Feed a Child - Reduce Malnutrition in Guatemala

 
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Feb 14, 2012

Nutrient Supplements for Children!

Dear Friends, I recently wrote a piece on "New Nutrition Supplements for Children" for an online global health clearinghouse website. Since one of those "New Nutrition Supplements" is Plumpy'doz, the distribution of which you have been supporting in Guatemala with your contributions to this Globalgiving Project, I thought you might like to read some excerpts (see below!). Also, check out the pictures I am uploading here of Plumpy'doz distributions and the links below to some videos of the same. As always thanks for your support!

 

Lipid based nutrient supplements (LNS) are perhaps one of the most exciting, and potentially transformative emerging technologies for the treatment of chronic malnutrition. LNS preparations are called ‘lipid-based’ because, unlike older nutritional formulations, they derive a much larger percentage of their calories from fats (typically from peanuts, milk, and vegetable oils). They also generally contain a full complement of vitamins and micronutrients. Because they are fat-based, these micronutrients may be more easily absorbed by the body (they are not bound up by plant phytates which are abundant in grain-based nutritional supplements). They also provide essential fatty acids, whose importance for promoting healthy growth and brain development is more and more appreciated today.
Most people have heard of at least one type of LNS product, Plumpydoz®, which has revolutionized the treatment of severe acute malnutrition in many countries throughout the world. Plumpydoz® is classified as a therapeutic food, meaning that it is extremely dense in calories and is essentially meant to be used in a situation where aggressive ‘refeeding’ is necessary. Since the product has a long shelf life, does not require mixing or cooking, and is tasty, it has produced a paradigm shift in the treatment of severe malnutrition. Previously, most cases of severe malnutrition needed to be hospitalized, often simply because the mixing and preparation of refeeding solutions was complex and required special tools and training. Plumpydoz® uncomplicates this process, which means that refeeding can happen in the home and in rural communities.

What many people do not know, however, is that new research has led to the development of a range of other LNS products, which are lower in calories while still providing a full complement of micronutrients. These products include some which provide a medium amount of calories (Plumpydoz® is one example) and some that provide a small amount of calories (Nutributter® is an example). These are very welcome developments, because they could potentially be used in development settings where chronic malnutrition, rather than acute malnutrition, is the norm. Chronic malnutrition, is generally a smoldering illness which affects a child over months to years and, until now, we haven’t really had any very effective tools for dealing with it. Using Plumpynut® for treating chronic malnutrition would be sort of like using a fire hose to put out a candle.

This isn’t to say that the ‘candle’ of chronic malnutrition is something to sniff at. There are many more children in the world with chronic malnutrition than with acute malnutrition. Whereas acute malnutrition puts a child at immediate and obvious risk of death, chronic malnutrition consumes their biological and social potential in a slow, insidious way. Chronically malnourished children are shorter than their peers. They have more frequent episodes of diarrhea and respiratory illness. They have slower intellectual development and lower IQs. They are less likely to complete school. As adults, and are more likely to be unemployed or to have low paying jobs. Perhaps most horrifying of all, chronic malnutrition as a child greatly increases the risk of obesity, hypertension, and diabetes in adulthood – directly contributing to the rising epidemic of these disease in the developing world.

Exactly how to combat chronic malnutrition with LNS formulations is not entirely worked out yet. There are some positive studies; for example, this study showed that the rates of severe chronic malnutrition could be reduced by supplementation with a Nutributter® like product in children in Malawi. However, the factors which influence and maintain chronic stunting vary significantly from environment to environment. For example, in Malawi chronic malnutrition is greatly influenced by seasonal food insecurity and cyclical droughts; in this type of setting, it is common for there also to be a lot of acute malnutrition. On the other hand, in Guatemala (which has the highest rates of chronic malnutrition in the Western hemisphere), there is no seasonality to malnutrition patterns; here, malnutrition is clearly related more to endemic racism and lack of access to basic medical care and only more obliquely to food production patterns and food insecurity. In short, what might work in one context to treat (or prevent) chronic malnutrition might not work somewhere else.

Clearly, there is exciting and important work to be done. In Guatemala, we have been working at Wuqu’ Kawoq with both medium calorie and low calorie LNS products. For example, we have been using Plumpydoz® in 5 different communities for about 12 months now. In these communities, the Plumpydoz® seems generally well accepted with decent uptake and utilization. In the cohort of the most severely stunted children, height recovery also seems to be progressing nicely. Most mothers also report reductions in rates of acute illness in their children. We are conducting a prospective analysis of the growth data in these communities over the next several years, which we hope will bear out these observations. Potentially the great advantage of a medium calorie preparation is that it could provide some nutritional boost to children who are already malnourished at the start of a program, and this is the hypothesis we are exploring – that Plumpydoz®, or another product like it, can provide both prevention of malnutrition onset in the youngest children but also some recuperation in older, already-malnourished children.

Links:

Nov 21, 2011

Save the Date Dec 16th! And Holiday Giving!

