69 posts categorized "1,000 Days"
Efforts to reduce malnutrition in Rwanda help to thwart the rise of HIV and AIDS, saving the lives of countless infants and young children. (Photo: Bill McCarthy for EGPAF)
By Lior MillerFor the past 10 years, Rwanda has made significant achievements in scaling up its health system to address the HIV/AIDS epidemic and maternal and child mortality. As the Rwanda Country Officer for the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), I have witnessed many of these transformations firsthand. While Rwanda is often cited as a success story for infectious diseases – deaths from tuberculosis, malaria, and HIV/AIDS dropped by 80 percent in the past decade – not enough people know about the remarkable improvements in reducing the country’s high malnutrition rate.
Malnutrition is a state resulting from too little food, inadequate nutrient intake, and frequent infections or disease. It can manifest in a number of ways, but the most common is stunting, which affects 165 million children under the age of ive worldwide. In 2005, more than half of Rwanda’s under-five population was stunted. Just five years later, the stunting rate had dropped to 44 percent. This number is still high, but due to concerted efforts by the national government and its partners, progress is expected to continue.
The first 1,000 days of a child’s development – from pregnancy to 2 years of age – are a critical period for health and survival. Adequate maternal and child nutrition during this period is crucial for both cognitive and physical development. Stunting, in particular, affects brain development and is associated with lower cognitive abilities, poor school performance, and lower earnings throughout the lifetime.
In response to the country’s high malnutrition rate, the Rwandan Ministry of Health developed the National Multi-sectoral Strategy to Eliminate Malnutrition in Rwanda. One of the key strategies outlined was the scale-up of community-based interventions to prevent and manage malnutrition in children under five years of age and in pregnant and lactating mothers. In this intervention, community health workers use behavior change communication to teach women about optimal feeding practices through a package that EGPAF and PATH harmonized with Rwanda’s national plan. The health workers counsel mothers, fathers, and other caregivers to promote social and behavior changes, including improved maternal diet, early initiation of breastfeeding, exclusive breastfeeding for six months, safe water and hygiene, how to care for a sick child, and growing kitchen gardens and learning small animal husbandry for diet diversity.
Counselors also discuss nutrition in the context of HIV, since malnutrition threatens the health of HIV-positive mothers and their children. Malnutrition weakens the immune system and causes faster disease progression. Inadequate food intake can affect adherence to antiretroviral medication and drug effectiveness. Because HIV progresses faster in children than it does in adults, the risks posed by malnutrition make them even more vulnerable to mortality. Moreover, because HIV-positive pregnant women are less likely to gain adequate weight than non-infected women, counseling on maternal nutrition during pregnancy enables them to give birth to normal weight babies, increasing their chances of survival.
Malnutrition has more detrimental effects than hungry bellies, and efforts to reduce stunting rates also improve maternal and child survival, decrease HIV-related mortalities, and increase economic productivity. Rwanda’s success in reducing malnutrition, and eventually eliminating it altogether, is due to a number of factors, including a strong health system with universal health coverage, integrated health services, and an emphasis on vulnerable populations. In addition, the importance of the government’s political and financial commitment cannot be underestimated. With more families being reached at the community level through the concerted efforts of the Government of Rwanda, EGPAF, and other partners, I have no doubt we can achieve the elimination of malnutrition and new HIV infections in children in Rwanda.
To learn more about the Elizabeth Glaser Pediatric AIDS Foundation's work in Rwanda, click here.
Lior Miller is Country Officer for Rwanda for the Elizabeth Glaser Pediatric AIDS Foundation, based in Los Angeles, CA.
On Monday, international government representatives, global nutrition experts, activists, and civil society leaders assessed progress made since September 2010—nearly 1,000 days ago—when the United States and Ireland launched the 1,000 Days Call to Action and the Scaling Up Nutrition Movement.
At the "Sustaining Political Commitments to Scaling Up Nutrition" meeting, United States Agency for International Development (USAID) Administrator Dr. Rajiv Shah reaffirmed the U.S. Government’s financial commitment to addressing maternal and child malnutrition and committed to building a partnership with U.S. nongovernmental organizations to leverage private resources in this fight.
