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obesity in Norway, and I were malnourished cildren.
do not think it's a problem These patients were given
of poverty. medical treahnent, but the main
action was therapeutic milk to
Socio-cultural factors strongly raise the nutritional status of
affect lifestyles. But returning these children.
to malnut+'tion in the develo-
ping world, people do not have The number of children that we
access to proper food because treated was quite small, and the
they do not have the financial work involved very labow
resources to purchase it. People intensive because they were
know what is good for their supposed to remain in hospital
health. But to purchase healthy for several weeks. Very few
COnSDlnlln?l'
food you need money! mothers were able to come to Ihernpauk:-losl

bnn+ilb a-irv .
these treahnent centres and stay
Rougbly, what does a balanced there forthe three to fourweeks
diet mean to you personally in necessary, particularly if they
temns of food intake? had other children at home. can be described as a ready-to- Q: The ICRC has taken a
Since 2001, 2002 and 2003 use therapeutic food. It is a different path. They talk
Q: You need vitamins, pro- there has been a kind of revolu- paste based on peanuts. There about the "home-based
tein, minerals, milk pro- tion dining which a completely are others, but this is the one development of nutrition".
ducts, meat products, etc. different strategy has been mostly used by MSF and Can you explain the
adopted. The children no longer UNICEF, difference?
Tndeed. But the problem in stay in hospitals but are treated
developing countries is that fra- by their own mothers at home There are also strategies being aThis is achially the same tg.
gile communities do not have using therapeutic food. The developed to prevent cNdren What I was just telling you
access to such foods. They have mothers big this food home from becorning severely debili- about this strategy of home-
to survive on a very poor with them from the clinic and tated in the first place, because based treatment implies that
cereal-based diet, wbich does that allows their cildren to to treat a malnourished child Plumpy'Nut, or an equivalent
not provide a sufficient variety regain weight. thoroughly is very costly. product, w'll be used by the
of nutrients. Sources of protein, mothers to treat their children.
different vitamins and different Q: So what you are giving Q: How much does it cost It's the same thing.
minerals are essential in a these children is in fact to treat a child with
balanced diet. high-calorie food? Plumpy'Nut? Q: Wouldn't it be better to
give people more health
The subject has been studied by High calories with forty essen- For a child, it's a between education than to distribu-

experts from various organisa- tial nuti'itional supplements. US$40 to US$60. This covers te this kind of food
tions. Rougbly, there should be This therapeutic food is easy to everything. The product itself is product?
forty different nutrients in the prepare and does not require roughly half of the cost, but you
diet of a child, especially after any medical supervision - or also have to take into conside- The recent school of thought

breast-feeding has been inter- much less than before. These ration the consultations and has been to provide health edu-
nipted. A complement to children are then checked once logistics. cation but, at the same time, we
breast-feeding should be provi- a week or every second week, should not assume that mothers
ded from age 6 months to 24 instead of spending the whole There are other products being do not know what is good for
months. This is an important time in hospital under supervi- developed for children who are their children. They do, but
period in children's develop- SlOn. moderately undernourished, they simply do not have access
ment and if they do not receive and these products are being to the products.
this nutrition at that time their Only a few children w'th seve- tested. aThis is where the temi

whole development is itnpai- re complicat'ons require hospi- "ready-to-use food" comes in, You can see this very easily in
red. Their iinmune system is tal teatment. So the advantage because some of these products all the Sahel countries. There
weakened, making them more of this strategy is that you can are meant for communities as a are hunger gaps-that's the per-
vulnerable to various diseases, treat far more patients because whole. In this situation, we do iod before the next harvest. It is
such as malaria. you do not need to admit them not talk about therapeutic food aperiod when there are no fresh
to hospital. Furthermore, it does but about "ready-to-use food". fniit and vegetables available.
Q: I know that MSF has not have any impact on the rest This is because some of these Therefore, people have to sur-
developed strategies to of the family. So instead oftrea- children are not sick yet, and to vive on a pure cereal diet, and
combat malnutrition. ting hundreds of patients, we avoid them becoming sick we dining this period you will see a
are now able to treat many provide them with supplements strong increase in malnutrition.
It is probably interesting for thousands of them. to their regular diet containing
you to understand the evolution essential vitamins and minerals. You cannot uphold the thesis
of the way MSF combats mal- Q: Tell me about the diffe- They are not so much inneed of that, for a period of four or five
nutrition. In the 1970s and rent products? the animal proteins and other months, mothers suddenly for-
1980s MSF set up small clinics elements they contain, but they get how to feed their children,
and hospitals in developing There are different products for really do need the vitamins and and then after the hunger gap
count+'es to receive patients. the different types of malnutri- minerals. they suddenly remember again.
Among these patients there tion. "Plumpy'Nut" is one that We think, therefore, that the
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