Both because of poverty and neglect, child hunger is widespread among school children in the slums of Nairobi. A black tea and a sometimes a mandazi (an unsweetened African doughnut) is a common breakfast with nothing for lunch. It is no surprise that children frequently complain of stomach pain and nausea.
The Feeding and Nutrition programme provides children with breakfast, lunch and a piece of fruit each school day. Breakfast is a local porridge known as Uji, and lunch is stew on rice with meat stew one day a week and vegetable stew the rest of the week. The fruit is seasonal so from March to April, it is usually bananas and in June, it is avocados.
The first goal of the Feeding and Nutrition programme is to eliminate child hunger enabling children to focus on their lessons and get a good education. A hungry child simply cannot focus and learn in class.
The second goal of the Feeding and Nutrition programme is to deliver the nutritional needs of the children at Porridge and Rice schools. Three micronutrient deficiencies are widespread in the Nairobi slums namely vitamin A, Iodine, and Iron, each having severe consequences.
An estimated 250 000 to 500 000 vitamin A deficient children become blind every year, half of them dying within 12 months of losing their sight.
Vitamin A deficiency is the leading cause of preventable blindness in children and increases the risk of disease and death from severe infections.
Vitamin A deficiency is a public health problem in Africa, hitting young children and pregnant women hardest.
Supplying adequate vitamin A can significantly reduce mortality. Conversely, its absence causes a high risk of disease and death.
For children, lack of vitamin A causes severe visual impairment and blindness, and significantly increases the risk of severe illness, and even death, from such common childhood infections as diarrhoea and measles.
The elimination of vitamin A deficiency is a WHO priority.
The impact of supplements on childhood mortality is as great or greater than that of any one vaccine – and it costs only a few pence a dose with dramatic effects like reducing blindness and premature death.
As breast milk is a natural source of vitamin A, promoting breastfeeding is the best way to protect babies.
The effect of vitamin A supplementation capsules lasts only 4-6 months, and fortified foods are expensive. The Porridge and Rice approach is to provide a vitamin A rich diet with foods like sweet potato, especially rich in the nutrient.
Iodine deficiency is one of the main cause of impaired cognitive development (permanent brain damage) in children living in poverty.
Some of the consequences of iodine deficiency are stillbirths, spontaneous abortions, and congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation.
Probably the worst consequence of iodine deficiency is the less visible, yet pervasive, mental damage that reduces intellectual capacity permanently limiting individual and national potential.
Iodine deficiency is a public health problem. According to UNICEF, there are still 54 countries where iodine deficiency is still a serious problem.
Iodized salt is the simple and effective solution. It is widely available and cheap. All Porridge and Rice meals use iodised salt ensuring that no pupil at a Porridge and Rice school will suffer from Iodine deficiency.
Iron deficiency is the most common and widespread nutritional disorder in the world.
As well as affecting a large number of children and women in developing countries, it is the only nutrient deficiency which is also significantly prevalent in industralized countries. The numbers are staggering: 2 billion people – over 30% of the world’s population – are anaemic, many due to iron deficiency.
In developing countries, iron deficiency is aggravated by worm infections, malaria and other
infectious diseases such as Malaria, HIV/AIDS, hookworm infestation, schistosomiasis, and other infections such as tuberculosis.
The number of people affected by iron deficiency is of epidemic proportions. The inviduous nature of this deficiency is that its greatest impact is not easy to observe or measure, and is frequently obscured by other more visible concerns. It is a significant cause of ill-health, premature death and lost earnings.
Invisible yet ubiquitous in many developing countries, the true toll of iron deficiency and anaemia lies hidden in the statistics of overall death rates, maternal haemorrhage, reduced school performance and lowered productivity. Iron deficiency anaemia affects millions. The health consequences are stealthy but devastating, invisibly eroding the development potential of individuals, societies and national economies.
Iron deficiency and anaemia reduce the work capacity of individuals and entire populations, bringing serious economic consequences and obstacles to national development. Overall, it is the most vulnerable, the poorest and the least educated who are disproportionately affected by iron deficiency.
In developing countries every second pregnant woman and about 40% of preschool children are estimated to be iron deficient.
The major impact for the pupils in the Nairobi slums is permanently impaired physical and cognitive development, increased risk of morbidity and reduced work productivity in later life as adults.
The Porridge and Rice menu is designed to meet the iron needs of the children it feeds. It includes large quantities of Roscoco beans and Kale 4 times a week as both are high in iron.
The WHO estimate that eliminating iron deficiency for developing countries can raise national productivity levels by as much as 20%.