Dear Friends, 

Thanks for all of your support for our nutrition programs this year in Guatemala! As you recall this project began almost a year ago and was kicked off by a brief special on ABC's 20/20 news program. We are excited to announce that we will again be featured on 20/20 in a follow-up segment, to be aired on Friday, December 16th! Be sure to tune in!

We also wanted to remind all of you who are looking for holiday giving opportunities, that Global Giving allows you to make a donation to this project as a gift to friends or family. When you do so, Global Giving will sent a card to the person you designate as the gift recipient! We are also eligible for extra bonus funds from Global Giving if we are one of the top 15 projects to have donations as gifts between November 23rd and December 31st. 

As always, thanks so much for your generosity and for all you do to make the world a better place!

Peter Rohloff, Medical Director, Wuqu' Kawoq (peter@wuqukawoq.org). 

Links:

Nov 15, 2011

Site visits to 5 communities

Dear friends,

I am just back from a great trip to Guatemala where, together with our nutrition staff and pediatricians, we made the rounds on 5 communities which are enrolled in the Plumpydoz project, funded by you all!

In all communities, we were very pleased with the progress that the children are making. Most children and mothers really enjoy using the Plumpydoz product, and we are seeing some early encouraging results in each location. For example, mothers report that their children have better appetites and are getting sick less often. Additionally, we saw many cases where the Plumpydoz is already making a big difference for children in terms of their growth. We expect that, as time goes on, these effects will become more and more pronounced.

Also, in each community, we took the time to visit with several very ill children. As you can probably imagine, whenever we start a nutrition program in a new community, we always find at least a few children who have previously undiagnosed illnesses other than malnutrition, such as congenital heart disease, seizures, etc. Since there really is no primary care for children in Guatemala, often visits with our doctors are the first these children have had. As part of our community based nutrition work, however, we at Wuqu' Kawoq also commit to treating any other medical condition we find in the children that we serve.

Thanks once again for all of your support and generosity in this project, and stay tuned for more updates! As always, email me at peter@wuqukawoq.org with any questions or concerns.

Links:

Oct 12, 2011

Feed a Child: On Oct 19, your gift grows 30%!

Photos from Collective Futures conference
Photos from Collective Futures conference

Dear Friends and Supporters,

It has been an exciting few months in Guatemala for Child Nutrition! We are also excited to announce that on October 19, GlobalGiving.org is matching all online donations at 30% up to $1000 per donor per project!

Thanks to your support, we now have 5 communities receiving comprehensive nutrition and medical care utilizing Plumpydoz! We have already had seen some successes, after just a few short months, with decreases in diarrhea and other illnesses in the recipient children. Of course we are following their growth closely and expect to see results there as well. 

Last week we sponsored a conference “Collective Futures" (http://en.futuroscolectivos.com/) in Guatemala bringing together 80 international non-profits, regional organizations, and government agencies to address major issues in community development. One focus of the conference was working together to fight child malnutrition in creative and practical ways. Our partners at Edesia (the manufacturers of Plumpydoz) gave an excellent talk on the use of the product to a packed room of health promoters, scholars and community members representing several countries and many regions of Guatemala.  

We hope that you will continue to support this exciting work! In particular, don't forget that on October 19, GlobalGiving.org is matching all online donations at 30% up to $1000 per donor per project! There is $100,000 available in matching funds from 12:01am EDT until they run out! You have been the most generous of supporters and we wanted to invite you to take advantage of the generous matching funds from Global Giving to help stretch every precious dollar! We know the economy is difficult right now and we are extremely thankful for each dollar you can provide to help change the future for children in Guatemala!

Please feel free to contact me at any time peter@wuqukawoq.org or check out our webpage www.wuqukawoq.org.

Thank you for Being the Change in these children’s lives!

Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference
Photos from Collective Futures conference

Links:

Jul 28, 2011

4 Communities now using Plumpydoz!

Dear friends and supporters, I just got back from another exciting trip to Guatemala!

Our child nutrition projects using Plumpydoz are progressing very well! The programs are now in full swing, with comprehensive nutrition as well as medical care, in 4 out of 5 target communities! We anticipate the last community will come on line by the end of August. These programs have been made possible entirely because of the support of you, our donors!

The product is being very well received in the communities, and we are already starting to notice a difference in the health of children! Community leaders, especially women, have been especially energized by the program, and it has already generated a lot of talk and interest about starting some other new programs as well, such as health programs for women!

The ABC news team was down again several weeks ago and shot some additional video of the project as well as interviews with mothers of children in the program and our local staff. We look forward to seeing some of that footage on ABC in coming months!

In the meantime, please enjoy the new pictures that I am attaching from one of the target towns, Paquip.

As always, feel free to drop me a personal line at any time at peter@wuqukawoq.org to discuss the project in more detail. I get a lot of email but I still try to respond in a timely manner!

Links:

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Organization

Wuqu' Kawoq

Bethel, VT, United States
http://www.wuqukawoq.org

Project Leader

Anne Kraemer Diaz

Bethel, VT Guatemala

Where is this project located?

Map of Feed a Child - Reduce Malnutrition in Guatemala