“Today, we have the opportunity to join our voices together-to draw strength from the past 1,000 days and seize the next 1,000 days to achieve progress that was unimaginable in the past,” Dr. Shah said. “The vision that guides our mission starts with the people our governments represent and who are reflected in our invaluable civil society partners who have long championed efforts to advance global nutrition.”
During the meeting, Interaction, the largest alliance of U.S.-based NGOs international , announced that its members have pledged more than $750 million in private funds over the next five years to improve nutrition—including efforts that focus on the 1,000-day window between a woman's pregnancy and her child's second birthday.
For more highlights from the meeting, watch the brief video below.
Tohomina Akter attempts to feed her daughter Adia, 17 months, in Char Baria village, Barisal, Bangladesh, on Thursday, April 19, 2012. Tohomina finished 7th grade and hopes she can help educate her daughter to be a doctor. (Laura Elizabeth Pohl/Bread for the World)
By Mary Pat Brennan
Do conversations matter? Do my conversations matter? Do yours? If conversations are about connecting with others then the morning conversation with my housemate over coffee, the Skype chat with my daughter, and the small talk I make on the elevator all matter, even if only to me and perhaps one other person.
But some conversations matter more than others. Some have the power to inform and plant seeds for the future–and even contribute to making the world a better place.
When we discuss maternal and child nutrition during the critical 1,000-day window between pregnancy and a child’s second birthday, we’re having a conversation that could change the world. According to information in Bread for the World Institute’s 2013 Hunger Report , “[h]unger during this time is catastrophic, because the resulting physical and cognitive damage is lifelong and irreversible.”
Her eyes held a weariness that I hadn't seen before. She was tired. She sat quietly, with her shoulders slouched, as she held her young boy in her arms. He was restless; hands scratching his head, eyes wandering up toward the ceiling. I could tell he was not eating well. Neither was she.
I was working late at the church and was the only person to hear the buzz that came from the side door. I had immediately welcomed in the young woman and child. Now, we were in the church’s kitchen. My head was dizzy, from work and the surprise of the unexpected visitors.It was an early autumn day. No one was yet used to the sky darkening shortly after 5 o’clock. The heat of the summer days was dwindling and the idea of colder days approaching made bodies crave sustenance.
I found three cold apples in the refrigerator, a quarter block of sharp cheddar cheese, half a loaf of bread and some caramel dipping sauce. There was a can of French onion soup in the cupboard. I made her a bowl of soup with shaved cheese on top. She dipped the bread in the broth and fed it to the boy. When he was through, she ate. They were quiet, as most of us are when we eat. I sat across from them at the wobbly coffee-stained kitchen table. Once she had enough, she thanked me and told me about her situation.
Her mother had kicked her out of the house three days earlier. She didn’t share the reason. She was 17 years old and her son was almost 2. She used to come to our summer youth programs when she was 10 and 11. She was trying to reach a teacher that was a member of the church. She mentioned the teacher’s name—I knew her. I had actually spoken to her earlier that day on the phone. So we called her up. After all of the caramel sauce and two of the apples were gone, the teacher arrived. The young woman thanked me again. The little boy had stopped scratching his head and gave me a smile before he rested his cheek on his mother’s shoulder.
I exhaled as the teacher thanked me. At the time, I didn’t really understand why I was receiving so many thanks, but now I thank God for blessing me with the stamina to work late that evening. Now, I’ve realized the importance of that simple act of feeding a mother and a child. And, once again, I thank God for blessing me with the ability to do that, and much more, for women and children.
Amanda Bornfree is a consultant in Bread for the World's church relations department.
Photo: Isaac, enjoying fresh fruit. (Laura Elizabeth Pohl)
Photo: Pat Donahoo's twin daughters, courtesy of Pat Donahoo.
Monday, March 25
By Pat Donahoo
Babies! Whether it is mom, dad, grandparents, aunts or uncles, we all get so excited about babies. When we hear the news of expectant parents we throw parties and buy gifts and start planning what the life of the child will look like. We think about bright eyes and chubby cheeks and smiling, happy faces.
