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close this bookScurvy and its Prevention and Control in Major Emergencies (WHO; 1999; 70 pages)
View the documentAcknowledgements
View the documentScurvy: definition
open this folder and view contentsIntroduction
open this folder and view contentsScurvy
open this folder and view contentsVitamin C
open this folder and view contentsRecommended Daily Allowance (RDA)
open this folder and view contentsSources of vitamin C
close this folderStrategies to prevent scurvy in large refugee populations
View the documentBackground
close this folderMain approaches
open this folder and view contentsDistribution of fresh foods
open this folder and view contentsExchange of rations/extra rations
open this folder and view contentsFortification of relief food
View the documentFortification of cereals
View the documentFortification of sugar
close this folderFortification of blended cereal-legume foods (blended foods)
View the documentAdvantages
View the documentDisadvantages
View the documentFeasibility
open this folder and view contentsSupplementation
open this folder and view contentsPromotion of kitchen gardens
open this folder and view contentsOther options
View the documentCosts
open this folder and view contentsConclusions and recommendations
View the documentReferences
View the documentAnnex 1
View the documentAnnex 2
View the documentAnnex 3
View the documentBack Cover

The fortification levels of currently available blended foods would need to be adapted if they were to be used as a vehicle for micronutrients, including vitamin C, for the general refugee population. The current ration of 30 g, at a fortification level of 30-60 mg of vitamin C per 100 g, does not cover daily requirements for vitamin C. Either the ration or the fortification level has to be increased. The following points would also have to be considered when choosing blended foods as the vehicle for vitamin C:

• How is the food prepared and how much vitamin C is lost in the process?

• Do all family members consume the food regularly (scurvy in refugees has been seen mainly in adults)?

• Is the food traded, swapped, fed to animals, etc.?

Blended food is used for rehabilitating young moderately malnourished children; it may account for 50% or more of their energy intake. Concern has been expressed (ACC/SCN, 1995) that an adapted blend used in the general ration may provide too high levels of some micronutrients-though not vitamin C-for young children. It was therefore suggested that the use of two blends should be investigated, the nutrient content of each being tailored for a specific purpose. The question arises here whether it would not be more convenient to fortify the staple cereals provided in the general ration instead of developing 2 cereal-legume blends.

Research carried out by OXFAM/UNHCR looked at the usage of blended foods in an emergency at the household level. In addition it investigated refugee preferences for a range of ration and non-ration foods, and looked at the feasibility of cereal fortification in a refugee situation. There were no major problems with either the use or acceptability of blended foods. The study, however, highlighted some technical and operational issues regarding quality control and timely supply of locally produced food products. The strategy of cereal fortification was shown to involve major issues of technical and operational feasibility in two Africa sites which would need to be dealt with for successful implementation of the use of fortified cereals in an emergency (Mears & Young, 1998). A study conducted by the Committee on International Nutrition (1997) suggested that much higher levels of fortification would be required depending on the ration size and that increasing Vitamin C fortification of all blended foods was not cost-effective.

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