Nourishing the Future (OPINION)

By Beverley J. Oda, Jan O'Sullivan T.D. and Dr. Raj Shah

An acutely malnourished child at a community-based treatment centre in northern Nigeria CREDIT: HUMNEWSAbsent from most of today’s headlines is the fact that more than 13 million people are currently threatened by the worst humanitarian crisis in the world. In the Horn of Africa the worst drought in 60 years has devastated farmlands, uprooted thousands of desperate families who are migrating in search of help and led to the outbreak of a massive famine in southern Somalia. 

As the world comes together in response, there is one underlying fact that—as long as it is ignored—could allow crises like these to reoccur. Emergency assistance is not a long-term solution.  In order to mitigate and prevent future tragedies, we must develop long-term, sustainable approaches to food security.

The problem of hunger and undernutrition is not limited to the Horn. In nations and regions throughout the world, one poor growing season can devastate the livelihoods of millions. Even when rains come do come and harvests are strong, too many families are forced to live on the edge, one meal away from hunger or suffering silently from undernutrition. Too many children grow up lacking the nutrients needed to fend off disease or develop their bodies and brains fully.

Globally, 200 million children suffer from undernutrition and each year it contributes to more than three million child deaths. Countries and aid organizations have long attempted to tackle the problem of undernutrition, but as with many of the important problems we face, it cannot not be solved without a unified response.

Fortunately, we now have the knowledge, tools and coordination necessary to institute both short-term emergency responses and long-term preventive strategies.  Critically, we also have the political will.  

In 2009, the leaders of the G8 joined at the L’Aquila summit to call for increased investment in agriculture and rural development to strengthen food security and economic growth. President Obama then launched an international effort called Feed the Future that brought more than 20 countries together to invest in food security throughout sub-Saharan Africa.

And last year, more than 100 organizations and entities joined together to launch Scaling Up Nutrition (SUN): A Framework for Action. Critically, this coalition realized that nutrition is woven into almost every meaningful issue of equity both between and within countries – from health to agriculture to social protection and stability.

No infant or child can have a fair chance at life when they are denied the vitamins and nutrients that are the building blocks for healthy growth. Accordingly, SUN proposed three scientifically backed recommendations: promoting breastfeeding, increasing the intake of vitamins and minerals, and employing therapeutic feeding to prevent moderate and severe malnutrition.

Each recommendation was designed with the potential of every child in mind; it is crucial that a child receives critical nutrients during the “1,000 day” window of opportunity between a mother’s pregnancy and until her child’s second birthday. Children given those nutrients during that window have the best chance to fulfill their intellectual potential and contribute to the economic development of their societies.

In the Horn of Africa, we are seeing the full spectrum of undernutrition’s impact, as children weakened by drought, hunger and disease suffer, while thousands of refugees desperate for their next meal show up every day on regional borders. Undernutrition and hunger exacerbate every major health threat–from birth and pregnancy complications to diarrheal diseases to living with HIV/AIDS to pneumonia. They also threaten economic growth, political stability and invite regional conflict.  

To truly invest in the potential of individuals, the stability of borders and the prevention of future disasters, we must focus on sustainably improving the nutrition of children, societies and the global community.

Beverley J. Oda, Minister of International Cooperation, Canadian International Development Agency

Jan O'Sullivan T.D., Minister of State for Trade and Development, Ireland

Dr. Raj Shah, Administrator, United States Agency for International Development (USAID)

Fighting Severe Malnutrition One Child at a Time in Nigeria's North (REPORT/VIDEO)

- Words: HUMNEWS staff, with UNICEF
- Video: Courtesy of UNICEF Nigeria. Edited by Max Ramming; narrated by Maggie Padlewska 

(HN, July 31, 2011) - As government and aid officials fight to stem to tide of malnourished children in the Horn of Africa, on the other side of the continent, a proven method of quickly guiding children back to health is showing impressive results.