I planned all of those things for my first pregnancy, too. Then, at seven months along, I began to have problems with my health. In spite of a blizzard outside, I was sent to the hospital for tests. A quick x-ray (before the day of sonograms) showed that there were, in fact, two babies. Oh no! I need a second crib and a second car seat and twice as many clothes and bottles and diapers…..Well, at least I had two months to prepare.
Ten hours after my x-ray, in the middle of the blizzard, I went into labor. The doctor said not to wait, to get to the hospital immediately because the babies were coming too soon and we needed to be certain to get there before they were delivered. They arrived two hours later—about 12 hours from the time I found out there were two of them. They lost weight, had breathing problems, had to be fed intravenously. It was 16 days before I was permitted to hold them in my arms.
Scary? Challenging? Yes. But within a year they had each gone from weighing just three pounds to falling within normal development range. Because they had to be on oxygen those first few weeks of their lives they had to be tested for possible vision problems later. But, after those initial challenges they grew and developed normally and there were no residual difficulties.
How can preemie babies thrive? Why is it that some babies go full term and still struggle? The truth is there are a whole host of reasons. One of those reasons can be addressed: nutrition during the 1,000-day period from the start of a woman's pregnancy through her child's second birthday. I was blessed to have nutritious food, vitamins, and excellent medical care during my pregnancy. When this unexpected challenge came along my daughters were healthy enough to be able to overcome those early difficulties. How different might the outcome have been without that safety net? If they survived, they might still have had physical or learning challenges. Full-term babies without the proper care face those same challenges.
During this time of Lent, as we journey toward the cross we may travel in despair, or we may remember the rest of the story and the hope that the events at the cross birth. As we face this challenge of child nutrition, will we give in to despair or recognize the hope that lies in the fact that we can do something about it?
Pat Donahoo is executive director at Disciples Women.
Three-year-old Mary plays near her house in Kamuli, Uganda. (Laura Elizabeth Pohl/Bread for the World)
Friday, March 21
By Amanda Bornfree
There’s a stillness that comes over me during the season of Lent. This stillness is soft yet strong, and each day, the stillness becomes stronger.
During this Lenten season, my attention is not only focused on my own spiritual growth and that of my community, but also on the growth of the 1,000 days movement. How does one become a champion for maternal and child nutrition? How does one become a stronger advocate for such an important cause? What makes a person willing to stand up? These are the thoughts I have during moments of prayer and reflection. I know there’s not one answer.
Is it purpose coupled with perseverance? Does one become a champion by chance, or is it strictly a calling? Is a champion’s stance enhanced through experience, or from study and research? Is a champion someone who has landed at the intersection of compassion and courage? Perhaps a champion is someone who believes in moral rights and defends them? Or maybe a champion is someone who just does what needs to be done—someone with a good heart and common sense? Is it clearly our duty as Christians to be champions? Is it in our nature as Christians to be champions?
As the questions and thoughts come, I return to the stillness with my heart wide open. I’m not anticipating that any particular answer will come, or even any answer at all. I’m simply preparing myself to be moved by the Holy Spirit, to be open to playing the role that’s needed in order to shine light on the 1,000 days movement and to fight hunger and malnutrition.
I ask that you, too, during your moments of stillness, look inside yourself and become a champion for maternal and child nutrition. As a woman of faith, I believe it is in our nature to be champions for this cause.
Amanda Bornfree is a member of Bread for the World and a consultant in the church relations department.
Khato Rana plays with her daughter Rita, 2, at the Nutrition Rehabilitation Home in Dhangadhi, Nepal. The facility, run by Nepali NGO RUWDUC (Rural Women's Development Unity Center), restores malnourished children back to health. (Laura Elizabeth Pohl/Bread for the World)
The United States has exhibited great leadership in the areas of global development, food security, and nutrition, but more must be done, said Rev. David Beckmann, president of Bread for the World, during testimony given Tuesday before the House Appropriations Subcommittee on State/Foreign Operations.
Beckmann asked the committee to continue its bipartisan support for food security, agriculture, and nutrition—especially in the critical period from the start of a woman’s pregnancy through a child’s second birthday, also known as the 1,000-day window of opportunity. High-level political leadership by the U.S. through initiatives such as Feed the Future, the 1,000 Days Partnership, and Child Survival Call to Action has increased awareness of the importance of maternal and child nutrition around the world, but more importantly, spurred other countries to action. But, Beckmann cautioned that such actions must be accompanied by an increase in funding, as well as important reforms to the U.S. foreign aid system, such as more local procurement, a more efficient food aid system, and greater transparency and accountability. He specifically suggested raising U.S. funding for nutrition from $95 million, in the fiscal year 2013 budget, to $200 million in FY 2014.
