From Roots in Farming to Managing Community Response to Malnutrition: Meet El Hadji Issakha Diop
With familial roots in farming, it is perhaps not surprising that El Hadji Issakha Diop became a nutritionist.
“As my father raised sheep and cattle, my mother raised vegetables. I was lucky,” he says, telling me about fruits he used to pick.
“I think this has been a great influence to me getting into nutrition.”
Diop’s early studies were in science, and after he completed his Master’s, he was supposed to be a teacher. But for the first time a graduate studies program in nutrition was launched in Senegal—and his family encouraged him to continue his studies.
His path crossed with the man developing Plumpy’Nut—a peanut butter-based therapeutic food—in Dakar as he presented his Master’s thesis, and he was recruited to test its efficacy against the WHO standard therapeutic milk called F100 as PhD student.
“The weight gain was significantly greater with Plumpy’Nut compared to the standard treatment. And the duration of stay in hospital was shorter,” he explains.
At the time, severe acute malnutrition was treated using therapeutic milk in specialized hospitals. But because the centralization meant very few children suffering severe acute malnutrition had access to treatment—too few children were brought to the centers due to cost, and often they were brought too late. Plumpy’Nut was developed to allow for severe acute malnutrition to be treated at home—the water that needed to be added to the therapeutic milk created an opportunity for bacterial contamination.
Around the same time, two NGOs, Valid International and Concern Worldwide, developed a radically different approach to treating severe acute malnutrition. Diop presented his research at a conference in Dublin in 2003—and was hired by Valid a few years later to teach others about the model. Widely adopted in 2007, what is now known as the community-based management of acute malnutrition (CMAM) approach screens children for malnutrition in their communities—and treats them at home if there are no complications.
Children with severe acute malnutrition are nine times more likely to die than a healthy child—a result of the disease’s damage on their frail bodies, as well as the weakness of their immune system. But now, says Diop matter-of-factly, “we know how to treat them.”
He came to Helen Keller International in 2010 to focus on nutrition as a whole. “People say I’m a CMAM guy … I’m a nutritionist,” he says.
Knowing how to treat them isn’t the only key. “Before screening children, we discuss proven solutions with communities to gain their engagement,” Diop says, highlighting HKI’s integrated approach. Trainings help community health workers learn how to manage malnutrition, and help families learn about essential nutrition and hygiene actions like breastfeeding and handwashing.
Just as important is following up with families with malnourished children to understand why they’re doing what they’re doing.
“Sometimes they have the knowledge, but they don’t practice,” he says of breastfeeding. “Sometimes they don’t have the time because they are too busy collecting wood, water, etc... Sometimes it is the influence of a grandmother. Sometimes it is social norms.”
Facilitated discussions help people come to their own conclusions about a practice without a trainer telling them what to do.
“When I want to discuss about the importance of having a variety of food, I try to ask people to share their different experiences,” he says. “One mother can say, ‘It is important. It helps the child to grow. It helps the child to be healthy. And I see you, your child is weak. You’re always going to the hospital. My child is healthy. I give him eggs. Maybe you should try this.’”
So while he supports HKI country offices in implementing, monitoring and evaluating their CMAM programs—and even advises other nongovernmental organizations—he’s returned to his roots in teaching. He’s beginning to train other facilitators on essential nutrition and hygiene actions who will support these mothers, and lecturing occasionally at university, too.
In this way, Diop’s own impact mirrors that of HKI: By translating his research into action, he has empowered others to manage acutely malnourished children—contributing to someday reducing the number of children who needlessly die from malnutrition every year from three million to zero.
Watch Diop's speech to the 2016 Spirit of Helen Keller Gala.