Sustainable Efforts to Fight Acute Malnutrition in Zimbabwe

Rutharo-Madzima-PicThis World Humanitarian Day, Dexter Chagwena, a Research Nutritionist from the University of Zimbabwe, and Rufaro Charity Madzima, an independent Nutrition Consultant, reflect on acute malnutrition in Zimbabwe, how the condition is becoming increasingly prevalent during periods of stability and what needs to be done to make efforts more sustainable.

Zimbabwe is no stranger to humanitarian crises. Over the past few years the country has experienced sporadic cholera outbreaks. Parts of the country are particularly prone to droughts and floods. Earlier this year the Tokwe-Mukosi dam flooded in Chivi– a rural district in Masvingo Provincean in south-eastern Zimbabwe – displacing 4000 villagers when their homes were submerged.

Masvingo province is located in the low veld of the country where rainfall is minimal and uncertain. Most parts of the province are drought prone, therefore, are generally unfit for agriculture. Villagers, therefore, make their livelihood through cattle ranching. Last February, when the dam flooded, villagers did not just lose their homes, but their cattle and sole form of livelihood. In the weeks that followed, malnutrition rose as many families could no longer afford a single decent meal and were left severely food insecure. As a result of the sudden lack of nutritious food and increased risk of disease, many children experienced a rapid loss in weight – a condition known as acute malnutrition.

This condition can quickly result in death without treatment. Thankfully, treatment is available. Cost-effective and high-impact approaches to treatment have revolutionized the fight against acute malnutrition. Through community-based approaches it is possible to identify and treat more children than ever before. Energy-dense, micronutrient-enriched foods —known as RUTFs —can effectively treat children in a matter of weeks, without needing to be admitted to hospital.

Acute malnutrition has been prevalent in many African countries for decades – affecting 13.2 million children in Africa alone. In Zimbabwe, like many African countries, young children tend to be the most vulnerable to this condition. Zimbabwe has made tremendous strides in tackling acute malnutrition over the years – today around 3% of children under the age of five affected, down from 7% in 2005-06. This has been, in large part, due to the support provided by humanitarian assistance to decenralise the community based management of acute malnutrition (CMAM) to almost every district of the country.

As a resource-limited country, Zimbabwe has achieved “tremendous successes under difficult conditions.” Recently, at the initiative of the Ministry of Health and Child Care, Zimbabwe has migrated from community based services to a more institutional based, integrated management of acute malnutrition (IMAM). This initiative is aimed at improving the previous CMAM approach to a more unified response in the management of acute malnutrition between health institutions and communities. But there is still room to advance our efforts and reduce the rates of acute malnutrition even further. To do this Zimbabwe, and other countries, need more sustainable approaches in fighting acute malnutrition in non-emergency settings.

While acute malnutrition does occur during humanitarian crises, it in becoming increasingly common in stable settings. Humanitarian efforts are crucial and must continue to provide life-saving support when incidents like the Tokwe-Mukosi flooding occur. But much more needs to be done to advance our efforts and provide a more sustainable approach in fighting acute malnutrition in non-emergency contexts to ensure that children who are at risk during times of stability are also able to access this life-saving treatment.

The supply of life-saving RUTFs is often restricted to periods of crisis. As a result, clinics can suffer from regular stock-outs – a major barrier to accessing treatment. Repeated stock-outs can contribute to community-based SAM treatment services as being perceived as unreliable, leading to significant increases in length of stay, absenteeism and children defaulting from treatment.

Globally, a staggering 1 million children die each year from this condition, despite the fact that it is preventable and treatable. If we hope to make a dent in this number, and safeguard the futures of millions of children, then more needs to be done to bridge the gap between short-term humanitarian funding and long-term sustainable development funding.

What can you do?

Sign the Generation Nutrition petition calling on leaders all over the world to take urgent action to reduce the number of children suffering from acute malnutrition and safeguard the lives of millions of children.

