rere, sequid endigenet quis ex es adis aut
aut mo coristorum eatusan daerfer natque dipsanim sequibus qui ulliaestem quatquas eaque nus,
solesti sequisit, is cor aut et excerru mendere, simusam, cum hicitiatiur?
Millab is excera doluptaquam nihiligendit laborum voluptiae. Nem rempore mporae perupta
ectinctet int re magnam, quo blatius resteni magnimosant ab inuscillam nulliqui delestiatio bla
proris dolupti corro eostesci con corporisi il earum vendae nis reste net venit alit expe namet
et maiorru menectotaes et ut quodicaborae dolupta dolorerum es dente venimet, volorum faces
minveli cienisqui consequam vercimpore omnimpo rerupti delit, que et endam quiam aut verspero
occus se cum volupta tionet mi, culparum faciis escideri reptis expe volorum de renecto taturias aut
te nienimp eliqui ut landio. Obis eic tem rem facculliquam quatur sum audi omniae quaessit quia
cum nonserspis molupta tiumquo od quam ent alignient que cus vent.
Rum quiaspel ipsandem quid que comnim est, sum ipsam reptatiate doloreprovid est voluptat
ipidend aeperum restibus alit quiae poris alit ius nonet oditae. et et velessunt quo iducium dolore,
nisque consequi apisti blaboriaessi odi assunt, volupta cullace atessequis quiaspi tatemperum esci
doluptate nihilla vid eventi occata quo volorum eaque nis que sitas dias dolesciuscim expeleniste
veriora temoluptatur as aut adio. Omnit venet invel molorep eratia il ipsape ventemo luptaspid ma
1 2 3 4
With the help of our supporters, these are some of the tools we use to fight malnutrition.
In areas where access to treatment centers and health care is limited, field workers travel to isolated communities to provide general check-ups, as well as nutritional health and hygiene education.
© Benoit Huet / MSF
The MUAC bracelet—a plastic band with a color-coded gauge—is used to quickly assess whether a child under five years of age is malnourished.
© Seb Geo
Every child that comes to a treatment center is registered upon arrival. A registrar writes down the child’s details, which may include their name and age, their mother’s details, and the name of their village.
Severely malnourished children who are unable to eat on their own are given therapeutic milk in the treatment center, delivered through a nasal-gastric tube or syringe.
THERAPEUTIC MILK
© Benoit Finck/MSF
Children who have severe acute malnutrition, or who also suffer from an infection or other disease, may need to be hospitalized to receive highly specialized inpatient care at one of our nutrition centers.
INPATIENT NUTRITION CENTERS
Moderately and severely malnourished children are weighed and checked for signs of edema, a symptom of malnutrition that causes swelling.
CHECKING WEIGHT
© Anthony Bourasseau / MSF
Children who are moderately or severely malnourished also have their height measured to calculate their height-to-weight ratio.
MEASURING HEIGHT
© Sven Torfinn
MOBILE CLINICS
IDENTIFYING MALNUTRITIONReady-to-use therapeutic food (RUTF) is administered to children diagnosed with severe or moderate malnutrition, unless they are in such a serious condition that they need to be hospitalized.
© Julie Remy
READY-TO-USE THERAPEUTIC FOOD
REGISTRATION
As a preventive measure, children at risk of malnutrition can be sent home with rations of ready-to-use supplemental food.
PREVENTION
© MSF
© Boris Revollo / MSF
© Kate Ribet/MSF
DOCTORS WITHOUT BORDERS IN ACTION—TREATING MALNUTRITION
“When children are malnourished they don’t want to play, they don’t want to be touched by anyone but their mothers. They isolate themselves. When they get better, you can see that they start to run around and play with other kids.” — Amy Parsons, Field Nurse, Niger
THE MUAC BRACELETIn a nutritional crisis, Doctors Without Borders teams must quickly assess which children are at greatest risk of dying from starvation. We do this by measuring the mid-upper-arm circumference (MUAC) of at-risk children with a color-coded bracelet. Readings in the red zone of 115 mm or less indicate severely malnourished children who need immediate treatment.
On the right is an example of a MUAC used in the field (not printed to scale).
© Anthony Bourasseau / MSF
A DEVASTATING CONDITION WITH LONG-TERM IMPACTMalnutrition is a life-threatening medical condition, caused by a diet lacking in essential proteins, fats, vitamins, and minerals. In many countries, malnutrition is prevalent due to failed harvests caused by environmental disasters such as floods and droughts, and soaring food prices. These factors combine to make the cost of purchasing nutritious foods impossible. As a result, children are denied the nutrients they need to grow and be healthy.
