School lunch in Haiti
Serving lunch at a school canteen in Haiti

For years, parents in central Haiti faced a terrible choice.They could send their children to school with empty stomachs, in the hope that they might gain the skills to someday escape poverty. Or they could keep them at home to work in the family gardens, to help produce much-needed food for right now. 

No longer. Thanks to the dedicated efforts of Zanmi Lasante’s child nutrition program, more than 17,000 children at 28 schools in central Haiti receive piping hot lunches every day—free of charge. Local cooks employed by the program prepare the nourishing meals from hundreds of giant sacks of rice and beans, distributed regularly by Zanmi Lasante (ZL) as part of the expanding struggle to eradicate child malnutrition from Haiti’s impoverished Central Plateau.

The broad smiles of the children are mirrored by their teachers, who know the tremendous impact this program has had on their schools. Now that parents no longer have to choose between education or food for their children, school attendance has increased significantly. And so have the attention spans and classroom performance of the children once they get to school.

“Before the lunch program started, many of my students would come to school hungry or wouldn't come at all,” recalls one teacher. “Since we began giving daily meals, they hardly ever miss a day and their academic performance has improved dramatically.”

"The program is one of the cornerstones of our commitment to social support in the Central Plateau,” notes PIH’s Food Assistance Coordinator Elisabeth Berger. “Its strength is that it takes a proactive community-based approach to preventing child malnutrition, ensuring that children won’t have to come into our clinics as patients."

Mounting a community-based drive to eradicate hunger

The school lunch program is just one component of ZL’s comprehensive, community-based approach to eradicating hunger in the Central Plateau. In towns and villages throughout the area, community health workers and clinicians from Zanmi Lasante teach families to recognize warning signs and seek out children with telltale symptoms. 

Throughout Haiti, hunger and malnutrition cripple and destroy the lives of poor people—especially children—at an astonishing rate. Nearly half of all Haitians are undernourished.  A recent study by ZL found that 92 percent of families living in Haiti’s Central Plateau suffer from extreme food insecurity.  And close to 50 percent of families in this area must feed their families on an income of less than 500 Haitian gourdes a month—just $12.50. 

Chronic malnutrition weakens the body’s resistance to disease, leading to a downward spiral of sickness and poverty for parents and their children that too often ends in early death. In young children, whose bodies are still developing, chronic malnutrition stunts physical and intellectual development, causing irreversible harm that may follow a child through life. 

When ZL health workers encounter a child suffering from malnutrition, they refer the child’s family to the nearest ZL clinical site.  There, malnourished children receive high-energy therapeutic feeding formulas until they regain a healthy weight. 

The family is also paired with a community agronomist who visits their home regularly, providing advice and assistance for improving their home garden.  This comprehensive support is vital to addressing the conditions of poverty and food insecurity that first caused the child to become malnourished. 

Agricultural projects help improve nutrition and incomes

Agricultural projects are increasingly important to ZL’s battle against hunger in the Central Plateau.  Beginning in November 2006, ZL started local production of its own high-energy therapeutic foods for children hospitalized with severe malnutrition. 

Through an innovative collaboration with a team of Haitian agronomists, the main ingredients for the therapeutic foods—peanuts, corn, rice, and beans—are grown for ZL’s child nutrition program at a nearby farm. Vitamins and minerals are then added and the foods are processed into fortified peanut butter and akamil, a high-protein porridge.

These locally-produced therapeutic foods provide the energy, protein and vitamins found in more expensive commercial brands—at a fraction of the cost. By growing and processing the food locally, ZL bolsters the local economy while also demonstrating the value of local resources in supporting community health.

ZL’s efforts to produce therapeutic foods locally were inspired and assisted by Meds and Food for Kids (MFK), a non-governmental organization working in northern Haiti that has developed a “ready to use therapeutic food” called Medika Manba © -- a fortified peanut-butter therapy. A successful pilot program with Medika Manba at two Zl sites confirmed findings from studies in Africa that showed this kind of treatment to be highly effective for child malnutrition. With technical assistance from MFK, ZL then began growing peanuts and preparing our own version of fortified peanut butter.

In the first two months of distribution, more than 30 children recovered from severe malnutrition with ZL’s locally produced therapeutic foods. In 2007, ZL will scale up its production to supply more than 2,000 children in need of nutritional support. 

Expanding food production at the ZL farm will offer yet another opportunity to improve food security in the Central Plateau. In partnership with Zanmi Agrikol, the team of Haitian agronomists who manage the farm, the land will serve both to produce nutritious food and to provide hands-on training for local farmers in techniques that can improve crop yields. 

These trained farmers will serve as ajan agrikol, or community agronomists, visiting malnourished children in their homes and working with their families to improve their gardens. 

Contending with unfair trade policies

Although training local farmers and providing emergency food support can help alleviate hunger in Haiti, many of the greatest causes of persistent food insecurity lie outside the country’s borders. As recently as the mid-1980s, Haiti was self-sufficient in production of rice, the staple food.  But trade agreements that opened Haiti’s markets to imported rice—mainly from the US—have progressively weakened the position of small-scale Haitian farmers. 

In 1995, under pressure from the International Monetary Fund (IMF), Haiti was forced to reduce its tariffs on US-grown rice from 35 percent to 3 percent, far below the regional Caribbean average of 25 percent. At the same time, corporate US rice producers continue to benefit from farm subsidies averaging $1 billion a year and rely on heavily subsidized water to grow a wetland crop in parts of California that would be a desert without irrigation. As a result, US producers can afford to export rice at prices below their real costs of production, making it almost impossible for small farmers in countries like Haiti to compete without some form of protection. From 1994 to 1995, the amount of rice Haiti imported from the US more than doubled.

Though the influx of cheap US rice helped lower food prices in the short term, it decimated Haiti’s agricultural sector. Most of the money spent on imported US rice has not stayed in Haiti, but instead gone to US rice growers—draining the Haitian economy. 

Haiti has closely followed the prescriptions of the international finance community for over a decade, earning the ranking of “least trade restrictive” country in the Caribbean by the IMF. Yet Haiti remains the poorest country with the hungriest population in the western hemisphere. 

While working to provide food for hungry people, Zanmi Lasante continues to call for the end of unjust agricultural and trade policies imposed upon Haiti by international financial institutions, so that children in Haiti may attend school without worrying where they will find their next meal. 

[posted December 2006]