Eat your vegetables

I spent the last two weeks in the village of Karenge, attending a course on nutrition taught by consultant from The States who worked with a local team that is giving technical assistance to the government.

The Positive Deviance/ Hearth idea is this: in every community there are malnourished children, but there are also well-nourished children, even among poor families. With some effort (a lot of effort for a foreigner, less for a village health worker) one can find out what the poor families with well-nourished children are doing that is different than the families with malnourished children, ie the positive deviants. It could be they collect wild leafy green vegetables or the plentiful avocadoes, or that they wash their hands before eating.

After identifying the good practices, one can teach them to people with malnourished children. Malnourished children and their mothers are invited a local home to cook an extra meal and feed it to their underweight baby everyday for two weeks, using the practices identified previously. They each bring the new, deviant foods as well as another necessary aspect of the meal – the bananas or firewood.

They feed their children together for two weeks, and then continue the supplementary meal at home until their child is no longer underweight. This ensures local solutions to local problems of malnutrition. It is sustainable, affordable, and culturally acceptable. It is exciting!