The UN says more than a million children each year die from malnutrition. Poor nutrition is one of many factors that weaken a child’s immune system, making it harder to recover from malaria, diarrhea and pneumonia. Every year, these three diseases kill up to five million children under five years of age around the world. But now health experts have a cheap and efficient tool to include in their arsenal against malnutrition – a paste that’s tasty, easy to eat, and high in nutrients. From Washington, VOA reporter William Eagle has the story.
A medicine that children love to eat? For many, that sounds like a contradiction, but it’s one of the selling points of so-called RUTFs, or Ready-to-Use Therapeutic Foods. The most famous was created about 10 years ago by a French nutritionist now working for the United Nations. It’s called Plumpy’nut.
Even infants can consume the peanut butter flavored treat, which is marketed as foil-wrapped bars or can be spooned out of plastic containers.
One aid agency (Doctors Without Borders) was sold on the product when it cut mortality rates among children under five from 35 percent to five percent. Since then, Plumpy’nut or one of its derivatives has been used to treat children in food emergencies in Ethiopia, Malawi, northern Uganda and Sudan. It’s also being introduced in number of developmental settings including Mozambique, Haiti, Zambia, Pakistan and Bangladesh.
Besides the taste, there are other advantages. The mixture can be stored for several months in tropical climates. And it’s fairly easy to make. All you need is a blender, peanut paste, vitamins, oil, sugar and dry milk. Small factories with just a handful of people have been set up to produce it in Kenya, Niger, Ethiopia and the DRC.
Jean Russell is Save the Children’s deputy country director for Malawi. From Lilongwe, she describes a local version of Plumpy’nut called chiponde.
"One of local NGOs producing the RUTF is called Project Peanut Butter," she said. "It began in 2005 with assistance from the US government and other donors. Project Peanut Butter has gone from producing three metric tons per week to 10 metric tons a week – that’s 500 metric tons a year. "
"It uses peanuts, or ground nuts, grown locally, but production is not high enough yet to meet the need. Everyone wants to work on it because it benefits the farmers, transporters, local markets and malnourished children."
Before chiponde was available, children were sent to a hospital to recover and were fed milk-based foods. But sometimes the hospitals or centers providing the service is far away. It’s also difficult for parents who can not leave home for several days or weeks. And, thanks to the effectiveness of chiponde and other RUTF derivatives, over 80 percent of children with acute malnutrition can be treated at home, rather than go to distant clinics.
But Russell says chiponde can be distributed by local community health volunteers or by mothers and other family members.
She said, "The clinically complicated cases are treated in hospital in the nutritional rehabilitation units as in-patients. When they are well enough, they are discharged to an outpatient therapeutic program or, if they are severely malnourished but don’t have clinical complications, they start in an outpatient therapy program."
"That’s where the RUTF comes in. They are assessed for their level of malnutrition, they are assessed for appetite (they need to have one for RUTF) and the children assessed to see if they might have malaria. They are automatically treated for worms, and given Vitamin A supplementation. Then, they come in [to the community health center] on a weekly basis to monitor their weight and improvement and to give the mother counseling messages."
Health experts say efforts are underway to replace expensive, imported dried milk in the paste so it can be manufactured more easily in the developing world. Other tests will see if chickpeas or sesame can be used in place of peanuts. There’s also a chocolate flavored version developed for adults, including those who have lost weight due to HIV / AIDS.
Nutritionists warn, however, that RUTF is not a cure-all, and that well being depends on treating the underlying cause of the malnutrition, whether it’s disease or hunger.