Energy Rich Cocktail Helps Curb Malnutrition in Africa
By William Eagle   (VOA)
Washington
05 July 2007

report on therapeutic foods audio clip
Listen to report on therapeutic foods audio clip

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.

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