“The U.S. government has …encouraged the world to use new knowledge about how best to reduce the carnage of child malnutrition,” he said. “We now have clear evidence, for example, that available dollars should go first to improving nutrition in pregnant women, new mothers, and young children in the critical 1,000-day window of opportunity. This will reduce preventable child deaths and lock in the potential of every child by giving them a good start to life.”
Beckmann’s testimony comes at a time when both a shrinking international affairs budget and the series of across-the-board cuts known as sequestration threaten funding for poverty-focused development assistance (PFDA). Many important international nutrition, food security, development, and humanitarian programs fall under the umbrella of PFDA. These programs build secure, healthy, and productive nations at a fiscal cost of less than one percent of the federal budget. Beckmann cautioned that the sequester, if not replaced with a more balanced plan, will slash $1.1. billion from PFDA this year alone.
“Some cuts kill,” Beckmann said, before explaining that sequestration will deprive 600,000 malnourished children of life-altering and live-saving nutritional assistance, deny 1 million poor farmers of agricultural assistance, and will stop 5 million people from receiving lifesaving medical interventions.
“As a Christian preacher, allow me to say that our nation’s efforts to help reduce hunger, poverty, and disease around the world are important to Almighty God,” Beckmann said. “I’m convinced that God loves me, all of us, and everybody—including the millions of families around the world who struggle to feed their children.”
Tuesday, March 19
By Inez Torres Davis
"The poor will always be with you."
These words have bothered me for much of my Christian life. To me, it infers God’s limits as well as our own. It is possible for us Christians to miss the mark, but is it possible for God to be unable to get us to be inspired enough to end poverty? Of course, these are idle thoughts, not intended to be idolatrous, but reflective of the struggle I have had for decades with the seeming inevitability of hunger and poverty. The poor will always be with you?
Years ago, while at Bible college, I was inspired as I sat and read this passage. I gained perspective by remembering the edicts: Who is speaking? Who is being spoken to? What is the context in which these words were said?
Jesus was speaking to Judas.
Judas was the fellow who handled the finances (what finances there were) attached to Jesus and his entourage. The suggestion may be made that Judas’ desire to overturn Rome and establish the new and improved Kingdom of Israel was as pointed as his ability to make sure cash was available to him for his handling of the expenses. This was likely not a system of economic cooperation he used, so it is legitimate to wonder if Judas would have really given that money to feed the hungry had he been given it.
The poor will always be with you, (Judas).
So, maybe, just maybe, Jesus was not addressing the inevitability of poverty as much as he was describing poverty as it relates to greedy folk? The kind of people who want more, more, more! More money. More power or control. People like Judas, who was able to exchange Jesus for some idea of grandeur and thirty pieces of silver.
At least 80 percent of humanity lives on less than $10 a day. According to UNICEF, 22,000 children, age 5 and under, die each day due to poverty. And the number would be much higher if older children were included in that figure. These dear children “die quietly in some of the poorest villages on earth, far removed from the scrutiny and the conscience of the world.” Today, 2.6 billion people around the world do not have access to adequate sanitation and about 885 million people do not have access to clean water.
So, the children die from treatable diseases without an anointing. But the money for the ointment that could have been pressed to their skin went somewhere else. It did not feed their bellies or eliminate their suffering or prepare them for burial, it went elsewhere. Where did it go?
The poor will always be with you, (Judas).
Inez Torres Davis is director for justice at Women of the Evangelical Lutheran Church in America.
By Barbara Anderson
I have never had to worry about having enough food—or enough of anything, for that matter. I have been very blessed. However, sometimes God gives you the opportunity to look through a different lens and your perspective changes. Sixteen years ago, my husband Phil and I were in the process of adopting a baby girl from China. The period of time when we were waiting to be notified that a child had been selected for us was difficult. It was a hard time for me because I had no control over the situation. I had to place my baby girl in God’s hands.
