Project Medishare's Akamil Factory Close to Completion

  • Posted on: 16 October 2009
  • By: Bryan Schaaf
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I sometimes see articles in small town newspapers about churches or schools sending food to Haiti.  The intention is good, but the impact is not - this is not how to promote food security.  Project Medishare takes a different approach by fighting hunger, creating jobs, and supporting the local economy at the same time.  Its Akamil factory, once operational, will produce fortified and highly nutritious food, from locally purchased ingredients, for malnourished children, pregnant women, and people living with tuberculosis and/or HIV/AIDS.  My hope is that this facility will be the first of many.  If you'd like to support this important effort, a link to Project Medishare's project fund-raising site is below.  

 

Dear Friends of Project Medishare,

 

Today is World Food Day, a day when the global community comes together to unite against hunger. We would like to take this opportunity to thank you for your efforts in helping us in our fight against malnutrition in Haiti's Central Plateau.

 

With your help Project Medishare has been combating childhood malnutrition which affects more than 50 percent of children in the Central Plateau. We are happy to announce our Akamil Production Facility's construction is complete and working toward setting up for full operation scheduled for January.

 

On this important day we would like to say thank you to the Caporella Family, Berlin Family Foundation, Coral Gables Congregational Church, UM Rotaract Club, South Florida Rotary Clubs and Rotary International, Center for Disease Control, Auto Gov, AkzoNobel, DSM and donors like you who are making the opening of this facility a reality.

 

The Akamil Production Facility will manufacture and distribute Akamil, a mix of locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A.

 

Introduced in the 1970s, Akamil is well-known and accepted in Haiti as an energetic and constructive food with a satisfying nutritional value that fills the deficits currently observed among children, pregnant and breastfeeding women and TB/HIV patients in Haiti.  The Akamil Production Facility allows Project Medishare to engage the community's local farmers and women's groups. Akamil will not only provide a source of nutrients for the people who need it the most, but also provide a source of economic development for the people. Once operational,  farmers throughout the community will sell their crops to the production facility, thereby allowing them to transition from subsistence farming to cash crop farming.

 

Akamil will also be sold to women merchants at a reduced price, and they will sell the final product throughout Haiti, thus beginning entrepreneurial opportunities for these women, many of who are heads of their households.

 

The Nutrition and Training Center adjoining the Akamil Facility is still under construction, but once complete will provide a place to train new and current health agents.  The center will collaborate with the full-service medical facility in Thomonde to stabilize and restore these childhood cases to the point where they can return home. Both the child and their caregiver will be housed in a designated residential section of the center for as long as three months. Funding is still needed to complete the adjoining Training Center.

 

Our fight isn't over yet, but thanks to you we are winning each battle one step at a time.  On this important day, World Food Day, we thank you for helping us continue this fight against malnutrition in Haiti's Central Plateau. The people of Thomonde and Marmont are forever grateful for your support.

 

Project Medishare for Haiti
8260 NE 2nd Avenue
Miami, FL 33138
USA

 

Contact Name: Dr. Barth Green

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Project Medishare
By Jennifer Browning
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The last piece of equipment required for the Akamil Production Facility arrived in Thomonde last week. Project Medishare is now in the process of putting all the equipment in place, so that we may start working toward a production start-up date. In the meantime, our staff is arranging for a technician to come to provide training on how to use the equipment properly. Once the technician arrives the facility will be operational and Project Medishare will begin conducting trials on all the equipment.
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Soon all the equipment will be put in place and tile layed out along the floors inside the Akamil Production Facility. For the past three years Project Medishare has been a part of this hopeful spirit of progress and change in Haiti. Medishare has been working toward a long-term solution regarding hunger and malnutrition in Haiti’s Central Plateau, starting with the community of Thomonde. Project Medishare has been working toward specifically solving the malnutrition problem in Haiti with the construction of the Akamil Production Facility and Nutrition Complex. Construction of the facility began over two years ago and despite severe hurricanes and the recent earthquake, the Akamil Production Facility is finally complete.
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Before the earthquake, Project Medishare planned to begin production of Akamil in late-January, however the final piece of equipment was held in customs long after the earthquake. Project Medishare staff for a while feared that the equipment had been damaged in the quake, but it was tucked away safely in the crate and has now arrived in Thomonde.
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The Akamil Production Facility will manufacture and distribute AKA1000, often referred to as Akamil (Nutrimil), a mix of locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A.
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With the recent migration of earthquake victims from Port-au-Prince, Project Medishare's population in Thomonde has increased by 29 percent. In Marmont, our population increased by 18 percent. This increases a burden on an already overstressed area when it comes to healthcare and food consumption.
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The Akamil Production Facility will not only help battle malnutrition in the Central Plateau, but provide additional jobs for locals in Thomonde and surrounding communities. Project Medishare will also purchase produce from local farmers that will be used as part of the ingredients for Nutrimil (Akamil).

