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Within Our Grasp

Childhood Malnutrition Worldwide and the Revolution Taking Place to End It

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On sale Apr 06, 2021 | 9 Hours and 44 Minutes | 978-0-593-39531-8
An important, hopeful book that looks at the urgent problem of childhood malnutrition worldwide and the revolutionary progress being made to end it.
 
A healthy Earth requires healthy children. Yet nearly one-fourth of the world’s children are stunted physically and mentally due to a lack of food or nutrients. These children do not die but endure a lifetime of diminished potential.
 
During the past thirty years, says Sharman Russell, we have seen a revolution in how we treat these sick children and in how—with a new understanding of the human body and approach to nutrition, and new ways to reach out to hungry mothers and babies—we have gone from unwittingly killing severely malnourished children to bringing them back to health through the “miracle” of ready-to-eat therapeutic food.
 
Intertwined with stories of scientists and nutrition experts on the front lines of finding ways to end malnutrition for good, Russell writes of her travels to Malawi, one of the poorest and least-developed countries in the world and also the site of pathbreaking, cutting-edge research into childhood malnutrition. (Eighty percent of Malawians are farmers subsisting on less than an acre of land and coping with erratic weather patterns due to global warming; fifty percent live below the poverty line; and forty-two percent of Malawi’s children are affected by a lack of food or nutrients.)
 
As she writes of her personal exploration of new friendships and insights in a country known as “the warm heart of Africa,” Russell describes the programs that are working best to reduce childhood stunting and explores how malnutrition in children is connected to climate change, how vitamins and minerals are preventing these harmful effects, why the empowerment of women is the single most effective factor in eliminating childhood malnutrition, and what the costs of ending childhood malnutrition are.
 
Sharman Russell, much-admired writer of luminous prose and humane heart, whose writing has been called, “elegant” (The Economist) and “extraordinarily well-crafted, far-reaching, and heart-wrenching” (Booklist), winner of the John Burroughs Medal for distinguished natural history writing, has written an illuminating, inspiring book that makes clear the promise of what is today, gratefully, within our grasp.
PROLOGUE
This blue marble spinning in darkness
 
 
I was eighteen years old in 1972 when astronauts in space took a photograph of the Earth, this blue marble spinning in darkness. Suddenly we were aware of our absolute dependence on this planet, oddly aware that, yes, this was our home. Like many young people in the environmental movement, I thought then of the Earth as my mother. How we are shaped in her womb. How we drink from her every day. Eat from her every day. How she nurtures us with so many gifts, so much beauty. How she loves every one of us.
 
Later, as I had children of my own and as the human population in the world doubled and would soon triple, I replaced the image of mother with that of lover. We are a new skin covering the Earth with our need, our greed, our tenderness. We are the storytelling animal unraveling and re-stitching forest and field, our human consciousness interpenetrated, mated with the Earth. It is too easy to joke about marital problems. Instead I give the metaphor its due: we are the bride of the world and we are the groom.
 
And now, as I wonder what the Earth will be like in the middle and end of this century and beyond—as I look at decisions we are making and not making—now I think of the future as our child. And this catches at my heart. This makes me feel something new.
 
. . .
 
A child dies from hunger, and the suffering of this one child is enough to catch our heart. We look at the photo of that little girl, her thin face and too-bright eyes—the way she points every bit of her dying self at the camera—and we think: This isn’t hard. I’ll take her home. What’s in the refrigerator? I’ll make some soup.
 
What we can hardly fathom is the physical and mental stunting of nearly one in four of the world’s children due to a lack of food or nutrients. One in four. Almost a third of the children in much of Africa and Southern Asia. More than 144 million stunted children under the age of five, with another 47 million children “wasted” or threatened by weight loss or failure to gain weight. These numbers are too big. Perhaps we are sitting at a computer desk or reading over breakfast. Our shoulders loosen. Our arms and legs relax. There’s nothing we can do.
 
