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Book Review: ‘Within Our Grasp’ by Sharman Apt Russell

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This article builds upon a news item featured in Field Exchange 65, where ENN announced the publishing of a new book by Sharman Apt Russell. This follow-on article features a review of ‘Within Our Grasp’ and highlights some of the key takeaway messages. https://www.ennonline.net/fex/65/withinourgraspmalnutritionbook

Thomas Stubbs is the Field Exchange Sub-Editor & Content Coordinator at ENN.

Childhood malnutrition is a difficult topic to write about. Often, the majority of airtime for this lamentable subject veers between two narrative extremes, making it difficult to access the full story. On the one hand, densely populated statistical reports with an impenetrable array of numbers target readers in the public health community, effectively quantifying the vast burden of malnutrition yet reducing the stories of these children to percentages on a graph. On the other, there are sullen campaign videos – often edited in black and white and featuring a matching voiceover – or donor newsletters, strategically drafted to invoke an emotional response in their readers. Both, of course, are products of their respective environments (raising funds to combat malnutrition and appraising the evidence on how that money should be spent) and, therefore, both play an important role within the humanitarian and development sector. Nevertheless, both mediums are inherently flawed in their ability to provide insight to this complex arena. By contrast, ‘Within Our Grasp’ sits neatly between these two extremes and makes for a compelling read for those looking for a recap on childhood malnutrition. Namely, where are we right now and how did we get here?

With this in mind, Russell effectively steers the reader through the story of malnutrition, its history and its evolution, framing it as a personal narrative, a far cry from that which can be found in most textbooks and journals today. For those with a scientific background, the narrative may come across as wordy and the book cannot be described as lean. However, this permits Within Our Grasp to be accessible, as the dilution of technical language allows the book to remain engaging yet factual, empowering readers of all types to learn something new. That is not to say that Within Our Grasp is devoid of empirical evidence. On the contrary, Russell has diligently researched the topic at hand, providing a helpful array of references and prevalence statistics on global malnutrition to satisfy the numerically curious among us.

The content, although focused on nutrition, is also wide-ranging, featuring topics such as the Doi Moi reforms in Vietnam, the practice of agroecology and the theory of fighting poverty with profitability using the ‘Fortune at the Bottom of the Pyramid’ concept put forward by the economist, C.K. Prahalad. This helps to frame the malnutrition problem as it is, multifaceted in nature and multisectoral in solution, exposing readers to ideas from different fields by showing them the value of cross-functional collaboration. Nevertheless, the bulk of knowledge sharing is still rooted in nutrition science, where Within Our Grasp effectively refreshes our minds on the aetiology of undernutrition. In particular, the book succeeds in talking the audience through the evolution in thought surrounding kwashiorkor, guiding readers through the various theories postulated over the last few decades, culminating in the current microbiome hypothesis which is still up for debate (Smith et al, 2013).

What sets this book apart is the personal stories embedded within the scientific explanations where Russell writes fondly of her experiences in Malawi, a low-income country that has played an important role in generating the evidence around childhood malnutrition. This provides context to the scientific breakthroughs that are outlined. The stories from the frontline reaffirm the importance of this subject and the lives that are impacted by every missed opportunity. The book quite rightly details the work of pioneers within nutrition (Steve Collins, André Briend, Mark Manary), medicine (Cicelly Williams, Mario Capecchi) and engineering fields (William Kamkwamba), which has the dual benefit of explaining how much work has gone into this issue so far, while also providing inspiration to future leaders and disruptive thinkers in the field.

As well as detailing these pioneers, Russell also draws attention to lesser-known projects and organisations that have been doing, and are continuing to do, important work in combatting childhood malnutrition. Some readers will already be familiar with the inventions that Russell articulates in this book such as ready-to-use therapeutic food (RUTF), specifically Plumpy’Nut – a gamechanger in the humanitarian sector. This is an important story, but Within Our Grasp goes further by shedding light on other innovative projects that deserve recognition. Moringa Miracles Limited, whose mission is to deliver a triple bottom line in Malawi, namely commercial success, social and environmental impact, is an example of such an enterprise. Other success stories include Mary’s Meals, which implements life-changing school feeding programmes in low-income countries, and Project Peanut Butter, another Malawian export which has played an important role in the development of RUTF.

Another innovative idea that Russell highlights, and one which may nod to the future of the humanitarian aid delivery model, is ColaLife, a non-profit organisation which was founded on the following question: “Coca-Cola seems to get everywhere in developing countries, yet life-saving medicines don’t. Why?”. Russell recognises the importance of highlighting these relative success stories, providing a much-needed change of pace from the sobering statistics put forward in large-scale documents, such as the joint UN-agency State of Food Security and Nutrition in the World 2021 Report (FAO).

At its core, Within Our Grasp leaves the reader with a defining sense of hope sullied by a dose of pragmatism. It is a summary piece that outlines the innovations and “revolution”, to use the author’s words, which preceded its publication. It is true that great progress has been made in the childhood malnutrition sector over the last few decades, yet Russell is keen to highlight that the industry is at a turning point. Ending hunger is ‘Within Our Grasp’ – perhaps closer than ever – yet more needs to be done. In this case, ‘more’ refers to novel ways of approaching the challenge of malnutrition, with the sector requiring great transformation in the years to come.

References

FAO (2021) State of food security and nutrition in the world 2021. Fao.org. https://www.fao.org/publications/sofi/2021/en/

Smith, M, Yatsunenko, T, Manary, M, Trehan, I, Mkakosya R, Cheng, J et al. (2013) Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science. 339(6119), 548-554.

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Thomas Stubbs (). Book Review: ‘Within Our Grasp’ by Sharman Apt Russell. Field Exchange 67, April 2022. p13. www.ennonline.net/fex/67/bookreviewwithinourgrasp

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