they’re lining up for it because it works

A peanut butter paste fortified with milk and vitamins is helping to save the lives of thousands of malnourished children in crisis-torn Niger Hilinki Tchadoua’s black eyes sparkle with life. Huge saucer-like objects, they stare out of a tiny face as if she is barely able to believe her good fortune as she sucks on fingers from a wizened hand.

At ten months, she is too weak and frail to do anything other than move her arm back and forth from the red plastic cup lying at her feet as she slowly brings a brownish porridge-like substance to her mouth.

“This is about as bad as you get,” says the nurse working at this emergency feeding centre for malnourished children in southern Niger. “But already the change is amazing. It is as if you can see her growing before you.”

Ousseina, her teenage mother, nods approvingly. “Before I came here I could not give her enough to eat. Now she is growing strong again.”

In Niger, where the United Nations says 150,000 children could die, Hilinki is lucky. She was so badly malnourished that she was admitted to this clinic, run by the medical aid organisation Médecins sans Frontières (MSF), for an intensive five-day feeding programme, and she is now feasting on a beige paste known as plumpy’nut.

Plumpy’nut – a fortified peanut butter stuffed with milk and vitamins – is just the sort of food that overweight Western children are advised to avoid. But for malnourished children it has an amazing effect, making it the undisputed hero of the current crisis in Niger, where 3.6 million people – 800,000 of them children – face severe food shortages.

Within two days, Hilinki’s weight has climbed from 4.6kg to 5kg (10lb to 11lb). She will stay at the clinic for a further three days and receive six meals a day. Nearly all of it will be plumpy’nut – a merging of the words peanut and plump – which can add as much as 1kg (2.2lb) a week to a hungry child’s weight.

“It is the only thing in this crisis that has acted quickly,” says an MSF nutritional assistant in a reference to the slow response of the international community to appeal after appeal ahead of the current tragedy in Niger.

Near by, Absu, a four-year-old girl whose curly black hair is shot with streaks of blonde – one of the telltale signs of severe malnutrition – sits on a plastic sheet at the feet of her grandmother and also hungrily devours a plate of the apparently magic paste. “She became sick some time ago – since last year we have not had enough to eat,” says Abu, her grandmother.

“I have struggled every day to find her food, but nothing works like the stuff they have here.” Absu’s mother died two years ago giving birth to another child.

Plumpy’nut, devised by a French scientist less than two years ago, is simple to deliver and to administer and has changed the nature of food-relief efforts. It comes in a small foil package, 2in square, and is given to children by their mothers. Once back to normal weight for their age, children need only one sachet a day to remain healthy.

Previously, malnourished children were given milk and other vitamin-packed substances in hospital, by drip. It took several weeks for them to regain strength, and all the while they occupied precious space in hastily erected emergency centres. Once they are back home, their only hope of survival would be if their mothers, often weak and hungry themselves, could supplement their breast-feeding with special milk formulas. Those are costly and in areas of poor water supply prone to spreading other diseases, such as diarrhoea – which can kill weak children. Aid workers are unanimous in their approval of the product.

“Normally, in a crisis like this, several children relapse once discharged, but here in Niger the number of returns is very low. This means we are getting something right,” says Johanne Sekkenes, the head of MSF in Niger.

Plumpy’nut was first used last year during the crisis in Darfur in western Sudan, but it is in Niger that it has come into its own. The crisis in the vast desert country in West Africa is not a traditional famine. There is plenty of food in the markets, but prices have rocketed because of a poor harvest after years of drought and, last year, the worst locust invasion for 40 years.

“This is a nutritional crisis, ” Johanne Sekkenes explains. “Children are suffering from the cumulative effects of poor diets, a lack of health services, and diseases, such as diarrhoea. That is why they are in a far worse state than the adults.”

Aid agencies have given warning that if food-relief efforts now under way are not sustained and there is another poor harvest then a catastrophic famine will follow.

(as seen in documentary on “60 minutes” 6/22/08)

via Doctors without Borders (aka Medecins San Frontieres)