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Academic Preparation 4B

A. Prereading

Look at the title, subtitle, and pictures. What do you think this reading will be
about?

What is malnutrition and why is it a problem in some countries?

What can we do to solve malnutrition?

Do you know about the organization called “Doctors without Borders”? If so, what
do you know about it?

B. Finding the Main Idea

As you read, try to answer these questions.

1. What is Plumpy’nut and how is it helping the people of Niger?

2. Why still are children still dying in Niger?

3. What does “Doctors Without Borders” want as a next step in solving


malnutrition?

A Life Saver Called "Plumpynut"


Anderson Cooper Reports on a Nutritional Breakthrough
(CBS) This segment was originally broadcast on Oct. 21,
2007. It was updated on June 20, 2008.

You've probably never heard a good news story about


malnutrition, but you’re about to. Every year, malnutrition
kills five million children - that's one child every six seconds.
But now, the Nobel Prize-winning relief group "Doctors
Without Borders" says it finally has something that can save
millions of these children.

It's cheap, easy to make, and even easier to use. What is this
miraculous cure? As CNN's Anderson Cooper reports, it's a
ready-to-eat, vitamin-enriched concoction called
"Plumpynut," an unusual name for a food that may just be
the most important advance ever to cure and prevent malnutrition.
"It's a revolution in nutritional affairs," says Dr. Milton Tectonidis, the chief
nutritionist for Doctors Without Borders.

"Now we have something. It is like an essential medicine. In three weeks, we can


cure a kid that is looked like they're half dead. We can cure them just like an
antibiotic. It’s just, boom! It's a spectacular response," Dr. Tectonidis says.
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"It's the equivalent of penicillin, you’re saying?" Cooper asks.

"For these kids, for sure," the doctor says.

No kids need it more than a group of children 60 Minutes saw in Niger, a


desperately poor country in West Africa, where child malnutrition is so widespread
that most mothers have watched at least one of their children die.

Why are so many kids dying? Because they can't get the milk, vitamins and
minerals their young bodies need. Mothers in these villages can't produce enough
milk themselves and can't afford to buy it. Even if they could, they can't store it --
there’s no electricity, so no refrigeration. Powdered milk is useless because most
villagers don't have clean water. Plumpynut was designed to overcome all these
obstacles.

Plumpynut is a remarkably simple concoction: it is basically made of peanut butter,


powdered milk, powdered sugar, and enriched with vitamins and minerals. It tastes
like a peanut butter paste. It is very sweet, and because of that kids cannot get
enough of it.

The formula was developed by a nutritionist. It doesn't need refrigeration, water, or


cooking; mothers simply squeeze out the paste. Many children can even feed
themselves. Each serving is the equivalent of a glass of milk and a multivitamin.
To see the impact it's having, 60 Minutes drove for 12 hours from Niger's capital to
a remote village, where every week Doctors Without Borders hand out Plumpynut.
After sleeping in a field under mosquito nets, Cooper and the team awoke at sunrise
to find mothers emerging from the fields. Many had walked for hours in the dark,
along treacherous paths, avoiding scorpions, spiders and poisonous snakes.

Rivers of women flowed into the site and within minutes there were
more than a thousand of them, all waiting to get packets or tubs of
Plumpynut. In a land where plastic bags are a luxury, they carry the
food home in their scarves, their hands, or simply stacked on top of
their heads.

"When you see some of these kids they don’t look sick. They don’t look
malnourished. They don’t have bloated bellies or little stick arms," Cooper remarks.

"The ones that we're used to seeing on TV, that’s the worst of the worst of the
worst. It's the tip of the iceberg. And then below that, there’s the iceberg. So,
there's a whole spectrum of malnutrition," Dr. Tectonidis says. "And when we go
and check these kids, well, they’re way off in height or in weight. They’re way off."
Niger has become Plumpynut's proving ground. A daily dose costs about $1; small
factories mix it here and in three other African countries. Tectonidis says other
companies could make similar products wherever children need them.

"There's many countries in Africa now saying, 'We want a factory. We want a
factory.' Well let's give it to them," he says. "We just have to focus on these areas.
We don’t have to feed the whole world. We have to go for the jugular. Where are
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they dying? Where are they wasted? That’s where we have to intervene. If you feed
them well until they're two or three years old it's won. They're healthy, they can get
a healthy life. If you miss that window, it's finished."

In Niger, most children need help now during what’s called the "hunger season,"
just before the new harvest. Old food supplies have run out and about all that’s left
is millet, a basic grain women pound for porridge. But millet doesn’t have enough
nutrients to keep kids alive; in America we use it as birdseed.

Normally a children's hospital 60 Minutes visited would have more patients than
beds. But now, thanks to Plumpynut, it has empty beds. Dr.
Susan Shepherd, a pediatrician from Butte, Mont., runs
Doctors Without Borders in Niger.

She says children that would have been hospitalized in the


past can now be treated at home. "The reason we can do that
is because we can give children Plumpynut here in the
ambulatory center, and they take a week’s ration home.
Moms treat their children at home and come back every week
for a weight check," Dr. Shepherd explains.

That's what Sahia Ibrahim has been doing. She’s already lost
four children to malnutrition. Now her six-month-old twins,
Hassana and Husseina, are malnourished and she’s worried
they might die too. So she’s been coming to the hospital for Plumpynut.

Hassana, at six months old, weighs only seven pounds. While that's what a newborn
should weigh, the little girl has put on a pound in just a week thanks to Plumpynut.

Children are weighed and measured at the distribution sites. They're also examined
to make sure they don't have any serious infections. Malnutrition destroys a child's
immune system, so they're more susceptible to diseases and less capable of
recovering from them.

