Plumpy’nut to the rescue of Zim children
MUTARE – On a cold winter morning, mothers with children on their backs trickle into a clinic in Mutare’s low-income suburb of Sakubva.
There’s no electricity, and the children wail as they are stripped naked, weighed and measured.
But they’re soon appeased by a meal wrapped in foil the size of a crisp packet. They suck at the contents through a bitten-off corner. Inside is Plumpy’nut, a peanut butter food that’s having a dramatic effect upon Zimbabwe’s malnourished children.
A mixture of peanut butter paste, vegetable oil, sugar, milk powder, vitamins and minerals, each packet of Plumpy’nut packs a 500-calorie punch in an air-tight pouch. Calories are what these children desperately need.
The 18 or so under-fives brought here every Monday are part of Sakubva’s community-based nutritional care programme for malnourished children.
The scheme has only been running for three months: doctors say the number of patients is likely to increase once other parents hear about it.
Sixteen-month-old Wanga Musoka is a first-time visitor to the clinic.
His mother undresses him to reveal wrinkled skin sagging off a skeletal frame. Wanga’s face has the chiselled look of someone older. The needle barely moves when he’s placed in the sling that hangs under the scale: he weighs “the same as a four-month old”, whispers one nurse.
After being scolded for not bringing him sooner, Wanga’s mother is given 21 sachets of Plumpy’nut to see her son through the next week.
“There is medicine in it, so it keeps the body of the child healthy,” says a nurse who would only identify herself as Mary Joyce. “We see a great improvement.”
Plumpy’nut – which is defined by the World Health Organisation as a Ready-to-Use Therapeutic Food (RUTF) – is manufactured by Nutriset, a company based in Normandy, France. It’s been used by aid agencies to curb malnutrition and save the lives of children in places like Niger and the strife-torn Sudanese region of Darfur.
In Zimbabwe, which is slowly emerging from nearly a decade of political and economic crisis, UNICEF has identified 22 000 children as suffering from severe malnutrition. Many of those are now being given Plumpy’nut.
“In terms of treating malnutrition Plumpy’nut does work well,” says UNICEF spokesperson, Tsitsi Singizi.
Working with Zimbabwe’s health ministry, UNICEF runs a national therapeutic feeding programme in 205 inpatient and outpatient sites: the Sakubva site is one of them. The hospital has been receiving technical and material support from aid group Medecins Sans Frontieres for some time.
This year, close to 3 000 cardboard boxes full of Plumpy’nut sachets have been distributed to feeding sites countrywide, says Ms Singizi. Another 27 000 are ready for distribution.
The outpatient feeding scheme is helping to “plug the gaps” in treating malnourished children, says Ms Singizi. She says children are often brought in with another ailment but then identified as suffering from malnutrition and treated.
“They can be monitored and they don’t need to be admitted (to hospital),” she says.
When malnourished children are admitted to hospital and put on Plumpy’nut, they often begin to thrive. At Mutare Provincial Hospital paediatrician Geoff Foster and his colleagues say hospital admission times for children under five have been cut from three weeks to 10 days – mainly thanks to the introduction of Plumpy’nut late last year.
Doctors have to be strict when prescribing Plumpy’nut: although Zimbabwe’s food situation has improved since the formation of a unity government in February, high prices mean there is a very real danger the life-saving supplement can go to the wrong recipients.
“You’ve got to give it to patients as a medicine otherwise it gets spread on bread or shared with other children. So you’ve got to say: ‘This is a medicine’ and prescribe it three times a day.”
Twenty years ago working with aid group Christian Care, Dr Foster helped set up a scheme to distribute cooking oil, mealie meal and beans to families of malnourished children.
The foodstuffs were distributed through clinics and mission hospitals in the district. Though well-meant, the scheme was far from ideal: the food would be shared.
“The great thing about Plumpy’nut is that it’s very transportable and you can actually deliver it as a medicine,” says Dr Foster.
In many cases, Plumpy’nut’s positive effects are plain to see.
“Children are admitted with malnutrition. Then they’re (treated and) discharged and they pick up weight and energy” after being put on an outpatients’ feeding programme, says Simba Pfumojena, a doctor in the children’s ward.
“They come back two weeks later and they’re doing very well,” he says. Six weeks later “you’ll be amazed – the child’s up, actually runs into the consulting room and they’re all over the place,” he says.
In the last decade, Zimbabwe’s worsening food shortages have meant many doctors were able to do no more than give nutritional information to distraught mothers, and counsel them.
“Up till now all you could do was put a dot on a card – growth monitoring – that’s all you could do. You could just watch the child’s growth decline,” says Dr Foster.
“Now there is something that can make a difference.”
Additional reporting: Zimonline
Posted by Dave Fish Eagle
on August 24, 2009. Filed under Health & Well Being.
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