Beyond maize, rice and other staples: Eating one food every day won’t make you healthy

Nutrition

Notes to broadcasters

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Beyond maize, rice and other staples: Eating one food every day won’t make you healthy is a drama about nutrition and the six food groups. At the end of the drama, there is a dramatized interview with a nutrition scientist. The scientist explains the basic facts of human nutrition and talks about dangerous symptoms of undernutrition.

The drama and the dramatized interview are based on actual interviews. You might choose to present this drama as part of your regular farming program, using voice actors to represent the speakers. If so, please make sure to tell your audience at the beginning of the program that the voices are those of actors, not the original people involved in the interviews.

Or you could use this drama as research material or inspiration to create a program on nutrition in your own area. You could interview a nutritionist from your area to talk about the situation in your country.

If you talk to nutrition experts, here are some issues and questions to explore:

Which nutritional deficiencies are dangerous to children and to adults?

Which local foods can prevent these deficiencies?

How does undernutrition during the first 1000 days affect children’s health, intelligence, and behaviour?

Do children in well-off families suffer from undernutrition? What kinds of undernutrition are common in well-off families? Which kinds are common in poorer families?

Estimated time for the drama, including intro and outro music and interview, is 40 minutes.

Note: In Malawi, there are six food groups. In other countries, there may be a different number of food groups, or the food groups may be defined a little differently. But the principle that a healthy diet must include a variety of foods from each of the food groups holds across all countries.

 

Script

CHARACTERS

CHIMWENDO
A farmer and community leader who is knowledgeable about nutrition.

SOKO
Neighbour of Chimwendo. Harvests plenty but is hit by hunger every year and children are undernourished.

IRENE (MRS. SOKO)
Wants higher-status life than she and Soko can afford

DOCTOR
The clinic doctor

MOTHER OF JANE
A rich woman in the village whose family owns a maize mill, cattle, a grocery shop, and motorcycle.

PRESENTER:
Before we start today’s drama, we should remind listeners that, in Malawi, there are six food groups. They include: first, vegetables; second, fruits; third, legumes, meaning the bean and lentil family that includes beans, groundnuts, and gram crops; fourth, grains and other staples such as cassava, maize, yam, and plantains or cooked bananas; fifth, oils and fats such as cooking oils and avocado; and lastly, foods of animal origin, including insects and rodents.

Listener, which food group do you have difficulty finding? Or perhaps it is difficult to eat one type of food in your home because of taboos or other beliefs attached to that kind of food. As you think about this question, enjoy the drama.

SIGNATURE TUNE

SCENE ONE:
AT HOME

FX:
SOUND OF MAIZE BEING FRIED ON THE FIRE

SOKO:
(CALLING) Mother of James … Irene, my wife.

IRENE:
(OFF-MIC) Here! (ON-MIC) Yes, my husband, Soko. Did you call me?

(PAUSE) Hey! Do you want to roast that whole kilogram of maize?

SOKO:
Yes. It’s not much, only two pans of maize—and one pan of groundnuts.

IRENE:
You are eating far more than your body needs. Don’t you feel satisfied after you eat?

SOKO:
(PROTESTING) Yes … This is simply a dessert.

IRENE:
You have just finished eating nsima and now you are roasting one kilogram of maize and a half kilogram of groundnuts. Why are you eating like a weevil?

SOKO:
It’s only a dessert. People who live in towns and stay in hotels eat something sweet after a heavy meal, like cakes, ice cream, or fruit. Why not me?

IRENE:
Stop trying to irritate me with your talk about towns and hotels. Do you keep lying to me that people in hotels squander food because I have never been to a city?

SOKO:
Irene, my wife, do you remember what our lead person Mr. Chimwendo says we should eat?

IRENE:
Yes, he says we should eat a variety of foods, all six groups. But I don’t think he means your kind of eating. Look, my husband, if you roast one kilogram of maize every day on top of nsima {Editor’s note: nsima is porridge made with maize flour], how many bags is that in a month?