"Often these kids aren't even hungry. It's the opposite. They are anorexic because
of the deficiencies they have. They lose their appetite," Tectonidis explains.

That's what happened to Mansour Miko and Maroufee Mazoo. Less than a year old,
they had stopped eating and became listless and weak -- so weak that when their
mothers brought them to get Plumpynut, the nurse put them in a van and sent
them straight to the hospital. Three days later however, they were smacking their
lips on Plumpynut, almost ready to go home.

"Have you seen kids who were on the brink of death brought back by Plumpynut?"
Cooper asks.

"Oh, yeah, for sure. Again and again and again and again," Dr.Shepherd says.

But not always. Sometimes parents wait too long before bringing their child to
doctors. 60 Minutes found Rashida Mahmadou in intensive care, barely clinging to
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life.

Rashida's condition was very serious. Her skin was literally peeling away -- one side
effect of malnutrition, as skin becomes thin, pliable, cracks easily, and bacteria
invade.

Just two hours later, Rashida's little heart stopped beating. She was just 19 months
old.

"She died of severe, acute malnutrition," says Shepherd, who says she sees this
happening every day.

Asked how she deals with so many kids dying, Shepherd tells Cooper, "It breaks
your heart. It can break your spirit. It can ruin your confidence in your ability to be a
good doctor. And it is sad. And I carry memories of many, many children with me
and I'll carry them with me for my entire life. But you certainly cannot indulge
yourself in that kind of sadness. We need to do something about this."
If Plumpynut is the answer, how come kids are still dying?

"The answer is getting to kids earlier," Shepherd says. "Once children are as sick as
she is, Plumpynut is not gonna save her."

Rashida was buried in a nearby cemetery, where the grave


digger told 60 Minutes he is burying fewer children than he
used to.

Two years ago this region had the highest malnutrition rate in
Niger. But now, after widespread use of the Plumpynut, it has
the lowest. Dr. Shepherd told Cooper they’ll be able to treat
more than 120,000 kids this year, up from just 10,000 children
three years ago.

What about peanut allergies?

"We just don't see it," Shepherd says. "In developing countries
food allergy is not nearly the problem that it is in industrialized
countries.

It's hard to imagine a less industrialized country than Niger. On


a list of 177 developing countries, the United Nations ranked
Niger dead last -- least developed. More than 70 percent of the people don’t know
how to read. Most work in the fields and earn less than a dollar a day. Nomadic goat
herders still roam this land -- their children and their kids travel by camel. Goats
seem to be the main garbage disposal, but clearly the goats are falling behind. You
can still spot a skinny guard dog, but we were told all the cats have been cooked.

In the countryside, where 85 percent of people live, girls start marrying as young as
11 years old. By the age of 15 most are wed, and by 16 most have already become
mothers. The average woman here will give birth at least eight times in her lifetime.
But largely because of malnutrition, one in five of their children will die before they
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reach the age of five. Of those who survive, half will have stunted growth and never
reach full adult height.

But now, with Plumpynut, more children are surviving and thriving.

"And kids are doing better. Moms say their child's skin is brighter. Their appetites
are better. And they’re less sick. You know, what more could you ask for," Shepherd
remarks.

Doctors Without Borders is asking for more of this type of food. Their success in
Niger proves, they say, that fortified ready-to-eat products, like Plumpynut, save
children's lives. Dr. Tectonidis says if the United States and the European Union
were willing to spend part of their food aid on this, more companies will start
making it.

"Even by taking a miniscule proportion of the global food aid budget, they will have
a huge impact, huge impact!" Tectonidis says. "We're not even asking for billions. It
will solve so much of the underlying useless death. So we gotta do that now."

"It's useless death," Cooper remarks.

"Wasted life. Just totally wasted life for nothing. Because they don't have this
product, little a bit of peanut butter with vitamins," Tectonidis says. "What a waste."

C. Vocabulary

Directions: Find each of the bold words in the reading. Read the sentence it is in,
and guess the meaning. Then use a dictionary to find the definition and the part of
speech (noun, adjective, verb, adverb). Write your guesses and the definitions
below.

1. concoction

Guess:

Definition:

Part of Speech:

2. revolution

Guess:

Definition:

Part of Speech:

3. widespread

Guess:
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Definition:

Part of Speech:

4. overcome

Guess:

Definition:

Part of Speech:

5. remote

Guess:

Definition:

Part of Speech:

6. emerging

Guess:

Definition:

Part of Speech:

7. intervene

Guess:

Definition:

Part of Speech:

8. deficiencies

Guess:

Definition:

Part of Speech:

9. cling

Guess:

Definition:

Part of Speech:
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10. pliable

Guess:

Definition:

Part of Speech:

11. thriving

Guess:

Definition:

Part of Speech:

12. underlying

Guess:

Definition:

Part of Speech:

D. Comprehension Questions

1. Explain why the country of Niger needs Plumpynut so desperately.

2. Why does Dr. Tectonidis compare the problem of malnutrition in Niger to an


iceberg?

3. Why does Dr. Tectonidis say, “We just have to focus on these areas. We don’t
have to feed the whole world. We have to go for the jugular. Where are they dying?
Where are they wasted”? Why does he mean by “jugular”?

4. What is “millet” and why can’t it be fed to children?

5. Explain how malnutrition kills a child.

6. What does “the brink of death” mean when Cooper asks, “"Have you seen kids
who were on the brink of death brought back by Plumpynut?"

7. Why aren’t children in Niger showing allergies to Plumpynut?

8. Do you think Plumpy’nut is a good solution to malnutrition? Why or why not?

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