The Plumpy’Nut Story
Like many countries of the Sahel region, Niger faces chronic food insecurity. Niger is one of the world’s driest countries: More than 80 per cent of the country is desert, and just more than 10 per cent is arable. The majority of Nigeriens, however, still rely on agriculture to make a living. The yearly rains in the Sahel region are unpredictable, and there have been many years of severe drought since the 1970s. Since then, for many Nigeriens who survive on subsistence farming, or base their livelihood on herds of goats and camels, it’s been hard to get ahead. In 2005, Niger experienced a severe food crisis, brought on by insufficient rain and locusts, and the compromised harvest left many people without enough food.
Malnutrition affects mostly the very young, and it is frustratingly treatable with the right tools. One such tool, a food product called Plumpy’Nut, has received international endorsement for the way it has radically improved the ability of healthcare providers to treat malnutrition. Developed in 1996 by the French company Nutriset, Plumpy’Nut is a peanut paste mixed with sugar, vegetable oil, powdered milk, vitamins, and minerals. The great success of Plumpy’Nut is its nutritional value, easy distribution potential, and the fact that children love to eat it, even when they’re sick. Children brought into clinics for treatment are given Plumpy’Nut packages or tubs to take home, and then return weekly to be weighed. Plumpy’Nut can save children’s lives, but it also creates a dilemma for hungry families.
In November 2012, I spent a month in Niger doing field research on children with disabilities for a large international development organization. One day, I found myself talking about Plumpy’Nut with a co-worker. I had come across the supplement already while in The Gambia the year before, during the East Africa food crisis. It seemed like a win-win idea: a pre-packaged mixture of healthy food, with no water or refrigeration needed. And the medical results are hard to dispute. Like most medicines, however, Plumpy’Nut is only effective when administered properly.
In Niger, Plumpy’Nut is often distributed through the Integrated Health Centres (CSI), which are government run and spread around the country. The supplements are supposed to go to mothers who bring in their malnourished children for treatment, and the mothers are supposed to get a week’s supply of Plumpy’Nut for their children. But before the packages even get to the health centres, many of the boxes are “diverted” – a euphemistic way of saying that some of those people who handle it along the way skim a few boxes off the top. The remaining packages are distributed to the mothers, who transport them back to their villages, often by walking for miles with their babies on their backs and packages of Plumpy’Nut balanced on their heads. But many of those Plumpy’Nut packages will never reach the children that need them most.
Plumpy’Nut, as anyone who has participated in demonstrations of the bar knows, is sweet, fatty, and tastes like peanut butter and icing sugar – like a candy bar. “Where do all those diverted bars go?” I asked my co-worker. “Sold,” he said, “to people like me. My nieces and nephews always ask for Plumpy’Nut when I come and visit – it’s the best candy I can bring them.”
Plumpy’Nut bars sell for about a dollar each at the market in Niger. Underpaid government workers might divert a box and sell the packages to pay rent or their daughter’s dowry. It’s impossible to know how many boxes are sold this way, but I got the sense from my co-worker that Plumpy’Nut bars were easily and readily available, if you knew where to go.
Those I feel the most sympathy for are the mothers of the undernourished children. A mother might be given a week’s supply of Plumpy’Nut for her two-year-old son who is underweight and sick. He certainly needs the calories, but so do her other children – women in Niger give birth to eight children on average, and at least one will not survive. So, what if she has five other children at home, and all of them need to be fed and clothed? A package of Plumpy’Nut sells for a dollar – more than a day’s earnings for many Nigeriens. One week’s supply of Plumpy’Nut bars buys a half-kilo of rice that could feed her whole family for a fortnight. What choice should she make?
It is difficult to find fault in the idea of emergency food aid, and particularly a product like Plumpy’Nut that combines the calories and nutrients necessary to save babies’ lives in an easily distributable package. But the untold stories of emergency food aid, and aid in general, should never be glossed over. Canada is currently reconsidering the value of aid as it realigns the Canadian International Development Agency’s priorities towards business development. Reconsideration is required – there are many things wrong with the current aid paradigm – but so is a deep appreciation for the unintended consequences of intervention.