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ReportontheMoringa&AmaranthusDisseminationSeminar:

SustainablesupportformalnourishedchildrenwithanemiaOn Monday April 3rd, and April 4th 2017 a seminar on how to support early childhooddevelopment under nutritional &medical aspects took place, as well as on how to use localresourcesforimprovingnutrition&healthintheruralarea.ThisseminarwashostedbyShiningEyese.V.andfundedbythefoundationFIATPanisGermany.TheSeminarwasconceptualizedbyMonikaandSilviaGolembiewski.The initial idea behind this seminar found its origin through the nutrition intervention studyimplementedfromFebruary2015toAugust2016byShiningEyesincooperationwiththeNGOBolpurManabJamin,fundedbyShiningEyes,FIATPanisandtheRotaryClub.ThisstudyispartofaPhDprojectof theeconomistSilviaGolembiewskiandthenutritionistCarolineStiller.ThepurposeofthisstudywastoinvestigatewhethertheaddingofMoringaoleiferaandAmaranthustricolorleafpowderversaanadjustedamountofanindustrialmicronutrientsupplementshowacomparable effect on the hemoglobin level in children. As a follow-up project participatorylearning andactionmodules are started in24 villages, accompaniedbymedical checkups andscreeningforemergencypatients,anemicchildren,moderatelyandseverelywastedchildren,TBpatientsandpregnantwomen.Thisholisticapproachwas fundedbyFIATPanisaswell, in thescope of “Auslobung für die praktische Erprobung von Forschungserbnissen zur BekämpfungvonHungerinErinnerunganden90.GeburtstagvonDr.HermannEiselen.”ShiningEyesisanon-profitcharitableNGOfoundedin2009.MonikaGolembiewski-theheadofthe NGO- has been active in India since 1994 to providemedical care and awareness to theSantal families in the rural areas around Bolpur, soon after her son Nico and his wife SilviaGolembiewski joined the work of Shining Eyes and are guiding and structuring Shining EyesactionsinIndiatogether.To use natural resources available and revitalize traditional knowledge about herbs and thepowerofnatureforhealthisonewayShiningEyeswantstostrivefor.FormanyyearsShiningEyes is using the Moringa leaf powder in programs to promote health. The Moringa &AmaranthusSeminar intendedtodisseminatethepositiveexperiencewithMoringaduringthelong-terminterventionstudyaswellastomultiplytheknowledgeandexperienceShiningEyeshashadwithMoringaovertheyearsthroughthecooperationofthetwoGermanhorticulturistsRolfandAnneBucher.The workshop will help to create a pool of innovative ideas which helps to develop newstrategiesforchange.OnthefirstdaywecouldwelcometheGermanambassadorMr.Schrod,aswellastheBDOMr.SamitPanigrahifurthertheSDOSampaHazrafollowedhisinvitation.SilviaGolembiewskiguidedtheaudiencethroughthespeechesinthetwodaysofseminarandorganisedaninteractiveexchangeofexperienceattheendoftheworkshop.Afterthewelcomespeech by Dr. Sujit Kumar Paul, Visva-Bharati University, the first presentation by Dr. med.Monika Golembiewski gave an insight into the situation on-site, this means illustration ofprevalences ofmalnutrition and key findings of the village work of Shining Eyes and therebyexperienced challenges and taken measures. The approach of Shining Eyes to combatmalnutritionandadvocatingdiseasepreventionincludesthevillageprojectskitchengardening,nutritionprograms,sanitationprograms,andawarenesstraining.Furthermedicalcheckupsareamain determinant of villagework building the bridge to diagnostic and follow up. During a

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village checkup it is screened for tuberculosis, pregnant women, malnourished or anemicchildren and with the subsequent coordination of diagnostics, prenatal care, home-basedsupplementary feeding or iron drop therapy. Severely sick patients are referred by a hospitalcoordinatortootherhealthinstitutions.

