MALNUTRITION: Impact of a probiotic fermented milk in the gut ecosystem and in the systemic immunity using a non-severe protein-energy-malnutrition model in mice

Author: Carolina Maldonado GaldeanoIvanna Novotny NunezAlejandra de Moreno de LeBlancEsteban CarmuegaRicardo WeillGabriela Perdigon
Credits/Source: BMC Gastroenterology 2011, 11:64

Malnutrition affects the immune response, causing a decrease of defence mechanisms and making the host more susceptible to infections. Probiotics can reconstitute the intestinal mucosa and stimulate local and systemic immunity.
The aim of this work was evaluate the effects of a probiotic fermented milk as a complement of a re-nutrition diet, on the recovery of the intestinal barrier, and mucosal and systemic immune functions in a murine model of non-severe protein-energy-malnutrition. Its potential protection against Salmonella enterica serovar Typhimurium (S.Typhimurium) infection was also analyzed.

Methods:
Mice were undernourished and divided into 3 groups according to the dietary supplement received during re-nutrition (milk, probiotic fermented milk or its bacterial free supernatant) and compared to well-nourished and malnourished mice. They were sacrificed previous to the re-nutrition and 5 days post re-nutrition.
The phagocytic activity of macrophages from spleen and peritoneum and the changes in the intestinal histology and microbiota were evaluated. Different immune cell populations and cytokine productions were analyzed in the small intestine tissues.
The effect of the re-nutrition supplements on the systemic immunity using OVA antigen and against an infection with S. Typhimurium was also studied.

Results:
Probiotic fermented milk was the most effective re-nutrition diet that improved the intestinal microbiota.
Its administration also increased the number of IgA+ cells, macrophages and dendritic cells. The production of different cytokine (IFN-gamma, TNF-alpha, IL-12) by these cells and the phagocytic activity in peritoneum and spleen was also increased.
This re-nutrition diet also stimulated the systemic immune response against OVA antigen which was diminished after the malnutrition period and also improved the host response against S. Typhimurium, decreasing the spread of pathogenic bacteria to the liver and the spleen.
The importance of the metabolites released during milk fermentation was also demonstrated through the analysis of the bacterial free supernatant obtained from the probiotic fermented milk, but the whole product showed the best effects in the parameters evaluated in this study.

Conclusions:
The administration of probiotic fermented milk as a dietary supplement during the re-nutrition process in a murine immunodeficiency model by malnutrition could be a good adjuvant diet to improve the gut and systemic immune response for the protection against Salmonella infection.

http://7thspace.com/headlines/384173/impact_of_a_probiotic_fermented_milk_in_the_gut_ecosystem_and_in_the_systemic_immunity_using_a_non_severe_protein_energy_malnutrition_model_in_mice.html

MALNUTRITION: Getting the recipe right for US food aid

JOHANNESBURG, 13 May 2011 (IRIN)

 Photo: Manoocher Deghati/IRIN
More of all the good things - protein and vitamins

Changing the food the US government supplies as aid could deliver better results and still save money, a new study says. The review for the US Agency for International Development (USAID) by researchers at the Tufts University Friedman School of Nutrition Science and Policy has been welcomed by NGOs and US food aid experts, but the findings have also come in for some criticism.
The two-year review considered if USAID food aid was up to date with current science, especially in its use of blended food and whether programmes matched the right products with expected outcomes.
"What we're recommending is approaches to enhance the many great things already being done with US food aid under the most difficult circumstances imaginable," Amelia Reese Masterson, research coordinator of the review, wrote to IRIN, referring in part to USAID’s budget pressures.
The review came up with 20 recommendations on some of the food products and programmes under Title II of the US Food for Peace Act, which covers food aid provided in emergency and non-emergency situations.

