Vitamin Angels spreads their wings over India and beyond
Spreading the Micronutrient Message
Beneath the smog-choked skies of Mumbai – where India’s 21st century rise to prosperity is evident in the shine of skyscrapers, the glitz of mega-malls, and the bustle of the Bollywood film industry – fast-moving streams of raw sewage dissect Mawlenagar Malad. This smelly, fly-infested slum is where 20,000 people live on one dollar a day, packed with their entire families into one-room, makeshift shanties. That population may seem a forgettable fraction in a metropolis that’s home to nearly 20 million, including some of the world’s wealthiest. But this is the face of modern India, where hundreds of millions still live in extreme poverty even though the subcontinent’s wallet keeps getting fatter.
But in Mawlenagar Malad, the sad stench of despair is slowly being suffocated by the pungent possibilities of hope. Over the past couple of years, the residents have taken the health and hygiene of the community into their own hands. They have embraced the importance of proper nutrition and – despite their lack of formal education and reliance on traditional superstitions – they are now strong believers in the power of vitamins and minerals to improve the wellness of their children. These days, there are classes every week in the slum on how to be more hygienic, how to give better food to children and how to incorporate more vitamins and minerals into your diet.
This development is the direct result of a fairly recent shift in the global fight against poverty and malnutrition. In the past decade, relief and humanitarian organizations have started to understand that it’s not just how much food goes in a mouth, it’s also what’s being eaten that plays a role in improving health. After decades of showering macronutrients, such as fats, carbohydrates and proteins upon the planet’s impoverished masses, humanitarian and development organizations are now shifting their focus to include distribution of micronutrients, those vitamins and minerals that people who are not struggling to find their next meal often take for granted. In many developed nations, people get their micronutrients through fortified grains, salt and dairy products, but also through a diverse diet that blends fruits, vegetables and meats rich in various vitamins and minerals.
Perhaps none are applying this micronutrient message more than Vitamin Angels, a nonprofit based in Santa Barbara, California, run by a former nutritional supplement executive named Howard Schiffer. From Mawlenagar Malad and India’s worst slums to Central America, Southeast Asia, and sub-Saharan Africa, Vitamin Angels has been distributing vitamins to children and mothers worldwide since the mid-1990s. Last year, Vitamin Angels began an ambitious campaign to eradicate global Vitamin A deficiency worldwide. But even that is just the tip of the micronutrient iceberg for Schiffer, who explained, “The day that kids are born who have a full chance of meeting their intellectual and structural capacity – that would be the end goal. Every person has a right to basic nutrition.” In addition to providing actual vitamin nutrition, the organization contains a strong educational program that teaches participants which foods to eat to obtain micronutrients and encourages and financially supports the growth of community gardens sown with healthy fruits and vegetables.
Opening Their Wings
Howard Schiffer
It wasn’t the malnutrition of Mumbai’s slum dwellers that threw Howard Schiffer into fighting global micronutrient deficiency. The
impetus was much closer to home: the 1994 Northridge earthquake, which forced tens of thousands out of their homes and into temporary camps. Working as president of nutritional company All One, Schiffer fielded a call from his friend at Direct Relief International, another globally focused Santa Barbara-based nonprofit. They needed vitamins to stave off the beginnings of illness in these quake camps. Schiffer tapped his connections in the nutritional supplements industry, and three days later, the vitamins showed up. He immediately realized the need for vitamins in disaster situations.
Working first under the wing of Direct Relief and then branching out on his own in 1998, Schiffer’s nonprofit grew quickly, jumping from 1994’s count of 100,000 vitamins distributed to a 2005 tally of 100 million. It was an entirely volunteer effort until 2004 when Schiffer – who’d taken out two mortgages on his house to stay financially afloat – began getting a salary; since then, the staff has grown to about one dozen people, but Schiffer said that 95 percent of the budget still goes straight to the programs. The nonprofit sent vitamins into Indonesia after the tsunami and New Orleans after Hurricane Katrina. They also began long-range efforts to stop mothers dying from childbirth in Bali with prenatal vitamins, to fight rickets in Tibet with calcium and Vitamin D and to improve childhood health in the Dominican Republic with daily multivitamins and anti-parasitic tablets, among many other programs.
To do so, Schiffer connects with existing agencies in these countries – such as midwife organizations in Indonesia and the ministry of education in Honduras – and adds vitamin distribution to their repertoire. “We try to be value-added,” he explained. That ensures a reliable infrastructure, keeps overhead costs down and leads to more in-country support and acceptance since the locals are still in charge. And childhood health, believes Schiffer, will make the rest of these peoples’ lives that much easier. “Our sense is that nutrition is a core strategy, a foundation piece,” he explained. “If you deal with that foundation, then you can deal with education and all those other things. But you’ve got to put that one in place first.”
