Nutrition in the first 1,000 days of a child’s life from pregnancy to the second birthday is absolutely critical in his or her development. Without adequate nutrition, especially during this window of time, these children face a high risk of physical and mental damage that is virtually irreversible and could compromise their future when their lives have only just begun. Yet, one out of four children – roughly 146 million – in developing countries is underweight, according to 2007 figures from UNICEF. In fact, 10.9 million deaths of children under five die each year in developing countries, and malnutrition and hunger-related disease caused 60 percent of those deaths, according to 2007 figures from UNICEF.
Rising food prices caused by changes in supply and demand of food (brought on by climate change and changes in food consumption patterns) is set to further exacerbate an already growing dilemma. In response to this escalating global problem, Concern Worldwide (Concern) and US-based group Bread for the World organized a conference on June 13, 2011, titled, “1,000 Days to Scale Up Nutrition for Mothers and Children.’ The meeting in Washington saw political leaders, UN, and World Bank representatives leading members of the private sector, and those from non-governmental organizations reiterate the importance of ensuring adequate nutrition is received by all children in their first 1,000 days on this earth, share best practices, and resolve to invest more in food security.
Concern Worldwide has been at the forefront of this fight against hunger since its humble beginnings in Ireland in 1968 as a humanitarian organization focused on disaster management. Now equally active in both disaster management and long-term development, Concern’s footprint can be found in 50 countries in Africa, Asia, and the Caribbean.
Humaneity Magazine speaks to Tom Arnold, CEO of Concern Worldwide, to find out more about the work his organization is doing.
Who we are
In 1968, Concern began its operations as an organization that dealt primarily in disaster management. Formed by a small group of determined people in response to appeals from missionaries working in war-torn, famine-stricken Biafra (a state in southeastern Nigeria), the organization has since grown and currently manages a wide range of developmental programs focused on emergency relief, education, health, livelihoods and AIDS/HIV.
In its early disaster management work, Concern was quick to recognize the vital connection between seemingly different humanitarian relief work such as short-term disaster management and long-term developmental work, and as a result, has been working in both domains with much success. As Arnold explains, “We very much see the connections between the two. You don’t just go in and sort out the immediate problem, you sort it out with a view to acknowledging there is a future. Concern has always made that connection that even though we have a lot of experience in responding very quickly and effectively to emergencies, we do it in a way that we think about the short-, medium- and longer-term needs of the population.” Illustrating the importance of this unique attribute and organizational ethos, Arnold talked about Concern’s experience at the Haiti earthquake disaster last year. “The case of Haiti was by any standard just a terrible disaster. We intervened early as we’d been working in Haiti for the past 16 years and knew the country. From that early intervention, we could get food, water, and shelter to the people immediately and effectively. We were also beginning to think about trying to get the children to school so we created spaces where children could be brought together to get an education. We also looked into health services for the people, which have a long-term impact.”
Innovative solutions
As an organization, Concern values, encourages and incorporates the philosophy of innovation. The organizational culture of innovation is encouraged from the top-down as well as from the bottom-up; field level staff on the ground can submit innovative ideas to upper management for their consideration. In fact, the culture of innovation has been key in its pioneering success and impact in the international developmental world. Arnold shared two of Concern’s signature innovations.
Community Management of Acute Malnutrition (CMAM)
The brainchild of Dr. Steve Collins of Valid International – who has been working with Concern for many years as a doctor – CMAM is an approach to malnutrition aimed at reaching children outside of traditional therapeutic centers, thereby increasing the organization’s impact and allowing more people to take advantage of such resources. Traditionally, children who faced malnutrition had to be fed at therapeutic centers until their health improved. Due to the distance of the therapeutic centers from their homes, many families or mothers had to accompany their children to the therapeutic centers and stay there for extended periods of time while their children got better. As such, the family members were unavailable to take care of important tasks at home, such as food production.
The CMAM approach gives families the capability to take care of their malnourished children from the comfort of their own homes and within the community. For example, children are given one week’s supply of medical treatment and vitamin-rich food, or ready-to-eat therapeutic food from the mobile clinics to take home.
