Episode Transcript

Lama Alsafi: 00:01 Hello and welcome to 15 Minutes to Change the World. Where in 15 minutes you can learn a bit more about the world and how you can help change it.

My name is Lama Alsafi host this podcast. Mothers across Canada are experiencing new and unexpected challenges as COVID-19 has changed the way we live our lives. Physical distancing has become the new norm, meaning expectant mothers are facing more difficulty accessing checkups. Many women are giving birth isolated in hospitals or at home. Families with newborns or small children are spending time away from their loved ones and parents are trying to balance homeschooling and day to day work. Even with a stronger and better resourced health system as we have in Canada, all these adjustments come with discomfort and increased anxieties and these challenges are not unique to us in Canada alone. Women around the world with less reliable health systems in place to support them are confronted with these challenges as well. We know that resources are in short supply for vulnerable communities and that the risk only continues to grow.

Today, our guest is Mandana Arabi, Vice President of Global Technical Services at Nutrition International, Mandana joins us remotely from New York City. Thank you for taking the time to speak with us today and welcome to the podcast Mandana.

Mandana Arabi: 01:48 Hi, thanks so much for having me.

Lama Alsafi: 01:50 I'm wondering if you can tell us a bit more about your background and how your interest in maternal and child nutritional health began?

Mandana Arabi: 01:58 Sure. So I'm actually a trained physician from Iran and, after I graduated from medical school, I've worked in the peri-urban areas of Tehran, the capital of my country in a refugee communities in very high need, low resourced communities, that opened my eyes to really the needs of women and children in these circumstances. And also I started seeing the impact of prevention and how you can have huge impacts at larger scale, with relatively simple solutions. So that really resonated for me and as a doctor and that's, that became the beginning of my work in specifically nutrition for maternal children and I continued my studies in nutrition sciences, got a PhD in International Nutrition. I've been working after that for more than 15 years now at the global level with UNICEF international NGOs focused on providing nutrition interventions in mostly in the developing world.

Lama Alsafi: 02:58 And you tell our listeners a bit more about Nutrition International and some of the work you do around maternal, newborn and child health.

Mandana Arabi: 03:06 Sure. Nutrition International is a dedicated nutrition international organization. They've been around for more than 25 years. Working through partnerships with governments, donors, implementers in countries to make sure that low cost, high impact nutrition interventions are available, especially to women adolescent girls and young children. We're also very active in generating evidence and making sure that our programming is evidence based and the learnings are, kind of really becoming the best practices in the field as well. So really building this continuum of evidence to action strongly, which I think is relatively unique for, a kind of implementation focused agency. And for me being the kind of supervisor of the technical services, I think this is really a key element to the success of NI (Nutrition International) to make sure that we also understand what works best and understand the technicality and the evidence that's needed to improve the different actions that we take in international nutrition.

Lama Alsafi: 04:12 Can you identify if there's a link for us between nutrition and gender equality that you've seen in your work?

Mandana Arabi: 04:18 I strongly believe that there is a very important and a strong link between nutrition, gender equality and from different perspectives. You know, when you look at the needs, women at different life stages have higher nutritional needs. As you can imagine, childbirth, pregnancy, lactation, adolescent women, we know that they are disproportionately affected by nutrition deficiencies. For example iron and iron supplements we know that anemia is really affecting women a lot more and in itself, you know, it's a nutrition condition but it affects productivity, work, productivity, caregiving, ability, pregnancy outcomes, outcomes for the mother and the baby. It affects basic quality of life on so many levels. And we cannot achieve gender equality without targeting. And addressing these gaps specifically. And you know, there are also different vulnerabilities in terms of access to food, access to quality foods, cultural practices that again I think might increase the vulnerabilities of women and we cannot address gender inequality without addressing those specific nutritional vulnerabilities.

Lama Alsafi: 05:30 Mandana is COVID-19 having an impact on pregnant women and those with newborns and vulnerable communities around the world?

 Mandana Arabi: 05:37 I have worked at the UN organization during crisis, you know, for example, the earthquake in Haiti. Other conditions where as you mentioned, different crisis conditions existed and this current situation with the COVID-19 has many similar and also additional perspectives in terms of added vulnerabilities for women. I think women are significantly affected by disruptions in regular care in general. Again, especially in those life stages such as pregnancy, they are, they need regular access to health care, antenatal care services for example, are crucial.And because of social distancing and isolation right now, we are very concerned that these,would be quite reduced Birth attendants, you know, quality birth attendants may not be available and might affect, again, the outcomes both for moms and babies. Um, nutrition needs are higher in general for women and again because of shortages or lack of access or disruptions in access, women could be at higher risk of you know, low access to quality of diets and deficiencies such as again, iron deficiency, that could be risky for them in this crisis condition as well.