Getting the ingredients right
The Tufts review addressed the issue of the source of protein in food products for children, pregnant and lactating women, and undernourished people on HIV medication.
Médecins Sans Frontières (MSF) has noted that US food aid destined for children usually comprises fortified flours based on grains and pulses such as corn-soya blend (CSB) or wheat-soy blend (WSB) and has lobbied for the inclusion of other sources of protein, vitamins and minerals.
Recent scientific evidence shows that animal-source proteins such as milk, better promote the growth of muscle tissue and resistance to infections, and are critical to children recovering from severe malnutrition, the Tufts review agreed. It also acknowledged that ready-to-use therapeutic foods (RUTF), usually lipid-based spreads, whose ingredients typically include nuts and milk powder, have led to a radical change in the way severe malnutrition is treated.
The review recommended that a wider range of products, offering varying quantities and types of nutrients for different programmatic contexts, be made available.
It is here that the review has contradicted itself, Nathalie Ernoult, Stephane Doyon and Susan Shepherd, members of the MSF's nutrition team, maintained in a written submission to the Tufts academics.
"The report itself states that there can be no 'one-size-fits-all' food supplement, and we could not agree more," the MSF team said, yet it "focuses primarily on how to improve the nutritional value of fortified blended flours."
The Tufts study argued for a single formulation for a cost-effective, enhanced CSB, which they dubbed CSB14, to meet the minimum nutritional requirements of three key target groups: infants from 6 to 11 months; children between one and three years; and pregnant women.
The MSF team said at least two enhanced CSB formulations would be necessary: one tailored to the needs of infants and young children and those affected by moderate acute malnutrition; the other for older children and adults.
UN organizations the World Food Programme (WFP) and the UN Children's Fund (UNICEF) are also considering experimenting with different formulations of CSB.
"As a field-level agency and occasional implementing partner for UNICEF and WFP, we [MSF] cannot over-emphasize the need for coherence in the nutritional supplements on offer for a given category of beneficiary," the MSF team said. "If the fortified foods provided by WFP, UNICEF and USAID for similar programmes are not interchangeable, nutrition programmes will simply become confused and ineffective."
MSF maintained that the formulation for younger children should have a higher protein content from animal-sourced food; and that the proposed fortification levels of iron and zinc were also too low.
Zita Weise Prinzo of the World Health Organization (WHO) said they were recommending that the diets of moderately malnourished children contain animal-sourced foods, without specifying how much. WHO is expected to release its guidelines for food formulations for moderately malnourished children in June 2011.
According to MSF, the proposed second formulation for older children and adults, would not require animal-sourced ingredients, and the current CSB recipe, with some adjustments to its vitamin and mineral content, would serve the purpose.
However, a senior nutritionist who preferred not be named told IRIN that in many instances it would be hard to imagine relief agencies successfully distributing two or more similar looking products for different segments even within a single family.
"Most large-scale programmes using CSB-type products involve take-home rations. It would be difficult for a programme to ensure the proper use of several similar products at home. The solution could be to have one ‘generic’ option used by most big programmes, similar to that proposed by the [Tufts] paper, and then several other options that would be used by ‘speciality’ programmes."
The CSB14 formulation depends on the addition of oil fortified with vitamin A to provide enough of the vitamin. "Our experience shows that it is difficult to count on the prescribed amounts of oil being added to the porridge in the home, not to mention all the logistical difficulties encountered with the distribution of multiple commodities to constitute a single ration," the MSF team pointed out.
The chemical forms of micronutrient supplements proposed by Tufts also differed from those on the list approved by the WFP, the biggest dispenser of US aid. "It is very important to come to common agreement on a list of acceptable chemical forms for all additives," the MSF team noted.

PEPFAR food
Programming should "be evidence-based, not driven by simple data on tonnages and 'hungry people fed', but by an understanding of the unit cost of impact," and this included HIV/AIDS-related programmes, said the review. It found that orphans and vulnerable children, and HIV-positive pregnant and lactating women, identified for priority food assistance in the US President's Emergency Plan for AIDS Relief (PEPFAR), were receiving not getting priority compared to other HIV-positive women and adults.

Photo: Jason McLure/IRIN
US food aid is evolving

The review suggested stronger links between ongoing antenatal, Prevention of Mother-to-Child Transmission (PMTCT), and Maternal and Child Health (MCH) services, and with programmes treating malnourished children.
PEPFAR country coordinators reported that requests to approve the use of funds for food were "commonly met with caution", the review said, which "contributes to low coverage of food assistance within programmes", and PEPFAR needed to send a stronger signal on supporting the allocation of funds to food in HIV support.