SOKO:
(DEFENSIVE) I use very little maize, not even a bag. That’s only 30 kilograms a month.

IRENE:
Anyway, I thought roast maize was in the same food group as nsima. We usually harvest 30 bags. But how many bags have we harvested this year?

SOKO:
Sixteen bags, and we have six bags surplus.

IRENE:
Don’t forget James! If everybody in the family eats, we have only three bags surplus.

SOKO:
But James is a baby. He’s just been weaned from breastfeeding. Can he eat even a single bag of maize in a year?

IRENE:
James needs three bags this year … they told us that at antenatal class.

SOKO:
No, that’s not possible. You are just trying to scare me with those numbers. I will not stop eating my dessert of groundnuts and roast maize. It’s just the same as eating fruit after a meal.

IRENE:
Yes, we’re supposed to eat fruit after a meal, but are roast maize and groundnuts fruit? Stop roasting all this maize! The pan you are frying is enough. (SHE SNATCHES AWAY THE REMAINING MAIZE)

SOKO:
(ANGRY) Irene! Mama of James! Where are you taking my maize? Give it back now!

IRENE:
Shame on you! I will take it back to the storeroom.

SOKO:
No, Irene. You are starting a fight.

SFX:
STOP SOUND OF ROASTING.

IRENE:
Leave me alone! You will not roast this other half kilogram. The half you roasted is enough!

SOKO:
I spent my energy and money on this maize. Bring it here!

FX:
CHILD CRIES FROM FEAR

IRENE:
Are you going to hit me?

SOKO:
(THREATENING) Do you want me to make you cry?

SFX:
CHILD CRIES LOUDER

SOKO:
No, I will not hit you. I am not a weak man that hits a wife. Give me the maize!

IRENE:
I won’t!

CHIMWENDO:
(COMING ON-MIC) Eeee … Soko! Soko, leave your wife alone! What is wrong?

IRENE:
Welcome, Mr. Chimwendo.

SOKO:
My wife is stopping me from eating a dessert to complete the six food groups!

CHIMWENDO:
Six food groups? Did you eat all the other food groups? Hmmm … I see you ate beans at lunch. That means you ate the groundnuts group already, and you have already eaten nsima in the staples group, so you don’t need to eat roast maize.

IRENE:
I told him that. But he insists that he is going to roast more maize because I didn’t cook pumpkins for a dessert.

CHIMWENDO:
No, Soko. Pumpkins, potatoes, cassava, and nsima are all in the staples food group. If you eat one staple during the main meal, that is enough.

SOKO:
When did pumpkins and nsima become one group? Pumpkins are fruits.

CHIMWENDO:
Yes … it’s better to eat fruit as a dessert.

IRENE:
Don’t pumpkins have starch? They’re a staple.

CHIMWENDO:
Look … although pumpkins are fruits, when they are cooked, they are in the staples group with cassava, nsima, sweet potatoes, and yams. You can eat one or two foods in the same group … but …

SOKO:
(INTERRUPTING) You say people can eat two staples in one meal?

CHIMWENDO:
Yes, you can eat two staples in one meal but ….

SOKO:
(INTERRUPTING) You hear that, Irene? You can eat two staples.

CHIMWENDO:
Soko, you can eat a variety of staple foods only if they complement one another in one dish. But not the way you eat─one big dish after another for the whole day.

SOKO:
So not a full dish of potatoes, then of pumpkins, then a full dish of nsima—not like that?

CHIMWENDO:
No, that is a recipe for inviting hunger into your home. If you want to mix foods from the same food group together in one dish, you have to reduce the quantities of each food in the mixture.

IRENE:
You hear? In the afternoon, you could eat animal foods and vegetables. You don’t eat roast maize as a dessert after eating a full plate of nsima!