12/17/2010
By Jennifer Browning
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The final pieces are being put in place to finalize the Akamil Production Facility in Thomonde. Ground breaking began June 2007 for the construction of the facility, but construction and final equipment installment was delayed after the January 12 earthquake. When production begins, it will mean so much to rural Haiti and those Project Medishare serves in the commune of Thomonde. DSM's Marienella Mendez, Project Medishare's Laurene Leger, and CDC's Mike Kaiser in front of the Akamil Production Facility in Thomonde. “ I am really surprised and I am really amazed at the job Project Medishare is doing here. Medishare is motivating Haitians to do things by themselves.With this project you involve the local community, the international community and private industry all together in a project that has sustainability,” Mendez said. “It is difficult to find projects like this that involves the entire community.” Three years ago Center for Disease Control (CDC) Senior Fellow Mike Kaiser met with then Project Medishare Executive Director Ellen Powers and began brainstorming about producing Akamil, a fortified nutritious supplement created by locally grown ingredients. Since then, with the combined support of Project Medishare President Dr. Barth A. Green, Co-founder Dr. Arthur Fournier, Country Director Marie Chery along with numerous supporters, the production facility became more and more of a viable reality. Today, Kaiser and Chery are putting the final touches to the plan.
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The CDC’s role in the project is to research and document whether the Akamil project is successful or not. Kaiser said the Akamil Production Facility is a great grassroots effort and supports Project Medishare’s mission in the Central Plateau. “It has the value of creating jobs for the farmers……and you are going to fortify something they like to eat, instead of something you are trying to make them eat,” Kaiser said. “[Akamil] is an indigenous food that [the people] already like and know.” Akamil when mixed becomes a porridge that people can mix sugar and fruit with in the morning or can mix with salt, vegetables and meat in the evening. “It becomes a staple food that can be fully nutritious, but the full-circle idea is that you are creating jobs for the farmers to then grow the crops and they now know that someone will purchase the crops if they grow more than what they need for just themselves," Kaiser said. "The Akamil plant can buy it from them."
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To help make the Akamil project successful, the University of Florida provided technical assistance through Project Medishare’s agriculture extention agents by providing training at Project Medishare’s demonstration farm and local farms around the community. But Kaiser pointed out that it isn’t just the community farmers who benefit from Akamil. Women in the community, benefit as well. “The other part is that you are creating jobs in the factory, creating jobs in the sale and distribution of the product,” he said. “We’ve talked about microlending with women—creating opportunities for women, which is a real big deal in Haiti, because right now the women don’t have the rights and the respectability that they deserve.” Kaiser added not only will Akamil benefit the community Project Medishare serves, but more importantly, that same community fully supports the project. “The enthusiasm that has been generated locally is incredible,” Kaiser said. “This is all being done locally.”
