His hair is thin and white, and his skin is broken, wrinkled and spotted with scabies. On his legs, open sores invite a cluster of flies, and on his foot, the squeeze of a thumb leaves an exceedingly prolonged imprint. He is weak, has little appetite and is severely malnourished. It is a condition by no means uncommon in Burundi, where the ghost of malnutrition has long since established itself in hills and homes throughout the tiny Central African nation's impoverished but verdant countryside, easily striking children whose access to food, health, sanitation and proper care is limited. However, since the outbreak of civil war in 1993, levels of malnutrition in Burundi have only increased, climbing ever higher as the overall health situation deteriorates.
Conditions are the worst by far in makeshift camps for the displaced.
In some of the worst-hit areas, particularly regroupment camps in Karuzi, rates of malnutrition for children have reached 18.7 per cent, and rates of severe malnutrition 4.9 per cent. Malnutrition's causes are many and difficult to determine. Before the war, Richard's family cultivated a small plot of land in the province of Karuzi, in central Burundi. The yield was relatively abundant, and they were able to sell the surplus of sweet potatoes, manioc and bananas in local markets. Their access to their fields, and therefore to their food, plummeted.