CHIMWENDO:
And don’t forget that you also need some legumes, some vegetables, fruit, meat, and some oil during the day. If you need a dessert, there is sugar cane. Or you can eat cucumbers, wild fruit, paw-paws, or guavas after a meal.

SOKO:
So I can eat at least a plate of fruits?

CHIMWENDO:
No. Even one or two mangos or guavas is enough for someone after a meal. Even sharing one mango or orange with your loved one is enough. What will you eat tomorrow if you finish all your fruit today?

SOKO:
Thank you for your help.

CHIMWENDO:
I will be visiting you a lot, because these nutrition issues need frequent reminders.

SOKO:
Actually you came just in time, before the quarrel turned into hell.

CHIMWENDO:
Before I forget, make sure you don’t overcook vegetables. Eat them frequently, whether they’re preserved and dried or fresh. Eat vegetables at every meal if possible.

IRENE:
They say if you overcook them, you kill the nutrients.

SOKO:
Where did you learn this?

IRENE:
They tell us these things during antenatal and post-natal clinics.

CHIMWENDO:
Let me ask you, how many bags of the beans group do you have?

SOKO:
I will tell you all the food we have. We have one oxcart of sweet potatoes, one oxcart of pumpkins, and five bags of soya beans, all sold. We had six bags of groundnuts but only two remain. We have 10 chickens, five goats, and 16 bags of maize.

CHIMWENDO:
So how many bags of beans do you have?

SOKO:
As I said, the soya is all sold … Out of six bags of groundnuts, we have two bags left. One bag will be for seed and the other we are eating. And we have 10 kilograms of beans.

CHIMWENDO:
You need to keep at least 30 kilograms of the bean group for each adult and half of that for your child. So you need 75 kilograms of the bean group for the whole year.

IRENE:
Do you hear? James is counted as a half person, not a quarter person like you thought.

SOKO:
Why do you talk like you know more things than me, even though you have never been to the city?

CHIMWENDO:
Soko, that is ridiculous. Not having been to a city or a hotel does not mean you know nothing.

SOKO:
But why keep food for a little child?

CHIMWEDNDO:
Children eat smaller amounts but they eat more frequently. Their bodies need more energy for growing and playing.

IRENE:
Yes. They get hungry more frequently. Isn’t that right, Mr, Chimwendo?

CHIMWENDO:
Yes. And remember to keep small livestock like pigeons and rabbits.

SOKO:
Animal meat is not an issue this year. We have a lot of birds and mice. We also have eggs from our chickens—and goats.

IRENE:
Do we eat goats in our house?

SOKO:
Yes, we do. Don’t you eat goat meat?

IRENE:
Only when you buy it. We have never killed one of our five goats to eat.

SOKO:
Now, we haven’t. Why would we kill a goat without a major ceremony? Are you out of your mind?

CHIMWENDO:
She is not mad. If you cannot kill a goat to eat in your homes, then please make sure you keep small livestock that are easy to slaughter. Like rabbits and chickens.

SOKO:
But these animals just keep you busy feeding them. Why not just hunt mice, insects, and birds? They are very abundant this year.

CHIMWENDO:
Ok, but make sure to keep your word and hunt them. Animal products have a lot of iron and protein. Children need a lot of iron and protein, both animal and plant protein from legumes. Serious protein deficiency can kill a child. Unless the child eats moringa powder, which is also very high in protein.

IRENE:
I have been encouraging my husband to keep pigeons and rabbits because they multiply fast and are easy to slaughter. But he doesn’t want them.

SOKO:
If you feed them, I will get them for you. But how many times do I need to repeat myself that rabbits are difficult to feed?

CHIMWENDO:
No, Soko, rabbits are not difficult to feed. I thought you had a dimba (Editor’s note: winter garden) where you could easily find rabbit feed, things like cabbage leaves and other waste materials.

SOKO:
Things are not good this year. Remember there is no water in the wetland because of last year’s drought.

CHIMWENDO:
Then keep pigeons. They feed on their own like chickens.