In Nigeria's dry north, a programme to endow individual communities with the ability to treat malnourished children has resulting in a sharp decline of cases.A weary mother brings her malnourished infant for the first time to a CMAM post near Katsina. CREDIT: M Bociurkiw

Malnutrition here, as well as in many parts of Africa, is not only due to lack of rain or climbing food prices. Aid workers say poor household feeding practices are also to blame: mothers either stop breast-feeding abruptly and too early or do not have the knowledge on how to prepare nutritious meals.

Dubbed the Community Management of Acute Malnutrition (CMAM), the concept is designed to nurse children back to normal over the course of about eight weeks. For the most part, children are treated at home with ready-to-use therapeutic food. It is a result of a close collaboration between the federal, state and local governments and communities, as well as UNICEF and the European Commission.

On a recent visit to a CMAM post in Katsina, mothers could be seen shepherding their malnourished children through a carefully-planned circuit. First come a check-up, then a consultation, and finally the mothers receive any needed drugs and anti-biotics, and food supplements, including the therapeutic food.

Careful records are maintained so that, over the course of eight weeks of rehabilitation, proper follow-up can take place. When the programme started, there were 100 cases a day treated; now, only about 20 mothers come in every day. "We are very, very happy with the results," said one health worker.

Midwife Fedosi Babendaga at the CMAM post. CREDIT: M BociurkiwThe programme is so finely-tuned that if a mother does not return for a follow-up visit, a trained community volunteer comes to knock on their door.

Midwife Fedosi Babengada says that, in addition to the case management, mothers are also offered nutritional advice on how to boost the health benefits of each meal.

Despite being one of Africa's most prosperous and populous nations, more than one million children aged five and under die of preventable causes every year in Nigeria. It has the fourth-highest number of underweight children in the world. This translates into more than two million children suffering from severe and moderate levels of acute malnutrition - most of them in northern regions.

CMAM reached about 54,000 severely malnourished children in seven drought-affected northern Nigerian states. It is funded by a 3 million Euro grant from the European Commission's humanitarian aid agency (ECHO).

The focus states border Niger Republic and the Republic of Chad - both of which appealed last year for humanitarian food aid following severe food shortages caused by the ongoing Sahel drought and climate change.

Apart from the effects of Sahel drought in Northern Nigeria, other major challenges in the region include poor child care practices - particularly low exclusive breastfeeding rates - as well as inadequate quality and quantity of complementary foods.

Starved for Attention - US: The U.S. Standard and a Double Standard

In the documentary above, Doctors Without Borders/Médecins Sans Frontières (MSF) and VII photographers Antonin Kratochvil and Jessica Dimmock take a closer look at the US Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that provides vouchers to low-income young mothers for the purchase of nutritious staple foods such as milk, fruit, eggs, cereal and rice.  The documentary also takes a look at the sub-standard foods the US, as the world's largest food aid donor, sends to other countries.

Starved for Attention - Burkina Faso: A Mother's Devotion

 “Starved for Attention” captures frontline stories of malnutrition from Bangladesh, Burkina Faso, Democratic Republic of Congo, Djibouti, India, Mexico, and the United States

Part I: What is malnutrition?

Malnutrition, specifically undernutrition is a serious medical condition marked by a deficiency of essential proteins, fats, vitamins and minerals in a diet. It is especially burdensome and dangerous for young, growing children.

Malnutrition is different from hunger although they are often confused. The principles of good nutrition are well established: exclusive breastfeeding for the first six months of life then an introduction to an age-appropriate complementary diet.

Infants and young children need energy furnished by high-quality protein to maintain healthy growth and development such as milk, eggs, and fish, essential fats and carbohydrates, as well as vitamins and minerals.

Malnutrition plays a significant role in mortality because the immune systems of malnourished children are less resistant to common diseases – contributing to one-third of the eight million deaths of children under five years of age every year.

These are largely invisible children and invisible deaths, occurring in places we normally don’t hear much about. Every year the cycle of malnutrition continues with negative economic and community consequences. This is an ongoing medical emergency that requires urgent action and attention.

The story of malnutrition continues - tomorrow Part II: Tackling Childhood Malnutrition