By Samantha Urban, ONE Campaign
The 1,000 Days movement is a response to recent food crises and new research on the economic and social costs of childhood hunger. It’s focused on providing proper nutrition during the first 1,000 days of children’s lives, beginning with their mother’s pregnancy. Proper nutrition during these days can heavily influence an individual’s ability to grow, learn, and work. In his new book, The First 1,000 Days: A Crucial Time for Mothers and Children – And the World, author Roger Thurow takes readers into the lives of families in four corners of the world—Uganda, India, Guatemala, and the United States—in order to show the science, economics, and politics of malnutrition.
We recently interviewed Roger on his book, how mothers and children are more adversely affected by malnutrition, and what we can do to help:
What, exactly, is so important about the first 1,000 days of life that you made it the title of your book?
The first 1,000 days – from the time a woman becomes pregnant to the second birthday of her child – is the most important period of individual human development. This is the time when the foundation for good physical growth is set, when the brain is developing most rapidly, when the immune system is strengthening. What happens in those 1,000 days determines to a large extent the course of a child’s life — his or her ability to grow, learn, work, succeed – and, by extension, the long-term health, stability and prosperity of the society in which that child lives.
Good nutrition is the cornerstone for all this development. Any hunger shock or bout of malnutrition or micronutrient deficiency during the 1,000 days can lead to physical and mental stunting, which is a life sentence of underachievement: diminished performance in school, lower productivity and wages in the workplace, more health problems throughout life and a greater propensity for chronic illnesses such as diabetes and heart disease as an adult.
One of every four children under five in the world today is stunted. The book illustrates how the costs of malnutrition and stunting – the cost of lower education, poorer productivity, greater health care expenses — ripple throughout society, from the individual to the family to the community to the nation to the entire world. Thus, a stunted child anywhere is a stunted child everywhere. A lost chance at greatness for one child is a lost opportunity for all of us. If we want to shape the future, to truly improve the world, we have 1,000 days to do it, mother by mother, child by child.
Why did you choose to follow women from Uganda, Guatemala, the U.S., and India—and were there any commonalities or differences in the cases that surprised you?
In writing the book, I set out to bring the first 1,000 days to life, to bring forth the faces, voices, emotions of mothers and children and families. The women in Uganda are pioneers in an effort to bring agriculture and nutrition closer together through biofortification: growing staple crops, like vitamin-A rich orange sweet potatoes and high-iron beans, that have higher levels of nutrients.
The moms in India are involved in a range of behavior change efforts to lower infant mortality. The women in Guatemala are pursuing knowledge in a nutrition rehabilitation program that promotes health, nutrition and cooking classes to achieve healthier pregnancies, births and children. The moms in the U.S., in Chicago, are confronting challenges in their social environments that range from living in food deserts to navigating a dramatic spike in neighborhood violence.
I expected to find differences stemming from culture, tradition, language and environment – and I did. But I also found, unexpectedly in some cases, commonalities among all the moms: their pursuit of knowledge, particularly on the nutrition front; their aspirations for their children; their battles with poverty, which prevented them from putting their knowledge into action; their frustrations with government to bring improvements in nutrition and health and infrastructure and security down to their household level. There is this, too: the nutrients vital for proper growth in the 1,000 days are humanity’s common denominator. No one is above them or beneath them, whether rich or poor, urban or rural, educated or illiterate, North or South, Republican or Democrat.
We know that poverty is sexist—can you discuss how girls and women are also more adversely affected by malnutrition?
In India, I’d often see a mom eating by herself, scraping together what was left after her husband and children had eaten. It was according to custom, that women in the family eat last, and usually, least. This pattern was also evident in Guatemala. It was also common that moms relied on their husbands to provide the grocery money; often, the men underestimated the need of their pregnant wives to eat more and eat better, so there wasn’t enough money to purchase sufficient vegetables and fruits and proteins. Often the moms found that their new-found knowledge, which was meant to be empowering, turned out to be a burden because they couldn’t properly act on the knowledge.
Malnourished, stunted children often become malnourished, stunted adults. Stunted girls become stunted mothers who in turn give birth to low-weight babies. The cycle of malnourishment and stunting spins through generations; poverty gets only deeper. It is exacerbated in places where women have little say over family size. In one of the Indian families, the husband insisted on having children until his wife gave birth to a son (which is a common desire in many Indian families). In the course of the book, their family grows from four children to five and then to six. All are girls. At the end of the narrative, their father realizes that his growing family has only made their climb out of poverty steeper: how, he wonders, will he feed, clothe and educate all his daughters?
What can governments and organizations do to fight malnutrition?
Governments need to reverse the neglect of nutrition; less than 1% of health budgets goes to nutrition. Although nutrition is the cornerstone of development efforts everywhere, it has essentially been nowhere in development strategies. Governments and organizations need to confront the economic costs of malnutrition; awareness needs to spread among financiers as well as humanitarians. Nutrition investments must be prioritized. Above all, political will must be mustered, by rich and poor governments alike, to end the scourge of malnutrition and eliminate the shame that one-quarter of the world’s children are stunted. The outrage must grow: What are we doing to ourselves, what great potential are we squandering, by tolerating continued malnutrition and stunting in the 21st Century?
The First 1,000 Days: A Crucial Time for Mothers and Children – And the World, is available now.