But now, 'Doctors Without Borders' believes that there is a product that can save millions of these children. And may possibly be the most important advance ever to cure and prevent malnutrition.
A ready-to-eat, vitamin-enriched paste - it's cheap, easy to make, and extremely easy to use. It is a simple formula: made of peanut butter, powdered milk, powdered sugar, and enriched with vitamins and minerals. It tastes like a peanut butter and is very sweet, and because of that many of the children love it. Developed by a nutritionist. It does not need refrigeration, water, or cooking; it is simply squeezed out in a paste and thus many children can even feed themselves.
Each serving is the equivalent of a glass of milk and a multivitamin.
In Niger, in West Africa, where child malnutrition is so widespread that most mothers have watched at least one of their children die, 'Doctors Without Borders' has been handing out Plumpynut. This was covered in a segment by 60 Minutes.
Niger has become Plumpynut's proving ground. A daily dose costs about $1; small factories mix it there and in three other African countries. In Niger, most children need help now during what’s called the "hunger season," just before the new harvest. Old food supplies have run out and about all that’s left is millet, a basic grain women pound for porridge. But millet doesn’t have enough nutrients to keep kids alive; in the western world it is used it as birdseed.
Dr. Susan Shepherd, a pediatrician from Butte, Mont., runs Doctors Without Borders in Niger, says children that would have been hospitalized in the past can now be treated at home. "The reason we can do that is because we can give children Plumpynut here in the ambulatory center, and they take a week’s ration home. Moms treat their children at home and come back every week for a weight check," Dr. Shepherd explains.
Children are weighed and measured at the distribution sites. They're also examined to make sure they don't have any serious infections. Malnutrition destroys a child's immune system, so they're more susceptible to diseases and less capable of recovering from them.
If Plumpynut is the answer, how come kids are still dying?
"The answer is getting to kids earlier," Shepherd says. "Once children are as sick as she is, Plumpynut is not gonna save her."
What about peanut allergies?
"We just don't see it. In developing countries food allergy is not nearly the problem that it is in industrialized countries."
On a list of 177 developing countries, the United Nations ranked Niger dead last. More than 70% of the people are illiterate and earn less than a dollar a day. The average woman will give birth at least eight times in her life. But largely because of malnutrition, one in five of their children will die before they reach the age of five. Of those who survive, half will have stunted growth and never reach full adult height.
Fortified ready-to-eat products, like Plumpynut, save children's lives. Dr. Tectonidis says if the more countries were willing to spend part of their food aid on this, more companies will start making it.
"Even by taking a miniscule proportion of the global food aid budget, they will have a huge impact, huge impact!" Tectonidis says. "We're not even asking for billions. It will solve so much of the underlying useless death. So we gotta do that now."
"Wasted life. Just totally wasted life for nothing. Because they don't have this product, *a little bit of peanut butter with vitamins,"* Tectonidis says. "What a waste."