The Most Beautiful Hell I Know by Pep Bonet

The arrival of so many refugees has worsened significantly basic statistical indicators for children in Chad. The rates of infant under-five and maternal mortality are extremely high. One in five children will die before their fifth birthday.

Only half of Chadian children are fully immunized against major preventable diseases. Acute respiratory infections, malaria and diarrheal diseases are the most common causes of death. HIV / AIDS affects 18,000 children under 14 years.

Chad is experiencing strong population growth and a large influx of refugees. The agricultural sector, subject to limitations resulting from adverse weather conditions, has dominated the country’s economy for many years. Oil extraction has recently become the main driving force of the economy. However, most of the population is dedicated to agriculture, a sector characterized by low productivity.

Despite the good economic results achieved during the last decade, two-thirds of the population still live in absolute poverty. In addition, limited health coverage and the poor quality of health care services foster child mortality levels.

The diet is based mainly on cereals (sorghum and millet) and starchy roots (cassava and yam), with the addition of vegetables. The consumption of animal products and fruits and vegetables, foods rich in micronutrients, is reduced. Nationally, the food supply barely meets half the energy needs of the population and, due to disparities in access to food, more than a third of the population is undernourished. Consequently, many households are affected by recurrent food insecurity, which can sometimes be very serious.

Although breastfeeding is a common practice in Chad, exclusive breastfeeding is exceptional and complementary feeding is often not introduced at the right time and not sufficiently diversified. These inadequate infant feeding practices, coupled with the lack of health coverage and poverty are the main determinants of malnutrition. Chronic malnutrition affects 41% of children under five. Malnutrition is therefore a serious public health problem. Furthermore, during the past decade, there has been no improvement at all in the prevalence of chronic malnutrition. The lack of sanitation and immunization has led to several epidemics, such as cholera, measles, meningitis and polio which have jeopardized more than 2.2 million children under five years. Armed conflict and education system weakness (lack of infrastructure, materials and qualified teachers) continue to hamper nationwide access to quality education in Chad.

Pep Bonet worked in Bebedjia, Chad at Saint Joseph’s hospital, where he spent eight days documenting the pediatric ward following Doctor Jorge Muñoz through his daily work.