SOKO:
I think I will try one of these small animals.

CHIMWENDO:
Good! And don’t forget to eat foods that contain oil, like avocado, and groundnut products like cooking oil.

SOKO:
Thank you for that refresher training.

CHIMWENDO:
(LAUGHS) We lead farmers need to visit and talk with you about these issues frequently.

SOKO:
We know you are doing this because they pay you.

CHIMWENDO:
No! We do this out of love. We are not paid.

SOKO:
Why do you want to lie to us? They take you to trainings in town where they give you delicious meals and lunch allowances, t-shirts, bicycles …

IRENE:
(INTERRUPTING) Please, my husband, take what Mr. Chimwendo is saying seriously.

SOKO:
Oh yes, I take him seriously. I know he is an NGO-trained person.

CHIMWENDO AND IRENE:
(LAUGH)

CHIMWENDO:
Plant more fruit trees, please.

SOKO:
Yes, sir!

IRENE:
(LAUGH) Be serious for a minute!

CHIMWENDO:
Fruit trees like paw-paw bear fruit after only one year, and are rich in vitamin A. How many paw-paw trees do you have?

SOKO:
I hear that some are male and don’t bear fruit.

IRENE:
(AMAZED) You hear? He has an excuse for everything.

SOKO:
Irene, why don’t you plant those fruit trees so that I can learn from you?

CHIMWENDO:
How many trees have you planted, Irene?

SOKO:
Answer him. You were showing off as if you knew more than me. If a duck cannot swallow, do you think a chicken can swallow? You didn’t plant any trees either.

IRENE:
Yeeee, Soko, so you are a duck and me a chicken?

SOKO:
That is what it means. What I fail at, you fail at even worse.

IRENE:
I will prove you wrong! I will plant some trees.

CHIMWENDO:
Yes, gender equality means that there is no job which is exclusively for men or women.

IRENE:
I will prove him wrong. I will plant fruit trees.

CHIMWENDO:
(GOING OFF-MIC) I have to leave. I wish you both all the best.

SOKO:
Thank you. You will see some fruit trees this year.

 

SCENE TWO:
AT HOME

SFX:
MORNING. SOUND OF A COCK

IRENE:
Soko, what are we going to eat this morning?

SOKO:
What foods are you thinking about, Irene, my wife?

IRENE:
I asked you first.

SOKO:
I think we should eat sweet potatoes seasoned with groundnuts.

IRENE:
I’m sorry; we’ve run out of sweet potatoes.

SOKO:
We have finished all those potatoes? If I remember correctly, we didn’t sell any sweet potatoes, not even a bucket. How did we run out?

IRENE:
What is that supposed to mean? Do you think I finished them? Have you forgotten that we ate them as a fruit after meals? We roasted at least one every night for dessert, apart from the ones we cooked. You were never able to sleep without eating a roast sweet potato.

SOKO:
That’s true, but you also gave potatoes to my sisters who were too lazy to grow them. And not only once! Your in-laws got a bucketful every time they visited us.

IRENE:
What’s wrong with that? They are your sisters. Do you want them to call me a mean and stingy woman?

SOKO:
Can’t you see that this affects our food budget? And you are also contributing maize to weddings.

IRENE:
But it’s our tradition. If your sister’s child is marrying, why not give some maize? If the village is making a firebreak at the graveyard, why not contribute some maize? If there is a funeral, why not contribute some flour? If a chief is installed, why shouldn’t I contribute some flour?

SOKO:
Can’t you refuse sometimes by telling them that our maize is finished? What can they do to you?

IRENE:
Nothing. But you just feel ashamed, because you are revealing family problems outside the family. It’s like telling people that hunger has already hit your family in August and September when we are supposed to have plenty.

SOKO:
Then why not give cash? They can use the money to buy things they want for the ceremony.

IRENE:
You are right … but you are telling me too late.

SOKO:
Okay. Let’s eat porridge seasoned with groundnuts today.

