World Food Day

Malnutrition is an enormous problem in Haiti, where 46% of the total population is undernourished, and 17% of children under 5 are underweight. Overall, Haiti has a Global Hunger Index label of Alarming, as assigned by the International Food Policy Research Institute, and an estimated 2.3 million Haitians are food-insecure. In honor of World Food Day, we wanted to share what we've been doing at the clinic to combat the problem of malnutrition in Thomassique.

The first relevant item is our Medika Mamba program, which aims to bring severely undernourished children back to a healthy weight. Medika Mamba is a peanut-based Ready-to-Use Therapeutic Food (RUTF), produced by the Cap Haitian-based organization Meds and Foods for Kids. Along with ground peanuts, the mixture includes powdered milk, sugar, oil and vitamins and minerals; essentially, it's an ultra-fortified peanut butter. Our Medika Mamba program is managed by Mis Solane, a Thomassique native. It was started in 2009 by Global Health Fellow Nick Cuneo.

To enter the program, malnourished children undergo an assessment by Dr. Gibbs, one of our service year doctors who aspires to a specialty in pediatrics. Potential patients are referred to her by other doctors in the clinic; our Ajan Sante; as well as Mis Solane herself, who conducts active patient searching in the community. Currently, there are 14 children enrolled in our program, and treatment usually takes between 6-8 weeks. Once in the program, patients see Mis Solane at the clinic each week to track their progress (measured by weight, brachial perimeter, height, and general demeanor), and receive that week's allotment of Medika Mamba. The great thing about Medika Mamba is that the food requires no refrigeration or preparation, and the treatment can occur in the patient's home. Mis Solane also provides education, hygiene necessities (such as soap, toothbrushes, and toothpaste), and a free Klorfasil system to each patient's family.

Once the child has recovered to a healthy weight, he is released from the program. It's truly incredible to see what Medika Mamba can do, completely transforming a limp and nearly-lifeless child into an energetic and sometimes even chubby one in a matter of weeks! Overall, the recovery rate of children in RUTF programs is 85%, compared to 25-40% otherwise. About a month after a child is released, Mis Solane conducts a surprise visit to his home, to check on his health and conduct a more general assessment of the living conditions (pictured at right). If the child has relapsed to an unhealthy weight, he is re-admitted to the program. Mis Solane also looks to see if siblings of the patient might need to enter the Medika Mamba program; in August and September 3 malnourished siblings were identified in this way and entered into the program. For patients in the outlying areas where our Community Health Centers are located, the Ajan Sante conduct the home visits.

Our second nutrition-related project is the School Lunch Program. In contrast to Medika Mamba's focus on rescuing a select number of extremely malnourished children from severe danger, the School Lunch Program aims to provide general nutritional and educational benefits to a great number of children. In this effort, we partner with the Minnesota-based organization Feed My Starving Children (FMSC), who ship down sea containers full of highly nutritious and easy-to-prepare lunches. Once the lunches arrive in Thomassique, we distribute them to a variety of schools in downtown Thomassique and the outlying towns (below are images from a recent delivery). The schools then take responsibility for preparing and dispersing the hot meals each day to their students. Thanks to an extra shipment of food from FMSC this year, which will be arriving on Monday, we were able to expand the program such that it now will provide lunch to over 3700 kids for the entire school year; that's more than 550,000 meals!

The benefits of this type of program are multiple, and extend beyond the overall nutritional benefits. As the Haitian saying goes, sak vid pa kanpe; an empty bag doesn't stand up. In other words, it's impossible to think or do anything when your stomach is growling! Having a nutrient-rich lunch helps students focus and learn more in school. The School Lunch Program is extremely popular in Thomassique, and we frequently have local school directors approach us asking us to be added to the program. Last Sunday, there was an especially nice moment as we delivered food to the school in Dahlegran: Virtually the entire neighborhood came to help unload the food, including women in their Sunday-best on their way back from church, and small children who marched to the depot with their future lunches balanced precariously on their heads.