In countries like Senegal, Action Against Hunger is on the frontlines preventing and treating hunger's deadly effects. Innovation is at the core of what we do, and tools to combat malnutrition make it so much easier to succeed. The Severe Acute Malnutrition (SAM) Photo App was designed to screen children for malnutrition around the globe. Nearly 75% of children do not have access to the healthcare they need, and a delayed malnutrition diagnosis can be fatal. The app is a breakthrough in detecting malnutrition -- with one simple click of a photo, we can determine whether a child is at-risk.
It works like this: first, a health worker, mother, or caregiver snaps a picture of a child. It could be a photo of just their arm or their whole body. Then, the app compares the shape of a healthy child to the child being screened. This minimizes human error by allowing reliable technology to estimate a child's nutritious status.
The traditional method of diagnosing malnutrition can be cumbersome and distressing for children. Oftentimes, heavy mechanical tools are used. If a child is too young to be weighed on a typical standing scale, babies are often placed in bucket scales. To measure a child's height, health workers must lug wooden measuring boards. This is a two-person operation: one person must hold a child's head in place, and another must slide the moving footboard up and record the corresponding measurement. All of these instruments are bulky and difficult to bring to hard-to-reach communities. They also often trigger stress in young children or make them feel overwhelmed.
Now, with the SAM Photo App, health workers don't need to carry the traditional, heavy equipment typically involved with malnutrition detection -- heavy bucket scales or height boards. The app makes the process fast and simple, rather than prolonged and error prone.
An arduous trek
Faty Dia, a health worker in Senegal, is eagerly awaiting this technology. She works in Matam, a region that has recently endured climate shocks and food insecurity.
"Matam is a district in the north of Senegal, with a very high rate of malnutrition in contrast to other regions of the country," said Dr. Alioune Mbacke, Chief Medical Officer in the district. "A lot of children suffer from malnutrition. About one in four children is affected."
Faty reports every day to a small infirmary, caring for her under resourced community.
One day, a young girl stumbled into Faty's ward. Coughing, feverish, and thin, the girl could hardly breathe. Faty immediately admitted the girl and suspected that she was malnourished.
Determining her nutrition status, however, was challenging. Faty had to rely on cumbersome tools -- heavy metal frames, large scales, and a wooden board -- to measure and analyze the girl's weight and height. The entire ordeal is complex and exhausting.
"You do four different things: weight measurement, height measurement, upper arm circumference measurement and the interpretation of the data," said Faty. "The measurements are not reliable because the children are often restless."
This tedious technique is customary in Faty's district. "The traditional method is very laborious and time-consuming, you first need the material and then you have to be assisted," she said.
On a typical evening, after a day at the infirmary, Faty makes house calls and goes from one family to the next to detect malnutrition. Often times, she travels to hard-to-reach remote villages. In extreme heat, she carries the heavy equipment for miles by herself. The journey is taxing and strenuous, but Faty knows it must be done. Oftentimes, it is the only way to reach malnourished children, because many families have no ability to travel long distances.
Many of these rural areas face high levels of hunger. "We are in a region with extremely high temperatures and heatwaves," said Dr. Mbacke. "We are in a region that is directly affected by climate change. That is a problem. That is also a problem with availability of agriculture resources."
Here, Faty finds it even harder to weigh children, especially as many get distressed or overwhelmed watching the other children go first.
Saving lives with a single click
It's moments like these where the SAM Photo App can save time and save lives. Soon, Faty will be equipped with the app, enabling her to detect and treat malnutrition so much faster.
"The app will make it possible to separate the children who need light care and those who need intensive treatment," said Nicole Idohou-Dossou, a community health worker. "The treatment can take place close to the family and is therefore more accessible and cheaper. Everyone will be able to save costs, and the data will be more reliable."
Even in the tool's early phases, screenings have been 90% effective. For health workers like Faty, the tool will be a game changer -- it can provide poor, rural areas with immediate information so long as they have even one of the most basic Android phones.
"This tool could be invaluable to community health workers in countries that have less structured or less well-resourced health systems," said Laura Medialdea Marcos, Principal Investigator of the SAM Photo App Project. "Ultimately, it could change the paradigm of the way the world screens and diagnoses malnutrition."
Still, the tool is only in the testing phases. "We can develop the app faster if we have enough money," said Dr. Francoise Siroma Nse'e Nomsili, Deputy Health and Nutrition Coordinator for Action Against Hunger. "If we had sufficient funding, we could perhaps provide the app in a few months."
Once released, Faty and others agree that the app will save lives. "I think if this photo app is available in the region, it would actively contribute to reducing malnutrition," said Dr. Mbacke. "The app allows us to diagnose children more easily, diagnose them faster, and diagnose them more reliably."