Saving money
Budget-constrained donors were "facing hard trade-offs between feeding as many people as possible and providing higher quality foods to improve nutritional impact per person," said Christopher Barrett, a food aid expert who teaches development economics at Cornell University in the US.
Scarce resources should be put to work more efficiently, and the Tufts review contributed significantly to improving understanding of these tradeoffs by policymakers, operational agencies and commercial suppliers, Barrett commented.
"It's important to move beyond a dollar-per-ton of food metric - the conventional way of looking at things - since that does not take into account exactly what kinds of foods are used for what purposes," said Patrick Webb, principal investigator of the Tufts review project.
"If we become more efficient in treating or preventing malnutrition, then it's the cost per case of malnutrition treated or prevented that matters, and that will go down when the appropriate tools (foods)are used in the right ways, even if unit costs of products rise slightly... because less is needed (over a shorter period of treatment)."
Some of the Tufts recommendations would cost more money - the addition of dairy products, new smaller packaging of some products for mothers and infants to prevent it from being consumed by the entire family - but Webb said the costs would be offset by improved targeting of the enhanced products.
Barrett noted that "With greater bang for the buck, it also becomes easier to defend valuable food aid programmes against those looking to trim budgets."
The review, the issues it covers and its recommendations will be debated at the US government's annual conference on food aid in June.
http://www.irinnews.org/Report.aspx?ReportID=92717

MALNUTRITION: Peru: Storm in a Glass of Milk

Ángel Páez LIMA, Jan 7, 2011 (IPS) - During his nearly five years in office, Peruvian President Alan García has earmarked 620.5 million dollars to the "Glass of Milk" Programme (PVL), the backbone of the policies aimed at reducing malnutrition levels in the country. But the results of the nutritional supplement programme are poor.
A Ministry of Economy and Finance report seen by IPS found that five of every 10 (51 percent) of the PVL's beneficiaries do not form part of the programme's target group: children under six and pregnant and nursing mothers from low-income strata.
Those who do not need the extra nutrition but receive the dairy supplement anyway have been dubbed "infiltrators."
The most serious situation is found in Lima. In the capital, which receives 30 percent of the national PVL budget, seven of every 10 beneficiaries of the programme (73 percent) are "infiltrators."
The ineffectiveness of the PVL in reducing malnutrition is reflected in the rise in "food poverty" in Peru from 2005 to 2010, according to the National Institute of Statistics and Informatics (INEI).
The García administration, which took office in July 2006, has allotted an average of 124 million dollars a year to the PVL, distributed among the 1,838 municipalities in charge of implementing the programme.
Between 2005 and 2009, Peru's poverty rate was reduced from 49 to 35 percent, a figure the government presents as a resounding success. But poverty statistics broken down by region, which IPS requested from the INEI, show that in 11 of the country's 25 regions, the proportion of people living below the poverty line actually increased.
"The Peruvian government has stated that nutrition, health and education are priorities in its social spending, which means 50 percent of the funds should go towards those areas, but that hasn't happened," Germán Chávez Contreras, director of research at the San Pablo Catholic University in Peru, based in the southern highlands region of Arequipa, told IPS.
The proportion "does not even reach five percent, because the executive branch finances other kinds of programmes that aren't in line with the stated priorities," he said.
In a recent seminar held by the Economic and Social Research Consortium (CIES), which brings together universities and private consulting firms and research centres, Chávez Contreras presented the study "Criterios para la asignación del Gasto Social en programas de salud y nutrición en el Perú" (criteria for assigning social spending to health and nutrition programmes in Peru).
"That explains why we are so far from reducing malnutrition among children under five and infant mortality in children under one. The population that should be covered by the social programmes isn't receiving the assistance," he said.
"It's a worrisome situation because the problem isn't the money but poor management, which is reflected in the erroneous allotment of funds and a lack of control and monitoring of the spending," he said. "The serious problems with the Glass of Milk are a reflection of what is going on with the rest of the government's social programmes."
Deputy Minister of Economy Eduardo Morón presented a report in 2009 which showed that social programmes like the PVL were losing an estimated 128.5 million dollars a year due to the problems in identifying and reaching the targeted populations.
"The most serious problems in the Glass of Milk Programme are that it is very poorly targeted; the lists of beneficiaries are out-of-date, incomplete, and contain data other than names; and worst of all, the programme does not have an impact on nutritional levels, because the people who need the glass of milk aren't receiving it," economist Juan Pichihua told IPS.
Pichihua is coordinator of the household targeting system, known as SISFOH, created in the Ministry of Economy and Finance to identify the population in need of social assistance from programmes like the PVL.
"It is a herculean task, but we have managed to make some headway," said Pichihua.
"A timetable of goals has been set to improve targeting in the PVL, including drawing up a complete registry of beneficiaries," he said. "In 2011 we should complete the evaluation of the people registered on the lists, to determine whether or not they qualify for the programme."
And in 2012, the lists should be purged of people who should not be receiving the aid, he added.
Updating the lists of beneficiaries will imply a restructuring of the PVL budget, which has remained unchanged since the start of the García administration.
However, that task will fall to the government of García's successor, who will be sworn in on Jul. 28, 2011.
"The municipalities are under the obligation to report how many beneficiaries there are, and identify them by name. But in 2010, of the 1,838 municipalities, only 712 fulfilled that provision," Pichihua said.
Álvaro Monge, with the Macroconsult consulting firm, which forms part of CIES, said that of the households included in the Glass of Milk Programme, 40 percent are no longer under the poverty line and do not qualify for the nutritional supplements.
"This is something that is also seen in other programmes, like the Seguro Integral de Salud (SIS - Comprehensive Health Insurance)," Monge told IPS. "Forty percent of the households covered by the SIS, whose aim is to assist the neediest families, are no longer poor. This is happening in Lima and urban areas along the coast where poverty has been reduced the most.
"Without a doubt, social programmes like the Glass of Milk are urgently in need of an overhaul, because not only are people who do not need it receiving the assistance, but those who do need it are being left out."
Pichihua said approximately 1.75 million of the 3.5 million beneficiaries of the PVL -- out of a total population of 29 million -- are "infiltrators".
"It's a huge loss of resources," he lamented.
http://ipsnews.net/news.asp?idnews=54064

