Moringa Project

 moringa tree

CWS/AGADA MOTHER AND CHILD HEALTH PROJECT

Early in 1997, CWS/Dakar prepared an overview of the Moringa tree and its various qualities which was then distributed among the network of CWS partners in the region. One contact, Mr. Martin Mané of the Senegalese organization AGADA (Alternative Action for African Development), responded with a proposal for a pilot project to educate the populations in the vicinity of Ziguinchor, south-western Senegal (the Casamance), in the use of this tree to combat malnutrition among infants and women of child-bearing age. CWS commissioned a feasibility study and, after some modifications, the project was approved.

The primary thrust of the project was to train the network of government health workers (doctors, nurses, mid-wives) in ways of using this plant, who in turn would recommend it to their patients and keep records of results. Towards this end informational booklets, brochures, a seminar and radio spots were put together by CWS and AGADA personnel.

The pilot project was intended to find answers to several questions regarding the value of Moringa and public reaction to its use. Although grown widely in the region, the leaves are only an occasional food source and much of the nutritional content is lost by the common practice of boiling the leaves and then discarding the water as many as three times before the leaves are eaten.

Among the questions to be answered:

  • Would Moringa leaves, leaf powder and pods be visibly effective in treating malnutrition and promoting physical health and well-being?
  • In a place where there is only very limited awareness of nutrition and the importance of balanced diets, would people see the value of adding Moringa to their foods as a purely nutritional measure?
  • Would people be receptive to changing the way they prepared fresh Moringa leaves?
  • Would people be receptive to adding new foods, such as Moringa pods, to their diets?
  • Would local consumption of Moringa remain dependent on outside encouragement and training, or could it develop spontaneously? 

In Senegal, where the tree is often grown around people's houses, the tree is called "Nebeday;" most likely a derivative of the English words "never die" in reflection of the tree's ability to withstand drought, grow quickly from seed or cuttings, and regenerate itself even after the most severe pruning.

Mr. Atabou Mané, supervisor of the primary health care department at the hospital in Bignona, 30 km north of Ziguinchor, is one of the 171 health workers who have attended a Moringa seminar. He was impressed with the possibility of treating malnutrition with locally-available products.

"We have always had problems with the classical approach to treating malnourished children. This was based on industrial products: whole milk powder, vegetable oil and sugar. All these things are expensive. When you tell a parent to go out and buy these things -- this can be truly costly for him. On the other hand, with Moringa the resource is locally available. The people themselves can produce it.

"We have done experiments in treating malnourished children with this plant and the results have been really spectacular. Now, when women bring their children to our hospital we explain to them about Moringa and show them how to prepare it. It is sufficient now to continue the training and publicity about this local plant which has so many virtues.

"Personally, I often suffered from fatigue. These days, when I feel tired I will eat Moringa and afterwards I always feel much better. I believe that if we can promote this tree on a large scale we could solve many problems. This year, during the wet season, we will plant Moringa trees behind the hospital."


Mrs. N'Deye Sakho, a colleague of Mr. Mané, is a nurse in charge of pediatrics at the Bignona hospital. She goes out herself to collect Moringa leaves and keeps dried leaf powder on hand to give out to mothers of malnourished children. She has kept records, including photographs, of children who have recovered from malnourished states through the addition of Moringa to their diets.

"When women bring their children here, we weigh the child and give medicines for any disease he has. Then we explain to the mothers the importance of Moringa and advise them to put a little bit of leaf powder in the child's food every day. From what we've seen so far, it is really an excellent product. When the women bring back their child some time later, we hardly recognize them!"

In her book are "before-and-after" pictures of several children who were treated solely with Moringa leaf powder, along with their ages and weights at various times. Among them:

  • Abdoulaye Diallo, a boy who weighed 5kg 100g at the age of five months when he was brought to the clinic on February 27. By April 13, his weight had increased to 8kg 950g.
  • Maimouna Diedhiou, a girl who at 50 months weighed 8kg 900g. One month later, on June 4, she weighed 9kg 900g.
  • Fatmata Gassama was 17 months old and weighed 6kg 350g on February 2. On May 18, she weighed 8kg 800g. "I think that, using Moringa, we won't have many problems in helping children recover from malnutrition because it is so easily available. Women usually have the tree growing around their houses. They can collect the leaves and prepare the product themselves.

"The other products I have used to treat malnourished children are also very good, but they can be very expensive and, right now, life is difficult for most people. For women to add these things to their children's diets costs a lot of money. For that reason, I think children can recover faster with Moringa because everyone can afford it. I personally eat it a lot."

Mr. Siaka Goudiaby, an administrator at the general hospital in the city of Ziguinchor, needed little convincing about the value of Moringa. A diabetic, he has for the past three years been controlling his blood sugar levels by periodically drinking a tea he makes from Moringa leaves. Directly after attending the AGADA training course, he took the initiative to begin planting the trees around the hospital.