Authors:

Dexter Chagwena, Research Nutritionist, University of Zimbabwe, College of Health Sciences

And Rufaro Charity Madzima, Independent Nutrition Consultant, JIMAT Development Consultants, Harare, Zimbabwe. www.jimatconsult.co.zw

Acute Malnutrition: An Everyday Emergency

To mark World Humanitarian Day, Sabrina de Souza, Nutrition Advocacy Co-ordinator at RESULTS UK, discusses why acute malnutrition is an everyday emergency.

When you see an image of an emaciated child, what’s your instant reaction? You wouldn’t be wrong in thinking that this child may be caught in the middle of some humanitarian emergency, such as a drought or a famine. It is a common outcome of such crises. Millions of children — 52 million to be exact — suffer from acute malnutrition, which causes rapid and severe weight loss, leaving children emaciated. In the most severe form — severe acute malnutrition — this condition can quickly result in death without treatment.

Credit: Sanjit Das/ RESULTS UK

Credit: Sanjit Das/ RESULTS UK

Thankfully, treatment is available. Cost-effective and high-impact approaches to treatment have revolutionized the fight against acute malnutrition. Through community-based approaches we are able to identify and treat more children than ever before. Energy-dense, micronutrient-enriched foods — known as RUFTs — can effectively treat children in a matter of weeks, without needing to be admitted to hospital.

Despite revolutions in treatment, 90 percent of children suffering from severe acute malnutrition (SAM) are unable to access the treatment they need. In 20 years, between 1990 and 2011, the global burden of acute malnutrition fell by just 11percent, from 58 million to 52 million. In sub-Saharan Africa, the numbers of acutely malnourished children actually grew during this period from 10 million to 13 million. This is due, in part, to the way that the treatment of acute malnutrition is delivered.

An everyday emergency

While acute malnutrition can occur during humanitarian emergencies, it commonly occurs in stable settings as well — making it an everyday emergency. The treatment of severe acute malnutrition is primarily delivered via emergency responses, which are typically short in duration. Therefore, children who are at risk of acute malnutrition in stable, non-emergency settings often struggle to access this life-saving treatment.

The supply of life-saving RUTFs is often restricted to periods of crisis. As a result, clinics can suffer from regular stock-outs — a major barrier to accessing treatment. Repeated stock-outs can contribute to community-based SAM treatment services as being perceived as unreliable, leading to significant increases in length of stay, absenteeism and children defaulting from treatment.

A staggering 1 million children die each year from this condition, despite the fact that it is preventable and treatable. If we hope to make a dent in this number, and safeguard the futures of millions of children, then more needs to be done to bridge the gap between short-term humanitarian funding and long-term sustainable development funding.

The UK: leading by example

Sustainable funding is needed so governments in high-burden countries can plan and implement long-term strategies to tackle acute malnutrition. The UK, which is among the top providers of humanitarian assistance, is making encouraging steps to fund multi-year nutrition-related programmes in a number of high-burden countries, including Sudan, Kenya, Somalia, Uganda, Ethiopia and Yemen, which aim to bridge the gap between humanitarian aid and longer-term funding. However, more needs to be done and there is scope to replicate these much needed programmes in other high-burden countries that DFID works in.

The Generation Nutrition campaign encourages other donors, including Sweden, Turkey, the United States and EU institutions, which sit alongside the UK as the top providers of humanitarian assistance, to follow suit in recognising acute malnutrition as a development issue, not just a results of a humanitarian crisis, that requires sustainable funding for both the treatment and prevention of life-threatening condition.

What can you do?

Sign the Generation Nutrition petition calling on leaders all over the world to take urgent action to reduce the number of children suffering from acute malnutrition and safeguard the lives of millions of children.

RESULTS welcomes Sveta to the Team

Hello everybody, my name is Sveta McGill and I have just joined RESULTS UK as Health Advocacy Officer. I originally come from Kiev, Ukraine, but have been in the UK since 2010 doing a PhD at Queen Margaret University in Edinburgh. My PhD thesis researched the impact of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) on HIV prevention policies and services in Ukraine which has the leading HIV rates in the European region.

svetaMy job of is now more focused on TB, and I am contributing to the Russian-language activities of the TB Europe Coalition (TBEC) - a network of activists and CSOs formed to increase the level of awareness, commitment and political will within the European Union and European Commission to fight TB. I bring to the job 15 + years of experience of working in the ex-Soviet region in public health, HIV/AIDS, TB, as well as gender policy and NGO development. I have also published a Russian-language journal “Aktualnye Infekcii” from 2007 to 2012 based in Kiev that focused on health care policy in HIV and TB, as well as programmes implemented by international donors in the region.