Stunting is a medical term, defined as two deviations below the height standards set by the World Health Organization. The vast majority of healthy children, no matter their race or ethnicity, follow the same growth patterns in their first five years. Genetic potential—what makes one person tall and another short—is expressed later in childhood. The first two years of life are when the brain and body have high demands for nutrients, and stunting usually happens at this time. It often starts before birth. Stunted children are not likely to catch up on their growth later. A stunted one-year-old will become a stunted ten-year-old and a stunted adult.
 
The number of hungry children in the world increases due to war and conflict, especially when families must flee their homes. Hunger increases because of “climate shocks” like extreme drought and erratic weather patterns. Hunger increases during outbreaks of disease such as COVID-19, with the devastating effects of that pandemic continuing today.
 
Even so, the majority of stunted children in the world are not the result of particular conflicts or shocks—as horrific and damaging as they have been and still are. The reality is bigger than any one event. In some countries, populations have lived with the suffering of childhood stunting for so long that the problem has become almost invisible. Short height is seen as the norm, not a consequence of poor nutrition. But a stunted adult is not the norm and is now at risk for a range of physical and mental problems—impaired organ function, impaired immune system, impaired cognition. Stunting is associated with higher rates of diabetes, heart disease, stroke, obesity, anxiety, and learning disabilities. Ending the misery of childhood malnutrition would have enormous consequences. Most malnourished children do not die—although some do, some 3 million a year. The rest endure a lifetime of diminished potential. They do less well in school. They do less well at work. They are sick more often. Almost certainly, they continue to be poor, since childhood malnutrition is both a cause and a result of extreme poverty.
 
Nourished children, on the other hand, have the opportunity to grow up to be more energetic and productive adults. Ending childhood malnutrition means that one-quarter of the next generation could learn better and engage more in society. Together, that generation could promote gender and racial equality. Together, they could face the challenges of global warming and disease. What would that future look like? We could find out, because the past fifty years of research have taught us surprising and remarkable things about the human body—specifically, how to prevent and treat childhood malnutrition. We have the knowledge, and we have the motivation, knowing that childhood stunting is an environmental and an economic concern, as well as a humanitarian one.
 
The future that is our child is the future of a hotter Earth and a degraded environment, a future of increasing shocks and the need for greater resilience. Ending childhood stunting is neither a digression nor a distraction from that urgency. We have failed so far to find the collective will to slow down greenhouse gas emissions and prevent apocalyptic changes to life on Earth. We have failed to acknowledge the human interdependence that laces this Earth. Perhaps our thinking has been too small. Perhaps we have been too narrowly focused on parts of carbon dioxide per million, on numbers and statistics. Perhaps our resolve will only be ignited by a larger story of who we are and who we want to be.
 
Feeding all our children begins with the understanding that they are all our children, that we are one body on the body of the Earth, and that we are all responsible for what happens on this Earth. The next generation of healthy children and adults cannot be separated from a healthy environment, and the fight for a healthy environment cannot be separated from the needs and desires of human beings. It is not either/or. It is not regulating the use of fossil fuels or empowering women, photovoltaics or better sanita­tion, reforestation or ending poverty, biodiversity or public health systems that protect us from disease. It is all of them together.

. . .
 
We are a new skin covering the Earth, and by this I mean we have reached a human population of 7.8 billion. For many years, over­population has been one of our great concerns. In the 1970s, this blue marble spinning in darkness became, for some, the image of a lifeboat lost at sea—a desperate situation of limited resources and too many people. That cultural trope lingers and may still have value in teaching us about the limits of a planet or ecosystem.
 
But the idea that children must die to prevent overpopulation has been proved wrong. The opposite is true. The link between population growth and child death and malnutrition is now clear. When parents know that all of their children are going to survive and flourish, they tend to have smaller families. When women have access to education, employment, and birth control, they tend to have smaller families. When people live in a healthy and functional society, they tend to have smaller families.
 
