The Littlest Things

Last week, Navyn Salem, Executive Director of Edesia, traveled to Cap-Haitien, Haiti with Edesia’s Nutrition Research & Policy Advisor, Nicole Henretty. The purpose of their trip was to visit a research project involving Mamba, a peanut-based Ready-to-Use school food snack, developed by Edesia, which is currently in trials at select elementary schools. Navyn’s twin daughters, who are in sixth grade, also joined and became witnesses to what life is like for their counterparts in Haiti. They also had a chance to visit a clinic that treats children with Severe Acute Malnutrition with Plumpy’Nut^®. Below is a first-hand account of that experience written by Zara Salem.

"The Littlest Things"
By Zara Salem

As our dirty, off-white SUV rumbled down the bustling, trash-filled streets, I looked out my window watching school children and motorcycles whiz by. I wondered where this adventure in Cap Haitien on the north coast of Haiti would lead me.

Photo credit: Karen O'Hern

We pulled into the small cement clinic that held school children on one side and babies on the other. They came dressed in their finest as if they knew we were coming and waited patiently to be checked for severe acute malnutrition with their mothers. The school children gathered around us wearing neatly pressed uniforms and matching big white bows in their hair staring in awe at us probably wondering where we came from and why.

The first baby entered the dark green room to be weighed and measured and given their weekly supply of Plumpy’Nut, a fortified peanut butter made from peanuts, milk powder, vegetable oil, sugar, vitamins and minerals, proven to treat the most severe cases of malnutrition. All of the babies there were severely malnourished and were very small and skinny. Here in Haiti most of the kids are very short and not healthy because they don’t get enough food to eat.

I looked around the room stunned to see all the babies eating the Plumpy’Nut when I noticed one in particular that seemed so weak she could not hold her head up and had many breaks in her skin. She was refusing to eat the Plumpy’Nut and turned her head whenever she was trying to be fed. We learned that the caregiver was not her mother but a cousin because the mother had recently died. She struggled to get tiny bites into her mouth but it wasn't working.

“I've seen this before. This little one is extremely thirsty.” My mom told me.
“Can we buy her some water?” I asked hopefully.
“Sure, here are a few gourdes (Haitian money) to buy some water. Hopefully that will do the trick.” She said with encouragement.

Photo credit: Navyn Salem

After buying the baby a pouch of water from the vendor in front of the clinic, she gulped it down like she had never tasted it before. We tried again to feed the baby some Plumpy’Nut and this time she finally started to eat! In between food and water she finished the whole packet of Plumpy’Nut with the help of Nicole, a nutritionist who works with my mom.

Nicole picked up the baby and became instantly concerned because she felt a rattle in the little girl’s chest. Without delay she went to find the nurse to see what was wrong. The nurse brought her into the office and soon realized she had pneumonia. They gave her some medicine to take home. They also checked her for HIV and fortunately she was negative. I was so relieved to hear the good news and so happy that Nicole was there to help.

The littlest things like picking up a baby can lead to potentially life-changing events. When a child is severely malnourished, complications can be life threatening. Without Nicole’s small action this baby could have died. I realized how little it takes to save a life and it is hard to imagine what might have happened if we didn't wander into that clinic that day.

A full-circle journey to Guatemala

By Andrea Aldana
Edesia | Global Nutrition Solutions
www.edesiaglobal.org

Edesia's Andrea Aldana at a conference in Guatemala.

In October 2011, I had the privilege of travelling to Guatemala to give a presentation on behalf of Edesia at a malnutriton conference, a topic now very dear to me, although 18 months ago I did not know it.
 
My name is Andrea Aldana and, since March 2011, I have been the Customer Relations Manager for Edesia. My two older brothers and I are all first-generation born in the United States. My parents are both Guatemalan, having immigrated to the United States in the late 70s. My parents are from Zacapa, referred to as “Tierra Caliente,” which is the very hot, dry corridor of the country where malnutrition rates are an estimated 30-40%, moderate for a country with the fourth highest rate of chronic malnutrition in the world. I didn’t know anything about these statistics until I started working at Edesia.

