Tuesday, February 3, 2015

Malnutrition and ICDDR,B

Icddr,b is the International Centre for Diarrheal Diseases Research, Bangladesh.  It is a research hospital funded by Canadian Development funding as well as funding other countries, including Australia, the UK and Sweden.  The hospital has a clinical component where they treat people with diarrhea using a low cost, low tech approach, which has proven to be extremely effective.  They also treat children with malnutrition using a similar approach.  The hospital also does a lot of research about diarrhea, it's treatment and more. Check out their website for more details. http://www.icddrb.org/

Mari, Debbie and I visited icddr,b last week to learn more about how they treat malnutrition since the rate of moderate to severe malnutrition on the children's cancer ward is around 40%.  We talked with several physicians and the head nutritionist.  The mainstay of treatment is giving high energy foods to the children, but to keep costs down, they make these themselves in the hospital kitchen.

Specifically they prepare a milk powder-based formula which is nutritionally complete and can be used when children arrive at the hospital with severe malnutrition. We tasted the formula, and I can honestly say that it's quite tasty!  Basically it tastes like sugary milk, yum! They shared the recipe for this milk with us and we've started to provide it for kids on the cancer ward who are severely malnourished.

The cost per litre is around 30 taka (50 cents Canadian), so it's very affordable, much more so than the commercial formulas which are typically used.

Secondly, icddr,b teaches the mothers to prepare a healthy dish called Khichuri which can be prepared at home and has appropriate amounts of fat, protein and carbohydrates to ensure that the child gets all the nutrients that he or she needs.

Khichuri is a common food in Bangladesh, so it's something that all the mothers are familiar with already.  It's basically rice, lentils, oil and some veggies all cooked together.
Yummy khichuri.
The key is that at icddr,b they've improved the recipe so that it contains more oil and more lentils, making it much healthier.  Again the cost per kilogram is around 50 cents Canadian, so very affordable.  The mothers are encouraged to make this and feed it to all of their children, not just the one who was malnourished, to prevent the other kids in the family from becoming malnourished.

We also tasted the khichuri from icddr,b's kitchen and I really liked it.  Mari has been busy preparing this at our house and then teaching some of the mothers on the cancer ward how to prepare it.

There are lots of barriers for us on the cancer ward, as the is no way to get the hospital kitchen at BSMMU to make something new.  And it wouldn't be clean enough even if they did make it!  So we're stuck trying to figure out how to make it on the ward.  Right now we're teaching each mother individually to make the khichuri or milk formula in her rice cooker.  All of the mothers have a rice cooker at the bedside which they use to prepare food for their child.  The food that the hospital provides is not very good and is perceived as not clean enough to feed to a child with cancer.

The kitchens at ICDDR,B.

More of the kitchens.

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