World Vision International

Interview with the Former Nutrition Director

Taking a Bite Out of Malnutrition

Nutrition expert Carolyn MacDonald talks to World Vision Canada's Childview magazine about one of the biggest threats to child well-being

By Kathryn Dorrell, Photography by Andrew Goodwin

NAME: Carolyn MacDonald 
TITLE: Former Nutrition Director and Team Lead for Nutrition Centre of Expertise, Global Health and WASH, World Vision International and World Vision Canada
LOCATION: based in Mississauga, Ontario

What is the Nutrition Centre of Expertise?

It’s a small group of professionals who are dedicated to deepening the quality of our nutrition programs, policies and strategies. We advocate for known, effective interventions that prevent and treat malnutrition and its underlying causes.

Why are so many children malnourished?

The number of deaths and disabilities from malnutrition is greater than any other single cause, including pneumonia, malaria or HIV and AIDS. But malnutrition is an invisible and silent issue. It’s easy to think of malnutrition as people not having enough food, but it’s a far more complex issue. For example, in India, girls may be anemic for years, but their pale skin is considered beautiful, or is not identified as a health issue.

In some communities, children are stunted because of malnutrition, but people think they are just small for their age. Malnutrition often isn’t identified at all, or it isn’t accepted as a problem until children are already starving.

Why is malnutrition so difficult to cure?

There are so many contributing factors—from poverty and cultural behaviours to access to food and agricultural and health practices. Some cultural practices are harmful and really difficult to change.

In Indonesia, for example, when newborn babies cry, mothers often give them sugar water from palm trees, not knowing this leads to malnutrition because it replaces breast milk. In other countries midwives give babies water to sip that they have washed their hands in before the delivery. They want to flush out the babies’ intestines, but it can introduce bacteria and infection.

Tell us about a World Vision nutrition program that is making a difference.

The Positive Deviance Hearth Model is making huge changes in the lives of mothers and children. We are using this program in many countries, such as Peru, Bangladesh and Mali. It involves what we call a “positive deviance inquiry,” where we look for children who are well nourished in a village where most children are malnourished. Along with the community, we talk to the mothers of healthy children to learn about their food practices. Then we have “hearth sessions” where the mothers gather every day for two weeks and learn from one another how to care and feed their children.

After just two or three weeks, children who were listless, or not walking yet because they were malnourished, gain energy and start walking around. Mothers are overwhelmed when they see the difference. It’s so encouraging; it’s like a miracle.

How does child sponsorship address maternal and child nutrition?

Sponsorship dollars go directly to programs that help children survive their crucial first five years. Our programs are targeted at pregnant women and children younger than two years old. For instance, we want to prevent iron deficiencies in children before the age of two because this protects a child’s ability to learn later on in life and helps them become productive adults. When we focus on preventing malnutrition, we are better able to achieve our educational goals. We stop the ripple effect of malnutrition.

How do you see your faith connecting to your work?

Helping people have access to good-quality food is part of God’s work and vision. God did not intend for anyone to go hungry. Also, a lot of malnutrition occurs in a child’s first two years of life and those children do not have a voice at all. Our work is giving them a voice.

Original Interview - Childview