Growing up in Rhode Island, I was blessed with a very loving and giving family. Along with my mother, who taught me the gift of giving without expecting something in return, I had four other great figures and mentors in my life. Of these, one is my father. The other three, I affectionately call my uncles. These Guatemalan men are more like second father figures to me. From these individuals, I learned the value and importance of giving back and helping those in need. I am who I am because of the values they instilled in me at a very young age. These individuals continually change my view on life and expand my thinking on what the term “giving back” means.

Prior to arriving at Edesia, in one of my frequent trips to Guatemala, besides visiting family, much of my time was spent in the town of Llano Verde at one of my uncle’s ministries, Hope of Life International. It was during one recent trip that the sight of a severely malnourished baby transformed my way of seeing the world once again. At Hope of Life, I helped with feedings at the local landfill, I aided in food distributions and visited the nutrition center, finding babies that were literally skin and bones and had inflated stomachs. Were these children starving? Were they lacking the appropriate medical attention and resources needed? Were they malnourished? Looking back, the answer to all these questions is yes, but quite honestly, those thoughts never came to my mind back then. At that point in my life I didn’t know how to relate hunger and malnutrition in the same sentence. At that point in my life, all I could think of was, “How can I help?”

When I left the corporate world behind and joined Edesia, my journey started to come full circle. Because of my position as the Customer Relations Manager, I was given an opportunity to learn about this preventable condition called malnutrition that kills more than AIDS, malaria, and tuberculosis combined. Reading articles, I soon began to understand the enormity of the problem, and the importance of nutrition in developing countries like Guatemala.

And then, I was given an opportunity to go back to the land of my forefathers, not only to discuss the topic of malnutrition at a conference, but also to teach the indigenous people of Patzun and neighboring towns of what malnutrition really is and the importance of proper nutrition, hygiene, education, development, etc. It was an amazing feeling to know that I was giving back to the land of my ancestors. The best part was seeing the faces of these individuals who were so receptive to learning and taking a proactive approach to improve the lives of their children. I could see in their faces the realization and enlightenment that comes with new information and knowledge—knowing that they wanted to make a change and that they could do their part and take the appropriate steps to put an end to the vicious cycle of malnutrition.

Almost 18 months ago, before I started working at Edesia, I can honestly say I knew a little but I did not know much more than those attendees did before coming to the conference. Throughout these past months, and through the help of my cherished mentors, I have learned what kind of person I aim to be and what kind of person I still have yet to become. Never has Ghandi’s quote resonated so strong as it does today in my life, “be the change you want to see in the world.”

A life-changing visit to Niger

By Navyn Salem, Executive Director
Edesia | Global Nutrition Solutions
www.edesiaglobal.org

If you’ve never heard of the Sahel, you’re not alone. I myself had to double-check my world map. It’s a region of Africa that includes Senegal, The Gambia, Mauritania, Mali, Burkina Faso, Niger, Nigeria, Chad, and parts of Sudan. There is a drought across these lands – the kind so severe, women are boiling leaves to feed their children – compounded by half a million Malian refugees searching for safety. There are 18 million people in the Sahel without enough to eat. Some 4 million children, born with bright eyes and promise, are now becoming skin and bones.

In early June, I traveled to Niger with Maria Kasparian, Edesia’s Director of Operations, who has been with me on this journey to manufacture Plumpy’Nut and other Ready-to-Use Foods from the very beginning. Two years after we opened the factory, it remains a priority for us to connect what we do every day in Providence, Rhode Island with the people it serves. It was also an opportunity for us to meet up with our PlumpyField partner, STA, who, from the capital city of Niamey, supplies Plumpy’Nut for all of Niger.

