FAQ

Frequently Asked Questions

Why is the project called Project Peanut Butter? In 2002, when it was realized that RUTFs were life-changing, Dr. Manary and his family returned to America from Africa determined to raise money to continue a program. There was no specific name for the project at first, except “the RUTF research program”. A woman at the Manary’s church and Dr. Manary’s great-aunt began to refer to the program as the “Peanut Butter Project”, describing the basic ingredient in the food. This evolved into Project Peanut Butter, and the organization took the name officially in 2004, when it was legally incorporated as a not-for-profit entity. Why do some starving children seem bloated? Many children who are starving appear “bloated” due to a fluid shift in their body. (A healthy person’s bodily fluid does not shift in this way). The medical term for this is “edema”. Protein in the body is a vital element that keeps the fluid in the right place. Children with malnutrition often have “protein-energy malnutrition”, a condition of low protein in the blood that allows the fluid in the body to go into the skin tissue and cause bloating. Edema is a sign of serious malnutrition. If their children are starving, why don’t these families practice birth control? Family size in the countries with high rates of malnutrition is high. At one point in all societies the number of children in a family was equated with wealth or even their relationship with God. Although this is not as much a factor in these countries today, parents still rely on a large family to help with the work and to keep the family from starvation. With high infant and under five mortality rates, parents are less likely to limit the number of children they have. Research shows that birth rates in societies drop AFTER childhood survival rates improve. By improving the child survival rate, we will increase the likelihood that parents will have smaller families. The size of families in Malawi has decreased due to the teaching of child spacing for healthier children. Why is the period from 6 months to 5 years of age so important to childhood health? At about the sixth month, breast milk no longer adequately provides all the needed nutrition for a child. The mother therefore adds other food to the diet. At the same time, the child has a very small stomach and cannot eat large quantities of what is likely already energy deficient food. It is often at this time in a child’s life when they are most vulnerable:
The decrease in breast milk brings with it a decrease in the child receiving antibodies from the mother. Therefore the child is more susceptible to infection.
The child’s newfound mobility, due to crawling and later walking, provides opportunities to explore. This exploration brings contact with various disease-causing microbes.
Decreased or complete discontinuation of breast feeding means the child no longer remains physically tethered to the mother, and is placed in the care of an older sibling. This situation increases exposure to other children and communicable diseases.
In times of decreased food in the home, the child does not have the ability to compete with older and equally hungry family members for what food is available.
The young child’s need for supervision precludes the child from taking part in “village foraging” like that of older children. (The typical school-age children often find food at other homes, or in the area around the village, picking berries or raiding gardens.) By age five, a child has the dexterity, independence and shrewdness to seek out food, and its immune system has had exposure to disease and has time to mature. At this point, the child is out from under the worst consequences of severe malnutrition. Why is the effort concentrated on the youngest children? Older kids are starving too. It is true that older children and adults do suffer malnutrition, but the largest population to suffer is that of the young child. This most vulnerable group was the target of the research and the heart of PPB’s program from the start. RUTFs are being used with older children and with HIV+ adults, and we are in the process of developing specific formulations of PPB’s RUTF that address the nutritional needs of other groups. At this point, the main focus of our work is on the most vulnerable children. Won’t these children simply get well only to remain in a life of poverty? It is true that once recovered from severe malnutrition, many children do continue to live in extreme poverty, but only rarely do they again succumb to malnutrition. PPB research shows that less than five percent will relapse. Why? Once restored to health with RUTFs, a child has built up some “reserve”. Even when faced again with a hungry period or an infection, the child who has recovered earlier with the use of RUTFs has enough strength and nutrition to fight through additional difficult times. Even HIV+ children, once graduated from the PPB program, and placed on retrovirals, grow and can remain in relative good health. Why isn’t Chiponde used everywhere? RUTFs are relatively new. The discussions of the RUTF concept between many collaborators began in 2000. The preliminary research occurred in 2001-2002. In 2007, the United Nations System Standing Committee on Nutrition, the World Health Organization and UNICEF endorsed community-based RUTF feeding protocols as the most effective treatment for severely malnourished children. The World Food Program endorsement followed. Since then, RUTF feeding programs have spread to many parts of the world. There is much work to be done and literally millions of children waiting for our care. Why don’t we hear about malnutrition in the news? Malnutrition is a silent killer, a silent epidemic. It affects the poorest people. Even though malnutrition is a major cause of death among children world-wide, it is a chronic condition of the poor and therefore does not attract much attention from those of us safe from its grasp. Why Malawi? Frankly, you have to start somewhere! The Manarys chose Malawi for the first field trials because it was a country where they had previously lived and worked. Dr. Manary had familiarity with the medical system of the country and was an adjunct professor at the Malawi College of Medicine. It was a natural progression to spread PPB’s work on the same continent. It is PPB’s hope that other not-for-profit groups and governments will attack malnutrition using RUTF in the many other countries where it could help.