Today, Schiffer is operationally prepared to go far beyond the seven million children and mothers they currently reach in about 40 countries worldwide. “We could reach 50 million this year if we had the funding,” said Schiffer, who said that Vitamin Angels’ annual budget is now about $1.5 million, but bemoaned the constant fundraising required by the lack of an endowment. “The challenge we’re facing right now is that our funding is for three to five months, but our programs are three to five years.”
We don’t want to be handing out vitamins forever. That doesn’t make any sense…. I’d be happiest if I came back to see gardens being planted. –– Howard Schiffer
Vitamins For Village People
In 2007, Vitamin Angels launched Operation 20/20, which seeks to end childhood blindness caused by Vitamin A deficiency throughout the world, by 2020. That requires distribution of Vitamin A every six months for kids between the ages of two and five. It’s combined with an anti-parasitic tablet that rids the child’s stomach of the worms prevalent in areas without clean water or basic hygiene.
The program costs $1 per child for four years of treatment. Vitamin Angels reached 4.5 million children in 2007 and will hit seven million this year. Though 17 countries across the world are already benefiting from Operation 20/20, the country benefitting the most, just by numbers alone, would have to be India, where two million children are receiving the vitamins.
Problems Everywhere
“India is the white elephant,” explained Schiffer, one afternoon last February on the way back from a vitamin distribution in Pune, a city of 2.5 million where 1.5 million live in slums. “Anybody who’s dealing in humanitarian relief has to come to a point where they realize they’re going to interface with India.”
But in a land of many problems, India’s greatest struggle is against catastrophic poverty. And though the urban slums get a lot of attention due to their deplorable living conditions, the bulk of India’s poverty is in the countryside, where more than 70 percent of the extremely poor reside.
Schiffer and his Vitamin Angels team visited one such area in early March on the Sundarbans Delta on the backwaters of the Bay of Bengal. A three-hour drive and one-hour boat ride out of Calcutta, the delta is comprised of more than 100 separate islands about half of which are occupied, and the other half remain home to the elusive Bengal tiger. The island villages appear idyllic at first glance, National Geographic-ready throwbacks to traditional communities: dung-covered homes surrounded by bright green rice paddies and coconut palms; men and boys throwing nets from their low-floating boats to catch fresh fish; cows grazing everywhere; various foodstuffs drying in the yard; communal kitchens inside familial compounds; grains stored in wicker granaries painted with native symbols; children spinning tops on the pathways; women dressed elegantly in colorful saris and sparkling jewelry. The communal nature of these villages is repeated in the urban slums, which is why many city dwellers say they prefer slum-life to more isolated apartment living.
Get a little closer, and the reality is that these people are surviving predominantly on a diet of rice, which does not have the necessary full complement of vitamins and minerals to prevent deficiency diseases and help them reach their full growth capacity, both physically and mentally. Furthermore, the village’s problems – lack of sanitation and clean water – are exactly the same as their slum-dwelling countrymen. They need vitamins as much as anyone, which is why a crowd of nearly 200 gathered for the Vitamin Angels distribution that Schiffer conducted earlier this year.
These distributions – during which the Vitamin Angels team is feted with traditional welcoming ceremonies, gives speeches about the value of vitamins, and then passes out the micronutrients – are just one aspect of Schiffer’s job as head of an international nonprofit. Like an orchestra conductor, on each of his trips abroad Schiffer must harmoniously blend aid distribution, deal-arranging, headline-generating, problem-solving, promise-making, fundraising, trust-building, speech-giving, staff-educating and ceremony-enduring.
Vitamin A is necessary for:
- Eyesight due to development of the membranes around the eyes.
- Mucus membrane integrity: skin, respiratory, digestive and urinary tract system linings.
- Immune system function.
Deficiency can lead to:
- Weakened immune system leading to reduced ability to fight off common childhood diseases.
- Poor eyesight, lack of night vision and blindness.
Vitamin A deficiency is the world’s leading cause of blindness. More than 50,000 children in India and 500,000 worldwide develop
preventable blindness from Vitamin A deficiency.
Some sources suggest that more than 10,000 U daily of Vitamin A taken by pregnant women can be toxic to the developing fetus. During pregnancy, appropriate amounts of the vitamin are important for cell differentiation and eye development.