IRENE:
Mr. Soko, please don’t be stingy! Get some money and buy some scones. We should drink tea. After all, we don’t have whole maize or soya flour in the house. I will mill some maize today so we can start eating porridge tomorrow. Go buy some scones, Soko.

SOKO:
My darling, I don’t have money for scones.

IRENE:
Just sell some groundnuts and buy scones.

SOKO:
Why don’t we just roast the nuts that we wanted to sell and eat them as snacks with tea?

IRENE:
Just go and sell some nuts. We don’t have time to shell the nuts and roast them. It is already 9 a.m.

SOKO:
Okay, Irene, I will sell some.

SFX:
SOUND OF NUTS BEING PUT IN A SMALLER BAG

 

SCENE THREE:
AT THE MARKET

FX:
SOUND OF PEOPLE AT MARKET

CHIMWENDO:
Madam, give me two scones. Ahh … Soko, let’s go.

SOKO:
Chimwendo, wait … let me finish the last sip of my tea. (PAUSE)

CHIMWENDO:
What about your child and wife? What are they eating this morning?

SOKO:
(DEFENSIVE) Chimwendo, I came here to sell groundnuts and buy some scones. And I felt cold, so I thought I would chase the cold away by drinking a cup of tea.

IRENE:
(COMING ON-MIC) Soko, you were drinking tea at a tearoom instead of bringing scones so all of us could drink together? (PAUSE) Give us money; we will drink tea with milk too.

SOKO:
But I don’t have any money. I just bought the scones.

IRENE:
James, let’s drink tea with milk just like your dad … I will sell more groundnuts so we can drink tea with milk, too.

SOKO:
But we said the remaining nuts were for James’ porridge.

CHIMWENDO:
Irene, please don’t sell more nuts. Keep them for your child.

IRENE:
Leave me alone; you have both taken your breakfast at the tearoom. It’s not my problem that there are no groundnuts. Soko will solve that later. He is the one who broke the agreement between us.

CHIMWENDO:
Soko, if you do not involve your wife in planning and be faithful to your agreements, you lose your partner’s trust. Then you face nutritional problems at home.

SOKO:
Yes, I’m worried that we will run out of maize.

CHIMWENDO:
Why do you say that?

SOKO:
I was roasting a lot and she was contributing in-kind to those unnecessary ceremonies. And I think she barters with things too when I am out….

CHIMWENDO:
I told you … when a woman suspects that a man is careless or eats when he is alone, she may sell food when you are out.… Talk it over together and solve your problem quickly. Do not wait until hunger strikes you.

SCENE FOUR:
AT HOME

FX:
` CHILD CRYING

SOKO:
Irene, why is James crying?

IRENE:
Soko, James is refusing to eat because his porridge is not seasoned with groundnuts.

SOKO:
I told you not to sell the groundnuts; they were for James. He is used to porridge seasoned with groundnuts. What are we going to do?

IRENE:
You should do something as a father. You should buy more nuts or milk or margarine.

SOKO:
I don’t have any money. (PAUSE) He loves eggs, so give him eggs.

IRENE:
We don’t have eggs either. Have you forgotten that we sold the hens to buy more maize?

SOKO:
Okay, I have 50 kwacha which I can use to buy freezes.

IRENE:
That’s my man talking now. Buy the ones he loves.

 

SCENE FIVE:
AT HOSPITAL

FX:
HOSPITAL AMBIENCE AND WEAK CRIES FROM JAMES

IRENE:
(UPSET) Soko, James is very sick. Listen to how he’s crying. If it was possible to suffer for him, I would take on his sickness.

SOKO:
Irene, his eyes are white and he is weak. He is refusing to eat, but he is getting fat.

DOCTOR:
(CALLING) James Soko!

IRENE:
Our son’s laboratory results are out. Let’s go, Soko.

SFX:
DOOR OPENING AND CLOSING

DOCTOR:
James Soko.