I am generally easy going and responsive, and try to stay positive at all times, work as a team and have an effect in everything I do. I like travel, music and musicals, walking, cooking, and spending quality time with family and friends. My favourite book is ‘Master and Margarita’ by Mikhail Bulgakov and my favourite composer is Tchaikovsky.

Gill Price reflects on her Footsteps for Futures challenge

This summer, Gill Price from the Stort Valley group will be doing five different local walks as part of her Footsteps for Futures challenge. To keep us updated on her challenge, Gill has created her own blog where she will be posting updates on how she is getting on. Have a read of her first post below and check out the rest of her posts over the next month directly from her blog

Education has been described as the best way to increase the health, wealth and stability of a nation and is a fundamental human right. It is a sad fact, however that more than 57 million children around the world do not go to primary school and at least 250 million children cannot read or count even if they have spent four years in school. I believe that every child should have the chance to go to a school where they are well taught. A good education is a shelter for life.

Gill's pic cropped

Thats the facts out of the way, now for the personal bit.

I live in Perry Green, the hamlet where Henry Moore spent most of his working life and where the Henry Moore Foundation he set up to carry on his work is situated. Theres a public footpath running through the grounds from which you can see many of the sculptures. Henry Moore knew the value of education. Speaking of his childhood in Castleford, Yorkshire Henry Moore said,

“My father was a miner at the time of a very long coal strike. We had a very thin time, but my father was unbelievably resilient and ambitious for his children. He had had to learn everything himself, from books and so on. He had had no help from his parents so he had a terrific struggle to do what he did. But he had tremendous hopes for his children and he believed in education and he made us go in for exams to get to the local secondary school, as it was called then; it became a grammar school later”.

One of the sculptures near the path is, ‘Large figure in a shelter’ It is the last bronze sculpture that Henry Moore made (1985 – 1986). It reminds me that a good education really is a ‘Shelter for life’ This last sculpture of Henry Moore’s is the first sculpture I am using in my ‘Footsteps for Futures’ series of walks raising money for RESULTS. I will be walking from my home to the local schools, following the routes that children might have taken in the past.

You can help me raise money for RESULTS here and help to give vulnerable children a ‘Shelter for life’ through a good education.

I decided to take part in this particular challenge for RESULTS as like Henry Moore my father too was the son of a miner who was determined to get an education for his sons so that they would not have to go down the mines. I too value the education I received and I would hope that every child could be given the gift of education.

Gill Price meets her local MP Mark Prish -MP for Hertford and Stortford.

Gill Price meets her local MP Mark Prisk -MP for Hertford and Stortford.

Being somewhat unfit, the walks will be a challenge but it’s great to know that I will be raising funds to help to change the lives of the most vulnerable children around the world.’

Please sponsor me here and help get all children the education they deserve.

Fancy doing a Footsteps for Futures challenge yourself? Find out more and sign up on the  Footsteps for Futures website.

 

 

Recording of August conference call now available

We are pleased to announce that a recording of our August conference call is now available to download. Just click on the link to access the audio.

the call launched our August monthly action which calls upon campaigners to contact MPs ahead of the crucial upcoming vote on the bill to enshrine the UK’s commitment to spending 0.7% of GNI on overseas aid; and asks them to meet with newly elected MEPs, to get the issues which RESULTS works on in front of our European representatives before they go into the main Parliamentary session.

 

Sarah Laughton takes a look at the need for teachers in delivering universal education

Sarah Laughton of our Macclesfield group, who joined RESULTS for two days work experience, wrote this blog on the issue of teacher shortages in sub-Saharan Africa.

Due to the ongoing work of organisations such as the Global Partnership for Education, and the rising school-age population in Sub-Saharan Africa, more children than ever are enrolling in primary education. However, this progress faces a potential barrier: a lack of teaching staff. A lack of teachers means a lower quality of education or even a lower availability of education.

