Letter on dangers of infant formula in Mongolia emergency, Emma Roberts

Dear Field Exchange,

Where have we gone wrong? Why is it that when food supplies get stretched, NGO and international staff still think of infant formula rather than supplementing the diets of the lactating mothers affected.

I am currently in Mongolia, following the "dzud", (a serious snow emergency) that has claimed the lives of some 2.4 million animals to date. The "mass starvation" predicted by the UN in March, has thankfully not happened but there are a number of families that have seen their vulnerability increase as their only means of survival has gone.

In a recent co-ordination meeting, where I believe I was the only nutritionist in attendance (in fact I think I am probably the only nutritionist involved in the emergency response here) one INGO, reported back from their recent trip to an affected area about the poor water quality, lack of fuel, and the loss of livestock. The INGO announced that due to the loss of livestock they would be purchasing infant formula to feed the vulnerable children. Another INGO is currently shipping in containers full of infant milk and other commodities.

There is no evidence of lactation failure, and no evidence that malnutrition rates in young infants are being affected by the dzud. What is actually happening is that mothers are spending long hours chasing animals across the steppe and are therefore tired.

SCF UK carried out a nutritional assessment in one of the 6 most affected provinces, the only NGO to actually carry out a formal assessment. We found that the incidence of acute malnutrition was very low, less than 2 % while the incidence of chronic malnutrition was almost the same as that found in the 1999 national nutrition survey (about 12.5% underweight and 24.6% stunted).

It seems that once again the easy option is in danger of being chosen. This opens up a whole new issue for those of us that work in nutrition. We have raised awareness for emergency organisations, but in a place like Mongolia, where emergencies rarely happen, most staff are development orientated working in long term projects but have had to respond to sporadic emergencies as the only people on the ground with resources at the time. The majority of staff are often nationals with health qualifications; nutritionists are few and far between and the ones that are, certainly here, are involved in research only. The "Infant Feeding in Emergencies" document¹ certainly had not reached here although its now been linked to the UN DMT web site so that interested parties can gain access to it.

We have a whole new audience that we need to inform and as disasters inevitably occur in 'new' areas we need to make haste. To give them credit, once the dangers of infant formula had been explained to this particular NGO, plans were rapidly altered. I hope that in other situations there are informed nutritionists on hand to spread the word.

Emma Roberts
SCF Nutritionist.
Mongolia

¹'Infant Feeding in Emergencies: Policy Strategy and Practice' A report by the IFEG. Produced by and available from the ENN at a cost of £3 per copy.