"We are going to plant one thousand trees this year around the hospital complex. That way we will always have a ready supply of leaves to treat the cases of malnutrition we receive. I have even suggested we rename the hospital "Nebeday!"

At the pediatrics and maternity department of Ziguinchor's hospital work Mrs. Bintu Ndour Sané, a mid-wife, and nurses' aides Mrs. Souadou Sagna and Mrs. Astou Magna. All three attended an AGADA seminar.

Mrs. Sané required a bit more convincing: "When I was a child my grand-mother would sometimes prepare Moringa leaf sauce. I would leave the house because the smell

made me nauseous! So that when we were told about this seminar, I really didn't see the point.

"But when we had the seminar, absolutely everyone was impressed. All these years we have been walking by this tree without knowing its virtues! We have learned about it late, but now that we know we are doing everything we can to promote it.

"After the seminar we gave some demonstrations for the staff who had been unable to attend. They were all really interested. They even asked that we meet at least once a month to try different ways of preparing the Moringa products. They were all ready to contribute to pay for everything we need to make the different preparations. Everyone is really interested in this."

At the end of the seminar, each participant receives a small sack of leaf powder to take home and try. Mrs. Souadou Sagna added two spoonfuls of powder to a palm oil sauce.

"My son really liked the sauce. He asked me where I had learned how to make it! Since then we have had the sauce on several occasions and I have prepared the pods three times. I no longer feel the fatigue I used to suffer from all the time. Since the first day, my children and I have seen the virtue of this plant."

Between April and December, 1998, the center for the treatment of malnourished children at this hospital treated 45 children aged 0 to 5 years, 20 of whom were severely malnourished, adding Moringa leaf powder to infant formulas. 17 of the severely malnourished and all 25 of the moderately malnourished enjoyed full recoveries.


Mr. Amadou Ba is director of the health post in Tendouck, a village located a few kilometers north-west of Bignona.

"We were all trained in the "classic" solution for treating malnutrition: a combination of whole milk powder, sugar and vegetable oil, sometimes peanut butter. But these ingredients are often too expensive for mothers to buy. The recovery of malnourished infants can take months this way. Now we have replaced this with Moringa.

"When a malnourished child is brought here, we start him on millet broth with a spoonful of Moringa leaf powder added, three times daily. We start seeing improvements within ten days."

Mariama Kamara is a woman living in Tendouck. She was a regular consumer of Moringa both during her pregnancy and afterwards. When her son Bassirou was born, he weighed 4kg. Nine weeks later, he weighed in at 7kg 500g. Mr. Adamou Ba, director of Tendouck's health post, says that in twelve years there he has seen only one other baby weigh so much at birth.

Awa Diedhiou was two months' premature when she was born on December 10, 1997. A very tiny baby, she weighed only 1.5kg. Her mother, 22-year-old Maïssata, also had problems.

"After the childbirth, I had no hope for my baby's life. She was so thin! And I was having problems myself. I was very weak and suffering from dizziness, and I was not producing enough milk for my baby.

"Martin Mané counseled me to try taking Nebeday with my meals. So, I began adding leaf powder to my food. A couple times I even put some powder in the formula for my baby."

In this photograph, Awa is five months old and weighs five kilograms. She is still a small baby, but appears to be quite healthy. Maïssata has no doubts about the reason for this.

"It was the Nebeday. After I started eating it my dizziness went away and I started producing enough milk. I felt

healthier, and both the baby and I began gaining weight." And what will she do the next time she gets pregnant? She laughed. "I will eat it regularly!"

Living on the same street in Ziguinchor is Mariama Diedhiou. She and her 17-month-old son Cheikh Aliou both appear very healthy. But this was not always the case.

"At first, when I tried to nurse my son I was not producing enough milk," recalls Mariama. "Then I started to eat Moringa. After a short while, I had enough milk again.

"In my family we now eat Moringa sauces at least three times a week. My son also eats the sauces with us. Every other time I had a baby, I lost weight during the months I was breast-feeding. This time, I have been gaining weight"


The health worker based in the village of Ediamath, near Tendouck, had attended an AGADA seminar. Upon her return to her post, she taught the techniques of Moringa preparation to the women of the village. On their own, they have devised many recipes for cooking the pods. Each woman keeps a sack of leaf powder in her house.

Comments made by the women during the demonstration:

"Since I began eating Nebeday, I have felt stronger. No more tiredness all the time."

"This is the first time I have not lost weight while breast-feeding a baby."

"I used to have pains in my lower back which were so bad that some mornings I could hardly get out of bed. But now, if I eat Nebeday in the evening, I will wake up feeling really good."

"Since we did the training and began eating Nebeday, not a single woman or child has had to go to the clinic. No one has gotten sick here."

"My husband is always asking me to prepare fried seeds and pods. (But he still won't give me the money to buy the oil!).