MALNUTRITION: Child malnutrition in India

VISHAL, the son of a farm labourer in the west Indian state of Maharashtra, is almost four. He should weigh around 16kg (35lb). But scooping him up from the floor costs his nursery teacher, a frail woman in a faded sari, little effort. She slips Vishal’s scrawny legs through two holes cut in the corners of a cloth sack, which she hooks to a weighing scale. The needle stops at just over 10kg—what a healthily plump one-year-old should weigh.
The teacher nods and puts Vishal back on the floor, where he sits listlessly before a jigsaw puzzle. That his teacher does not look perturbed is unsurprising. Nearly half of India’s small children are malnourished: one of the highest rates of underweight children in the world, higher than most countries in sub-Saharan Africa. More than one-third of the world’s 150m malnourished under-fives live in India.
That makes the sight of small, skinny children depressingly routine. Vishal’s rural village is not especially impoverished; 120km (75 miles) from Mumbai, India’s financial centre, it offers factory-work as well as the farm labour most country people do. But the battered register in Vishal’s nursery, a government-run centre known as an anganwadi (literally, courtyard), shows that close to half the children are malnourished, a handful chronically so. “It’s always been this way,” says Sunanda, the anganwadi teacher, who has weighed the children in her care every month for 25 years. “Nothing has changed.”
Almost as shocking as the prevalence of malnutrition in India is the country’s failure to reduce it much, despite rapid growth. Since 1991 GDP has more than doubled, while malnutrition has decreased by only a few percentage points. Meanwhile, the chasm between lucky and unlucky Indian children is growing: under fives in rural areas are more likely to be underweight than urban children, low-caste children than higher-caste children, girls rather than boys. And the disparities are growing. India seems certain to miss one of its key Millennium Development Goals: halving malnutrition by 2015.
Malnutrition places a heavy burden on India. It is linked to half of all child deaths and nearly a quarter of cases of disease. Malnourished children tend not to reach their potential, physically or mentally, and they do worse at school than they otherwise would. This has a direct impact on productivity: the World Bank reckons that in low-income Asian countries physical impairments caused by malnutrition knock 3% off GDP. Why, then, has India done so little to reduce it?
There are many reasons. Most fundamentally, poor parents find it hard to buy enough food; but that is by no means the only factor. Impoverished and rural families are also less likely to go to a doctor when their children fall sick, which they do a lot, thanks to dirty water and poor hygiene. Inadequate nutrition lowers the immune system, increasing the risk of infectious disease; illness, in turn, depletes a child’s nutritional stocks. Tara, a two-year-old in Chandan, a village in the northern state of Rajasthan, has yet to bounce back from a bout of gastroenteritis that put her in hospital a year ago. Since then, any weight gain has been offset by frequent bouts of diarrhoea, says her mother, Maya Devi, as she holds her limp child on her lap. Tara weighs a pitiful seven kilos.
Cow’s milk and water
Even the children of wealthier families suffer surprisingly high rates of malnutrition. Government data show that a third of children from the wealthiest fifth of India’s population are malnourished. This is because poor feeding practices—foremost among them a failure exclusively to breastfeed in the first six months—play as big a role in India’s malnutrition rates as food shortages. Here lies an opportunity: educating parents about how to feed their children should be more quickly achieved than ensuring that the 410m Indians who live below the UN’s estimated poverty line of $1.25 a day have enough to eat.
