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Saturday March 25 2023

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Home Topics Rights

The furthest behind “in every context will always be women”

Scale up of care for malnourished mothers has been almost zero per cent

by Lise Colyer
February 25, 2021
in Policy, Features
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Pat Mc Mahon earned his stripes in the field for more than a decade before combining advocacy with his role in charge of Mothers First, a community programme in India dealing with malnutrition in pregnant and new mothers, as well as children.

Now he’s concerned that this year’s United Nations Food Systems Summit will overlook malnourished mothers, and pregnant mothers in particular.

“The UN’s sustainable development goals come with a commitment that no one will be left behind and that we’ll endeavour to reach the furthest behind first,” he says.

“But the furthest behind are not mentioned anywhere in the Food Systems Summit, even though the World Food Programme’s head David Beasley is telling us that 30 million people in the world are on the brink of famine. It doesn’t make any sense. We don’t even have a definition of who the furthest behind are.”

Pat Mc Mahon is quick to provide a definition, “It’s women. The furthest behind in every community, in every context will always be women. You walk into any village and the people with the lowest body mass index will be women – the lowest of all will be in pregnant women.

“Sixty per cent of people who are hungry are women.

“We don’t have gender nutritional equality – it’s a term that we coined at Mothers First. We need parity.”

“She had maybe a day without treatment, or she would have died”

The rate of malnourishment is not surprising given that, as he says, “Only one per cent of funding from international development aid goes to nutritional interventions.”

The journey for Pat Mc Mahon began in 2004 while he was on holiday in India, as a newly qualified nurse. He got lost in a Varanasi slum.

“I found a child dying of malnutrition. I could see clinically and clearly that she was dying and needed help. My background allowed me to act quickly. She had maybe a day without treatment, or she would have died.”

He raced her to the nearest private hospital and said he would pay for her treatment.

“Within a matter of two hours I’d said to the doctor, I can see we could have a programme here,” he explains. “And we ended up renting 10 beds from the hospital for almost a decade, funded from private donations. We set up the programme within that business model.

“Our profit was the child becomes well and we were willing to pay a certain amount for that. That’s how we set up the first feeding centre in the State of Uttar Pradesh, using that infrastructure.

“So, I stayed on in India. I was so affected, my instinct was to help. I had no idea this would become my life’s work.”

“We developed the programme we call CMAM Plus One – the one is the mother”

That first child’s name was Tiza and Pat stayed in contact until she was 12 and the family left the area.

In 2015, after 10 years of treating malnutrition, the local government allowed Pat’s team to start the first community management of acute malnutrition (CMAM), with ready to use therapeutic food, in that state.

“When we got into villages we very quickly realised this was not solving the problem because mothers themselves were malnourished,” Pat Mc Mahon explains.

“And that’s why we developed the programme we call CMAM Plus One – the one is the mother. So, we distribute the ready to use therapeutic food along with a pack of local food for malnourished pregnant mothers – we’ve combined both programmes.

“Even though it’s a humanitarian recommendation to take care of malnourished mothers, scale up in the humanitarian world has been almost zero per cent because they haven’t focussed on prevention or focussed on mothers.

“Now, at Mothers First we are not seeing the same level of malnutrition because we are in the cycle of prevention.

“When women are malnourished, their lifegiving role is compromised – there are consequences. When you treat foetal malnourishment, and intervene in the inter-generational consequences, you see the improvements we’ve seen. The international community has failed to recognise that.”

“The best way to ensure a good start for children is to take care of mothers first”

The programme treats women from the time their pregnancy is confirmed, at around three months, until four months after they have given birth.

Once the free distribution of local, nutritious food has ceased, around 30 per cent of mothers continue with the new diet, showing the educational value of the programme and its long-term impact.

“The best way to ensure a good start for children is to take care of mothers first,” says Pat Mc Mahon. “A mother will automatically share with the household. Social protection programmes recognise that a mother’s instinct and priority will be to spend protection on food to look after her family.

“The international community has devalued that instinct.

“Around 650 million women are malnourished in our world and 700 million women are anaemic. Only 20 per cent of mothers have enough folic acid. We’ve forgotten the mothers.”

With a team of 17, Mothers First is serving 18 villages in Utter Pradesh with around 200 women on the programme at any one time. It’s a model that Pat Mc Mahon says is ready to scale and he urges humanitarian organisations to adopt it.

Extra value is delivered in that local farmers are encouraged to grow lentils rather than wheat, which is less nutritious, to supply the local need.

“I’m deeply touched by famine because my own people suffered this”

The hunger Mother’s First comes across stems from the simple inability to afford the nutritious food which is readily available in markets across India.

“This is why I was so pleased to see the UN Rapporteur on the Right to Food advocating a rights-based approach for the Food Systems Summit,” he says.

“It was the first time I heard anyone take this approach – the idea of the right to food.”

When addressing the number of people in famine-like conditions, Pat Mc Mahon says his Irish heritage has an impact, “I’m deeply touched by famine because my own people suffered this. I connect my own famine history and this experience.

“After being asked into a hut and seeing a mother and her two children who were literally starving to death, I felt the connection very deeply. That’s where I started with advocacy. Within three months I was at a Sun Global Movement gathering in Milan.

“It’s a responsibility for all of us in Ireland because we know about it.”

With this in mind, Mothers First is lobbying for more international aid out of Ireland and for the media to turn its attention to the question of hunger.

Pat Mc Mahon joins our speaker panel at Bossing It, Quota’s Women’s Day event via Zoom on March 3rd. Do come along.

Further reading:

  • Women’s Day mini-brief: it’s still a long way to the top

  • Women represent the leadership needed for a well-nourished world

  • Study finds over two thirds of food systems leaders are men

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Lise Colyer

Lise Colyer

Lise Colyer is a founding editor of Quota. She seeks to improve food systems by communicating effectively across the business, policy and research sectors. Contact LiseColyer@quota.media.

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