Concern and Valid International piloted a CMAM project in Malawi in 2001, providing ready-to-eat therapeutic food that was based on peanut butter, enriched with vitamins and easily produced locally. Over the three-year pilot period, Concern quickly found that this new approach produced positive results. As Arnold explains, “We demonstrated that we were able to achieve two key things through the CMAM pilot: Firstly, the mortality rate of the region was reduced and secondly, the coverage of resources was substantially increased. When we assessed the overall effect here, we saw that (the CMAM approach) was a different way of doing things.” In April 2007, this new approach of fighting malnutrition was recognized by the UN as a best practice, adopted for use by other UN organizations such as UNICEF and the World Food Program, and has been recommended for use by Governments.
Cash Transfer System ( Social Security)
In 2008, Concern in collaboration with the Kenya Government introduced the Cash Transfer System, which provided monthly cash – instead of the direct provision of food – to the beneficiaries, enabling them to purchase food items of their choice from the local markets. The cash transfers were made using mobile technology and beneficiaries could access the money from their local bank or local trader. As a result, almost all participants reported increased meal frequency and diversity.
Arnold elaborates, “We were being very strategic in terms of getting money to people who needed the money in an innovative way, and they were buying the local food of the economy. It made a great deal of sense.”
Innovating Fundraising
As Arnold explains, the philosophy of innovation also extends to the way Concern approaches fundraising. First, a good reputation built on a lot of trust is absolutely fundamental for fundraising. With that aspect achieved, Concern engages a variety of methods to achieve its fundraising goals. For example, it has a system where people who support the organization can give on a regular monthly basis, which is particularly important for long-term planning, as the organization is able to forecast its budget with more clarity. Concern has also raised money and awareness about nutrition by hosting a one- or two-day fast in Ireland. Participants fasted for one or two days and asked their friends to sponsor them and donate the money to Concern. Recently, Concern started a ‘Women of Concern’ idea, where a group of well-known women was brought together as an advocacy group for Concern.
This is for me a real success story. He had a huge impact on his community while he was working with us and now even more so.”
Can you share a beneficiary’s story?
In 2002, Malawi underwent a severe drought that left many families without sufficient food and, due to increased food prices, many families could not afford to buy what little food was left. Dowa, a district in the central region of Malawi, was one of the hardest hit areas. The Loveness family of Chimbaku village found it increasingly difficult to gather food every day, with competition for their main source of food of wild fruits growing. One of their children, Samuel, eventually succumbed to acute malnutrition and fell ill.
As Josamu Loveness recalls, “I had nothing to give my family. As a result, one of my children, who was two years old, started swelling. I took him to Nambuma Parish Hospital and was told that he was suffering from acute malnutrition.”
Samuel was lucky as Concern and Valid International were piloting the CMAM program in the area, and became one of the first beneficiaries of the project.
“When we brought Samuel to the hospital, he had no appetite. The hospital gave him milk and the following day he was put on a strict diet of chiponde (local name for ‘ready-made therapeutic food’). His recovery was miraculous. Within days, we could see some great changes in his health,” recalls Loveness.
Today, Samuel is 11 years old and studying in the primary school. He is healthy and according to his parents, doing well in class.
Can you share five lessons learned/advice for other NPOs?
- You have to be clear about what you want to do and not spread your organization too thin. Make out very clear objectives and make sure your organization has the resources and skills available to try and meet those objectives.
- Have very good, solid financial management.
- Think through what it is you want to do and build relationships with the right people.
- Listen to the beneficiary communities. Do not assume you know the answers before you speak with the beneficiaries.
- Collaborate with the beneficiary communities, their views are important and collaboration with them is essential.
What’s next for the organization?
Arnold shares what the future is in store for Concern: “We’ve been looking at the next few years and we really want to focus on hunger and health, which are two areas that we think are going to be of crucial importance. The areas that we have considerable expertise in, we want to build on and continue to have a bigger impact in reaching more people and benefitting more people’s lives.”
He adds, “Innovation and using technology to a greater and better extent has to be at the heart of what we do as well because no matter how much we have as an organization, it is still not going to be enough given the scale of the problem. Therefore we have to be innovative and come up with newer and better ways of doing things.”