ANUP PRAKASH

In May 2007, when US medical student Mark Arnoldy was visiting Nepal he had an experience that would change the course of his life. After eating a paneer dish containing cashews and peanuts, he suffered an immediate allergic reaction. Then a banda prevented him from reaching hospital.

The episode gave him a rare glimpse of what it feels like to not have access to healthcare when it's most needed.
He survived but it got him thinking more about the properties of peanuts and not just the negative ones? but their ability to beat malnutrition in children.

He realised that what nearly caused his death could actually take the form of life saving medicine for numerous children suffering from malnutrition. Using peanut butter as a cure has already been pioneered in some of the worst afflicted African states?- Ethiopia, Malawi, Niger and Sudan.

A third year medical student at the University of Colorado, Mark took a year off and came back to Nepal, where there are more than 500,000 children under five, who suffer from malnutrition.

Studying peanut butter production with Meds and Foods for Kids in Haiti, Mark saw how fortified peanut butter; known as a ready-to-use therapeutic food (RUTF) could be highly effective in stimulating weight gain among malnutrition sufferers. Developed by a French paediatric nutritionist in the 1990s the product has already been certified by WHO, WFP and UNICEF as an effective method to treat patients with severe malnutrition and no access to healthcare. Children have been cured of malnutrition in approximately 8-12 weeks after it was given.

Mark has been working with Himalayan Health Care in Nepal and is looking for ways to make fortified peanut butter as cost-effective as possible. Surbottam pitho is cheap. But unlike surbottam pitho, fortified peanut butter requires no preparation at all and has an extremely long shelf life (up to two years). Also to prepare surbottam pitho, mothers or carers require know-how and clean water or milk?none of which is available amongst the poorer and less educated families.

"This initiative is also a way to support the local economy," says Arnoldy adding that he hopes that fortified peanut butter, which contains peanuts, sugar, oil, powdered milk and a vitamin and mineral complex, can be produced in Nepal, rather than imported.

He hopes the project will be fully-implemented in various regions by January 2010.