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The sale of Akamil doesn’t stop in the commune of Thomonde. “The international community has said they will purchase Akamil to use in school feeding programs,” Kaiser said, “and thanks to all the donors who have contributed to this project, there is no overhead and the plant will be able to produce and sell the product at cost as a not-for-profit enterprise.” One of those contributors is DSM who has donated the vitamin-fortified pre-mix for the Akamil product. The pre-mix for Akamil contains Vitamin A and B complex (Thiamin B2, b12), Iron and Zinc making it a complete formula that can be consumed by the whole family from children to adults. Iron and zinc helps with anemia as well as the immuno process, and additionally these nutrients help to improve the growth rate in children. DSM manager Marienella Mendez said her company became involved with Medishare through AzkoNobel, a supplier of iron. AkzoNobel contacted DSM and asked to assist Project Medishare with the vitamin supply and pre-mix. But DSM not only decided to donate the pre-mix, they wanted to participate further by providing technical assistance.
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“We wanted to participate in the complete process to be sure the pre-mix is going to be used in the right way,” Mendez said. “We have a social responsibility with our products. We need to make sure that the people taking these vitamins that their bodies are absorbing them the right way. We have the responsibility to ensure the product is being used correctly. In order to obtain the right product we are helping make sure that the vitamins and minerals are created at the right levels.” After this Mendez and DSM will join Kaiser and the CDC in formulating a nutrition survey, which will be managed by Project Medishare’s community health agents. Mendez said the goal is first to give Akamil to 300 families and six month later these same families go in for blood tests to monitor the levels of iron and other nutrients. Community health agents will continue to test the families once a month to monitor nutrition levels. Afterward, Akamil will be offered to the whole community and will also be available for other NGOs to purchase for their programs. Mendez said the nutritional survey is an important part of the process. “This kind of test has to be done to sort of close the circle because when the kids or the families eat the Akamil we need to ensure the levels are good for them and will produce positive changes in their body and in their metabolism,” she said. “This helps us continue to make sure the right levels of the vitamins end up in the body and actually helps improve their nutrition.”
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The nutritional surveys, according to Kaiser, are an essential part of Akamil’s business plan. And thanks to AutoGov and Motion Computer for donating data software, Blackberry’s and digital tablets, information collected by the community health agents will be available immediately. “That information is creating electronic medical records which can be communicated to the local doctors, local clinics and it is immediately provided to the Ministry of Health,” Kaiser said. “People don’t have to wait two or three years for the results of a nutrition survey, which is typically how it is done. All of this information will be available immediately thanks to AutoGov and Motion Computing.” In addition to the local medical community having instant access to information, the Ministry of Health will also receive these electronic medical records. “[The Ministry of Health] are really excited that they are going to receive electronic medical records and they are going to have this way to collect information,” Kaiser said. “For Medishare, because we have done this nutrition survey, someone else can come in and conduct future health surveys because all to the equipment is there.” “And now they are collecting their own data, and they don’t have to rely on the Pan American Health Organization (PAHO) to collect it for them, which always takes time,” Kaiser said. “Now [the Haitian people] can do it themselves, if we can teach them….and they can, and this is happening right here. We really are taking this concept of don’t give them a fish, but teach them to fish. That is what we are really doing from the beginning.”