While waiting, I would pray for the birth mother carrying my daughter, pray that she had access to good food and was healthy. I prayed for my daughter’s birth, that it would go smoothly and things would be OK. I prayed that my baby girl would have milk and food until we arrived in China to bring her home. I prayed for her health, that someone was watching over her. I prayed she was growing at a healthy rate and was not hungry when she went to bed at night.
Finally, the day came when we arrived in China to bring our precious miracle home. When she was placed in my arms and I could hold her and see her, I knew that God had heard and answered my prayers. Our daughter, Carrie, had beautiful chubby cheeks and was happy and healthy.
Upon arriving home we visited our pediatrician, who confirmed that Carrie was one of the healthiest babies she had seen coming from an orphanage oversees. For many babies around the world, this is not the case. They do not have access to good food and nutrition. Their birth mothers did not have access to good medical care, vitamins, or nutritious food.
According to Bread for the World, “Globally, more than one-third of child deaths are attributable to undernutrition.” In a world of technology and plenty, why can’t we put an end to world hunger? We need to work together, through the Bread for the World and the 1,000 Days Movement, to improve maternal and child nutrition so that precious lives can be saved.
During this time of Lenten reflection, ask God what he is calling you to do so that all women and children have access to education, medical care, good nutrition, and a chance at a happy and healthy future, just like my daughter Carrie and your loved ones.
Barbara Anderson is executive director of All Hands In, an Arlington, Mass., ministry working on issues of human trafficking. She is also a past president of the American Baptist Women’s Ministries.
Inez Torres Davis (l) with a Bread for the World delegation to Africa. (Bread for the World)
Tuesday, March 12
By Inez Torres Davis
Come with me to a poor, urban neighborhood in Dar es Salaam, Tanzania. It's 2011, and I'm with a delegation from Bread for the World. We are headed up a sharp stairway that stops and starts in unexpected places. We carry food along this uneven, broken way, this Via Dolorosa.
Soon, I surrender my bag of powdered milk because the stair heights range from three to 18 inches. This is our second-to-last day in Africa and after all of the walking of the past 10 days, my troubled foot requires the cane I brought with me, just in case. Still, the help of my fellow pilgrims is what is getting me up these stairs, this way of grief, in stifling heat.
We are taking this food to two families. The food is for their graciousness in allowing a bunch of well-meaning U.S. Christians to learn from them the way of the cross. We are only visiting one family because the other family has had a death. A four year old under-nourished little boy died last night in Dar es Salaam. He died because his little, weak body could not endure chicken pox. Chicken pox is a deadly disease along this way.
This house where death has visited is on our way to the second. As we reach this house a woman’s sharp and painful wailing dissects us and great grief wraps itself around our legs, our minds, and our hearts. We stop outside her door in an African heat that seems to increase exponentially with her suffering. We suffer with her. We pray. We furtively look into one another’s eyes as we leave the food that we brought for this family on this way of sorrow.
By the time we get to the second house we realize our catalog of questions for them has shattered. We have inhaled enough of the poverty to make our chests hurt. We have ingested enough of the sorrow and we have grown heavy with knowing. We have already learned enough. We are more than a little numb.
But I want to describe this space to you; at least, I will try. I am standing at one entrance of what is perhaps an 18x18 foot cement building. I stand at one end of a very narrow hall that opens on both sides, dividing the space further. Wide halls are not needed—there are no fat people living here, and those who can't walk don’t use wheelchairs. Multiple households live here. Sixteen people call this space, divided into five or six quarters, home.
There is a communal cooking ring in the narrow hall. Blankets hang across six doors. As we hand the food—which now looks, to us, like not nearly enough to address such a great need—to the mother of the second household, she thanks us profusely.
I need you to see this woman. I need you to see her children. We must all do more! Please, carry this story beyond the borders of this page! Please know that we must make sure that funding for USAID, Feed the Future, and the 1,000 Days Movement continues. But we must also be bold enough, and inspired enough, to see the gospel as it is preached along this way of suffering. For the hope of the resurrection, we must ask!
Inez Torres Davis is director for justice at Women of the Evangelical Lutheran Church in America.
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