A GLOBAL ISSUE
© Fastxmsf
MALNUTRITION
WHY WE NEED YOUR SUPPORT
“Eating millet porridge every day is the equivalent of living off bread and water. With luck, toddlers here might have milk once or twice a week. Young children are so susceptible to malnutrition because what they eat lacks essential vitamins and minerals to help them grow, remain strong, and fight off infection.” — Dr. Susan Shepherd,
Doctors Without Borders pediatrician
333 Seventh Avenue, 2nd FloorNew York, New York 10001www.doctorswithoutborders.org
mmmm
50 56
62 68
74 80
86 92
98 104 110 116
122 128
134 140
146 152
158 164
170
52 58
64 70
76 82
88 94
100 106
112 118
124 130
136 142 148 154
160 166 172 178 184 190 196
54 60
66 72
78 84
90 96
102 108
114 120 126
132 138
144 150
156 162
168 174 176 182 188 194 200 206 212 218 224 230 236 242 248 254 260 266 272 278 284 290 296 302
202 208 214 220 226 232 238 244 250 256 262 268 274 280 286 292 298 304
180 186 192 198 204 210 216 222 228 234 240 246 252 258 264 270 276 282 288 294 300
Malnutrition contributes to at least one-third of the eight million annual deaths of children under five years of age.
Children between six months and two years of age are most at risk.
Doctors Without Borders/Médecins Sans Frontières (MSF) has a particular focus on this age group, because if a child does not have access to a nutritious and balanced diet when the mother starts supplementing breast milk with other foods, their physical growth and mental development can be permanently impaired.
THE CRITICAL WINDOW
© Alice Davies/MSF
WHAT IT TELLS US:
Severe acute malnutrition
Moderately malnourished
At risk of malnutrition
Not at risk of malnutrition
MUAC RESULT RED: less than 115 mm (severe malnutrition and threat of death)
· very low height-to-weight ratio
· visible severe wasting*
· presence of nutritional edema (fluid in the feet—up to the face in severe cases)
MUAC RESULT ORANGE: 115-124 mm (moderate malnutrition)
· low height-to-weight ratio
· signs of wasting*
MUAC RESULT YELLOW: 125-134 mm (risk of malnutrition)
· medium height-to-weight ratio
· initial signs of wasting*
MUAC RESULT GREEN: more than 135 mm (normal)
· acceptable height-to-weight ratio
· appetite for food
· no signs of wasting*
THE DEBILITATING EFFECTS OF MALNUTRITIONWhen left untreated, malnutrition can lead to death or many health issues, particularly in babies and young children. They can suffer stunted growth, blindness, and impaired mental development if malnutrition is not detected and treated in time. Malnourished children are also at higher risk of dying from treatable illnesses like measles, upper respiratory infections, or diarrhea as a result of their weakened immune systems.
THE POWER TO HEAL IN THE HANDS OF MOTHERSSince 2005, the most effective tool for saving malnourished children’s lives has come in a small airtight foil packet that costs only 33 cents. Ready-to-use therapeutic food (RUTF) is a peanut butter-like paste that contains fortified milk powder and delivers the 40 essential nutrients that can bring a child back from the verge of starvation.
Before RUTF, Doctors Without Borders had to hospitalize severely malnourished children for weeks. Now our teams provide mothers with packets of RUTF to heal their children at home. Most malnourished children treated with RUTF recover in six weeks without ever being hospitalized.
HOSPITAL CARE FOR THE SICKEST CHILDRENSeverely malnourished children who have no appetite—or who suffer from malaria, pneumonia, or other diseases—are admitted to our inpatient centers for intensive, round-the-clock medical treatment. These children are at the greatest risk of death. But with proper care, most do survive and can be rapidly discharged to an outpatient program.
PREVENTING MALNUTRITION—CARE BEYOND CRISESDoctors Without Borders advocates for making nutritious, age-appropriate foods a critical part of infant mortality prevention programs. When Doctors Without Borders and our partners in Niger provided nutritional supplements to young children at risk of malnutrition in the fall of 2010, we documented a 50 percent lower death rate among children who received the milk-based, fortified paste.
DELIVERING EXPERT MEDICAL SOLUTIONS
© Benoit Finck/MSF
© Jean-Marc Giboux
© Alice Davies/MSF
RESPONDING TO A MEDICAL CRISIS
© Serene Assir/MSF
MSF43824EI2
* Wasting is when a child’s body becomes emaciated and atrophied from malnourishment.
IDENTIFYING MALNUTRITION