One issue that I feel sometimes it's not brought up as strongly as it should is really the role of women as caregivers and the burden of care and just how much they are affected, you know, times when there's higher need and higher demand. Women, we know that front line community health workers in the developing world is a lot higher. So their profession, like their jobs are actually more in caregiving jobs, but then also in households, they are the caregivers of anybody who is affected by COVID-19 as well as they themselves could potentially be affected. While the ongoing needs of being a mom and a partner and, and you know, again, taking care of the household are still, there none of that has changed. So basically a lot higher demand, with perhaps increasingly reduced resources.

Lama Alsafi: 07:44 Is it too early to talk about the longer term impacts of COVID-19 or from your experience? Can you, can you anticipate what these might be?

Mandana Arabi: 07:52 It is too early, but again, we know a lot from before and how household resources, come in to play and individual resources come into play in response to crisis. What we know in general is that, you know, households and individuals, that have resources for coping and resources for support generally do better. Sometimes we call this the positive deviance, you know, you might be in the same communities going through the same kind of external shock, but if you do have those resources, you will be able to be the positive deviant, not to be as badly affected. Some of these factors of course are economic, but it's also having support, having support from women's groups, having support from the health system, receiving resources specifically that will be put in the hands of women for decision making.

Again, for example, in social protection programs for when the programs target women and allow women to receive the benefits. It's been shown that women spend them for health and for kind of child well-being outcomes perhaps then, you know, they, you know, in the context of crisis potentially they could even be considered better decision makers. So can we make sure that we target them and we allow them to make decisions and empower them so that they have more resources. I think the biggest concern for me is, is resources being increasingly depleted and then in places where women are already not benefiting from a lot of resources or are even disempowered for decisions, they already are in great danger.

Lama Alsafi: 09:31 Mandana, what are the, some of the actions that governments and NGO's are taking to support vulnerable populations during this time?

Mandana Arabi: 09:38 It's been amazing. I think, I've been part of this whole movement from very early days with other NGO's, in my own organization. So it's an impressive amount of effort going into making sure we respond and we respond well. We are targeting these vulnerabilities together we are looking at for example, new ways of delivery of services to make sure the disruption in the healthcare system do not affect, especially women and children as badly as they potentially could. We are looking into guidance for home based care and making tools available, to countries that will have to deal with this epidemic pandemic in one way or another. We are looking at new approaches to provide some of these targeted nutritional specific intervention to women and children. We are considering things like providing multiple micronutrient supplements that can be given for 180 days. So they don't need regular return or access to the healthcare system, they can be delivered at the community or household level. Similarly, micronutrient powder supplements for young children that could supplement. There are food security packages or social protection packages that are also being put in place by governments.

Lama Alsafi: 10:48 Mandana, how can someone who is listening at home right now, or in their car take action, I wonder if you can pass on some tangible things that they can do to help in this matter or to create positive change?

Mandana Arabi: 11:00 I think all of us are dealing with, you know, being professionals, moms, caregivers to our children, to our elderly parents, to our partners. And my personal experience has been that these all really blend together and they don't leave much time for self care and really for, for putting ourselves also, kind of at the center sometimes and making sure we have our resources and we are resilient enough and we're aware of how we are being affected. So I would say self care and really knowing that there is a lot of burden of care just by nature of being a woman. A lot of us willingly and lovingly accept it, but it's still a burden and we need resources for being able to deliver. So I would say just kind of having that time deliberately there and asking for help if it is available. And then more of I guess the kind of social or outward looking.

I would say just being alert and influencing decisions when we can, especially for women and for making them visible. I do have a bit of a concern still when I, you know, listen to panels and other big key decision making discussions going on today and I don't see women's voice like I don't hear women's voice there. You know, you don't see those perspectives being there. I think it's important that women are represented not in a tokenistic way but really deeply heard and their perspectives are part of this response to COVID. So I think all of us have to call for that. It can't be just one person or it can't be some of us who are gender specialist. It's really has to be, all of us need to have that unified voice and I feel there's still work to be done in that sense.

Lama Alsafi: 12:39 Thank you so much Mandana for joining us today. It's been a pleasure speaking with you.

 Mandana Arabi: 12:43 Thank you for having me. It was wonderful to talk to you as well. And thank you so much for the great work that you're doing.

Lama Alsafi: 12:49 Thank you. And we'll be on the lookout for more great things to come from Nutrition International. I want to thank you again and thank you to all of our listeners for tuning in. As always, you can stay up to date on our newest episodes of 15 Minutes to Change the World on Spotify and iTunes.