Pictures:Workshoppictures:recipetastingofself-designedMoringa-Date-Balls,MoringaCookies,andthetwomeals Halwa and Khechuri enrichedwithMoringa/Amaranthus leaf powder. An insight on naturalmedicinemadefromherbsorrootswasalsogiven(Lina–aSantal).PDDr.rer.natScherbaumtogetherwiththeGermanembassadorMr.Schrod.C.Stiller–nutritionist-ontherightside,organisedandcontributedtotheexemplaryrecipepreparation.ThenutritionistCarolineStillercommentedonthetwolocalgrowingplantsMoringaoleiferaandAmaranthustricoloraspotentialsolutionsforasustainablepreventionofanemiatogetherwithintensive awareness trainings and kitchen garden projects. At first the two plants MoringaoleiferaandAmaranthus tricolorwere introducedbypicturingnutrient compositions indetail,therebyhighlightingtheholisticnutrientcompositionofMoringacomparedtootherplantfoods,consideringthequantityandqualityofprotein,aswellasthehighamountsofvitaminA,C,B-vitamins,andE-vitaminandadequateamountsofironorcalcium.AmaranthusisoutstandingintheironcontentbutalsoshowshighlysatisfyingamountsofvitAandC.Thenstudyoutcomesofthe long-term nutrition program hosted by Shining Eyes were introduced. The preliminaryresults revealed a more positive trend of hemoglobin development from February 2015 toAugust2016inchildrenofallinterventiongroupsincomparisontothecontrolgroup.Theleaf-powder supplemented intervention arm showed comparable results in hemoglobin

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development as compared to the commercial micronutrient supplemented intervention arm,followed by the plain nutrition intervention offering merely plain meals without additionalenrichments.Furtheranalysiswillshowwhethertheresultsaresignificant.MoreoverMoringa oleifera leaf powder production and its storagewas indicated and diverserecipes were introduced (Moringa Cookies, Moringa-Date-Balls, Moringa-Chickpea-Rice Balls,HalwaandKhechurienrichedwithAmaranthusandMoringaleafpowderintheratio2:1).PDDr. rer. nat. Scherbaum fromUniversityofHohenheimGermany focusedon the first 1000daysofachild´slife,andtheimportanceofmotherchildinteraction.Abalancednutritionbeforeconceptionandduringpregnancy,followedbyanexclusivebreastfeedingphaseforthegrowinginfant and in-time introduction of nutrient-dense complementary feeding after six months iscrucial forhealthygrowthofthe infant. If thehealthstatusofthemother isalreadyweakandthe feeding of the infant poor, then malnutrition is carried on to the next generation oftenclosely linked topoverty. Further thenutritionof the fatherplaysamore important role thanassumedinthepast.Thismeansduetoyetunknownepigeneticmechanismsthefathershavetogainamoreimportantrolewhentalkingaboutchildhealth,notlastbecausethefathersarealsothe decision-takers and without them mothers are still powerless for change even thoughawarenessmaybethere.Thismeansfutureawarenesstrainingsshouldbeofferedformenandforwomen.Further shepointedout that traditional recipes canbeupgradedbymaking smallchanges in thecomposition thereby implyinga significant improvement in theoverallnutrientcompositionbalancingsomenutrientdeficits.

Pictures: Workshop pictures. On the left PhD student Silvia Golembiewski (economist), followed by Dr.Swapan,Prof.Kumkum,andSt.TheresaSisterwhonotesdownacquiredknowledgeonMoringarecipes.Dr.med.MonikaGolembiewskicommentedontheconsequencesofmaternalmalnutritionwithregardtophysicalandmentalimpairmentsofthefetus.Malnutritionaffectsorgandevelopmentof the heart, kidney and lungs and implies multiple metabolic dysfunctions e.g. high bloodpressure, or diabetes. The nutritional influences on epigenetics are immense. Further drug oralcoholabusus,stressor infectionswerelistedasmaindamagingfactorsforthegrowingchild.Preventiveprecautionswerenamedaswelltopointoutpotentialawarenesstopicsinordertoprecluderisksforchildhealthintime,amongstotherschildspacingisimportanttoname.Further Dr. Monika emphasized how important motoric and cognitive input is for thedifferentiation and connection of neurones during childhood. Cognitive learning has to bepromotedinthefirsttwoyearsofachild´slifeasthisearlytimeperiodisofutmostimportanceforneuralnetworkinganddecidesoverthelearningcapacityofthechildinfuturelife.Onlyifachildreceivesadequatenutritionandisintellectuallychallengedatthesametime,itwillreceiveitsfullmaturityofbrainafterthesecondyearoflife.Prof.Dr. SwapanMukhopadhyay followedon and gave insights into crucial steps of anatomicbraindevelopment,aswellastheimpressiveabilityofthebraintoreconstructitselfinordertoretainabilitiesafterinjuries.

