For the past several weeks, Haitians have been holding protests around the country, demonstrating against corruption, unemployment and food shortages, which brings us to the third part of NPR's series on food aid in Haiti.


Two different humanitarian groups are building big factories in the country to manufacture a kind of enriched peanut butter. It is a life-saving product. It's used to treat severe malnutrition in children. The problem is Haiti doesn't need two factories. Each one, by itself, could satisfy the country's current demand. NPR's Dan Charles brings us a story of altruism and competition.

DAN CHARLES, BYLINE: This tale of two factories is also the story of two organizations. Both are dedicated to improving the lives of people in Haiti. The first one is Meds and Food for Kids, or MFK. It was founded by a pediatrician from St. Louis, Pat Wolff. She set it up to make a special kind of peanut butter for malnourished children. That peanut butter includes also sugar, oil, powdered milk and lots of minerals and vitamins - just a simple recipe, but it saves lives. MFK started small in a rented house in Cap-Haitien on the country's northern coast.

PAT WOLFF: We started doing this in 2003. And in 2006, PIH contacted us.

CHARLES: PIH, Partners in Health, is the second organization in this story. It's much bigger than MFK and it's world-famous for its work treating AIDS in poor countries. Its founder, Paul Farmer, is one of the most charismatic figures in the whole field of global public health.

WOLFF: They said, oh, what a great idea. Tell us more about that, and we were totally transparent to them.

CHARLES: Wolff and her colleagues shared their recipes, their technologies, and Partners in Health soon set up its own kitchen-scale production of enriched peanut butter to hand out to patients in its clinics in central Haiti. Then Pat Wolff and Meds and Food for Kids decided to do this on a much bigger scale.

They raised $3 million - part of which they'll need to pay back with interest - and they built a factory. They just got it running a few months ago. MFK's Jamie Rhoads shows me expensive machinery made of stainless steel in white, clean rooms spitting out little, foil-wrapped packages of life-saving peanut butter.

JAMIE RHOADS: In the world of industrial food production, it's probably not, you know, the top-of-the-line, most sophisticated thing, but certainly for here and from what we started at, hand-grinding things, this is space-age technology

CHARLES: It has to be high-tech to meet the quality and purity standards set by international organizations like UNICEF. UNICEF buys this product and distributes it to hospitals and clinics all over Haiti. Pat Wolff says now UNICEF doesn't need to import it from France or the U.S.

WOLFF: We can make everything that's needed for the whole country of Haiti.

CHARLES: Except that Partners in Health is now building a factory, too, just as big. That factory is funded by a $6 million grant from Abbot Laboratories, the pharmaceutical company

JOEL MALEBRANCHE: You can hear my voice echo, it's so big.

CHARLES: Joel Malebranche from Partners in Health is standing inside a cavernous cinder block shell. In a few months, if all goes well, there will be machines here, churning out that miracle peanut paste.

MALEBRANCHE: So it's really exciting, the prospect that we're going to be have an opportunity to help all the kids that suffer from malnutrition in all our sites.

CHARLES: Now, Jonathan Lascher from Partners in Health insists his organization is not competing with MFK. We won't sell our product to UNICEF or the World Food Program, he says. We'll pass it out for free just to people in the regions of Haiti that we serve.

JONATHAN LASCHER: I certainly think there are ample opportunities for both MFK's operations to scale up their production facility, to meet most of the demand across the country.

CHARLES: And there are opportunities for our factory to do other things, he says. For instance, we'll have so much excess capacity, maybe we'll make regular commercial peanut butter, too. We might sell it to help keep the operation afloat, financially. In any case, Lascher says, we want our own factory, so we can provide opportunities for peanut farmers in our home area, in Haiti's central plateau.

LASCHER: When that center opens, farmers around the area are going to know that this center is a beacon of economic opportunity for them to bring their peanuts, and we'll purchase them.

CHARLES: Lascher and his colleagues at Partners in Health don't seem threatened by MFK's factory. It doesn't affect their plans much. Meds and Food for Kids, though, is much smaller, financially more fragile, and it does feel threatened. Here's MFK's founder, Pat Wolff.

WOLFF: There's not enough local peanuts, and there's not enough need for this product in Haiti, to have two factories that hope to be sustainable into the future.

CHARLES: It's not just that her factory could lose sales, people at MFK say PIH's factory project also has sucked away funders and consultants who were donating their technical expertise.

Still, even if a second factory isn't good for MFK, the more important question probably is: could it be good for the people of Haiti?

I called up someone who knows both organizations, Mark Manary, a professor of pediatrics at Washington University in St. Louis. He was one of the first to use this peanut butter cure for malnutrition. He first showed MFK's Pat Wolff how to make it years ago in Africa. And when PIH was thinking about building their new factory, they asked Manary for advice.

Manary doesn't really take sides. But he says as far as I can tell what's going on here does seem like a waste of money.

MARK MANARY: It seems like the, you know, two factories isn't appropriate for Haiti.

CHARLES: This kind of thing happens, he says, because NGOs - non-governmental organizations - are well, they're organizations. They compete; they do things that will attract recognition and promote their own brand.

MANARY: Unfortunately, branding is a powerful force among many NGOs. And it is basically true, I think, that once an organization exists, it tries to survive.

CHARLES: But that can also prevent it from cooperating with others or stepping aside to let another organization thrive. I understand that impulse, he says. I've tried to build an organization, too. But it can distract you from the people you're really trying to help.

Dan Charles, NPR News.

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