“Peanut Butter Medicine” – Guatemala vs Haiti


There was an interesting piece published on CNN.com today about Ready to Use Therapeutic Foods (RUTFs) at use in Haiti (see the link, below). This piece is a great conversation starter – and we want to take the opportunity to provide some basic information about the states of child malnutrition in Haiti and in Guatemala, and to explain the difference in our approach versus the approach documented in the featured piece.

What is Malnutrition?: According to the World Health Organization (WHO), malnutrition essentially means “bad nourishment”. It concerns not enough as well as too much food, or the wrong types. There are two types of malnutrition that we typically see in the developing world: acute and chronic. Severe acute malnutrition (referred to in the Haiti piece) is defined by a very low weight for height, by visible severe wasting, or by the presence of nutritional oedema. In other words, these kids ‘look sick’. They look like they are wasting away.

Although acute malnutrition does occur in Guatemala, it is chronic malnutrition that is absolutely pervasive. Children who suffer from chronic malnutrition fail to grow to their full genetic potential, both mentally and physically. The main symptom of this condition is stunting – shortness in height compared to others of the same age group – and takes a relatively long time to develop.

Okay, so what? Why is it so important to prevent stunting in babies and toddlers? According to the World Bank, growth failure before the age of two can have profound and irreversible effects on a child’s ability to learn, and produce income over their lifetimes. It can result in permanently impaired IQ and social development, and makes a child more susceptible to chronic disease. These children start school later, quit earlier and miss more days in between. Furthermore, women who are stunted are far more likely to have stunted children. And, all of this is determined in the first 24 months of life.

Treatments: The product that is documented in the Haiti piece is called a Ready to Use Therapeutic Food (RUTF). According to the USDA, RUTFs are designed to be used as a sole food source (with the exception of water and breast milk). In our communities, we use Ready to Use Supplemental Foods (RUSFs). At the moment, WK uses two products, Nutributter and PlumpyDoz, acquired from the nonprofit Edesia LLC.

As the name implies, RUSFs are designed to supplement a child’s diet – not as a sole food source. The products we use are specifically designed for children 6-24 months of age. Interestingly, the children we see are born with normal weights and heights and grow well along their growth curves until 6 month of age. This means that maternal nutrition and breastfeeding practices are sufficient to guarantee child health until they are 6 months old. By introducing a high quality RUSF at 6 months, when infants should be transitioning to complementary foods, we can provide food security to the kids and prevent the decline in their length/height-for-age.

WK is proud to be a leader in the treatment of chronic malnutrition in Guatemala, and will soon announce an exciting new program to expand our current reach!

You can read the Haiti piece in its entirety at: http://www.cnn.com/2011/WORLD/americas/10/11/cnnheroes.haiti.children/index.html?hpt=hp_c2