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Pictures: Moringa leaves drying and usage of leaf powder in cooking program, an exemplified design of akitchengarden,anthropometricmeasurementstoseekoutwastedchildren,healthworkerappliesTonoferon-irondropstoananemicchild,medicalcheckupinthevillagebyShiningEyes.Attheendofthefirstworkshopdayapodiumdiscussionclosedtheday.Questionsraisedweretheappropriatedosageofleafpowdertoachieveagoodcomplianceandhowtoerasethefearof the Santhals that "Moringa could lower the blood pressure to a harmful extent". One keystatementnamed,wasthatthefrequency inwhich leafpowder isofferedtoaperson ismoreimportant than the dosage. In general the consumption should be in a regular manner.(Proposeddosageofleafpowder/orfreshleaveswereincludedintheConferenceposters).Dr.SusantaKumarpointedoutthatMoringacanbeutilizedinmanyspheresoflifeandshouldbe further promoted. On the other hand the audience was aware that malnutrition can becombattedbynotonlyonestrategybutmanymeasureshavetobetakenintoconsiderationatthesametime.AmongstothersmostimportantwillbetoraisetheawarenessforahealthylivingineachSantalfamily.Onlythenvillagersthemselveswillrecognizeconditionsofsicknessearlyinenough,andwill adapt to potential changes in a sustainable way. The kitchen garden approach was wellreceivedand isonepromisingstrategy toachievea self-sufficient living foreach familywitha

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diversifieddiet-includingAmaranthusandMoringaamongstotherdarkgreen leafyvegetablesandavarietyofcoloursinsidethegardenaccordingseason.Thediversifiedkitchengardenplaysakeyroleforimprovingnutritioninaholisticapproach.When considering theMoringa leaf powder production on government level a main issue ofconcernwasahigh-qualitypoductionofthisleaf-powderasnutrientswillbelosteasilyintermsof wrong harvest, production or storage conditions. If the government wants to include leafpowderinregulartermswithabroadimpact,thenqualitycontrolisonemajorissuethathastobeassured.Anetworkhastobedevelopedwhichiswellconnectedandinter-related.MoringaandAmaranthusleafpowderhavetobeproducedwiththehighestqualitystandardavailabletopreventtheformationofbacteriaandpreserveasmanynutrientsaspossible.Ingeneralahighinterest fornaturalapproacheswasthere,butalsofor furtherfinalstudyresultsthatmanifestthebeneficialroleofthesetwoplants.

Pictures:Workshoppictures.MonikaGolembiewskipresentstherisksforchildhealthandtheimportanceofabalancednutritionandcognitivestimulationinearlychildhoodtoachievefullbrainpotential,Moringacontainsallnutrientsandfattyacidsneededtopromotebraindevelopment,PDDr.rer.nat.Scherbaumcommentsontheviciouscircleofmalnutritionacrossgenerations.The second daywas opened by Boro Baski, a Santhal -who found beautifulwords for a trueapproach, ifwewanttochangesomething,thechangehastocomefrominside.TobuildtrustamongtheSanthalsandthosenotbelongingtothetribe isthemainstep.WehavetoseetheSanthals fromourhearts thenwewillunderstandhowtobringprogress.This trust-building isonemajorissueShiningEyeslongsforandhasattainedduringthelastyears.Prof. Kumkum- Bhattacharya, Visva Bharati University, Santiniketan took up from here andpointedtothe importancetoraisethepositionofwomenandthatonlyabetternutritionwillmakethechange.Hereeducationisonekeyroletoraiseawarenessbutalsonutritionisequallyimportant to maxing out education to achieve full potential. Moringa is a plant well knownhowevernotexcessivelyused;theknowledgeaboutpossibilitieshowtouseithastobespread.PDDr.rer.nat.Scherbaumfurthercommentedonhowtoachieveamorebalancedandhealthydiet.Hereshegavehintshowtochangeexistingeatinghabitswitheasymeasuresandinsmallsteps, thereby improving the overall nutrient density in a significant manner. Especially shehighlighted thevulnerableperiodsofpregnancy, lactationand complementary feeding,not toforgetthemonthsbeforebecomingpregnant,whicharecrucialforchild´shealth,aswell.

