The “Strong Food” recipe has been passed to other areas of Afghanistan and more children will not die of malnutrition because of this unique product.

In the country with one of the highest infant mortality rates in the world, U.S. military and civilians are teaming with local governments to combat malnutrition and save the lives of children.

On March 28, members of Panjshir Provincial Reconstruction Team delivered a shipment of ingredients to make a concoction dubbed, “Strong Food” to Charmaghzak Basic Health Clinic in the Dara District of Panjshir, Afghanistan.

According to U.S. Air Force Capt. Michael Calnicean, a physician’s assistant with the Panjshir PRT, the delivery of almonds, sugar, sunflower oil, soy flour and multi-vitamin enriched milk will be mixed together to form a low cost nutritious food with a long shelf-life.

Figures from UNICEF place the average lifespan for an Afghan at 44.5 years old. Information from the UNICEF web site says that one in four Afghan children doesn’t live past the age of 5 and more than half the children in the country are malnourished.

Calnicean points to Strong Food as a way to help solve the medical crisis affecting Afghanistan. Strong Food is a medicinal product that is appealing to children.

According to Calnicean, “It’s kind of like cookie dough.” The amount needed is based upon the height and weight of the individual, added Calnicean.

The mixture was originally formulated by a PRT in another province. The malnutrition issue is wide spread across the country.

Currently Strong Food is only distributed at two clinics in the Panjshir province. Dr. Samad Karim, Line Director of Public Health for Panjshir province, is looking to expand distribution of the product.

“Dr. Karim is looking at ways of getting Strong Food out to all the clinics in the district, including two mobile clinics,” said Calnicean.

One way to increase distribution according to Elizabeth Smithwick, United States Agency for International Development Field Program Officer for Panjshir PRT is to train women to administer the Strong Food through a program in the works called Strong Women.

Smithwick said the Strong Women program will help distribution in many ways.

“One is that it employs women,” said Smithwick. “It will employ three women per clinic to mix it, distribute, administer, keep the records and everything else,” Smithwick said. “Hopefully, by doing this, it expands it throughout the province, all seven districts.”

Another advantage is that it will free up clinic personnel to handle the normal case load of an all-purpose clinic in Afghanistan.

“It will help reduce the strain on the clinic. On the days that they do Strong Food, it’s insane,” said Smithwick. “They have difficulty addressing all the Strong Food needs as well as all the people who are regularly coming to the clinic.”

U.S. Soldiers, Airmen, and civilians from Panjshir PRT drove to the clinic on narrow, winding roads hauling the life-saving ingredients. Once at the clinic, they carried the 110-pound bags of almond and sugar up 10 flights of steps to a storage room.

Dr. Amed Abdullah was there to greet them and help offload the supplies. At the Charmaghzak Clinic, Abdullah sometimes sees upward of 400 patients a month.

Abdullah said through a translator that the biggest problems he deals with are stomach related illnesses, pneumonia and skin diseases. When asked how many of these cases were related to nutrition, he said, “All of it is affected in some way by nutrition.”

Grateful to get the supplies, Abdullah said, “It will help out so much.”

U.S. Air Force Tech. Sgt. Carolyn Mcilvaine, of Westfield Mass., who is currently deployed as a medical technician for the PRT says it is rewarding to see progress.

“It’s good to see the improvement as things go on,” said Mcilvaine. “They keep a record of height and weight measurements. You can look back over a period of time and see the kids getting healthier and stronger.”

DVIDS
Story by Staff Sgt. Donald Reeves

This is an amazing story and ought to have been covered in detail by the main stream media.

When it came to facing the issue of malnutrition, a local Afghani public heath administrator provided the team with a starting point. Dr. Zamarai Sultan, the Qalat public health administrator, shared some information with Doctor Arnold about a product he knew of that had been used in other countries like Africa.

Based on this starting point, Doctor Arnold and Captain Harrelson found a recipe online, in July, they thought could be successfully reproduced, and more importantly, they believed could be tweaked for the local production. The “Ready to Use Therapeutic Food” recipe they settled on called for only five ingredients – sugar, oil, powered milk, almonds and liquid vitamins, all which are available for purchase in village markets.

“We are using this particular recipe because there is no cooking required,” Capt. Harrelson explained. “The types of ingredients we are using are not water based, so this can stand on a shelf without refrigeration for four months. This really works perfectly. It won’t go bad. It won’t cause disease, and it won’t cause sickness.”

Doctor Arnold said he believes this, compared to other projects PRTs have done in the past, is one can have a profound effect. “We can teach them to make this; the materials are here in the country, and they can sustain this. They just need to know how to do it and know that it exists,” he said.

A single batch of the sweet-tasting RUTF can feed a child who is severely malnourished for 20 days for less than five U.S. dollars. A child receives a 600 calorie serving of the supplement to eat throughout the course of a day. This routine will bring a child back to healthy state so a normal diet can be started.

The peanut butter like consistency of the supplement, designed specifically for those 6 months to 5 years old, has more benefits than just being easy to make.

“The children don’t have to actually chew it, they can suck on it. They don’t have to have a lot of strength or teeth,” Captain Harrelson said.

Here are some photos to illustrate the subject.