Child malnutrition, nutritional programmes, stop-gap measures and container gardening in family gardens

Very concerned about the problem of child malnutrition in developing countries, in particular in the drylands, I read with great attention IRIN’s article on ‘GUINEA: Child malnutrition - moving beyond stop-gaps’ <http://www.irinnews.org/Report.aspx?ReportId=88233>

To make things clear, I republish here the definition of Malnutrition terms used in the text:Wasting is the main characteristic of acute malnutrition. It occurs as a result of recent rapid weight loss, malnutrition or a failure to gain weight within a relatively short period of time. Wasting occurs more commonly in infants and younger children. Recovery from wasting is relatively quick once optimal feeding, health and care are restored. Wasting occurs as a result of deficiencies in both macronutrients (fat, carbohydrate and protein) and some micronutrients (vitamins and minerals).

Chronic malnutrition, on the other hand, is commonly referred to as "stunting", i.e. a failure to grow in stature, which occurs as a result of inadequate nutrition over a longer time period. It is a slow, cumulative process, the effects of which are not usually apparent until the age of two years. Severe acute malnutrition (SAM) is the most dangerous form of malnutrition. If left untreated, SAM can result in death.Source: Action contre la faim

In this article on child malnutrition IRIN said that nutrition experts in Guinea are studying options for treating moderately malnourished children as funding shortages disrupt normal programmes using fortified flour. Local health centres ran out of supplies and had to use corn-soya blend (CSB), which is normally only used in cases of moderate acute malnutrition and provided through the UN World Food Programme (WFP).

It is said that WFP seeks funds to maintain CSB stocks in Guinea, although humanitarian workers and nutrition experts underline the need to find alternative and long-term solutions and a more sustainable strategy.

IRIN also confirmed that local nutrition workers are debating the viability of using ‘Plumpy'nut’ or using local foods, prepared specially for children's nutritional needs.Sheryl Martin of Helen Keller International in Guinea told IRIN: "Stop-gap measures may be better than nothing but a plan is needed to assure adequate funding for the CSB …………………" "We are all frustrated by the lack of funding and are doing the best we can in the short term."

According to IRIN Kasraï, Head of Action contre la Faim (ACF, Action against Hunger) stated that it is important to use an integrated approach - not only therapeutic feeding but also programmes to address the principal causes of undernutrition in Guinea, by boosting people's livelihoods, ensuring proper breastfeeding and weaning practices and improving home hygiene and access to health services, sanitation and safe water. "The challenge is in finding a reliable way of ensuring that moderately malnourished children receive fortified [with vitamins and other micronutrients] and high-caloric diets in the home."

Mamady Daffé, Health Ministry head of nutrition, underscored that the combination of poverty and a lack of knowledge of children's nutritional needs contributes to child

malnutrition. He said even if families understand children's nutritional needs, many do not have the means to meet them. "People's living conditions must improve. Without this we will not be able to tackle malnutrition," he told IRIN. "The cost of living is up; people cannot buy what they need to eat properly."

As you can see, there are a lot of interesting ideas and views in this article. Trying to summarize the points made by different people and groups, I came to the following personal conclusions:

1. Together with the nutritional experts, the humanitarian workers and the ACF (see above) I believe that child malnutrition in developing countries (not only in Guinea) can only be reduced or extenuated if alternative and long-term solutions can be combined in a integrated approach to develop a sustainable strategy. The funding of stocks of CSB is only a small part of this approach.

2. Boosting livelihoods of every family living in poverty and threatened by hunger and malnutrition should be based upon the following major fields of activity:

(a) Improvement of home hygiene and health services. (b) Production of local fresh food, applying container gardening in a family garden

for every affected family. (c) Alleviation of poverty.

The best practices for improving home hygiene and health services are well known. Funding of these practices is a conditio sine qua non.

Sustainable production of fresh food in a small family garden or a school garden can be achieved with a minimum of financial resources. One can always start with small-scale pilot projects to show the efficiency of this method and then apply it gradually at a larger scale until chronic hunger situations in the country are completely extenuated.

It should not be too difficult to find donors interested in partnerships for the build-up of such a strategy. The growing interest in container gardening, recently shown by global attention for “sacks gardening”, indicates time has come to accept that locally producing fresh food, full of macronutrients, vitamins and micronutrients, is far more preferable for meeting the children’s needs than continuing delivery of fortified flour, corn-soya blend (CSB), Plumpy’nut or any other sophisticated therapeutic foods, used to treat malnutrition.

If one wants to eradicate hunger, malnutrition and poverty, using an integrated approach, therapeutic feeding should surely be maintained as a safety belt for acute malnutrition situations, but more importance should be given to addressing the basic causes of hunger and poverty. That’s where family gardening and school gardening, with container gardening in all its inexpensive but very efficient forms, are coming into the picture. Give every family, every school a chance to produce in its own small garden vegetables and fruits, and there be no deficiencies of macro- and micronutrients anymore. Mothers having at least one decent meal every day will be happier with improved breastfeeding. Vitamin deficiencies will not weaken their babies anymore.

Let us foresee for a moment that people and school children will take good care of their own kitchen garden and produce a bit more vegetables or fruits than what they need. That surplus can be taken to the market and offer opportunities for a growth of the annual

income. Alleviation of poverty can thus be incorporated in a sustainable strategy. No more expensive nutritional programmes, no more need for stop-gap measures, no more child malnutrition? It sounds unbelievable, but small-scale pilot projects have shown that it can be achieved in the future. Why not giving it a chance? Seeing is believing.