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Sibdas Baski pictured the plantsAmaranthus viridis andMoringa oleifera and emphasized thefavorablenutrientcomposition.Then Dr. med. Golembiewski gave insight into how to organize and conceptualize a holisticawarenessprograminthevillage.Themainaimofeveryawarenessprogramshouldbetolooseno single child, to reach all people in need and tobuild trust and knowledge. This illustrationshowedthecloseinterrelationbetweenimplementationandcontrolgroup.Toassureadequatecompliancehavingthecontrolgroupisdecisiveforsuccess.Awarenessprogramsandinteractivetrainingsareonekeyforself-reflectionandmakingnewexperiences.Familiesrealiseachangeinthe health seeking behavior of their children through preventive actions, followed bymodificationofownhabitsandindependantaction.Swapan Bikash Saha -the director of nutrition of CINI (Child in Need Institute) reported thenutrientamountsper100gofNutriMix.HeillustratedthesuccessstoriesofchildrenwhogainedweighteffectivelyafterNutriMixtherapyandcounselling.Furtherheoutlinedthedifferentstepsof a health program: screening for malnutrition, intensive and repeated counselling sessions,home-basedsupplementaryfeeding,continuedfollow-upandmonitoring.To round up the seminar key drivers for success of programs fighting childmalnutritionweredistributed to the audience by Silvia Golembiewski. Each guest was invited to participate ingroupworkanddobrainstorming.Laterthethoughtsofthegroupworkswerepresented.Mainissues were to empower women, by education. Further to achieve change in small steps, byusingalreadyexistingrecipesorstructures.Interactivecookingsessionsmaybeonepartofit,tostart with the things villagers can provide. This means everybody is required to bring whathe/she has, or what they think what should be in the daily diet. Then lacking food arecontributedbythehostofsession.

Pictures:Thechangeoffoodhabitshastostartathome.Pictureonthetop(left)showsatypicalsituationastobefoundinthevillage:thefatherisnotfullyawareofthechild´shungerorhisneeds.Thefollowingpictureillustratesawomanwhoreceivedcookingtrainingforabalancedanddiversifiedmeal.Germanstudentstrainsocialworkershowtoteachvillagersinthefoodcircle(illustratingdifferentfoodgroupsthatshouldbepresentin the daily diet). Families learn how to prepare complementary food and how to use instant mix powderenrichedwithcommercialmicronutrientstofeedtheirchild.

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Inordertomakewomenunderstandandeasilyrememberagainalreadyexistingstructureshavetobeused,e.g.thecoloursoftheIndianflagtoreflectdifferentfoodgroupsasstaplefoodsorroots (white), protein rich foods (red) and vegetabels and fruits (green). Further the 3G(everybodyknowsfrommobileshop),could illustratethefunctionofdifferent foodgroupsGofoods (staples for energy), Grow foods (meat, egg, legumes, nuts for protein), Glow foods(vegetablesand fruits that strengthen the immunesystemandconcentrationand let theeyesglow/shineforvitaminsandminerals).Tomakepeoplemoreaccountabletheyhavetobelinkeduptoeachothertobuildanetworkofexperts.Knowledgeexchangeshavetofollow.Everbodywho likestochangesomethinghastospend time inside the community, again to build trust and in order to understand allinterrelationsandinfluencingparameters.Wehavetomakeusafacilityofwhatisalreadyexisiting.Weneedtotrainfacilityworker.Thismeansworker who link up to each other, give the structure, who try to seek out vulnerablechildren in the Anganwadi Centres and who try to find sustainable solutions to combatmalnutrition. Further the facility worker will provide training to the AWC worker in teachingmoduleslikemalnutrition,anemia,emergencysignsorhygiene.TheAnganwadiworkersshouldlearnhow to transport critical knowledge in a comprehensiveway.Best is topicture complexinformation as simple as possible packed in real stories experienced by people. The wholesessions have to be repeated and interactive with role playing to track progress. GenerallyAnganwadiCentersshallprovidecognitive input for thechildren,alongwithhighquality food.Food alone is not sufficient. Learning has to be in a creativemore open-mindedway. To thechildrenwewanttogivethepossibilitytocreateownideasandstrategiestoseekoutstructuresforgoodlivelihoodsinthefuture.Further the inclusion of Moringa and Amaranthus leaves in the awareness trainings of thecommunityorleafpowderinthenutritionprograms,shouldbeadvocated.Facilityworkerhavetotrainincrucialawarenesstoincludeleavesinthefamilydietandgetinvolvedinleafpowderproduction.Inthiswayweachievesustainabilityinmanyareas.Noparallelstructureshavetobecreated,ratherwehavetopullinthesamedirectionatonetime,formaxingoutwhatwehave.Inthiswaywecanstrengthenthelinkbetweenhealth,nutritionandagriculture.