In Haiti, children are known to eat cakes made of mud to fill their empty stomachs and many families struggle to give their children one meal a day, so providing a relatively easy, free and tasty way to combat hunger goes a long way.
For Haiti’s 300,000 or so children who face malnutrition, a high-calorie, high-protein paste, known as Nourimanba, could prove a lifesaver.
Made from peanuts, milk powder, vegetable oil, and sugar, Nourimanba is similar in taste and texture to peanut butter but with added vitamins and protein.
The medical charity, Partners in Health and U.S. healthcare giant Abbott Laboratories and Abbott Fund, the company’s charitable arm, opened a new factory in Haiti earlier this year, which aims to boost production of Nourimanba and reach thousands more undernourished children.
“Haiti is one of the hungriest countries on earth. It has very, very high rates of child malnutrition,” said Dr Joia Mukherjee, chief medical officer at Partners in Health, a U.S.-based nongovernmental organisation. “Malnutrition is the major underlying cause of death in children under 5 in Haiti and in other developing counties.”
In Haiti, nearly a quarter of children aged 6 to 59 months experience chronic malnutrition, according to UNICEF.
Three years in the making, the Nourimanba production plant got off the ground in July thanks to a $6.5 million donation from the Abbott Fund. So far the plant has churned out more than 6,000 kg of the nutritionally fortified peanut butter.
The factory stands in Haiti’s Central Plateau region, a rural area hit hard by child malnutrition where community health workers screen children for malnutrion by measuring their height and weight.
“Kids who need treatment are given a jar of a prescribed amount (of Nourimanba). The treatment lasts from six to 12 weeks. Often for six weeks that’s the only thing kids eat. They take it throughout the day according to a specific prescription,” Dr Mukherjee told Thomson Reuters Foundation in a telephone interview from Boston.
Nourimanba is also ready to eat. It doesn’t need mixing with water or refrigeration, and it can be given to children at home.
“This treatment means you don’t have to have children in hospitals for weeks at a time,” said Dr Mukherjee, who is also an associate professor at Harvard Medical School.
Child malnutrition, she says, affects the development of the brain and reduces brain capacity.
“Malnutrition is treatable and reversible. You can restore deficits in malnourished children in most cases. After six weeks on the treatment you can start to see the difference. Kids engage and start to make eye contact and smile,” Dr Mukherjee said. “But if chronic malnutrition is not treated your brain doesn’t develop properly.”
Making Nourimanba isn’t that hard, she says. Peanuts make up its main ingredient, which are produced by farmers in Haiti.
It’s hoped the factory will help revive the local economy.
“We source all peanuts locally. We hope to create a virtuous cycle that provides a stable market for local farmers and jobs,” Dr Mukherjee said.
Child malnutrition has plagued Haiti for decades. But why do so many children go hungry in Haiti?
Part of the reason is because people are too destitute to buy enough food in Haiti, where 80 percent of the country's 10 million people live on less than $2 a day.
Haiti’s high child malnutrition rates ultimately boils down to the country not being able to produce enough food to feed its population, at a price most people can afford. That stems from a long history of unequal land distribution, years of neglect of agriculture and food dependence and aid, coupled with a U.S. agricultural policy that destroyed local farming, experts say.
“This was not a colony but a slave plantation. Land ownership is in the hands of a few. Production of food is highly political in Haiti. Haiti could produce enough food,” Dr Mukherjee said. “But a policy largely driven by the U.S. in the 1980s meant U.S. crops, like rice, were being dumped in Haiti, undermining agricultural production.”
Such a policy meant Haitian farmers weren’t able to compete with cheaper U.S. imports, decimating the country’s own rice production.
There’s growing consensus among experts that the influx since the 1980s onwards of subsidised cheaper farm imports to Haiti - ushered in by World Bank and International Monetary Fund free-trade policies that obliged Haiti to open its markets - delivered a massive blow to Haitian agriculture from which it has never recovered.
While it will take years to reverse the effects of such policies and underinvestment in Haitian agriculture, many children in the Caribbean nation will continue to rely on fortified peanut paste to get past their fifth birthday.