[afro-nets] MSF criticises Lancet undernutrition series (2)

["Shamim ul Moula" <shamimul.moula@gmail.com>]

"Home-based care with RUF revolutionised the treatment of severe acute malnutrition in young children. As a supplement to breastfeeding and traditional complementary foods, these spreads are highly effective in the first two to three years of life," MSF's statement seemed interesting, great and more practical as "Home-based care" can be the most sustainable way to combat widespread severe acute malnutrition in the population groups in different geographical areas. Hospital setting and special milks are not available everywhere as we felt it in Bangladesh while heading a Tdh Lausanne funded special nutrition unit in a hospital in famine and poverty-ridden riverine north Bangladesh (where we used to struggle for procuring CMV from Nutriset France as  although "cheap", but supply could not be maintained through a sustainable supply chain mechanism).

Also it may be true that some sophisticated hospital settings are required in some of the places to  combat the acute medical emergencies associated with severe acute malnutrition cases. However, still if the management can really be made successfully through home based care, the management of the severe acute malnutrition will be revolutionized.

But the question to a worker like me from a poor country (avoiding calling "developing country" dream!), what is the standard of that "home" for that "home-based" treatment (is it of the standard of ours one?) and what is that "Ready to use food (RUF)"? Hope, at least that is also not a product of any multinational commercial company? I hope, these RUF also can be made with locally available constituents for better sustainability of the management as we tried in north Bangladesh famine ridden riverine poor areas in past with hundreds of growth monitoring centers for screening out the severe acute malnourished.

Also what can be done for the psychological stimulation for the severe acute malnourished children? I hope MSF has some home-based solution or answer for that.

In fact, these were very few of the many concerns encountered in the grassroots level works in a poor country, so I put it for you all who cares for the deadly severe acute malnutrition for the children in the famine ridden poor countries.

Dr. S.M. Shamim ul Moula
MBBS, Ph.D.
Bangladesh
email: mailto:shamimul.moula@gmail.com