The government, however, has largely failed in both areas. Two big, expensive schemes designed to reduce malnutrition—a public distribution system (PDS) that provides subsidised food to the poor and a vast midday-meal scheme, to which 120m schoolchildren are signed up—are hampered by inefficiency and corruption. But the government’s main effort to tackle child malnutrition, the Integrated Childhood Development Service (ICDS), has failed for rather different reasons.
The ICDS, launched in 1975, is the world’s biggest early-childhood scheme. It provides, in theory, an anganwadi centre with one teacher and an assistant for every 1,000 people. Each centre is responsible for providing nutritional care to pregnant women and all children up to six, the age at which Indian children start school. Anganwadi centres also provide daily pre-school child care and education, as well as keeping a dozen-odd registers recording everything from children’s weights to financial accounts. Overburdened by this long list of responsibilities, anganwadi workers have tended to focus on the group they see every day: children over the age of two whose mothers take advantage of free child care and daily meals offered by the centres. While these meals—supposedly providing each child with an extra 500 calories a day—are certainly beneficial, they do not replace the nutritional guidance the parents of young children need. More seriously, this emphasis on older children means that the under-twos and pregnant women barely get a turn.
Unfortunately, this is precisely the group the government should be targeting. Most growth retardation occurs by the age of two and is irreversible. Often, it starts during pregnancy. More than half the women of childbearing age in India are anaemic—a condition that can be much improved by fortifying food—and 30% of Indian children are born underweight. In healthy infants, this could be corrected with six months of exclusive breastfeeding. But especially in rural India, where women often go back to the fields mere days after giving birth, babies’ diets are often supplemented with cow’s milk and water, which exposes them to infection.
That risk increases after six months, with the introduction of solid food. The quality and reach of ICDS centres varies from state to state: the most impoverished states, with the highest rates of malnutrition, also have the lowest numbers of centres. But countrywide the scheme suffers from the usual ailments of public services in India. Recently the production of daily meals served at anganwadi centres was taken out of the hands of pilfering contractors and given to groups of local women. A complicated system of payments, however, means that even in a state like Maharashtra, which has done more than most to improve ICDS services, centres must wait four months for cash to buy pay food bills. The two meals served at Vishal’s anganwadi—a plate of puffed rice dotted with a few nuts and a serving of sprouted moong dal—seem unlikely to give him 500 calories. Vandana Krishna, the state’s secretary of Women and Child Development, says the funding gap could be solved by giving village panchayats, or local governments, a special fund to make loans to anganwadis. But this would need a lot of money.
So too would any significant improvement in the government’s efforts to fight child malnutrition—with one exception. Fortifying the food handed out by the PDS would be an economical and effective way to lower rates of anaemia and increase nutrition. So far, India has resisted that idea. But most experts agree that the country will make a serious dent in child malnutrition only when it focuses on pregnant women and the very young, perhaps by providing an additional worker in each anganwadi centre to make home visits. “India has missed its big window of opportunity by not giving priority to mothers and the under-threes,” says Victor Aguayo, chief of Unicef’s nutrition programme in India. “It cannot afford to do so any longer.”
http://www.economist.com/node/17090948?story_id=17090948

