One Child at a Time; Holt and SPOON Partner to Improve Nutrition

Jennifer Goette, Holt’s director of strategic initiatives, is currently visiting Holt’s partner programs in India with Zeina Makhoul of the SPOON Foundation. Here, Zeina and Jennifer are working to develop a pilot nutrition screening program for orphaned and vulnerable children. Once complete, the nutrition screening will be implemented throughout Holt’s country programs — ensuring all children in care receive the vital nutrition they need to grow and thrive!

by Jennifer Goette, Holt Director of Strategic Initiatives

Jennifer with children in the kitchen at VCT.

There is a story of an elderly man and a little boy who discover a beach littered with thousands of starfish.  The starfish go on and on as far as the eye can see.  Knowing that these little creatures will surely die in the hot sun while the tide is going out, the little boy picks up one of the starfish and throws it into the sea.  He does this a few times before the old man says, “Son, you will not be able to save them all!  Why are you wasting your time?” As he tosses another starfish into the sea, the boy replies, “But father, it made a difference to that one!” He picks up another.  “And that one!”  And he reaches for another.  “Also that one!”  As the boy continues to throw starfish into the sea, the old man understands.  Soon he joins in and one by one, they both throw starfish into the sea.

This story comes to mind when looking at the complex issue of malnutrition in India.  In a country where a staggering 47% of children in the general population are malnourished, it is horrifying to think about the number of orphaned and abandoned children who are failing to receive the nutrients they need for healthy development.  But much like the story, while the numbers are overwhelming, our actions do matter to the children we are able to reach.  We are able to make a difference for those children who come, one by one, into our care.

At Vathsalya Charitable Trust (VCT) in Bangalore, one of Holt’s long-time partners in India, the staff estimates that 85 to 90 percent of children entering their care show signs of malnutrition.  To help address this issue, Holt recently began partnering with the SPOON Foundation, a Portland, Oregon-based non-profit agency that strives to improve nutrition for orphaned, fostered and adopted children. With training and technical support from SPOON, Holt and our staff and partners around the world are hoping to change the picture for children who get off to a difficult start in life. Holt and SPOON have designed a bold new initiative to identify malnutrition in children and create positive changes in our pediatric nutrition and feeding practices. Three of Holt’s partner organizations will take part in the first phase of the project, including two in India and one in Haiti.

Zeina Makhoul, SPOON’s nutrition assessment specialist, and I are here in India this week to visit and learn from the two local organizations participating in this pilot nutrition screening program. Zeina and I have spent the last few days with the staff at VCT to learn more about their current nutrition and feeding practices, as well as clinical support for children in their care. Expert in child care and child welfare programming, VCT’s staff already possesses a strong understanding of the critical role nutrition and feeding play in the lives of the children in their care. With insight and training from Zeina, our goal is to give the staff an even wider range of resources and empower them to identify and treat different forms of malnutrition, including vitamin and mineral deficiencies.

Children in care at VCT eating lunch.

During our visit, Executive Director Mary Paul and her staff share numerous stories of children they have saved from the brink of death.  They describe one little boy named Rajeesh*, who was an especially tough case.

Rajeesh was two years old when he was found abandoned and referred to VCT’s branch office in Raichur.  Rajeesh’s initial medical examination diagnosed him as having severe anemia and moderate cognitive delays.  At the time, Rajeesh was not able to speak and could not sit up without assistance.  He had a protruding stomach, often a sign of protein deficiency.

This little guy was immediately given a blood transfusion for anemia and started on iron, zinc and calcium supplements.  With a balanced diet and regular monitoring of his anemia, it took more than one year in care before the staff noticed significant improvements in his energy and his iron tests reached normal levels.   A few months before his third birthday, Rajeesh was transferred to Bangalore, where he now lives with a loving foster family and has access to speech therapy twice a week.  Although Rajeesh continues to struggle with concentration and has some difficulty speaking, signs of the irreversible damage caused by early malnutrition, he has shown vast improvements in his energy level and overall health.

Lunchtime for babies at VCT!

Zeina and I meet Rajeesh when he comes to the care center for informal school.  He is quite the character, teasing the other children while bouncing around from one activity to the next.  His deep brown eyes have an impish twinkle.  He knows how to charm the caregivers – you can tell he is a staff favorite.  As the mid-morning snack is passed around, he is quite the helper, passing out orange wedges and collecting plates when snack time is finished.  As the other children wash their hands and return to classes downstairs, Rajeesh is the last child remaining.  We giggle as we watch him take a cup out of the cupboard, help himself to a drink of water, and then place the unwashed cup back in the cupboard.  He flashes a big smile and skips off.  One of the cooks shakes her head and smiles as she retrieves the cup and washes it.  What a cheeky kid!

Rajeesh has been matched with an adoptive family and will soon start a new life in the United States. He is one of the lucky ones – a child who has survived and thrived in spite of the difficult circumstances of his early life.  While we may not be able to counter all of the effects of malnutrition in children coming into care, we want to do whatever we can to give children the best start in life.  Rajeesh, and other children coming into care, deserve the very best treatment we can offer.

It’s stories like these that drive Holt and the SPOON Foundation to look for new ways and additional resources to tackle the problem of malnutrition in orphaned and abandoned children, one child at a time.


Together, Holt and SPOON are working to ensure all children in care receive the vital nutrition they need to grow and thrive.

Zeina Makhoul, SPOON’s nutrition assessment specialist, is also keeping a blog while traveling with Jennifer in India. Click here to read it!

In September 2012, Zeina also visited the Holt Fontana Village in Haiti, the first pilot site chosen for nutrition assessment. Click here to read blog posts from her trip to Haiti!

Click here to learn more about our work in India.

* To protect his identity, this child’s name has been changed and no photos of him are posted.



3 Replies to “One Child at a Time; Holt and SPOON Partner to Improve Nutrition”

  1. You are doing wonderful work. The percentage of malnutrition-ed children in India is a disgrace to that countries government.Keep up the great work!!

  2. The smile on those kids’ faces tell the story: full tummies and happy smiles. Good workm Holt and SPOON!

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