March 2nd, 2017 by Stephanie Peace
Prior to starting medical school, I spent 2 years (plus all of my college summers) working for a non-profit organization called Project Peanut Butter, which specializes in local production of ready-to-use therapeutic food (RUTF) used to treat malnutrition in children. RUTF is essentially souped up peanut butter and contains all of the macro and micronutrients necessary for catch up growth. A key component to the success of RUTF is that it can be used as outpatient therapy, which protects children from hospital-acquired infections, enables families to stay together at home (rather than the mother having to leave the rest of the family and farming to stay at the hospital for weeks or even months), and in randomized-controlled trials even worked better for achieving cure and avoiding remission than standard inpatient therapies (milk formulas called F-75 and F-100). Needless to say, I’m pretty passionate about RUTF and malnutrition treatment!
While working in the pediatrics ward, I saw the typical trifecta of pediatric illnesses in Uganda: gastroenteritis/dehydration, malaria, and of course, malnutrition. At Kiwoko, they are using F-75 and F-100 for inpatient management of malnutrition. Occasionally they are able to get RUTF from their local government hospital, but there are frequent shortages so they can’t rely on that for treatment. Typically, they use the RUTF in HIV+ children to help them stay above the malnutrition curve after they have completed their treatment with F-75 and F-100. The nutritionist, a Ugandan nurse named Sister Jane, also teaches families to make a supplement they can use at home made from ground peanuts and fortified milk powder. I shared with her the recipe for RUTF so that she would be able to add some of its components in what she teaches families.
Having seen the major impact that RUTF can make for children (and families), it’s a shame to see shortages like those in Uganda affecting patient care – yet another challenge of low-resource medicine!