foyibi and the battle against malnutrition

this adventure is all about malnutrition— trying to understand how it happens and how to fix it. why? because it is by asking these two questions that foyibi (above) is alive today.

foyibi lives in a rural community outside of kigali. last august i was able to meet her when my hosts at gardens for health international decided to help her family and test out a new style of treating malnutrition. i went along during a house visit and when i saw her she was sad, without energy, and so sick she was unable to start school— even at the age of nine.

something a friend and volunteer here nicknamed “bns (aka bent neck syndrome)” comes to mind. once you see a child with “bns” it is almost haunting because it goes against the very nature of (healthy) children: energy, happiness, and play. while this is not a picture of foyibi below, the truth is that all children with “bns” look the same: hopeless.

gardens for health international gave foyibi’s family seeds, gardening tips, and some basic health education and she rebounded quickly. previously local clinics provided her family with food supplements that brought her back to healthy weight but she continuously relapsed into malnutrition and sickness.

when i visited foyibi this trip she was full of energy and climbing trees, attending school, and (most importantly) happy. the child i met last year is gone without any sign of coming back.

but even now as a healthy child, the chronic malnutrition she faced affects her life. foyibi is just a smidge taller than her five-year-old cousin. this physical developmental delay is frequently called stunting, and can also be accompanied by cognitive delays that challenge education and job potential for individuals throughout their lives. girls with developmental delays can also face complications while delivering children. mothers facing chronic malnutrition can pass on malnutrition to children in utero as well as when breastfeeding- leaving severe long-term impacts.

so how does this continue to happen when we live in a world more than capable of feeding our seven billion neighbors? and how can we go beyond treating symptoms of malnutrition and really get at it’s roots to eradicate it?

malnutrition is clearly a complicated topic. like i said before- it not only starts with not having enough food, but not having enough of the right food.

rwanda has one of the highest population densities in the world and small pieces of land mean not a lot to eat. this is very serious when you don’t have enough money to buy food and your garden is your kitchen.

no land or not enough land and you are forced to buy the cheapest foods and just like in the usa they are nutrient-void foods that leave you feeling full but empty in health.

poor education on nutrition and health leave people unequipped to understand basic illnesses or even the importance of hygiene.

restrictions on teaching family planning and gender inequality and violence bind women into unhealthy and unsafe relationships and withhold resources designed to empower them to be able to decide on their family size.

illnesses including hiv/aids keep families from being able to work for money or work in their own fields. it also frequently orphans children and places them as heads of households.

and the everyday realities of poverty— lack of access to any land, clean water, firewood, or clean living environments fuel the cycle that spirals families and children deeper into malnutrition.

but there is hope.

there are a lot of programs— from grassroots to united nations set to fix this. but we need to change how the prescription for malnutrition works. we need to fix food aid by addressing more of the causes and complications of malnutrition. and we need to change how we view the families looking for our help.

step one, the solution must be local. every child here that has been diagnosed with moderate malnutrition gets nothing from the government clinic as for food assistance. nothing. how is this possible? well, none of the corn-soy blend porridge from the usa has been shipped here. maybe it went to other places, maybe it was held up somewhere, maybe the prices changed. this porridge blend is crucial for getting children the nutrients they need to not slip into severe malnutrition. it also is in desperate need for those who just left being severe malnourished and are trying to make their way back to a healthy weight.

efforts are being made within rwanda to be able to make this fortified porridge and peanut butter supplements locally. challenges faced include a lack of capacity for storing large amounts of grain in such a humid, rainy, and hot climate as well as international patent law (lets not even talk about the asshat that patented food aid recipes). but let’s take it further and make things really local – what if people learned to grow their own solution in their back yard?

let’s recognize food as treatment to malnutrition and illness. sounds like common sense, but you’d be wrong. better food means better nutrition means better immune system means better health means better life. get it? it all starts with growing and cooking of healthier, more diverse foods. we could all look into what we eat a little closer when it comes to figuring out our own health.

but if it was as easy as “…teach a man to fish and you feed him for a lifetime” it’d be done. where are all these people that live on a lake and do not know how to fish? education goes a long way, but providing basic resources creates access to necessaries.

the solution must invest in families. take a long-term approach to equip families with the tools to be able to prevent and to treat malnutrition and other illness. educate on clean water, hygiene, family planning, hiv/aids, saving money and more to be able to tackle malnutrition at it’s roots. most families facing malnutrition are already subsistence farmers; let’s give them a boost in the right direction to improve their techniques and practices so that they are able to best care for their well-being.

all of these beliefs and ideas are incorporated into gardens for health international’s prescription against malnutrition. they have built a model that not only addresses many of the roots to malnutrition, but helps the local clinics to take on those roles to be able to treat malnutrition without any presence from gardens for health international (that’s what sustainability really means). it takes time to build the ability for clinics to treat malnutrition themselves this way, but the fact that everything is designed for gardens and health to leave shows the investment within communities that they strive to make.

if anyone reading is moved to make a small (tax deductible) contribution to their organization, you can do so on the gardens for health international global giving page. they really use small contributions from individuals to do so much, and the money goes to what you see— the more than 300 families enrolled since foyibi.

so thanks for reading- this has been what my ‘vacation’ has been filled with. mind maps of interrelated causes and effects of malnutrition, late night dinner conversations and a lot of coffee all to try to get a slight idea of some of these issues. please don’t take my word for it, read about it and research more. and i have to say— when tackling this issue means spending lots of time in the back of a pickup truck going to rural clinics and homes, chatting with and taking portraits of mamas and their babies, and walking through our local town, my vacation was perfect.

back to baltimore and celebrating autumn.

-tbk