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Salama.

My name is Olivia.
I document my adventures in Madagascar as a Peace Corps Volunteer, with the mission to share culture and empower others through my writing.
Enjoy! 

Got Plumpy’nut? The Repurposed Market of Food Supplements in Madagascar

In the muddle of Hilary Clinton’s emails that were revealed on the Internet last year, a lot was left unexplained.  One line in particular stood out: “Plumpy’nut?”

A lot is left to wonder (Plumpy,what?!) But for those working in global health or living in areas with high rates of malnutrition, the term is quite familiar.

The small peanut butter packets are called a ready-to-use-therapeutic food, known as RUTF and used to prevent malnourishment – if they are used in the ways intended. Often that’s not the case.

Just over a decade ago, a French doctor invented a treatment for severely malnourished children that had a revolutionary, life-changing impact. The product goes by different names in different parts of the world, such as Plumpy’Nut, Nourimanba and Chiponde. It’s basically peanut butter with some added ingredients: dried milk, oil, sugar, and essential minerals and vitamins.

To summarize, an NPR article provides a good explanation of the product:

What Makes Plumpy'nut? Source:USDA National Nutrient Database

What Makes Plumpy'nut?
Source:USDA National Nutrient Database

Doctors suggest that this peanut butter paste is used as a supplement rather than as a meal. The idea that this enriched peanut butter is a replacement for food is vital for its effectiveness. Studies have shown that this therapeutic food is one of the most successful ways to nurse malnourished kids back to health, explaining why organizations like UNICEF and other NGOs distribute it. When it is used as a replacement for healthy foods like milk, eggs and grains, it cannot help severely malnourished kids get back to a normal weight.

The packets can’t help the malnourished kids if they are being sold for a profit at the market, either. Though boxes of Plumpy’nut are distributed to hospitals and health centers in areas with high levels of poverty and malnutrition, the peanut paste often doesn’t reach those its intended to help. Sold at the market for anywhere between 500 and 600 ariary ($0.15-$0.18), sellers will often place one packet next to their array of fresh vegetables. Wary not to display too much of their product, the rest of their supply is kept hidden. The packets are sold as one-time snacks to customers rather than as a part of a regimen to nurture children back to health. In an area that lacks many resources and is currently plagued by a drought, business opportunities are strategically and ardently sought out.

Idealistically, Plumpy’nut serves as a useful tool to address the 18 million children around the world suffering from malnutrition. But the coexisting issue of poverty seemingly gets in the way – it is calculated that only about 3 million people are getting the treatment needed.

But, it’s a double-edged sword. It’s hard to reprimand a hardworking mother who has no food left to sell, as her crops have all shriveled from the drought, that she isn’t making the best choice for her family as she decides to sell the supplements for a profit. Sold at 500 ariary-a-pop, she is making money to provide for her family of ten in the midst of a severe famine. But as soon as the peanut butter paste is used for other than its intended purpose, the global issue of malnutrition continues. Simply said, it’s a complicated issue in need of a complex solution. 

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