September 30, 2008

13 Min Read
Saving children: One vitamin at a time

by Karen Raterman

It had been a long day. The wake-up call at India's Ravishankar Maharaj Eye Hospital was at 3:30 a.m. to drive to the Ahmedabad airport for a flight to Kolkata (formerly Calcutta). By evening, Howard Schiffer, founder of Vitamin Angels, was addressing a crowd of parents and children in the Kolkata's Madhyamgram neighborhood. In this city of more than 13 million people, these children live in, at best, overly crowded conditions in two-story shanties and cement-block houses. Few homes have running water or proper sanitation.

But thanks to the Believers Church and its Bridge of Hope Project, these children will have vitamin A. An important new partner for Vitamin Angels' India program, the Bridge of Hope group has arranged for Schiffer and his team to distribute vitamin A capsules and antiparasitic tablets. One of many in-country partners to Vitamin Angels, Bridge of Hope serves more than 12,000 poor children, both Christian and non, in and around Kolkata, India's second-largest city. The children welcomed the Vitamins Angels team, throwing flowers at their feet and greeting them with songs, speeches and dances. Schiffer was in his element as he looked out at the sea of curious faces.

"Vitamin Angels believes every child has the right to grow up healthy," he says. "Each of you has a gift to give India and the world. But to do that you have to be healthy, and vitamins help give you the best chance to be healthy."

Schiffer detailed Vitamin Angels' mission to eradicate childhood blindness from vitamin A deficiency, and then explained to parents and children that vitamin A is important for good vision, immune health and normal body development. As he finished his speech, missionary workers from the Bridge of Hope swung into action. Nearly 100 children politely formed a line and awaited their turn, mouths open, eyes wide, as the workers squeezed the golden liquid vitamin A into their mouths and then encouraged them to chew the antiparasitic tablet that came next. A distasteful grimace usually followed.

As the distribution took place, Schiffer wandered among the parents and children, chatting and asking mothers their children's names, ages and about living conditions in the neighborhood. He singled out mothers with children who looked particularly malnourished or ill and gave them bottles of multivitamins with instructions to take one every day.

This scene played itself out two to three times daily for Schiffer, who, with his videographer and some accompanying journalists, was on a February and March trip to India to distribute vitamins in six cities. The schedule was grueling. The next morning began at 6:30 a.m. in Kolkata with a three-and-a-half-hour bus ride covering only about 125 miles. Traveling by road in India is laborious. Narrow, poorly maintained local roads, coupled with the congestion of foot travelers, street vendors, rickshaws, bicyclists, cars, buses and the ever-present sacred cows, make for a harrowing, stomach-churning experience.

Nagendrapur is located on Raidhigi Island in the backwaters of the Bay of Bengal, between Kolkata and the border with Bangladesh. From the bus, the group hitched a ride with rickshaw wallahs to a congested port town, where they boarded a canopied boat for the one-hour journey to the island. Every aspect of the trip was orchestrated by the Believers Church team.

Hospitality and ceremony were an important and necessary part of the Vitamin Angels tour in India. When the team arrived in Nagendrapur, they were welcomed riverside by village children in their school uniforms and by four sari-clad women, who performed the traditional West Bengal welcome by blowing conch shells, offering blessings and presenting the visitors with marigold necklaces and colorful cotton shawls. The whole party then walked together along a makeshift road of inlaid bricks and straw on an elevated section of land between rice fields. Along the way, they were greeted by curious villagers going about daily tasks of washing clothes, tending fields and drying peppers.

Space and locally grown food appeared more abundant here than in poor neighborhoods in Kolkata, but conditions in Nagendrapur are still primitive. Families live in one-room mud huts where cow dung rests on rooftops to dry so it can later be used as fuel. There is no running water, electricity or latrines, and few children have shoes.

This lack of sanitation is the crux of health problems in the developing world, and, in particular, in India. Because of the large number of people without basic services, hygiene, sanitation and water, as well as nutrition, are key to a solution for malnutrition-based blindness, Schiffer says. It has become Schiffer's mantra during the past 14 years as he has traveled the world bringing vitamins to medically underserved children in poor urban and rural areas.

