Gorman, Kathleen, S
Malnutrition; Intervention; Prevention; Ready to Use Therapeutic Foods; Global Public Health
Few, if any, tribulations in the field of public health have managed to transcend the epidemiological transition from acute to chronic disease as malnutrition has. Officially, malnutrition is a category of diseases that includes micronutrient deficiency, under-nutrition (calories/protein), as well as excessive nutrition. The World Food Program estimates that 842 million people worldwide do not have access to enough food, approximately 146 million of which are children. The most serious types of hunger are known as Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), with 20 million and 35 million respective cases each year occurring in children less than 5 years of age. While MAM is serious in its own right, when left untreated a child can develop SAM, and suffer from severe wasting of their fat and muscle tissues. Despite current global food production being sufficient for almost twice the world’s population of 7 billion, approximately 15% of all people are under-nourished, the majority of which live in developing nations.
If no intervention occurs, the complications associated with malnutrition may disrupt the body’s fundamental processes, leading to potentially irreversible physical and mental deficits. Both SAM and MAM have also been associated with an increased susceptibility to external pathogens such as Malaria or Tuberculosis; Malaria alone claims the lives of 3000-4000 children every day. Furthermore, the consequences of these complications tend to exacerbate the circumstances that create the initial risk of malnourishment, e.g. disease and developmental deficiencies. In other words, the effects of malnutrition can result in an individual being unable to either work or go to school, leaving them less capable of earning enough money to afford food or education, thus perpetuating the vicious cycle of poverty.
Using a local non-profit organization named Edesia as both a model and a resource, I examined the current policies and procedures in place to alleviate the burden of malnutrition in developing nations. Edesia is part of a network of small organizations known as Plumpyfield, which specializes in the production of a line of ready to use therapeutic foods (RUTFs). Edesia and their counterparts design RUTFs to treat SAM and MAM, as well as supplement local diets in an effort to minimize the effects of malnutrition. International aid organizations such as UNICEF purchase these RUTFs from Edesia and distribute them based on need, which is typically determined by natural disasters or famine due to seasonal crop shortages. Plumpyfield’s mission statement cites prevention by means of reducing the number of people affected as the ultimate goal of their interventions. While their products have been shown to effectively treat the symptoms of malnutrition, the data has not indicated a significant decrease in incidence as an outcome of using RUTFs. As a result, I began to examine the challenges faced by international aid organizations working to reduce global hunger by exploring the following questions: What constitutes an appropriate treatment or intervention? In what ways do these types of programs support or hinder prevention as previously defined? What types of interventions are similar organizations implementing in comparison with the work of Edesia and the rest of Plumpyfield?