SOKO:
Yes.

DOCTOR:
The results show that James is not suffering from malaria, but is wasted, a condition that we call kwashiorkor. You were not giving him enough protein, like eggs, groundnuts, and other protein-rich foods.

SOKO:
Yes, doctor.

DOCTOR:
You look like a young couple. Why wouldn’t you feed your child with protein-rich foods?

IRENE:
We ran out.

DOCTOR:
Don’t you grow legumes?

IRENE:
We do. We had five bags of groundnuts and …

DOCTOR:
(INTERRUPTING) That much? Where did it go?

IRENE:
His father roasted it all. He was eating it as a dessert.

SOKO:
(SHARPLY) Have you forgotten that we sold it to buy tea?

IRENE:
The mistake we made was to roast groundnuts every day as a dessert.

DOCTOR:
Madam, selling all your remaining groundnuts was just as big a mistake as eating them as dessert every day. In fact, we advise people to eat at least a handful of groundnuts every day if possible. Was your son sick when he was eating nuts every day?

IRENE:
No, sir.

DOCTOR:
Groundnuts are rich in protein and oil and therefore a very important part of your children’s diet. Here at the hospital, we will give him chiponde (Editor’s note: peanut butter), a ready-to-use therapeutic food which is made from groundnuts. The nuts are the treatment for your child’s condition.

IRENE:
We are sorry.

DOCTOR:
Sorry to who? It’s your child we are talking about. (PAUSE) What about eggs? Don’t you have any chickens?

IRENE:
We sold the chickens.

DOCTOR:
Why?

SOKO:
She was donating a lot of food to ceremonies and exchanging with plastic buckets; so we needed to replenish our maize.

DOCTOR:
You are good at reporting on each other. Instead, you should live like a couple. Plan together! Okay? Don’t you have goats?

SOKO:
We have five goats.

DOCTOR:
Why didn’t you sell the goats?

SOKO:
We never thought of that.

DOCTOR:
It’s good to keep small animals that you can slaughter when you need to. Chickens, rabbits, and pigeons can help supply meat protein to your children.

SOKO:
My wife refuses to feed small animals.

IRENE:
Is it a woman’s job to feed rabbits and pigeons?

DOCTOR:
It’s a family job! You are facing undernutrition because you don’t work together as a family. Why are you thinking of men’s jobs or women’s jobs when you are a family? Anyone can do any job.

IRENE:
Okay, we‘re sorry. We will start working and planning together.

DOCTOR:
You need to take action—or your child may die!

IRENE:
(SOBS) No, doctor.

DOCTOR:
Why didn’t you give your child goats’ milk? Are your goats not nursing young ones?

SOKO:
(LAUGHS) Who could milk goats?

DOCTOR:
(STRONGLY) You or your wife!! What is wrong with that?

SOKO:
Ohhh … a man like me milking a small goat? How much milk would it give anyway?

DOCTOR:
Goats’ milk is very good for drinking. Any amount is enough for your child. Some goats can fill a 300-millilitre bottle— enough for the whole family!

IRENE:
You mean people drink goats’ milk?

DOCTOR:
Oh yes, goats’ milk is very good for humans.

IRENE:
We never knew that. I would have milked the goats.

DOCTOR:
Your child is seriously ill and we are going to admit you to the hospital. Like I said earlier, we will give him chiponde and observe him. Look! His whole body is swollen and his skin is peeling off. The kwashiorkor that he’s suffering from may kill. Follow me; I will give you a bed.

 

SCENE SIX:
AT THE HOSPITAL

FX:
SOUNDS OF A HOSPITAL WARD, CHILDREN CRYING

IRENE:
(SURPRISED) Mama Jane, are you visiting someone in the ward?

MAMA JANE:
I am here with my sick daughter. Why are you here, Irene? Is James sick?

IRENE:
James is undernourished. He has kwashiorkor. He lacks nutritious food and is swelling up and his skin is peeling off.

