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FACE TO FACE Ursula meets: KATE GODDEN • Global nutrition expert • Consultant on food security • Nutrition lecturer
We arranged to meet at a lovely bright café in North London. I was early, and so spent some time looking at the wallwide map. Huge islands that I had never heard of, took my notice: Novaya Zemlya, Svalbard, Ellesmere and Baffin islands. By glorious serendipity, the large map was the most perfect backdrop for my date with Kate. I had been looking to interview someone who had worked as a nutritionist for a famine relief agency, but numerous calls to humanitarian aid charities came to nothing. When I met Kate at a meeting, she became the fly who flew into my web. She was just what I had been looking for: someone who applied nutrition science to decisions, not in a cool calm office, or clinic, but in the chaos of a loud and hot and dusty tent. Kate always loved food, but her science skills proved better than her cookery skills. She graduated with a BSc in Physiology and Nutrition from the University of Southampton in 1985. Here comes the clue to her future career: “It was a great annoyance to me that graduation day clashed with the huge Live Aid concert at Wembley, which was a fundraiser for famine relief in Ethiopia,” said Kate. After a gap year of travel and jobbing, Kate decided that dietetics offered the perfect combination: science, talking about food and a good chance of a job. She attended the post graduate dietetics course in Leeds and in 1988 she attached the letters ‘RD’ to her name.
Ursula meets amazing people who influence nutrition policies and practices in the UK. For two years she worked as a basic grade dietitian in London. She enjoyed the work, other than the constant coding required for monitoring each patient encounter or work activity. “It was the early days of computer systems, which was so time-consuming,” said Kate. It seems Kate wanted more excitement in her career. The charity Voluntary Service Overseas was looking for nutritionists to go to North Central China. After a threeweek language course in Beijing, Kate arrived in the mainly Muslim province of Ningxia. She was there to teach nutrition at an agricultural college, but was always at the mercy of her interpreter: was what she was saying the same as what her students were hearing? She managed to find the contact details of someone who worked at the Food and Agriculture Organisation (FAO) and requested some Chinese language nutrition books. She was surprised and delighted when a huge package of fantastic resources arrived. Kate returned to London and completed a one-year MSc degree in Human Nutrition at the London School of Hygiene and Tropical Medicine. She was now battle ready to work in the areas of chaos and need. Malanje, in Angola, was being held siege and the charity Medecins sans Frontier (MSF) was providing emergency aid to the local population. “This really was the extreme end of a crisis and there were many thousands of starving people,” said Kate. She was responsible for setting up the feeding stations for the
Ursula Arens Writer; Nutrition & Dietetics Ursula has a degree in dietetics, and currently works as a freelance nutrition writer. She has been a columnist on nutrition for more than 30 years.
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“You knew that you could never solve all the problems you wanted to help with. But you also knew that you were making a big difference . . .” Children at Malanje in Angola
under-fives. All children were assessed and the severely undernourished ones obtained the refeeding porridge (made from corn-soya blend, sugar, dried skimmed milk and vitamin A fortified vegetable oil.) Supplies were flown in and Kate could easily calculate stock levels by counting planes and multiplying by 20 tons. There was a mixture of kwashiorkor and marasmus presentations, often within families. But on refeeding, children with kwashiorkor quickly lost fluids and their puffy faces and pot bellies. Kate commented that, “Boys are worse affected by undernutrition than girls. Historically protein boosting was thought to be most effective for treating wasting. Now it is all about providing energy (from a balanced mix of nutrients).” There have been many developments in the delivery of food aid over the last 20 years, and I mention the proprietary peanut paste Plumpy’Nut®. “It is widely used and it works,” said Kate. “But it is an expensive and profitable product, and it is a shame that cheaper local products are not used for refeeding projects.” From observing film snippets of famine relief, I always found the constant weighing of starving children irksome: it seemed a fussy and unnecessary procedure for the obvious condition. But Kate explained, “This is really important to identify the more extreme conditions, which are not always obvious, and to monitor the progress of groups. For example, it helped us to identify poor results in one of the four feeding sites in Malanje; we found this was due to more aggressive guards controlling access. Over the period of MSF 10
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intervention, severe wasting in young children went from 36% to 12%, and such data is essential to support decisions and further funding.” It must have been so difficult to cope with the daily traumas and miseries. “You knew that you could never solve all the problems you wanted to help with. But you also knew that you were making a big difference,” said Kate. And all around were observations of dignity and kindness. Her next job was in Kandahar in Afghanistan. She was there to do survey work to monitor nutrition status. “Dealing with local leaders (Taliban) was always very difficult and frustrating and the physical environment was extreme: the dry winds were so hot and fierce, it was like being next to a hairdryer,” she said. But day-to-day encounters with Afghani male colleagues and women and children were always a great pleasure. Kate held many senior project posts in many countries and, increasingly, nutrition was but one of her many responsibilities. With marriage and children came the decision to move back to the UK. She is now a freelance consultant to many government and NGO clients and advises on emergency and development feeding projects. She explains Scaling Up Nutrition (SUN) projects to me, as I am sure she explains equally well to students at the University of Westminster (where she also works as a part-time lecturer on the Global Nutrition course). As we left, I noticed Kate’s very pale translucent skin. Was it the white shimmer from her halo?
This material is for healthcare professionals only.
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Reference: 1. Canani RB et al. J Pediatr 2013;163:771–777. Nutramigen with LGG® is a food for special medical purposes for the dietary management of cow’s milk allergy and must be used under medical supervision. Nutramigen with LGG® is not recommended for premature and immunocompromised infants unless directed and supervised by a healthcare professional. IMPORTANT NOTICE: Breastfeeding is best for babies. The decision to discontinue breastfeeding may be difficult to reverse and the introduction of partial bottle-feeding may reduce breast milk supply. The financial benefits of breastfeeding should be considered before bottle-feeding is initiated. Failure to follow preparation instructions carefully may be harmful to your baby’s health. Parents should always be advised by an independent healthcare professional regarding infant feeding. Products of Mead Johnson must be used under medical supervision. *Trademark of Mead Johnson & Company, LLC. © 2018 Mead Johnson & Company, LLC. All rights reserved. LGG® and the LGG® logo are registered trademarks of Valio Ltd, Finland. Date of preparation: September 2018 UK/NUT/18/0060i