Worldwide statistics are alarming. According to the World Health Organization, vitamin A deficiency affects between 100 million and 140 million children around the world every year. Of those, 250,000 to 500,000 go blind. The primary cause of VAD is chronic malnutrition from a lack of red, green, yellow and orange fruits and vegetables—foods rich in vitamin A. The issue is finally receiving some attention. Shortly after Schiffer's trip to India, the 2008 Copenhagen Consensus, a priority rating of the world's biggest challenges by 50 top economists, put distribution of essential vitamins as the No. 1 investment.

Vitamin Angels' program is a no-brainer, according to Schiffer. "Chronic malnutrition and poverty are the immediate crisis," he told missionaries at the Believers Church. "This is a problem, but we know the solution today, and we can change lives dramatically."

Vitamin A can have an important impact on public health. Statistics show that vitamin A supplementation in deficient populations can reduce child mortality by 23 percent. It helps children under 5 who are most vulnerable, and it is especially important for babies under age 1. While blindness is the most commonly known effect of vitamin A deficiency, children who lack this micronutrient may also suffer from infectious diseases, such as measles, diarrhea and malaria, according to WHO reports. "The further we get into this," Schiffer says, "the more we see that blindness is just the sentinel marker. In the end, the malnourishment is taking their lives."

Industry support

The Vitamin Angels plan is simple. The blindness-prevention program administers two high doses of vitamin A, along with two antiparasitics, per child, per year. The de-worming tablets are necessary, Schiffer explains, because if the child has worms, parasites will consume the vitamin A before the child can absorb it. The cost of the vitamins and antiparasitics as well as the logistics, education and administration is 25 cents for each child each year. The total cost of a four-year program is $1 per child. In March 2006, Vitamin Angels set a goal to eradicate VAD by 2020. The India trip was the group's first major step in its Operation 20/20 global campaign.

But distribution of vitamins is only part of the story. Schiffer spends countless hours in his Santa Barbara, Calif., office and traveling around the country soliciting funds and product donations from the natural products industry, including companies such as NOW Foods, Zsweet, Irwin Naturals, Purity Products and retailers like the Vitamin Shoppe and Pharmaca Integrated Pharmacy. "There are so many organizations that people can donate to where they don't know if they are going to make a real impact in the world. This isn't one of them," Schiffer says. "We know that with vitamin A, these children won't go blind."

"For us, Vitamin Angels is the choice because it is a low-tech, low-cost program that is efficient and has high impact," says Tim Avila, president and CEO of ZSweet. "There is not a lot of overhead. It is not like a program where they have to make expensive AIDS drugs." Working with Vitamin Angels is attractive to many industry companies because its mission is well-aligned with the industry and provides a positive message about the value of nutrition and efficacy of dietary supplements. The Vitamin Shoppe, based in North Bergan, N.J., which recently announced it would double its support of Vitamin Angels in 2008 to impact 1 million children in the Operation 20/20 program, reports that Vitamin Angels resonates with its employees and customers. "Rarely does a company have the opportunity to associate its charitable giving with an organization so closely aligned with its own mission," says Tom Tolworthy, CEO of the Vitamin Shoppe.

Companies working with Vitamin Angels can also customize programs specific to individual businesses. For example, Purity Products makes a donation for every person who purchases a cup of coffee at its offices. With 150 employees, the company has been able to generate more than $600 a month through its Coffee Clutch for a Cure program, which amounted to more than $5,000 a year for Vitamin Angels.

Los Angeles-based Irwin Naturals developed a program that involves consumers and store employees to maximize donations to Vitamin Angels. The company supports its in-store campaign, which launched last May, with promotional efforts such as store displays, informational brochures, signs and television advertising to create consumer awareness about Vitamin Angels.

In addition to rallying industry support, Schiffer travels at least once a month, talking about the program and developing partnerships in all 18 countries in which Vitamin Angels operates. In its 14 years, Vitamin Angels has distributed approximately 100 million vitamins around the world. Vitamins have been given to pregnant mothers in Bali, to children in Tibet, to the survivors of the 2004 tsunami in Indonesia and to the victims of Hurricane Katrina.

Local partners
In-country partners are essential to the operation, and Schiffer makes connections with local agencies to piggyback on existing programs. These partners, which include everyone from village midwives to ministers of health and education, provide a local infrastructure to keep costs down, provide better navigation through bureaucracies and easier acceptance with villagers. "To expand and ramp up, you have to have a plan," Schiffer says. "Most partners have good intentions, but they often have no idea what it takes. The people who excel are the ones who keep asking questions and monitor what's happening."

