Public Nutrition from an Approach to a Discipline: Concern's Nutrition Case Studies in Complex Emergencies

The Public Nutrition approach, like that of Public Health, is context specific. It places an emphasis on populations rather than individuals and is inter-disciplinary in nature. Both approaches seek to understand the complex aetiology of a clinical outcome such as malnutrition within the widest possible framework. Public Nutrition uses the UNICEF conceptual framework and adapts and expands it. The authors of this article argue – through the examination of a number of case studies taken from the work of Concern Worldwide (hereafter referred to as Concern) in southern Sudan, Rwanda, Angola, Tanzania and DRC – that there are two critical constituents of the Public Nutrition approach. These are: a contextual analysis (including the use of surveillance information for programme design and advocacy) and community involvement at all stages of the project cycle. Some of the key obstacles to the adoption of the Public Nutrition approach are identified by illustrating two practical programme settings. For the Public Nutrition approach to be more widely used, the authors recommend a number of key strategies including the further dissemination of case studies and the clarification of the scope and boundaries of the approach. These strategies will enable Public Nutrition to evolve both as a practical programme framework as well as an academic discipline.     

Evaluation of a cost e ective technique for treating aquaculture water discharge using Lolium perenne Lam as a biofilter

Wastewater stabilization ponds generate low cost by-products that are useful for agriculture. The utilization of these by-products for soil amendment and as a source of nutrients for plants requires a high level of sanitation and stabilization of the organic matter, to maintain acceptable levels of soil, water and air quality. In this study, two aquaculture wastewater treatment systems; recirculating system and a floating plant bed system were designed to improve the quality of irrigation water in local communities with low income. In both systems the grass species Lolium perenne Lam was used as a plant biofilter while vegetable specie Amaranthus viridis was used to evaluate the performance of the system and the suitability of the phyto-treated water for irrigation. It was found that the harmful material removal rate for recirculating system was 88.9% for TAN （total ammonia nitrogen）, 90% for NO2--N, 64.8% for NO3--N while for floating plant bed system 82.7% for TAN, 82% for NO2--N and 60.5% for NO3--N. Comparative analysis of the efficiency of waste element removal between the two systems revealed that both systems performed well, however, plant growth was not robust for floating plant bed system while recirculating system is energy consuming. Although both systems did not attain sufficient levels of TN （total nitrogen） and TP （total phosphorus） load reduction, the treatment with L. perenne remarkably improved the irrigation water quality. A. viridis plants irrigated with the phyto-treated discharge water had lesser concentrations of heavy metals in their tissues compared to those irrigated with untreated discharge. The control plants irrigated with untreated discharge were also found to be highly lignified with few stems and small leaves.     

Livelihoods,power, and food insecurity: adaptation of social capital portfolios in protracted crises—case study Burundi

The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor‐based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework.     

The Management of Severe Malnutrition in Burundi: An NGO's Perspective of the Practical Constraints to Effective Emergency and Medium-term Programmes

The NGO, Action contre la Faim (ACF), has been operating in Burundi since 1994, where the situation has dramatically hampered humanitarian programmes. These include poor security resulting in an inability to maintain 24-hour care for the severely malnourished and poor access to the beneficiaries, all within a politically and economically unstable context. However, ACF has been able to capitalise on lessons learnt and reflect on ways to move forward, which have included the improvement of their capacities in the treatment of severe malnutrition and the integration within broader disciplines and national structures.
The protocols for the treatment of severe malnutrition currently used in Burundi have been developed as a result of the research of ACF over the past five years. Other aspects of the nutrition programme remain to be further developed. These include, for example, an improved capacity to care for severely malnourished adolescents and adults; and also a better knowledge of the beneficiaries to allow for stronger links between the provision of treatment and support for their longer-term food security.     

Reconciling reintegration: the complexity of economic and social reintegration of ex‐combatants in Burundi

The extent to which disarmament, demobilisation and reintegration (DDR) programmes initiated by state or multilateral agencies can realise the reintegration of ex‐combatants remains debated. While some consider that DDR should have the ambition to result in long‐term reintegration, others argue that DDR should focus on short‐term goals. This paper explores experiences with the reintegration of ex‐combatants in Burundi. It shows the interconnectedness of economic and social reintegration processes, and demonstrates that the reintegration of ex‐combatants cannot be seen in isolation from the wider recovery and development context in which DDR is taking place. Moreover, the case demonstrates that reconciliation and social reintegration are deeply interconnected, to the extent that social reintegration may fail if reconciliation is not taken into account. Rather than a debate between long‐ and short‐term goals, the focus should therefore be on increasing the understanding of reintegration processes and finding ways in which programmes can contribute to those.