The good news is that most of the world has reached this point. Fertility rate is the average number of children a woman will have in her lifetime. Our global fertility rate is now 2.4, down from almost 5 in 1950. The reasons for this decline have to do with urbanization, greater economic prosperity for both women and men, and literacy for both women and men. In Bangladesh, there is a new saying: “Two are good. One is better.” In Bangladesh, women on average have 2.0 children. In India, 2.2. In Mexico, 2.1. In Brazil, 1.7.
 
Unfortunately, the decline in global fertility does not mean we will soon see fewer people. The number of humans in the world will continue to swell before we stabilize. The next generations will add their children to the total population. Some of us are living longer, so the population reduces at a slower rate. And some of us who are poor and undernourished continue to add to population growth by having more than two children per woman (roughly our replacement rate). Many of us living in extreme poverty are in Africa, in countries where a woman on average still has four or five children, a third of whom are stunted due to malnutrition, with one child in five dying before the age of five. Ending increased population growth means empowering these women and feeding these children.
 
In other ways, too, the goals of humanitarians and environmentalists are aligned. The majority of the extremely poor are farmers living on small plots of land. Helping smallholder farmers is all about building soil and planting trees that sequester carbon—the marriage of agriculture and ecology called agroecology. Healthy children require clean water and air, as well as cheap, sustainable alternative energies that heat homes and cook food. Healthy children need a stable environment and a commitment to mitigating global warming. Healthy children become part of an educated society that values biodiversity and understands our dependence on the Earth.
We come from the Earth, turning plants and animals who also come from the Earth into energy and movement and thought and story. It is as simple and miraculous as that. We come from the Earth, and we have become the Earth. We are the storytelling animal, telling stories about ourselves and our future. Feeding our children is such a good story.
© Emanuel Stamler
SHARMAN APT RUSSELL is a professor emeritus in humanities at Western New Mexico University and an associate on the faculty of Antioch University. She is the author of Diary of a Citizen Scientist (winner of the 2016 John Burroughs Medal), Knocking on Heaven’s Door (winner of the Arizona Authors Association Award), and Teresa of the New World (winner of the Arizona Authors Association Award). She lives in New Mexico. View titles by Sharman Apt Russell

About

An important, hopeful book that looks at the urgent problem of childhood malnutrition worldwide and the revolutionary progress being made to end it.
 
A healthy Earth requires healthy children. Yet nearly one-fourth of the world’s children are stunted physically and mentally due to a lack of food or nutrients. These children do not die but endure a lifetime of diminished potential.
 
During the past thirty years, says Sharman Russell, we have seen a revolution in how we treat these sick children and in how—with a new understanding of the human body and approach to nutrition, and new ways to reach out to hungry mothers and babies—we have gone from unwittingly killing severely malnourished children to bringing them back to health through the “miracle” of ready-to-eat therapeutic food.
 
Intertwined with stories of scientists and nutrition experts on the front lines of finding ways to end malnutrition for good, Russell writes of her travels to Malawi, one of the poorest and least-developed countries in the world and also the site of pathbreaking, cutting-edge research into childhood malnutrition. (Eighty percent of Malawians are farmers subsisting on less than an acre of land and coping with erratic weather patterns due to global warming; fifty percent live below the poverty line; and forty-two percent of Malawi’s children are affected by a lack of food or nutrients.)
 
As she writes of her personal exploration of new friendships and insights in a country known as “the warm heart of Africa,” Russell describes the programs that are working best to reduce childhood stunting and explores how malnutrition in children is connected to climate change, how vitamins and minerals are preventing these harmful effects, why the empowerment of women is the single most effective factor in eliminating childhood malnutrition, and what the costs of ending childhood malnutrition are.
 
Sharman Russell, much-admired writer of luminous prose and humane heart, whose writing has been called, “elegant” (The Economist) and “extraordinarily well-crafted, far-reaching, and heart-wrenching” (Booklist), winner of the John Burroughs Medal for distinguished natural history writing, has written an illuminating, inspiring book that makes clear the promise of what is today, gratefully, within our grasp.

