Tuesday, July 14, 2009


I wrote the original diary on this topic almost a year ago to the day and thought perhaps that it was a topic worthy of revisiting.

Every year, malnutrition kills five million children - that's one child every six seconds. Many do not get the milk, vitamins and minerals their developing bodies need. Furthermore, some mothers in these villages can't produce enough milk themselves and can't afford to buy it. Even if milk was available, its very difficult to store -- there’s no electricity, so no refrigeration. Powdered milk is useless because most don't have clean water.

But now, 'Doctors Without Borders' or 'Médecins Sans Frontières' believes that there is a product that can save millions of these children. And could 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, West Africa, where child malnutrition is widespread, 'Doctors Without Borders' has been handing out Plumpy'nut. This was covered in a segment by 60 Minutes.

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.

Niger has become Plumpy'nut'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 who 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 Plumpy'nut 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 explained.

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 Plumpy'nut 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, Plumpy'nut 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."

Fortified ready-to-eat products, like Plumpy'nut, save children's lives. nutritional specialist for Médecins Sans Frontières, Dr. Milton 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."

Médecins Sans Frontières is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, healthcare exclusion and natural or man-made disasters.

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