Vitamin Angels relies heavily on its partners to educate local villagers about the purpose of vitamins and to help with distribution logistics. "We can't do our work without you," he told the Believers Church missionaries. "Women control health care at the village level," he explained. "It's the mothers, grandmas and aunties who know who's pregnant and who's sick. We must get them involved."

Nourishment for the lowest castes

Back in India, Schiffer and his team were in the southeastern coastal city of Chennai (formerly Madras), India's fourth-largest city with 6.4 million people. The Believers Church-Bridge of Hope is once again the guide as the team visited a slum near the outskirts of Chennai called Kodungaiyur. This distribution was similar to the others: Children offered an assortment of skits, traditional dances and speeches. There was one notable exception. The party was joined by a visiting government dignitary, Salma Roakkiah, chairwoman of Tamil Nadu's Social Welfare Board, who offered her support and endorsement.

One of the poorest areas Vitamin Angels visited, the Kodungaiyur neighborhood is flanked by a city dump and a recycling facility with mountains of trash surrounding it. Most children in this Bridge of Hope project are part of Chennai's lowest caste. Their parents are mostly rickshaw wallahs and rag pickers, people who sort through the trash for discarded items to sell. The families live in government housing in the area—a grouping of four-story cinderblock buildings with one-room apartments and multiple families living in each. There is no running water and the children play in a trash- and debris-filled road surrounding the complex.

Schiffer took an unscheduled tour through the neighborhood, chatting with the residents through Bridge of Hope translators. The group was invited into a one-room house with a corrugated tin roof. A family of four lives in the house, which has a small kitchen area in front. A single bed and a small black-and-white television are the only furniture. The family said it is a pretty nice place to live—until the annual monsoons come, when the low-lying area floods and the residents must evacuate.

Schiffer and the team rejoined the guides and headed off to another distribution outside the city. They ended their day at a dinner with Chennai-based philanthropist Dr. N Sethuraman, a long-time partner with Vitamin Angels and one of the few India-based business supporters of the program. He is a restaurant entrepreneur as well as board chairman of the Menakshi Mission Hospital and Research Center in Madurai, the group's next stop. Dinner conversation inevitably moved toward reaching more children and longer-term solutions to poverty and malnutrition.

That vision is never far from Schiffer's thoughts. Back in Santa Barbara following two more tours, one in Guatamala and one in Honduras, he mused that the goal is clear, even if the exact road to it is not. "It is just becoming so obvious—the opportunity is enormous. We are in a good position to reach these people, but we must grow the organization."

Schiffer's plan is to capitalize on growing validation, such as that from the Copenhagen Consensus, to enlist more corporate partners and create market-based distribution in these developing countries. "It would be a lot of work for Vitamin Angels on the front end—we would identify health promoters in the villages and provide education, mechanics and product, but once they got the product, they would know what to do with it."

Eventually, if he gets his wish, Schiffer will see more than vitamins distributed to these villages. He envisions sending seeds, fertilizer and volunteers to help train communities in basic gardening skills. Children must be involved, he is fond of saying. "They are very proud to help feed their village and classmates. And we want them to understand that vitamin A comes from food, not just capsules."

Schiffer would be happiest of all if he came back to find villagers growing gardens full of vitamin A-rich foods. After all, he says, "We can't give out pills forever."

But for now, he soldiers on. At the last distribution in Chennai, in the village of Padappai about an hour outside the city, Schiffer delivered yet another speech and praised the Bridge of Hope's effort to embrace both traditional Hindu culture while teaching Christian values. Its goal, according to the Rev. Praison John, back in Kolkata, is to create healthy, productive citizens and a new vision for India. "We are honored to help Vitamin Angels fulfill their mission," he says. "Not only are we strengthening the children, but we are strengthening the country too."

Despite the fanfare in Padappai, stray dogs looked on, goatherds shepherded their animals by and women in saris plodded past, loads of wood on their heads for the evening fire, only mildly curious about the strange visitors in their midst. The India of today, while in transition, still has a long way to go.

Karen Raterman is a freelance writer who has been covering the natural products industry for more than 12 years. On her trip to India she was blessed by an elephant in the Sri Meenakshi temple in Madurai and is awaiting the good fortune it will bring her. You can contact her at [email protected]

Natural Foods Merchandiser volume XXVIII/number 10/p. 60,62,64

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