UNESCO data shows that around a third of sub-Saharan countries such as Nigeria and Eritrea will need to hire more teachers by 2030 in order to help ensure good quality universal education. In fact, statistics suggest that unless many of these countries start recruiting now they could face huge shortages by 2030.

One example of this issue is in Djibouti. Currently only 54% of the country’s primary school-aged children are enrolled in school. As the push for universal education continues this figure is expected to and hopefully will increase quite dramatically. However, in order to accommodate this increase in demand and achieve universal primary education Djibouti will need to recruit around 17% more teachers per year. This is a huge challenge in a country with limited resources to allow it to make large expansions to its workforce.

However, some governments in the region have begun to take big steps towards dealing with the issue and to prevent potential shortages in the future. Since 1999 Ethiopia has been increasing its teaching staff by around 11% per year meaning there is a good chance that it will escape future problems. However, in other countries such as Eritrea recruitment is struggling to combat the high number of teachers leaving  due to sickness or retirement; for every seven teachers recruited, 10 are expected to leave, meaning that the number of teaching staff is actually expected to decrease leaving the country with a serious shortage. In fact this is not an uncommon issue in the region as on top of the 2.1 million new teaching posts expected to be created in the coming years, it is also estimated that a further 2.6 million positions will need to be filled as teaching staff leave.

Nevertheless, although Sub-Saharan Africa still accounts for 46% of the global shortage of school teachers, an issue that urgently needs to be solved in order to achieve universal education, successful steps seen in countries such as Ethiopia show that it can be done and along with the support and guidance of organisations like the GPE hopefully by 2030 governments will be able to assure good quality universal education.

Sabrina’s Footsteps for Futures: Inspired by Sylvia

sabrina-1-300x300Millions of children do not receive the education they deserve. For some this is because there are simply no schools for them to attend, but for many, schools do exist and there are other factors that prevent children from learning. One of these barriers is the distance children have to travel to get to school, which ultimately discourages children from attending, and those that do, may arrive too tired to concentrate.

Sabrina de Souza, Nutrition Advocacy Coordinator, reflects on her Footsteps for Futures challenge.

Inspired by Sylvia

A couple of weeks ago I came across a story about an eight-year old girl Tanzanian girl called Sylvia, who is determined to get an education that each school day makes a long and often risky one-and-a-half hour journey by foot – on her own. Her story has inspired me to do the Footsteps for Futures challenge to raise awareness for millions of children, like Sylvia, who have no other option but to travel long, difficult and even dangerous journeys to achieve an education.

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Slyvia’s home. Photo credit: James Stone / Plan International

As I read more about Sylvia and discovered that her closest primary school was a 7km walk away. That meant in a whole school year – 180 days – she walked over 2520km. That’s the equivalent of 60 marathons a year! Yet, Sylvia says that she is ‘one of the lucky ones’ in Tanzania, as many children her age are not able to access school at all. As many as 29 million primary school-aged children, more than half of them girls, are out of school in Africa.

Her story made me think about the contrast between my experience of getting to school and hers. The only and closest school to her was 7km away. My primary school was a very short distance in comparison – only 2.5km (1.6 miles) – and it was not necessarily the only school near where to I lived. I did a quick search of how many primary school there were in my hometown and discovered that I had the choice of sixteen, many within very close walking distance.

I started to think back to how I traveled to school as a child. In primary school I was lucky enough to be driven from home directly to the school gates – a journey that took no more than 5 minutes. The ease of my journey to school was something that I had completely taken for granted – until reading about Sylvia’s story.

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Photo credit: James Stone / Plan International

Slyvia would travel over an hour and a half to get to school. Her family lived in a rural village, in the centre of the farming land. To get to the main road she could have to walk through the dense fields. She only has one pair of shoes – flip flops – so she will often get cuts and scratches on her legs and feet. Once they wear out, she will have to walk barefoot. Once she reaches the road she must be careful of the on coming traffic – there is no pedestrian footpath. In the wet season the roads become flooded and she has to wade through deep water that collects in the road. To avoid the dangerous roads she will sometimes walk along the railway line to school. But this is equally dangerous as trains travel down the line.