Project Medishare began ground-breaking on its Akamil plant in June of 2007. Akamil (pronounced Ak-ah-mil) is a nutritious mixture of corn and beans, rice and beans, and/or wheat and beans that resembles oatmeal. Haitians like to mix their Akamil with fruit and sugar and serve it for breakfast and/or mix it with vegetables and salt (and meat when available) and serve it for dinner. Akamil was first introduced to Haiti in the 1960s by food scientists from Virginia Tech University (VT’s AK-1000). Unfortunately, large scale production never occurred in Haiti. Nevertheless, Medishare has been working with the CDC on a business plan to not only produce Akamil on a large scale, but also make the product more nutritious and more affordable. And together with Rotary International and numerous other donors, Medishare is about to make VT’s original dream of large scale production of Akamil in Haiti a reality!
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Haiti’s Central Department (CD) has the highest rates of malnutrition and disease in the country, so building a food processing plant on the CD will not only create jobs for farmers and Akamil plant workers living on the CD, but also improve public health and nutrition for all persons living on the CD. Medishare’s grass roots campaign to produce Akamil also includes a research agenda to study the impact of Akamil on the CD and to generate electronic medical records that will allow local doctors and health care workers for the first time to collect their own public health data rather than relying on the international aid community to collect that data for them. The benfefits are:
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-Reduces malnutrition and disease in Haiti, especially for women and children.
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-Creates jobs and creates an incentive for farmers to produce crops locally.
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Improves access to healthy, affordable food inside the country.
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Reduces deforestation, illegal charcoal production and soil erosion by creating alternative jobs in agricultural and food processing (NOTE: Reducing the cooking time of Akamil dramatically reduces the need for charcoal production, and at the same time provides jobs/income for Haitians who have been relying on charcoal production for income/employment).
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-Builds a food processing plant entirely from donations (NOTE: the Akamil plant construction alone has already created more than 175 jobs locally and will create additional non-farm jobs in the food processing sector).
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-Creates opportunities for women in the direct sales, marketing and distribution of Akamil (i.e., through micro-lending opportunities.
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-Develops an ongoing Monitoring and Evaluation Platform (MEP) to generate public health data for Haiti’s Ministry of Health (i.e., including a baseline survey with state-of-the-art electronic data collection that enables MOH to collect its own public health data locally rather than relying on the international aid community).
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-Introduces innovative hardware and software that will become the basis for providing electronic medical records for local doctors and open the door for additional research/interventions on Haiti’s remote Central Plateau.
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Achievements/Accomplishments: Among the many accomplishments since December are the final completion of the Akamil plant and Kay Pasha Training Center; the placement of food processing equipment on the Akamil plant floor; wiring and installation of fans and mosquito screening along the plant’s roof line; installing security gates and gravel for the plant’s driveway; purchasing a water purification system and hot water heater; ordering additional medical supplies and equipment for the initial baseline survey; and continuing to explore new additions for the plant, including:
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1) Exploring the addition of solar panels for the plant’s roof (seeking donations);
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2) Building silos to store raw commodities (seeking donations);
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3) Continuing to investigate drilling a freshwater well on the property (i.e., expressly for Akamil plant $10,000 of which has already donated for this purpose), and;
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4) Obtaining a premix blender/mixer especially designed for Akamil (NOTE: The Akamil production process calls for adding micronutrients to an extruder, and while we can certainly do this, it would be much better to add the micronutrients after the extrusion process. We plan to analyze vitamin losses (i.e., vitamin C and A most likely affected), but are considering adding either a V-blender or ribbon blender, being especially cognizant of any “dead points” in the mixing process. We can probably acquire a piece of equipment from the Dominican Republic, but are also considering designing/constructing our own blender, made especially for Akamil to enhance the production process).
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As noted, these refinements are not necessary to start production and in no way are responsible for delaying plant start-up. However, as with all manufacturing processes we must constantly refine and upgrade the plant and these new additions/refinements will do so and be more thoroughly pursued in the second quarter of 2011 after the plant has opened and is fully operational. Our most immediate concerns at the moment include such things as identifying, interviewing and hiring plant workers; identifying women for direct sales/marketing trained in micro-lending sales/distribution); obtaining needed for plant supplies and raw materials/commodities for plant start-up; etc.
