Dr. Judy McLean will be our guest speaker for class on February 4, 2009. This class will be an interactive class in which your ideas and solutions for the following challenges will be appreciated. Please read the following and come to class prepared to participate.

INTERNATIONAL NUTRITION ‐ some challenges

During the late summer and fall of 2008 I spent time in Rwanda, Malawi and Kenya evaluating the nutrition situation in a number of communities. I also worked with teams on several community based nutrition intervention projects that included food supplementation with a nutrition education component. The following are three of the regions and scenarios I encountered. Numerous solutions have been suggested to improve nutritional status in these communities but there are at least as many constraints to implementing solutions. Your thoughts and ideas would be appreciated! 1) MALAWI – RURAL VILLAGE COMMUNITY I was given some primary data from the community regarding food intake and food security which I integrated with secondary data including key informant interviews and direct observations. The rate of stunting (low height for age) in Malawi is the highest in Africa. Stunting is due to undernutrition during the period between conception and age 2‐3 years. Key nutrients that are low in the local diet include zinc, iron, protein, fat and vitamin A. Poor infant and child feeding practices are a factor in the rate of malnutrition which is compounded by intestinal worms, malaria and HIV/AIDS. Malawi has one of the highest rates of HIV/AIDS in the world at 14% among adults between 15 and 49 years of age and over 550,000 orphans. Opportunities for girls are few due to limited access to education and cultural constraints. Universal primary education is one of the MDGs yet only 42% of children in Malawi reach grade 5. Only 25% will reach secondary school. Nutrient deficiencies are associated with lower cognitive abilities. In order to improve the micronutrient status of children in school and those under 5 years of age, it has been suggested that home and school gardens be implemented. PLEASE CONSIDER THE PROS AND CONS TO THE FOLLOWING: a. Home gardens b. School gardens c. Nutrition education in the schools and communities d. Growing indigenous vs non‐indigenous vegetables 2) RWANDA – SCHOOL MEAL PROGRAM My role was to assess the school meal program for nutritional adequacy in quantity and quality of food. This is the introduction to my report: There is almost universal agreement that school meals are an effective means of keeping children, particularly girls, in school. The school meal program in Mobinga is an important component of the community’s progress towards achieving Millennium Development Goal #2, ensuring primary education for all. Results from qualitative as well as quantitative research strongly support the role of school meals in helping children to concentrate, assimilate knowledge and perform better on tests, thus broadening their options in life. As elsewhere, education helps remove barriers to overcoming poverty. At Mobinga, the school meal program provides lunch for over 5000 children in 5 primary schools. The school lunch provides an adequate amount of food energy (~700 kcal) and protein (~17.5 g) for a single meal from the maize/beans/oil combination, but is low in micronutrients. Occasionally rice is substituted for maize which provides a similar amount of food energy but is lower in protein and fat than maize meal. Originally the school meal program was to provide the children with a breakfast of maize porridge in addition to a lunch of maize, beans and oil plus tinned beef or fish. Unfortunately the breakfast had to be cut due to a lack of sufficient firewood or other fuel needed to cook two meals each day*. In addition, the tinned beef or fish is rarely delivered. The headmaster believes that almost 100% of children come to school without breakfast limiting their ability to focus on school work due to hunger. In order for schools meals to be most effective at alleviating hunger and thus improve concentration, the WFP recommendation is that food be provided as early in the day as possible, yet the children do not receive lunch until 12:40 PM. The food most children receive at home in the evening consists primarily of cassava, potatoes, beans, sometimes rice, oil and greens. The overall diet is therefore limited in energy, protein, fat and the micronutrients needed for growth, learning and the prevention of disease. *The children are expected to bring firewood each day so their food can be cooked. There is little wood in the area as it has been deforested and little grows at present. QUESTIONS a. Would a school garden improve vitamin and mineral status? How much would need to be grown to make a difference in nutritional status i.e. vitamin A? b. The WFP provides the components of the basic meal. What about switching to locally sourced food? c. What impact does a school meal program have on overall food intake of young children? d. How could the breakfast be prepared or provided with a lower input of resources? e. The WFP will eventually pull out, perhaps sooner rather than later with the current economic crisis. How could the meal program be sustained if this happens? 3) A COMMUNITY OF SOMALI PASTORALISTS My role here was to evaluate the cultural and social constraints to food security in the community and suggest appropriate interventions. The rate of anemia in children between 6 months and 2 years is 100%. The Somali’s are traditional herders of camels and goats. This is the introduction to my report with some excerpts from other relevant sections: Pastoralists have historically been vulnerable to food insecurity, not only because they do not produce enough food, but because they hold little in reserve. Traditionally they maintain little savings, and do not practice income generating activities. Voluntary and involuntary sedentarism are increasingly common with conflict and climate change forcing nomadic groups away from traditional grazing lands and into settlements. Pastoral sedentarism, as has occurred in Dertu, is accompanied by many changes to the traditional diet including the introduction of foods not commonly consumed by nomadic people, and a concurrent reduction in the intake of more traditional foods. Dietary acculturation is associated with nutritional benefits in some cases, but in many it increases the risk of energy and nutrient deficiencies. The Somalis of Dertu practice food avoidance based on a long history. Principle foods avoided include: all pork products, fish and shellfish, eggs, green leafy vegetables, all birds and wild animals. Food culture also dictates how certain foods can be prepared and who gets preference for particular foods. Young children in the first two years of life are often fed exclusively camel’s milk leading to multiple nutrient deficiencies. YOUR SUGGESTIONS OR THOUGHTS ON IMPROVING FOOD SECURITY IN THIS COMMUNITY?