Out of curiosity I did some research into how other children traveled to school. I found out that almost 70% of children in South Africa walk to school. Those who live in rural areas, or those in the poorest quintile, are more likely to walk than those who live in urban areas.

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I took my education for granted

Education was something that I completely took for granted. I admit that my attendance wasn’t the best. I would on numerous occasions ‘pull a sicky’ just so I could have a day in bed. I guess I didn’t see the harm because I always knew it would be there tomorrow. I never saw education as a right or a privilege. I admit on days I probably thought it was a bit of a chore. As a child you don’t realise the amazing opportunity available to you – at least I didn’t.

It wasn’t until I went to Tanzania and volunteered as an English teacher at a primary school that I realised how lucky I was. There was a rickety old school bus that would pick the children up from school – at least the children who’s parents could afford to ‘contribute’ to the yearly bus transfer.  The children who could not afford to get the bus would walk for well over an hour, and would often get reprimanded for being late or dirtying their uniform along the way. In the classroom, I’ve never met children who were so eager to learn. They were willing to do whatever it takes – walk as long as it took – to achieve an education. But it would sometimes come at a cost. I remember one little boy who always  struggled to keep his eyes open during the class, and as a result his school performance suffered. I now realise it was probably because he was so exhausted from his journey that he just couldn’t concentrate in class.

So why am I supporting the work of RESULTS? To ensure that not only can children get to school, but that once they get there they receive a quality education that will help them break the cycle of poverty.

Join the challenge

The Footsteps for Futures campaign runs until October 2014. You can complete your own Footsteps challenge at any time. Money raised will go towards RESULTS’ work to increase access to education for children around the world.

To get involved or to sponsor a participant, simply visit www.footstepsforfutures.org

Joe joins RESULTS for a week

My name is Joe and I am 16 years old and live in Camberwell. There is a requirement at my school that all students in year 11 should do a week of work experience during their summer holiday. I chose to do my work experience at RESULTS because I had heard about the work that is done here and it fascinated me. This is because I am incredibly interested in the social and economic issues that many people face in parts of the developing World and how charities like RESULTS plan to combat them. The specific area of work that I am interested in is microfinance. Microfinance interests me because I feel that it is of extreme importance to give people the money necessary to bring them out of poverty and move towards generating a steady income. This way society is able to progress further economically and through this economic progression comes much improvement in other aspects of society such as health and sanitation. I am greatly looking forward to acquiring new skills during this week and gaining a greater insight into the work that RESULTS and other charities alike do.

We Must Invest in an AIDS Vaccine

By Baroness Gould of Potternewton, Co-Chair of the Sexual Heath Forum and Chair of the All Party Parliamentary Group on Sexual Health.

This blog was originally posted on the Labour Campaign for International development blog.

Baroness GouldThis Tuesday I was fortunate to observe first-hand the work being done to develop an HIV/AIDS vaccine, here in London at a laboratory at the Chelsea and Westminster Hospital.

This work is being carried out by the International AIDS Vaccine Initiative (IAVI). Since 1998, they have been co-ordinating and leading clinical trials with partners across the world to find the approaches and compounds with the most potential. We were welcomed by Dr Martin McMorrow and Dr Phillip Bergen, who explained the scale of the challenge facing their team: the HIV virus varies far more widely between strains, and between countries, than any other infectious disease we are fighting.

The need for an HIV/AIDs vaccine cannot be doubted. As Co-Chair of the Sexual Heath Forum and Chair of the All Party Parliamentary Group on Sexual Health, I have long been convinced of the severity of the burden that this disease places on communities in the UK and overseas.

HIV/AIDS kills 1.6 million people a year, making it the most deadly infectious disease globally. It disproportionally affects those in developing countries, and people who are in their most productive years. In doing so, it deprives these countries of workers and caregivers, and increases healthcare costs.

Groups who already have less voice in society are also more at risk from HIV. 57% of new infections globally are in women, who often have less say in decisions that affect their sexual health such as whether to use a condom. AIDS is now the leading cause of death for women of child-bearing age in sub-Saharan Africa. Due to how the disease is transmitted, prevalence rates among gay men are much higher than in the adult population. Worryingly, some governments are now introducing laws to make it even harder to reach gay men by further criminalising same-sex relations.

