Dear all:

During my graduate studies we spent a lot of time on health policy.  In essence the reason why WIC was successful in reducing UNDERnutrition when it was first implemented was not really due to nutrition education.  It was actually due to income transfer.  It is much more palatable to offer food rather than cash in many countries because of the political fear of "socialiism".  So, the assistance is disguised in a more palatable manner.  My pediatrician actually worked in a rural area where he saw the impact of the initiation of WIC on young children.  It was a complete transformation where he was working.

as is the case with any of the schemes for food distribution.  As with any food distribution system, often the type of food is dictated by agricultural surpluses.  It is not driven by the healthiest choices of food.  Hence, again and again you find situations in which the food distributed may take care of caloric needs, but then create additional nutritional imbalances.  For instance, in Niger, after one of the famines, all of the food programs were distributed food packages that did not include any source of vitamin A.  The food sped up the metabolism and many young children then developed xerophthalmia, the worst form of vitamin A deficiency which has a 90% mortality rate.  It took a long time for the aid organizations to realize that they needed to work on vitamin A deficiency.  In fact, it was the Ministry of Health, with the assistance of other types of organizations that finally put in place the programs to reduce vitamin A deficiency.  There are other examples of outbreaks of pellagra in Southern Africa.  IN these situations allowing people to trade the food package for other locally available food that will complement the diet often helps. When that isn't possible supplements can be helpful.   Sometimes, if people are given half a chance they really will eat a healthy diet.  If healthy foods are unavailable, unaffordable or inaccessible (e.g.  it become challenging.

Best, Susan Burger

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