From the Field 5 : Mariek

If you have attended one of my presentations you will be familiar with Mariek.

I met this little boy when I was coordinator of the nutrition program at Leer Hospital in South Sudan. Mariek was brought to our hospital with a two week history of diarrhoea and vomiting. On arrival he was extremely dehydrated as well as severely malnourished.

If you look at the first picture you can see how thin his arms are and how loose the skin appears. This is a combination of his dreadful nutritional status and dehydration. Our first job was to reverse the life-threatening dehydration. This was done by giving him intravenous fluids through the cannula (plastic tube in the vein) that you can see in his left hand. We were able to correct his hydration status quite quickly and almost like a loofah, this charming little boy expanded!

The second picture was taken a couple of weeks later. The dehydration is no longer an issue but his arms remain very thin as he has little subcutaneous fat reserves left due to his illness.

Our approach regarding his nutrition was extremely cautious. First of all we had to very slowly get his body used to having some intake again so as not to provoke a potentially life threatening physiological response called refeeding syndrome.  This is phase one of the treatment for severe malnutrition. Phase two is much more fun as it is the fattening up stage! Regular feeding with high calorific therapeutic food soon starts to pile the weight on as you can see in the third photo.

After six weeks, Mariek was at a point where he could be discharged home. The third picture was in fact taken on the day of his discharge. This is one of my favourite pictures.

At my presentations, if people ask me what do MSF do?  I say “this is what we do, and we do it well”.


To keep this remarkable work happening, please consider donating to MSF via my ongoing fundraising project HERE



Photo & story with permission given at the time

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