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It should be noted all of the accomplishments made in the last quarter of 2010 were made despite the Cholera outbreak in Haiti, violent Presidential elections, and a great deal of time lost due to the holidays. Nevertheless, we are happy to report most if not all of the missteps identified in the fourth quarter of 2010 have now been corrected; not least of which was the Indian-made extruder with its 50Hz motors. Correcting this problem alone required a great deal of time and research. Initially, we thought we could simply purchase replacement motors for the equipment but later learned new motors would not solve our problem (i.e., as the extruder would have to be shipped back to India for recalibration). Fortunately, with the help of several electrical engineers in the U.S. (donated), we were able to explore a number of other options (i.e., adding an external frequency/voltage converter; adding a second generator solely for the extruder; adding an AC/DC inverter/rectifier; adding a highly sophisticated “Black Box” manufactured for the U.S. Department of Defense that allows soldiers in Afghanistan and Iraq to plug-in any electrical device known to man; etc.). Every option considered had to be thoroughly investigated to avoid additional time delays, not to mention additional expense. But after weighing all of the options, the electricians agreed the best decision was to obtain a second, dedicated generator for the extruder (i.e., converted for 50Hz operation). The estimated value of this converted generator exceeds $30,000, but is being offered to us for the cost of conversion ($9500). We plan to purchase the generator from Power Source Electric in North Carolina and ship it directly to Haiti. Medishare would like to use the remaining balance on the Rotary account toward the purchase and shipment of the converted generator, which will enable us to use the existing extruder that was purchased/shipped from India. We believe this to be the quickest, the easiest, and the cheapest solution available to us.
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Other major delays in the fourth quarter of 2010 were due to change in focus to allow Project Medishare to answer quickly and effectively to the widespread Cholera outbreak that originated in the Central Plateau and Presidential election violence in Haiti. Since our last report we have also finalized the Akamil package labeling, which will initially be sold and distributed in two sizes on the CD (i.e., small/2 servings and extra-large/40 servings). In the second quarter of 2011 two additional package sizes will be added, including a medium/6 serving package to accommodate retail merchants and bulk/sacks for wholesale distribution to international aid agencies and food distributors.
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Edits/revisions to the business plan also continue to be made as a result of the many improvements identified in December and January, which have resulted in the further reduction of the Akamil cost per serving, making it even more affordable for Haitians. In addition, several new donors have been approached to offset start-up costs for the plant (i.e., such things as the initial set-up/printing for the Akamil packaging; constructing silos to reduce raw commodity costs; etc Finally, changes in the Akamil name/logo were made. The attached label is in English for editing purposes only. The final printed version will be in French and Creole. Akamil trials are expected to begin in March with the arrival of the converted generator and at that time we also expect to undertake the long awaited baseline survey, involving 300 children, which will be launched simultaneously with plant start-up operations (i.e., NOTE: the initial product will be given to the 300 children to measure growth/health improvements and should further drive Akamil sales/marketing).
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Financial Summary and Timeline: As noted in the attached balance sheets, Rotary donated $107,733 to Project Medishare in 2007 for Akamil plant equipment and development. As of February 1st, approximately $9,000 remains from that donation and Medishare will request that it be applied toward the purchase of the converted generator needed to power the Akamil extruder originally purchased from India (i.e., converting the extruder motors from 50Hz to 60Hz).
The Presidential run-off election results are scheduled for March 20th and we expect Akamil trials and a ribbon-cutting for the plant immediately thereafter (i.e., assuming no additional violence or political controversy results in Haiti). We are still planning a soft-opening and baseline survey in the next 30 days, with the initial product to be consumed by the 300 children in the baseline survey. Once we begin production in earnest, we expect bulk sales to large retailers and international aid organizations to begin in the 2nd quarter of 2011
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Critical Issues/Grass Roots Advocacy: It is hoped this grass roots Akamil campaign on the Central Plateau will be replicated in other departments as not-for-profit Franchises, creating even more jobs, encouraging even more Haitian self-determination, and providing even more indigenous food fortification strategies in Haiti and, in the process, avoid the need for international aid organizations to introduce imported food interventions (i.e., “For Haitians, By Haitians”). Already, more than $700,000 has been donated through this grass roots campaign undertaken by Project Medishare for Food Security in Haiti through private donations, partnerships with Rotary International and other organizations, and the valuable technical assistance from CDC, University of Miami, University of Florida, Haitian MOH and others.
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Few gave this grass roots campaign in the Central Department any chance for success when it began three years ago but the local community has enthusiastically supported the project and taken ownership. Because the international community has enthusiastically embraced this grass roots campaign and has expressed a genuine interest and willingness to participate and purchase Akamil for its own school feeding programs, PEPFAR programs, WFP, CRS, etc., it is hoped these bulk sales will assure the sustainability of the project and allow for replication elsewhere in the country.

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