JANE:
My daughter was suffering from marasmus. She was very thin, she looked old, and she was not growing. She just cried all day and night.

IRENE:
Is that undernutrition? Isn’t that the bad effects of your husband’s promiscuity? Or maybe witchcraft?

JANE:
Thinking and worrying about witchcraft was a waste of my time. And I know my husband doesn’t have affairs.

IRENE:
But what food do you lack in your house? You have cattle, you have milk, you have money … Whatever you want, you can buy. So what kind of undernutrition can enter your house? Is this a joke?

JANE:
I used to think the same way. But when I came here, the doctor explained things to me. They didn’t give my child any medicine, only good, nutritious food. And she is fine and getting well.

IRENE:
(AMAZED) Really?

JANE:
Yes, it just happened to me.

IRENE:
I can’t believe it! What foods were you missing for your child to be malnourished?

JANE:
When the child refused to eat nutritious foods like milk, I didn’t encourage her. She ate some foods and refused others. I just accepted her choices, and bought her a lot of drinks and puffs.

IRENE:
Mine too was refusing some foods. But I learned that he loves good food. He loves milk, and he loves groundnut porridge and eggs. But we finished all our protein-rich foods and never thought of buying more. I never thought of milking goats either.

JANE:
Can people drink goats’ milk?

IRENE:
Yes, that is what we learnt here. Shhhhh … the doctor is coming.

DOCTOR:
Irene and Jane … you should indeed share your experiences, the rich and the poor …

IRENE:
True.

JANE:
I am ashamed of myself that my child is malnourished.

DOCTOR:
Teach your children not to be selective about foods. They should get used to nutritious foods like milk, moringa, and nuts.

Have you both fed your children?

IRENE:
Yes, doctor, we have just finished feeding them. But my child has diarrhea.

DOCTOR:
James has responded to the treatment and is eliminating the fluid that filled his body during kwashiorkor. You are lucky; we will not lose him.

IRENE:
(SIGH) Thank you. I was so worried.

DOCTOR:
But he needs to stop having diarrhea within two days. For now,

just continue giving him the chiponde.

IRENE:
Okay, doctor.

DOCTOR:
Imagine … a child from a rich family suffering from starvation. But it’s actually quite common.

IRENE:
I told her that either she was bewitched, or that her husband is promiscuous.

DOCTOR:
Sometimes people think about old beliefs to explain their problems. The truth is that children need lots of nutritious, high-energy food because they are growing and very active.

IRENE:
Okay.

DOCTOR:
And because their stomachs are small, they need to be fed frequently with a variety of foods that give them lots of energy.

JANE:
Which foods, doctor?

DOCTOR:
They need a mixture of the six food groups to grow well. Staples, animal foods, legumes, vegetables, oils and fats, and fruits.

IRENE:
Which foods should I give James more of?

DOCTOR:
All of the groups are important. You should try all six types of foods every day. Different foods deliver different nutrients to the body, so eating a variety of foods daily gives the body all it needs for physical and mental development, and healthy growth. Irene, you stopped giving your child protein.

IRENE:
It’s true, doctor. But when I go home, I will follow the principles of a good diet. Six food groups! Never sell groundnuts for foods that are not as nutritious.

JANE:
I thought that processed foods, the ones we buy from stores, are more nutritious than homemade.

DOCTOR:
Not all processed foods are nutritious. Undernutrition exposes children to illnesses that are dangerous to their lives and well-being. So please use nutritious, locally-grown foods and make sure you feed your children with a variety of foods from each of the six food groups. Do you get me, ladies?

BOTH:
Yes, doctor.

CLOSING SONG

PRESENTER:
We hope you enjoyed the drama. Now in the studio, I am with a nutrition scientist who will answer a number of questions on human nutrition. You are welcome.

What forms of undernutrition are common among villagers and farmers?