"The first time I put the leaf powder in a sauce for my family, my son felt sick afterwards. He vomited, and there were white worms {tapeworm} in the vomit."

"Some of the people here eat some leaves raw every morning or cook leaf sauces five times a week."

"The pods taste very good, like sweet potatoes."

"After we boil the pods, we distribute the water and drink it. It tastes sugary."

"If you eat Moringa pods, you won't have any constipation!"

"You sleep very well when you eat this."

(Have any bad side-effects been noted?)

"When my children eat it, they sleep longer."

Mr. Georges Ousmane Diatta is director of the health post in the village of Thionk-Essaie. He also reports instances of children voiding tapeworms after eating Moringa leaf powder, and cases of chronically weak women recovering health and strength from the addition of Moringa to their diets. He says that every mid-wife and health worker in the zone is being requested to grow a Moringa tree. "People are getting jealous about their trees," he noted. "Before, nobody bothered much about them. You could go anywhere and collect the leaves. Now, people are refusing permission for their neighbors to harvest from their trees. Some people are now walking as far as 10 kilometers away to get leaves."

In Dioubour, 20 km north-east of Ziguinchor, AGADA trainers prepare to give a Moringa familiarization seminar to the women of the village. Since the training was given to health workers in the region, various health agents have requested AGADA to visit their respective villages to repeat the seminar for the benefit of the local

population. Two local radio stations also broadcast programs about Moringa, twice weekly for a month. As a result, requests for training are coming in from well outside the project's target area. In addition to the health workers, AGADA had given the seminar to 1,436 people as of May 20, 1998.

Safiatou Goudiaby and Aïssatou Diatta, the AGADA trainers, travel from village to village on mobylettes to give the seminars. All the materials they need can be found at each site, since the trees are common to the area. Part of the training course consists of demonstrating ways of preparing Moringa leaves and pods so as to retain the maximum amount of nutrition possible.

CONCLUSIONS

An outside evaluation of this project was conducted in December, 1998 by a team comprising the director of Ziguinchor's regional office for nutritional feeding programs, the regional director of the primary health care program, and the director of the Dakar-based consultancy firm Performances. They interviewed seventy individuals during the course of the evaluation. This was necessary because, without the benefit of long-term and statistically rigorous studies, the conclusions are perforce based on anecdotal evidence. Based on their report, some answers can be given to the original questions:

Would Moringa leaves, leaf powder and pods be visibly effective in treating malnutrition and promoting physical health and well-being?

Through the project's collaboration with local health posts, successful treatment of malnourished children has been well-documented. Interviews with men and women who have made Moringa a regular part of their diets point out that they have a keen awareness of improvements in their health and energy. The evaluation cited two villages (Coubalan and Tendouck) where the women remarked on the general improvement in health, particularly among children, since the Moringa promotion. At one health post (Tendouck), the pharmacy is now even offering Moringa leaf powder for sale to mothers with malnourished children (at a price of 25 CFA francs, 5 cents, per sachet).

In a place where there is only very limited awareness of nutrition and the importance of balanced diets, would people see the value of adding Moringa to their foods as a purely nutritional measure?

It is apparent that one does not need an education in nutrition to know whether or not one is feeling healthy. People interviewed have expressed every intention of continuing to include Moringa in their diets because of the sense of physical well-being it gives them. The evaluation cited the village of Coubalan where virtually every household now maintains a stock of Moringa leaf powder.

Would people be receptive to changing the way they prepared fresh Moringa leaves?

Traditionally, Moringa leaves are boiled two or three times and the water discarded after each boiling. This is done to remove some of the bitter taste of the leaves. However, some of the individuals interviewed claim that they are no longer discarding the water or boiling the leaves more than once. In addition, making sauces with leaf powder instead of fresh leaves appears to be quite popular because it saves time and is easy to use.

Would people be receptive to adding new foods, such as Moringa pods, to their diets?

This has been surprisingly successful, since new foods are often very difficult to introduce in West Africa. People interviewed have shown considerable inventiveness when it comes to preparing Moringa pods, seeds and flowers.

Would local consumption of Moringa remain dependent on outside encouragement and training, or could it develop spontaneously?

Partly thanks to radio broadcasts about Moringa, partly through training provided local communities by some of the more dynamic health agents, and partly through ordinary word-of-mouth and example, Moringa and its properties are gradually becoming known even outside the project's target area. The project directly sponsoring the plantation of 10,000 trees in 1998, but it is likely that a similar number were planted by individuals within the region.

Based on documentation, interviews and anecdotes, Moringa oleifera is a plant with a multitude of attributes. To date, absolutely no negative side effects to even daily consumption of Moringa have been recorded (unless sleeping more is considered bad). Unexpected benefits of Moringa include an apparent cure for tapeworms and help in controlling diabetes.

Moringa appears to have tremendous potential to prevent or cure malnutrition in the tropics and sub-tropics.

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