Photo By: Lindsay Rosenfeld

By: Hannah Nemer

The beauty of MANA as an RUTF (Ready to Use Therapeutic Food) is that it is ready to use. But just because it is ready and capable, does not guarantee its immediate implementation.

When Lindsay and I came to Uganda, we both underestimated the difficulties of MANA distribution. I had this cartoon image in my head of Lindsay and me in superhero capes, armed with a fortified peanut butter nutritional supplement as we fought off malnutrition. While MANA has such superpowers, our superhero distributing skills are lacking.

We have spent the past three weeks, with four boxes full of just-waiting-to-be-eaten MANA – four boxes that could save the lives of four severely malnourished children. And yet, in boxes the MANA still remains.

It’s difficult to isolate exactly one reason that MANA distribution is not as easy as it would seem. As much as I would like, I cannot simply hand over the packets to a child with demonstrated need. Legally, a qualified clinician must serve as a middleman. In that legal vein, Uganda’s anti-competition agreement with Nutriset, the manufacturer of the RUTF Plumpy’nut, further complicates distribution. As a for-profit business, Nutriset has a monopoly on the supply of RUTFs in Uganda, meaning that Ugandan MANA distribution is legally questionable.

Legal hoops aside, MANA also must also deal with the unexpected. Lindsay and I are working with Renee Bach, a woman who runs a local children’s clinic from her home. About two weeks ago, Renee identified a malnourished child who could benefit from MANA treatment. This two-year-old boy, however, has been much sicker than originally imagined. His dehydration and aversion to food have pushed back the MANA start-date by almost two weeks.

Furthermore, the work that Renee does is so in demand and so necessary that she is inundated with new emergency cases everyday, making it difficult for us to justify taking her time with discussions of logistics.

Still, we are hoping that within the next week we will get the MANA go-ahead.

Changing the world is not as simple as having a heart in the right place and a plane ticket to Africa. Even the best of intentions are subject to unexpected turn of events.