Beta-carotene is a plant phytonutrient that gets converted in the body to Vitamin A. Vegetables sources of beta-carotene include:
Dark green leafy vegetables:
Kale
Spinach
Turnip greens
Collard greens
Cilantro
Red and orange vegetables & fruits:
Carrots
Red and yellow peppers
Winter squash
Tomatoes
Nasturtium
Sweet potatoes
The distributions conducted by Schiffer during these trips are largely symbolic (they only serve 100 or so kids each time, whereas more than two million are served every six months in India alone), but they also give him a chance to check in with the various in-country agencies that he uses to distribute vitamins and educate villagers about health, hygiene and sanitation. And so far, whether working with religious organizations such as Believer’s Church near Calcutta, government agencies such as the education ministry in Pune or health providers such as the Child Eyecare Charitable Trust in Mawlenagar Malad, Schiffer has yet to see any misuse of vitamins or deworming tablets, which can fetch as much at $8 per pill on the black market. “Fortunately, we’ve been led to the right people,” he explained.
As vitamins were dispersed on the island village, Schiffer smiled broadly as he played with the children under the brightly colored tent. “What I see all over the world is that they’re just kids,” he explained. “They’re no different than our kids. They were just born in untenable circumstances. They were just born in the wrong place at the wrong time, and even with that, there’s so much joy.”
Micronutrients and Global Health
Of course, Howard Schiffer’s job doesn’t end every time his plane lands at home. In addition to fundraising, speech-giving, and running the day-to-day operations of Vitamin Angels, Schiffer also attends conferences to learn more about global health problems/solutions and meet the people behind the fight. One such conference happened in Santa Barbara a few days after Schiffer returned from India, when he joined dozens of global health experts to discuss “Hidden Hunger: Socioeconomic and Scientific Challenges.”
Focused solely on improving the developing world’s micronutrient nutrition, the conference brought together economists, public health officials, humanitarians, nutritionists, doctors and scholars from Guatemala, Pakistan, Baltimore and beyond. “We can’t break the poverty-education-nutrition-health trap without a common agenda,” urged the opening speaker Klaus Kraemer, of the Swiss humanitarian agency Sight and Life, explaining that the lack of micronutrients – especially Vitamin A, iron and iodine – is a major reason families get stuck in the cycle of poverty. Micronutrients have been deemed “one of the best buys in advancing global welfare,” according to the Copenhagen Consensus of 2004.
As such, speaker Zulfiqar Bhutta of Karachi, Pakistan, opened, “I think the world is positioned uniquely to see an end to these major micronutrient deficiencies over the next decade.” Bhutta, who works with Micronutrient.org, admitted that vitamins can be a hard sell to governments that are dealing with strife and acute disease, but said it’s an easy argument to make since malnutrition is robbing these countries of five percent of their GDP, yet it would only take 0.3 percent of the GDP to eliminate malnutrition (both caloric and micronutrient malnutrition). “This would be the bargain of the century,” he explained, later adding, “The stronger economic argument we have, that’s the best chance we have, because the ministries of finance control the purse strings.”
Immersed back in sewage stench and strewn trash of Mawlenagar Malad, this message hits home for Schiffer. “[For] this entire slum [it] costs just $2,500 to provide Vitamin A and deworming medicine,” he explained. “That’s not a lot of money.” Indeed, one of Vitamin Angels’ most amazing promises is that just $1 can help prevent one child from going blind due to Vitamin A deficiency.
In the future, Schiffer plans to start getting vitamins to younger and younger children, bolstered by a recent study that shows a drastic decrease in child mortality for kids who get a dose of Vitamin A within a few days of being born. Then the focus will shift to women’s health and pre-conception. Meanwhile, community education programs must grow and gardens full of nutrient-rich vegetables must be planted. “We don’t want to be handing out vitamins forever,” Schiffer said. “That doesn’t make any sense…. I’d be happiest if I came back to see gardens being planted.”
For Schiffer, the promise of micronutrients is nothing short of a miracle. “There are many problems in the world today that require billions of dollars and decades to solve,” he explained one afternoon in the squalid suburbs of Calcutta, while teaching a group of Indian educators the benefits of growing and eating Vitamin A-rich foods such as papaya, carrots, and bell peppers. “This isn’t one of them. We can solve this now.”
For more information about Vitamin Angels, visit: vitaminangels.org
Matt Kettmann is the senior editor at the Santa Barbara Independent and has covered global health issues in Africa, Asia, South America and the United States for a variety of publications.
By Matt Kettmann
