Malnutrition

Dr. Maria Simonson, who created a health, weight and stress clinic at the Johns Hopkins Hospital, died Wednesday at her Westminster home of complications from a stroke. She was 83. Co-author of the book The Complete University Medical Diet, she ran a multidiscipline weight-loss program at Hopkins and was a health and stress consultant to airlines and other industries until retiring about 15 yeas ago. Born Maria Day in Shanghai, she was raised in Turkey and Greece where her father, a U.S. Navy admiral, was posted.

Peter Hermann's article on getting aid to Palestinians illustrates that conflict begets food insecurity, and that food insecurity begets the malnutrition occurring in Gaza and the West Bank ("Getting U.N. aid to Palestinians a struggle in itself," Jan. 2). Data collected in June 2002 by Al-Quds University in Jerusalem, with technical support from Johns Hopkins University, showed that 7.8 percent of children under age 5 from 1,000 West Bank households studied were acutely malnourished, and 11.7 percent were chronically malnourished.

RAMALLAH, West Bank - A typical breakfast in Fatima Khodour's three-room apartment consists of tea and boiled tomatoes seasoned with thyme and olive oil. For the late afternoon lunch, the main and final meal of the day, the menu is the same, plus fried potatoes. It feeds 11 people from three generations. "I know this isn't enough," said Khodour, 39, whose family has been without a source of income for nearly two years, ever since clashes between Palestinians and Israelis cost many Palestinians their jobs.

JOHANNESBURG, South Africa - A new report estimates that 2.5 million people have died as a result of almost three years of fighting in the Democratic Republic of Congo, which would make the central African conflict one of the deadliest in recent history. The study, to be released in full tomorrow by the New York-based relief group International Rescue Committee, says the majority of the Congo war's victims have been killed not by bullets but by rampant disease and malnutrition in the remote, rebel-held jungles of the nation's interior.

KARMAIYA, Nepal -- The talisman tied above the entrance to Harsha Bahadur Bot's house is a bundle of rice, the flawed foundation of life in the plains of Nepal. Rice sculpts the landscape into diked squares of green or gold. The diesel pop-pop-pop of the rice mill is the sound of a village from afar, its beating heart. Rice is the basis of every meal, and a family's supply is bank account and insurance policy rolled into one. That the grain has the power to conjure good or ill seems obvious to Bot, 45, a farmer and fisherman.

She faints. She coughs. She recovers. She faints. She coughs. She dies. Oh, and her frailty inspires lust in the man who revives her. They fall in love. Her name is Mimi, and, as the heroine of "La Boheme" takes to the stage in the Baltimore Opera's performances of Puccini's 19th-century opera, some in the audience can't help but ask a few technical questions. For instance, why is Rodolfo hanging around Mimi as she wastes away in the final death scene? Doesn't he realize she's contagious?

As adults grow older, proper nutrition is often threatened by diminishing appetites and a host of factors, including ill-fitted dentures, depression, confusion and chronic disease. A coalition of health care experts, including the American Academy of Family Physicians, recently reported that an estimated 40 percent of the nation's 2 million nursing home residents aren't getting the nutrients they need. And it is thought that about half of them were malnourished before they even arrived at the homes.

SAN ILDEFONSO, Mexico -- At just 1 month old, Maria Isabel Esquivel is chubby, smiling and alert, and her older brother and sisters now run with bounding strides through the family's tiny cornfield in this dirt-poor Indian village.The vigor of the Esquivel children brings to life the startling statistics that are emerging from several ambitious nutrition projects in the Mexican countryside.The goal is nothing short of transforming the humble tortilla, Mexico's corn-based staple food, into a protein-fortified "supertortilla" that would give a nutritional boost to the nearly 20 million Mexicans who live in extreme poverty.

Our favorite new bracelet isn't made of sterling silver. Dainty charms don't dangle prettily from it; there are no jewels to catch the light. The Bracelet of Life is just a strip of paper -- but it sure catches attention.Its colored zones make it a handy tool for doctors helping out in global crises, from droughts to civil wars. Here's how it works:Doctors slip a bracelet on a child's arm and quickly see how close that child is to starving. Wrap the bracelet around the arm of a well-nourished child, slip the tab through its slot and pull, and the tab stops on the green zone.

TLAHUITOLTEPEC, Mexico -- She looks healthy now, laughing among two dozen other children in a rescue center run by Roman Catholic nuns. But when 8-year-old Catarina Hernandez arrived here, her belly was bloated and her legs swollen with water -- the final stage of malnutrition.The condition is so close to starvation that it normally appears only in times of famine, but Sister Alicia Estrada, who runs the center, says the nuns see it routinely. In the lush hills that surround this village in southern Mexico, hunger is day-to-day normality.