POVERTY: ETHIOPIA: Pastoralism against the odds

2 September 2010 (IRIN) -
Pastoralists’ disproportionate contribution to Ethiopia’s economy is belied by their marginalized status and by policy assumptions that they would be better off farming. But those who raise livestock tend to make the most of marginal land, according to experts, and are often proficient at adapting to changing circumstances. “People think that pastoralist production systems are just static and backward but this isn't true. “Besides women changing roles, pastoralists are using cell phones and participating in trade and development in their areas. This is key to shift policymakers’ thinking of the pastoral system,” Charles Hopkins, CARE’s pastoral programme manager, told IRIN. Although pastoralism has been recognized as a way of life in the Ethiopian constitution, the long-term focus is on sedenterization. “Pastoralists are often seen as people who should be told what to do,” said Hopkins. Pastoralists are often referred to as `Zelan’, a derogatory Amharic term meaning aimless wanderers. Yet mobility is a necessary response to climate and vegetation variations, according to experts, who regard pastoralism as a sophisticated land-use system that allows people to live on the harsh drylands that would otherwise provide livelihoods for no one. “Pastoral lands are also seen as idle and given to agriculturalists. With the growing food demand, pastoralists will always have this problem,” added Hopkins. Ethiopia has one of the highest populations in Africa and most of its citizens rely on agriculture. Grazing land is reducing due to the conversion of land for farming, an elder in the Jerar area north of Jijiga in Somali Region, told IRIN. “Before some of us were pastoralists but now most of our livelihood depends on farming,” he said. “But farming is like a game of chance, you harvest or you don’t. In the pastoral system, you move with the drought. At the farm you may work so hard for nothing.” Insecurity is affecting livestock movement too - there has been internal pressure in Somali Region from armed groups seeking the region’s secession. Informal trade Despite the odds, pastoralists, estimated at about 15 percent of the population, are contributing about 40 percent of the agricultural gross domestic product in Ethiopia, according to a 2009 Humanitarian Policy Group paper.
The milk market is a hive of activity Informal systems, heavily dependent on communal ties, are especially important in the dynamic unofficial cross-border trade in live animals in exchange for consumer goods across porous borders. The government describes the trade as contraband. “If a trader has the animals, we disperse them in different ways to Somaliland as we speak the same language,” said a livestock broker at the Jijiga Livestock Market. Nearly all animals crossing into Somalia are re-exported to Saudi Arabia, Yemen and the Gulf states. “There are few legal livestock exporters as we are limited by the tax system,” he added. Official marketing systems are burdened by regulations and taxes. “Livestock traders want to formalize the trade but there are bureaucracy problems such as the requirement to open accounts, and the need for foreign exchange yet Somalia lacks a functioning central bank,” said Mohamed Abdinoor, the US Agency for International Development (USAID) pastoral and livestock programmes technical adviser. The peripheral location of most pastoral regions leads to their being squeezed out of domestic livestock markets. Cattle and sheep sold in Addis Ababa, for instance, predominantly come from the highland areas, exacerbating informal trade in a country said to have the largest livestock population in Africa. According to Abdinoor, a clear policy on pastoral lands and reliable meat and live animal markets will help. USAID’s Pastoralist Livelihood Initiative programme is providing development and emergency support through pasture rehabilitation, water harvesting, targeted livestock feeding and slaughter destocking. It is also providing linkages with livestock pharmacies and animal health workers. Livestock serve as critical buffers against falling into persistent poverty, not only in pastoralist areas. “We depend on God. We also support each other in times of hardship by loaning animals,” livestock trader Abdikarim told IRIN. According to a UK-based Institute of Development Studies (IDS) report, effective engagement with pastoralists requires an understanding of these supportive connections. “This… is critical for pastoral systems where social, political, economic and environmental insecurity is catapulting people from managing well to merely surviving, often without warning.” Women’s role
Besides women changing roles, pastoralists are participating in trade and development in their areas Pastoral women are increasingly involved in income generating activities, too, ranging from goats and sheep brokerage to buying and reselling bulls and cereals. The milk trade largely depends on women. Every morning, women in their brightly coloured shawls unload donkeys and camels laden with yellow milk jerricans at collection points strategically along the highway to Jijiga town. “We all know each other. There is no risk of the middle man running off with our money,” said one of the women as she tied her jerricans to the waiting truck. Unique drawings help identify her jerricans. “The truck driver takes the milk to a broker in Jijiga for sale. He comes back with other foodstuffs and commodities that we need.” Payment is made once every five days. “Sometimes the milk goes bad and has to be returned. We warn the women about this,” said truck driver Geshe Alemanyuhu. There is a lack of milk preservation facilities but the women use smoke from the burning of some herbs to treat the milking trough, `dhiil’. This, they say, keeps milk fresher for longer. Education Increasingly, pastoralists are also embracing education. “In the past, the brightest boy in the family would be kept back from formal education and educated through the clan. Increasing livelihood insecurity and reduced herd size for some is changing that. Now the brightest boys, if it can be afforded, are being selected to send to school,” the IDS report said.But barriers remain such as long trekking distances to school. The harsh climate in Afar, for instance, also means that fewer children there attend and stay in school, as families depend on mobility to survive.CARE’s Hopkins said: “For the pastoralist, education is being seen as an adaptive mechanism.” aw/cb
Theme(s): (IRIN) (IRIN) (IRIN)
http://www.irinnews.org/Report.aspx?Reportid=90373

