Constantia and Gustavo
In the Mozambican village of Cobue, Constantia and her family farm a small plot of maize and cassava. They are subsistence farmers who eat what they grow themselves. Most rural Mozambican farmers have neither fertilizer nor formal training in agricultural techniques or management. A hoe and machete are the tools of their trade.
Mozambique is a southern African country of 23 million people, most of whom (81 percent) live below the international poverty threshold of $1.25 per day.1
Constantia’s experience with her firstborn child, Gustavo, is all too common here and in other villages around the world where a large share of people are hungry and poor. Gustavo developed normally until he was a year old, but then he contracted malaria. Constantia stopped breastfeeding him out of fear that her milk was contributing to his illness. But this weakened Gustavo’s immune system and he developed other infections that stole his appetite.
As advised by her family and neighbors, Constantia fed him a thin porridge of maize flour and salt. The porridge kept Gustavo from becoming dehydrated, but it also worsened his malnutrition by filling his stomach without giving him the nutrients he needed. He had no appetite and began to refuse all food.
Gustavo then gained some weight back—but this was bad news because it meant his body was retaining water. At 18 months, Gustavo weighed only 17 pounds— including the water weight. His condition, known as edema, put him in mortal danger.
In addition to medical care, Gustavo needed food aid. Constantia brought him to a clinic, where she learned how to feed him a fortified milk formula with a syringe and then did so, every two to three hours around the clock. The formula was specially designed to maximize the toddler’s absorption of energy, protein, and micronutrients.
Gustavo’s appetite slowly returned and finally he could be coaxed into eating solid foods. He was given Plumpy’nut, a high-protein therapeutic food served as a paste. Though he rejected the other protein-rich foods he was offered, Gustavo found Plumpy’nut tasty and he ate it voluntarily.
Now, a year later, Gustavo is able to eat the same food as the rest of his family. Although his attending physician had suspected he would die, the little boy runs and plays with other children in the village. But the whole family still lives on the edge of hunger.
Issues
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