Excerpt

PROLOGUE
This blue marble spinning in darkness
 
 
I was eighteen years old in 1972 when astronauts in space took a photograph of the Earth, this blue marble spinning in darkness. Suddenly we were aware of our absolute dependence on this planet, oddly aware that, yes, this was our home. Like many young people in the environmental movement, I thought then of the Earth as my mother. How we are shaped in her womb. How we drink from her every day. Eat from her every day. How she nurtures us with so many gifts, so much beauty. How she loves every one of us.
 
Later, as I had children of my own and as the human population in the world doubled and would soon triple, I replaced the image of mother with that of lover. We are a new skin covering the Earth with our need, our greed, our tenderness. We are the storytelling animal unraveling and re-stitching forest and field, our human consciousness interpenetrated, mated with the Earth. It is too easy to joke about marital problems. Instead I give the metaphor its due: we are the bride of the world and we are the groom.
 
And now, as I wonder what the Earth will be like in the middle and end of this century and beyond—as I look at decisions we are making and not making—now I think of the future as our child. And this catches at my heart. This makes me feel something new.
 
. . .
 
A child dies from hunger, and the suffering of this one child is enough to catch our heart. We look at the photo of that little girl, her thin face and too-bright eyes—the way she points every bit of her dying self at the camera—and we think: This isn’t hard. I’ll take her home. What’s in the refrigerator? I’ll make some soup.
 
What we can hardly fathom is the physical and mental stunting of nearly one in four of the world’s children due to a lack of food or nutrients. One in four. Almost a third of the children in much of Africa and Southern Asia. More than 144 million stunted children under the age of five, with another 47 million children “wasted” or threatened by weight loss or failure to gain weight. These numbers are too big. Perhaps we are sitting at a computer desk or reading over breakfast. Our shoulders loosen. Our arms and legs relax. There’s nothing we can do.
 
Stunting is a medical term, defined as two deviations below the height standards set by the World Health Organization. The vast majority of healthy children, no matter their race or ethnicity, follow the same growth patterns in their first five years. Genetic potential—what makes one person tall and another short—is expressed later in childhood. The first two years of life are when the brain and body have high demands for nutrients, and stunting usually happens at this time. It often starts before birth. Stunted children are not likely to catch up on their growth later. A stunted one-year-old will become a stunted ten-year-old and a stunted adult.
 
The number of hungry children in the world increases due to war and conflict, especially when families must flee their homes. Hunger increases because of “climate shocks” like extreme drought and erratic weather patterns. Hunger increases during outbreaks of disease such as COVID-19, with the devastating effects of that pandemic continuing today.
 
Even so, the majority of stunted children in the world are not the result of particular conflicts or shocks—as horrific and damaging as they have been and still are. The reality is bigger than any one event. In some countries, populations have lived with the suffering of childhood stunting for so long that the problem has become almost invisible. Short height is seen as the norm, not a consequence of poor nutrition. But a stunted adult is not the norm and is now at risk for a range of physical and mental problems—impaired organ function, impaired immune system, impaired cognition. Stunting is associated with higher rates of diabetes, heart disease, stroke, obesity, anxiety, and learning disabilities. Ending the misery of childhood malnutrition would have enormous consequences. Most malnourished children do not die—although some do, some 3 million a year. The rest endure a lifetime of diminished potential. They do less well in school. They do less well at work. They are sick more often. Almost certainly, they continue to be poor, since childhood malnutrition is both a cause and a result of extreme poverty.
 
Nourished children, on the other hand, have the opportunity to grow up to be more energetic and productive adults. Ending childhood malnutrition means that one-quarter of the next generation could learn better and engage more in society. Together, that generation could promote gender and racial equality. Together, they could face the challenges of global warming and disease. What would that future look like? We could find out, because the past fifty years of research have taught us surprising and remarkable things about the human body—specifically, how to prevent and treat childhood malnutrition. We have the knowledge, and we have the motivation, knowing that childhood stunting is an environmental and an economic concern, as well as a humanitarian one.
 
