By DAVID LINDSAY/ Global Health Frontline News

Northern Haiti

11-month old Pierre Wisny is painfully thin, with ribs showing and his skin practically hanging off him. He weighs just 11 pounds (five kilograms).

When the circumference of his arm is measured, which is an indicator of deep body fat, he’s well into the red zone. No surprise, Pierre is severely malnourished.

The same applies for three-year old Alcincord Guerviscon.

Even without measurements it’s clear to see that his growth has been stunted by the same condition.

In most of these cases, the children got this way due to poverty and a lack of access to good food.

If they’re not given emergency treatment, they could die or suffer more effects of malnutrition, including reduced brain development.

For staff at this clinic in northern Haiti, the intervention comes in these bright green packets.

They contain Medika Mamba, which means “peanut butter medicine” in Creole.

It’s a ready-to-eat paste, packed with nutritious ingredients, that over a period of weeks gives a jolt to the system and puts children back on track.

It’s made by a us-based non-profit called ‘Meds & Food for Kids’ (MFK).

Thomas Stehl: “You can’t rehabilitate a child who has severe malnutrition with a plate of beans and rice. There’s just no way. Their stomachs are too small and their nutritional requirements are too great to ever be satisfied in that way. So the quantity and the density of food is really important and that is why ready-to-use therapeutic food and Medika Mamba is such a great answer.”

At another clinic, where children have been on the therapeutic food for several weeks, the difference is striking.

When Guerline d’Haiti arrived three weeks ago she weighed ten pounds.

After three weeks in the program, she’s gained two pounds and is far more active.

The head nurse says Medika Mamba is a life-saver.

Nurse Toby: “If you have children that can’t eat, really eat, and there are many ways of feeding one’s self, that child won’t survive. But with the mamba medication, specially made for little children, if that child starts taking the mamba normally, and regularly, the child will recuperate and start eating again.”

Even though emergency foods like Medika Mamba have been proven to work, the best course of action is to prevent malnutrition from setting in in the first place.

Here, at Fort St. Michel hospital, 350 children who are at risk – but are not malnourished – are enrolled in a study of a supplementary food known as Nutributter.

It contains fewer calories than Medika Mamba, and is  designed to be taken with regular food, essentially topping up nutrients that are lacking in the child’s diet.

But there are critics of this type of intervention.

Marcos Arana-Cedeno is a consultant who’s studied malnutrition in Chiapas, one of Mexico’s poorest states.

He says fortified foods can do more harm than good. “They are promoting dependence. They are promoting these kinds of products. It’s very easy to make a distribution of these products and it requires more energy and more effort to bring people to participate, to understand the messages.”

But MFK says its program does take the long-term interests of the community into account.

Rather than simply import the food, the organization makes the product in Haiti and works with local farmers, buying their peanuts and teaching them how to improve their yields.

Jamie Rhoads: “Their evolution of thinking about business, about expanding their peanut production, about how that translates to other things is really striking and you know, their organizing around the prospect of being able to sell those peanuts.”

MFK has also been testing peanut seeds from as far away as India to see if they will produce better crops than the varieties currently used in Haiti.

While some of the farmers view these strange-looking plants with suspicion, the program has taught them better techniques.

Plovert Petit-Frere, farmer’s cooperative president: “We can say yes, we’ve improved, especially in weighing the crop because we’ve been able to conserve more of it that will last longer.”

MFK also plans to buy a lot more peanuts in the coming years.

That’s because it has just installed a machine that produces a new version of its product, called ‘Plumpy’Nut Medika Mamba.’

It follows a deal with Nutriset, the world’s leading producer of ready-to-use therapeutic food.

The new paste will use nutriset’s recipe, which meets the requirements of major agencies like the World Food Programme and UNICEF.

Each serving must come in an individual 500 calorie pack, and have a shelf-life of two years.

With the big aid agencies as potential new customers, MFK is scaling up to produce the new Medika Mamba in far greater quantities.

The expansion includes plans for a new factory, which the organization says will create at least 50 jobs.

And once the aid agencies approve local crops for use as the main ingredient, MFK says it will use nearly 1,000 peanut farmers as suppliers.

Thomas Stehl: “It is about children of course, but it is more than that. It has the opportunity to actually catalyze economic and agricultural development in a country where, you know, it’s needed.”

And in turn, maybe the children themselves will not only survive the effects of malnutrition, but go on to lead a new generation of Haitians that is more self-sufficient.

David Lindsay is the Managing Editor of Global Health Frontline News. For more, go to www.ghfn.org