SCIENTIST:
Children mostly suffer from undernutrition in the form of stunting, meaning that they are shorter than normal height for their age. Undernutrition also manifests as lower than normal weight for a particular age, and in deficiencies of micro-nutrients such as vitamin A and iron.

PRESENTER:
Is it true that children of the rich are sometimes malnourished? What forms of malnutrition are common among the rich?

SCIENTIST:
Yes, children in rich families are often malnourished too. Malnutrition comes in two forms, undernutrition and overnutrition. Overnutrition is the condition that is most common in the rich. It manifests in being overweight or obese. This is associated with high blood pressure, diabetes, a higher rate of heart disease, and other health problems.

PRESENTER:
Are the children of people who have plenty of food sometimes undernourished?

SCIENTIST:
Yes, parents sometimes feed their children foods that are not nutritious. Such children may lack micronutrients such as vitamin A or iron.

PRESENTER:
What are the most common forms of malnutrition in Malawi?

SCIENTIST:
Stuntedness is the most common form of undernutrition in Malawi. It is caused by inadequate intake of food in terms of both quantity and quality, and/or frequent illnesses. Vitamin A and iron deficiencies are also common in Malawi. The primary symptoms of vitamin A deficiency are poor immunity to disease and night blindness. The symptoms of a shortage of iron are fatigue, weakness, and frequent infections. If not corrected, this may cause anaemia.

PRESENTER:
How can we prevent these common illnesses?

SCIENTIST:
We can prevent vitamin A deficiency by eating animal foods like liver, and yellow and orange fruits and vegetables. We can prevent iron deficiency by eating animal products such as fish, meat, and poultry. It is likely that mice and other rodents are also a good source of iron. Legumes such as beans have smaller amounts of iron, but they make an important contribution, especially if they are bred to contain more iron than usual.

PRESENTER:
How serious is undernutrition?

SCIENTIST:
Children who have wasting diseases like kwashiorkor and marasmus can die. Kwashiorkor is a serious form of undernutrition in which a child eats enough calories but lacks protein. Symptoms include swelling, especially of the ankles, feet, face, and stomach, irritability, and skin problems such as peeling. Marasmus is also a severe form of undernutrition, which usually occurs before a child is one year old. A marasmic child is a starving child, with very little energy intake, and is extremely underweight. Severe deficiency of iron and vitamin A can also result in death.

PRESENTER:
How does undernutrition during the first 1000 days of life affect children’s future health, intelligence, and behaviour?

SCIENTIST:
The first 1000 days from conception to the second birthday are a very sensitive period for human growth. If children are undernourished, they are very vulnerable to illnesses. Undernutrition during this period can affect brain and cognitive development.

If a child is stunted during this period, he or she may not catch up in later years of growth. Being stunted during the first 1000 days is associated with mental retardation or intellectual disability, and can affect the part of brain that is associated with behaviour. There are reports that some children are hyperactive because of childhood undernutrition. So it is very important to ensure that expectant mothers and children up to two years old eat well.

PRESENTER:
This is the end of our program. Our phone lines are open. Please tell us what is causing food shortages in your area and which food group is it difficult for families to find enough of.

Acknowledgements

Contributed by: Gladson Makowa, Senior Producer, Story Workshop Education Trust, Blantyre, Malawi.
Reviewed by: Dr. Alexander Kalimbira, Associate Professor of Human Nutrition and Head of Department of Human Nutrition and Health at Lilongwe University of Agriculture and Natural Resources

Information sources

Interviews:
Farmers near Lisandwa Primary School in Traditional Authority Njombwa, Kasungu, Malawi, interviewed on September 4, 2015.
Dr. Alexander Kalimbira, Associate Professor of Human Nutrition and Head of Department of Human Nutrition and Health at Lilongwe University of Agriculture and Natural Resources, Malawi, interviewed on October 10, 2015.

 

gac-logoProject undertaken with the financial support of the Government of Canada through Global Affairs Canada (GAC)