We visited clinics and hospitals in Niamey and Maradi (reachable only by UN plane) with Ismael Barmou, STA’s Deputy General Manager, to see how Plumpy’Nut is impacting human lives. As I stood in the malnutrition ward of a regional hospital, my chest tightened, and I had to work hard to keep my composure. There were no welcoming smiles, only blank, empty stares. My camera, normally always at the ready, dropped down to my side. I couldn’t bring myself to snap images of so many children and mothers in despair. To my left, a little girl lay on a bed, emaciated, listless, and very alone. I didn’t know her story. “Where is her mother?” I asked myself. All I could do was watch her chest rise and fall – as I did with my own newborn girls – and I clung to the possibility that, in this place, because of the nutritional peanut-paste we make, her life would continue.

It is almost impossible to tell the ages of the many children we saw. To me, they often looked like infants, maybe about three months old, when in fact they could have been two years old.

It was heartbreaking to see so many children with feeding tubes filled with therapeutic milk, and so many lost, overwhelmed, and tired, young mothers beside them. In Niger, as in many developing countries, girls are forced to marry at young ages. One mother, who looked 16, saw me walking by and lifted up her baby for me to take. Without enough food, without nutrition, this is what life becomes.

A mother in Niger waits her turn for Plumpy'Nut.

The number of malnourished children – too weak to even lift up their heads – will soon increase dramatically as we enter “the hunger season” in this place of sandstorms, little-to-no rain, and 120 degree weather. In two months, the health system will be strained. But the experts we met from the World Food Programme, Save the Children, UNICEF, and the government gave us hope. They said that this year may be different for Niger, and hopefully for all of the Sahel. Better, more-sophisticated early warning systems have led to faster mobilization of funds and placement of lifesaving supplies. If health clinics have good stocks of therapeutic milks, Plumpy'Nut, and other nutritious foods, the peaks of the crisis can be weathered for now.

The Sahel is not just a place on a map for me anymore, but a place I have been, if only for a short time. Now that I am back home in Rhode Island, where temperatures are moderate, rain and food plentiful, children healthy and playing upstairs, when I read the headlines about the Sahel, an even stronger urgency rises up from inside. I see a mother holding out her baby for me to take. In that gesture, I carry with me her pleas for a better life.

Plumpy'Nut for Bethlehem

By Heidi Reed, Communications Manager, Edesia | Global Nutrition Solutions 

A community health worker in Ethiopia.

In April, I had the opportunity to attend a nutrition workshop in Ethiopia, in the heart of the Horn of Africa. It was organized by Nutriset, the inventor of Plumpy'Nut. As part of the experiential learning experience, a group of us visited a maternal/child health clinic in Addis Ababa. It was an opportunity for us to see how Plumpy'Nut is integrated into the community health programs.

The group first visited an exam room where children get checked for signs of severe acute malnutrition. While we were there, a little patient arrived, holding the hand of her mother: a two-year-old girl named Bethlehem. This energetic little girl with short hair and big, sweet eyes was wearing a jumper dress with bright chartreuse green tights and ruby red shoes.

We watched the doctor measure Bethlehem's weight-to-height ratio and the circumference of her mid-upper arm. The values were noted in her medical history. The doctor showed me in the large resister how after eight weeks of Plumpy’Nut, Bethlehem had successfully climbed out of danger into the normal range for growth. She would only need one more prescription of  Plumpy’Nut—another 14-day supply. Everyone in the room was smiling. Bethlehem’s mother said, in her native Amharic, that she couldn't believe how much her daughter loved eating Plumpy’Nut.

Once outside in the clinic’s courtyard, I watched Bethlehem playing around her mother’s skirt, while they waited in line to have the Plumpy'Nut prescription filled by the clinic's pharmacists. Since I did not have my camera with me, I could not take photos of Bethlehem. Instead, I did my best to memorize the bounce in her step. I could barely take my eyes off the playful movement of her ruby red shoes. I wondered where those feet would carry her in life, now that the community health workers and Plumpy’Nut had made her healthy again.