Malnutrition: an endless battle in Madagascar

by Hervet Randriamady (ELP 2015), Marine Operations Coordinator at WCS, Madagascar Malnutrition has always been a major public health concern in Madagascar. This month (May 2016), the United Nations Secretary-General Ban Ki-moon highlighted it during his speech to the members of the Malagasy parliament. He commented on how, alarmingly, malnutrition costs the country more than a billion and a half dollars each year – while also saying that “the human toll is immeasurable”. According to the World Food Program, Madagascar is ranked fourth worldwide for having the highest rate of chronic malnutrition, which impacts roughly 50% of all children under five. The first time I was aware of the magnitude of malnutrition was in the 1990s when a famine occurred in the far South of Madagascar. The government back then, led by the President Zafy Albert, organized a grand telethon “SOS Sud” to rescue those people starving to death. I vividly remember the hoard of trucks, full of food from Antananarivo, passing by our house in Antsirabe before making their way on the 1,000 km journey to the deep South. The population of Antsirabe enthusiastically welcomed the heroic delegation. The word kere, which means famine, reverberated repeatedly throughout the speech the president made at Independence Square in Antsirabe. The battle against malnutrition seemed to be on, and seemed to be winnable. Unfortunately, to date, Madagascar has not escaped the grip of malnutrition. First, mother nature has made the matter worse, with the deep South experiencing frequent droughts for many decades. Rainfall is seen as a blessing; hunger as the penalty for when it stops. Just a couple months ago, some people from that same area died from severe malnutrition. Members of the government including the current President Hery Rajaonarimampianina rushed to the South to assist the victims. And although the most severe cases of malnutrition are found in the deep South, it exists ubiquitously across the country. Malnutrition is crippling for the development of the region and the country as a whole. With my new position as an Assistant Research Manager on a new research program directed by the Planetary Health Alliance (PHA) at Harvard University, my colleagues and I hope to shed light on how malnutrition is a primary root cause of poor health in Madagascar. More broadly, the research program will focus on understanding how nutrition impacts the incidence of infectious and non-communicable diseases, and how climate change could affect these two relationships. Put another way, a lack of adequate nutrition and a changing climate could make communities more vulnerable to some diseases. We want to better understand how this happens and highlight the need for a broader approach to our thinking of malnutrition, disease, and climate. I will be working with Christopher Golden, the Associate Director of PHA and Research Scientist at the Harvard T.H. Chan School of Public Health for the second time and with Benjamin Rice from the Department of Organismic and Evolutionary Biology from Harvard University, who is the Health Programs Director of PHA in Madagascar. The research project is in collaboration with Catholic Relief Services (CRS) and Princeton University. The research is innovative as multiple academic areas are involved to address malnutrition such as economics, medicine, evolutionary biology and environment. By encompassing these fields of study, it is the quintessential sustainable development concept that I learned from the Beahrs Environmental Leadership Program (ELP) at UC Berkeley in 2015. What I have learned from ELP will be critical for the success of the research. ELP has equipped me with the right training. Having been trained as an agricultural economist to address malnutrition, my knowledge was theoretically restricted to a narrow-view of the venerated economic law of supply and demand. With this new research I will get more understanding of malnutrition in Madagascar. In short, I hope that malnutrition will be a myth for the next generation of Malagasy people and I look forward to working on this project as it aims to move us closer to that goal.