MALNUTRITION: BURKINA FASO: Vital role for local food

OUAGADOUGOU, 6 July 2010 (IRIN) - Local food - like sesame, tamarind and certain leaves - is a vital tool in the fight against malnutrition, say aid workers training families in northern Burkina Faso. Communities who know the nutritional value of local food, and have the means to conserve and use it, are far less vulnerable, say the NGO Eau Vive and local health workers. "Nutritional foods are all around us, right here," said Balima Léopold, health worker in the town of Dori, northern Burkina, who has worked with Eau Vive to show villagers how to incorporate locally available ingredients into meals. "For example, there are leaves rich in vitamin A for making a good sauce for children." Health workers train local women in making porridge fortified with foods including tamarind, soumbala (a local bean), fish and baobab fruit, Koné Blandine, a midwife and nutrition trainer in nearby Gorom-Gorom, told IRIN. The women in turn teach fellow villagers. Eau Vive also shows people how to get the most nutritional value out of milk from their livestock. "A lot of milk is produced in the Sahel region [where most families raise animals] from July to September," Eau Vive country director Juste Hermann Nansi told IRIN. "But most people discard any surplus for lack of a way to conserve it." The NGO - as part of a three-year "sustainable food security" project funded by the European Union - is teaching villagers to make a cheese that keeps longer than milk and provides a nutritious supplement to meals. Local products properly conserved can help improve the nutritional value of meals particularly during the dry season, said Maïmouna Sanon/Traoré with the European Union in Burkina. "The use of local foods is appropriate in Burkina's Sahel region because they are at hand, adapted to people's eating habits and accessible to the most vulnerable... The ultimate goal is to prevent malnutrition." Food aid dependency For Eau Vive's Nansi and health workers in northern Burkina the promotion of local foods is also a way to combat dependence. "The Sahel region regularly faces drought, water shortages and malnutrition, and this has meant almost perpetual outside assistance. That affects people's mentality," Nansi said. "If our approach proves effective people will have less need for outside help to fight malnutrition." Eau Vive and health workers said initially it was difficult to get villagers motivated about their approach. "We asked them to come to our demonstration with local ingredients," nutrition trainer Koné told IRIN. "At first they were disappointed that we were not coming with bags of food but in time they have seen that they have good nutritious foods at hand." Health worker Balima said: "Education is the only means to show people that they must not count on outside aid." Monotonous diet Still, nutrition experts say local diets are generally deficient in essential nutrients, and local food promotion projects have yet to be applied on a large enough scale to broadly reduce malnutrition. "A lot of communities in this region have a tendency towards a very simple monotonous diet and we are always working to increase the variety of foods they use," said Robert Johnston, nutrition specialist with the UN Children's Fund's (UNICEF) West and Central Africa office. Fortified products - produced either locally or outside - will continue to be an important tool in reducing child malnutrition in the region, he said. "You find [fortified spreads and fortified cereals] throughout West Africa," he said, adding that an important role for UNICEF, the World Health Organization and the Food and Agriculture Organization is to ensure that such products are safe. "I think most of us cannot see a way around the use of products to satisfy the micronutrient and nutrient needs of infants in the entire region." He said promoting a diversity of foods in infants' diets is necessary and beneficial, but stressed that the foods should be accessible and already part of caregivers' feeding habits. Eau Vive currently does nutrition work in 104 villages in northern Burkina; its activities include infant growth monitoring, and education on malnutrition's causes and treatment. A 2007 Eau Vive study in the region showed that families did not understand children's nutritional needs, Nansi said. "Many do not make the link between what people eat and their health." He noted that hygiene and access to water play a considerable role in proper nutrition and well-being. "It is not enough to solve the issue of accessibility to food."