The future that is our child is the future of a hotter Earth and a degraded environment, a future of increasing shocks and the need for greater resilience. Ending childhood stunting is neither a digression nor a distraction from that urgency. We have failed so far to find the collective will to slow down greenhouse gas emissions and prevent apocalyptic changes to life on Earth. We have failed to acknowledge the human interdependence that laces this Earth. Perhaps our thinking has been too small. Perhaps we have been too narrowly focused on parts of carbon dioxide per million, on numbers and statistics. Perhaps our resolve will only be ignited by a larger story of who we are and who we want to be.
 
Feeding all our children begins with the understanding that they are all our children, that we are one body on the body of the Earth, and that we are all responsible for what happens on this Earth. The next generation of healthy children and adults cannot be separated from a healthy environment, and the fight for a healthy environment cannot be separated from the needs and desires of human beings. It is not either/or. It is not regulating the use of fossil fuels or empowering women, photovoltaics or better sanita­tion, reforestation or ending poverty, biodiversity or public health systems that protect us from disease. It is all of them together.

. . .
 
We are a new skin covering the Earth, and by this I mean we have reached a human population of 7.8 billion. For many years, over­population has been one of our great concerns. In the 1970s, this blue marble spinning in darkness became, for some, the image of a lifeboat lost at sea—a desperate situation of limited resources and too many people. That cultural trope lingers and may still have value in teaching us about the limits of a planet or ecosystem.
 
But the idea that children must die to prevent overpopulation has been proved wrong. The opposite is true. The link between population growth and child death and malnutrition is now clear. When parents know that all of their children are going to survive and flourish, they tend to have smaller families. When women have access to education, employment, and birth control, they tend to have smaller families. When people live in a healthy and functional society, they tend to have smaller families.
 
The good news is that most of the world has reached this point. Fertility rate is the average number of children a woman will have in her lifetime. Our global fertility rate is now 2.4, down from almost 5 in 1950. The reasons for this decline have to do with urbanization, greater economic prosperity for both women and men, and literacy for both women and men. In Bangladesh, there is a new saying: “Two are good. One is better.” In Bangladesh, women on average have 2.0 children. In India, 2.2. In Mexico, 2.1. In Brazil, 1.7.
 
Unfortunately, the decline in global fertility does not mean we will soon see fewer people. The number of humans in the world will continue to swell before we stabilize. The next generations will add their children to the total population. Some of us are living longer, so the population reduces at a slower rate. And some of us who are poor and undernourished continue to add to population growth by having more than two children per woman (roughly our replacement rate). Many of us living in extreme poverty are in Africa, in countries where a woman on average still has four or five children, a third of whom are stunted due to malnutrition, with one child in five dying before the age of five. Ending increased population growth means empowering these women and feeding these children.
 
In other ways, too, the goals of humanitarians and environmentalists are aligned. The majority of the extremely poor are farmers living on small plots of land. Helping smallholder farmers is all about building soil and planting trees that sequester carbon—the marriage of agriculture and ecology called agroecology. Healthy children require clean water and air, as well as cheap, sustainable alternative energies that heat homes and cook food. Healthy children need a stable environment and a commitment to mitigating global warming. Healthy children become part of an educated society that values biodiversity and understands our dependence on the Earth.
We come from the Earth, turning plants and animals who also come from the Earth into energy and movement and thought and story. It is as simple and miraculous as that. We come from the Earth, and we have become the Earth. We are the storytelling animal, telling stories about ourselves and our future. Feeding our children is such a good story.

Author

© Emanuel Stamler
SHARMAN APT RUSSELL is a professor emeritus in humanities at Western New Mexico University and an associate on the faculty of Antioch University. She is the author of Diary of a Citizen Scientist (winner of the 2016 John Burroughs Medal), Knocking on Heaven’s Door (winner of the Arizona Authors Association Award), and Teresa of the New World (winner of the Arizona Authors Association Award). She lives in New Mexico. View titles by Sharman Apt Russell