In the video posted above, Jay, a talented medical student who co-manages Project Peanut Butter's clinical sites during his year long commitment in Malawi, moves through the later stages of a typical assessment of a child's nutritional health.
I should note, this child's weight and other basic health indicators were assessed earlier.
A height scale is on the bench before Jay.
The man on the opposite side of the bench from Jay is a "HSA," a government paid Health Surveillance Assessor. The HSAs are stationed in rural areas throughout the districts where the Project is engaged. They serve as informal partners with the Project and provide a link to many of the villages and other remote communities.
A combination of measurements that include weight to height ratios, age, and other calculations allow Jay to determine if this child's health and life are truly at risk.
The Project uses international standards for malnutrition and a substantial base of additional research data to qualify and track each child's health.
Many of the children brought to the clinic are tested and not qualified for treatment - they are reasonably healthy and nutritionally stable. These children are often hungry and sometimes have other medical complications, but they are not in crisis. They are sent home with their caretakers without additional food. The mother's and other caretaker's major gain is a positive assurance that their children are not at immediate risk for severe malnutrition. The mothers and other caretakers for these children are often encouraged by the doctors and other members of the Project staff to come back to the clinic in a month for further assessments.
The Project is clear about core values - there is a tight focus of Project resources on children who are in desperate need, children who are moderately or severely malnourished. The Project makes a commitment to serve of these vulnerable children free of charge. At the clinics, no children are turned away.
This, I believe, leads to the relative calm for the entire community of mothers. There is a sense of trust that if their children need immediate support, food and other Project resources will be available.
It is my understanding that the most critical period for children in terms of nutrition is the period between the end of breast feeding and an age of about three years old. A child's development and lifetime health, size, mobility, and intellectual capacity are all significantly impacted if adequate nutrition is not in place during this time frame.
As Jay states in this short footage, the child featured in this video clip has "Severe Acute Malnutrition" and evidence of "Wasting." This child's statistics indicate a crisis.
Without treatment this child is not likely to survive.
As the video evolves, Jay gathers critical information and enrolls this child in the Project's highly successful, intensive, nutritional program which utilizes "RUTFs," or Ready To Use Therapeutic Foods, a dense paste of peanuts, milk powder, vegetable oil, sugar, and vitamins and minerals called "Chiponde" in Malawi.
Fortunately, the child in this video footage is highly likely to recover in a short period of four to eight weeks and sustain a very positive level of health through the early years of his life.
Each day, Monday through Friday, Jay and El, the other medical student engaged with the Project, work with a team of nurses, HSAs, and additional Project staff to assess the health of a hundred to six hundred children. They return to each site every week to two weeks.
In many cases, extreme poverty, domestic issues, and health complications lead to periods of the year when a large number of families have little to no food.
In some situations, a child's nutritional requirements and overall health status are complicated by exposure to Malaria, TB, HIV, and other factors.
The flow of a day long clinic during the most challenging times of the year is quite mesmerizing and exhausting - singing, clapping, long lines, measurement after measurement, endless crying children, and big, big heat.
I remain inspired and humbled by the work this team completes.
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