It has been encouraging to see increased efforts and partnerships inflate the number of people who can access treatment to nearly 10 million a year – such as through the Global Fund to Fight Aids, Tuberculosis and Malaria. I am proud that the last Labour Government was a leading supporter of this work, and glad that the current Government have upheld the UK commitment. The spread of the disease has now slowed – but it will not be controlled without further bold decisions.

No disease in history has ever been controlled without a vaccine. Half of the HIV-positive population still does not know their status, and for every three people who access treatment, another four acquire HIV. Nor do we have the resources to control this disease through treatment alone, though it is a very important part of the solution. Ultimately, vaccines are much cheaper and more effective, and when used in conjunction with treatment and education, could spell the end for HIV/AIDS.

IMG_8671As Dr Bergen explained, the science may be challenging but it is producing exciting results. Clinical trials in 2009 found compounds that acted to create ‘neutralising antibodies’ that can stop infected cells reproducing, and subsequent work has refined this approach. IAVI has set up partnerships with private companies to develop any compounds identified in the next stages of its research.

I was concerned however, to hear that funding from the UK Government to IAVI has fallen in recent years, from £40 million from 2008 to 2013, to just £5 million in this current period. While it is both important and laudable to fund treatments that save lives now, it is also important to fund the research and development that will create the drugs to control these diseases in the long term.

It seems apparent that the current model of funding drug research and development has left us waiting on private companies to deliver these new drugs. For the so-called ‘neglected diseases of poverty’ like HIV/AIDs, TB and Malaria, which kill 14 million people a year between them but offer no short-term returns on investment, we may be waiting for a very long time. On the other hand, partnerships between Government, private companies, and philanthropic foundations (so-called ‘Product Development Partnerships’ such as IAVI) have been producing results, as they combine government-backed investment and interest in public health needs with the capital and capacity of the private sector.

Partnerships such as IAVI require significant long-term investment and support, and we need the UK Government – and other governments – to show leadership and pledge this support. A Labour Government with Jim Murphy leading our development work has already nailed its colours to the mast. We have pledged to support fairness around the world, with good health and the benefits it brings central to this vision. We will need an HIV/AIDS vaccine to turn this vision into reality, and so I for one am calling on all Parties to support IAVI and partnerships like them.

For more information about IAVI and their work, visit www.iavi.org.

For information about the importance of supporting research and development of drugs for diseases of poverty, such as HIV/AIDS – and about the ways we can do this, such as Product Development Partnerships – please visit www.results.org.uk.

My Footsteps: Laura Kerr, Paisley Grassroots Group

Laura Kerr, of the Paisley RESULTS grassroots group, remembers her time at school and share her motivation for undertaking her own Footsteps for Futures challenge. 

How many times has someone said to you “put yourself in their shoes” in order to make you think about a situation differently?

g0jMPDtfWell that’s exactly what the team at RESULTS challenged me to do a few weeks ago, and that’s exactly what I’m going to be doing for five days next week when I take part in the Footsteps for Futures challenge.

So whose shoes am I putting myself in?

I’m putting myself in the shoes of millions of children around the world who have to struggle to get the education they deserve. There are many reasons children don’t receive an education or can’t make the most of the basic education they do receive but I’m just focusing on just one in my challenge; the difficulty in simply getting to and from school.

My school was just a 10 minute walk from my home. My friends, who stayed further away. would get a lift from their parents or get the bus or train to school. The furthest anyone I know came from was a 20 minute bus ride away. I was able to work hard at both primary and secondary school, go home and do my homework with the resources I needed, and I got the grades I needed to go on to university.

Looking back, all this seems normal. I now realise how privileged I was to stay so close to school, be able to concentrate throughout the day having not been allowed out the house without my breakfast, and be able to do my homework when I got home, however dark it was (and in Scotland it really could be dark just as you were getting home from school) because we had electricity.

Over one third of primary school aged children are not learning the very basics in school; whether this be by the fact they can’t get to school, or when they do get to school, they are tired, unable to concentrate, or are not able to access the resources they need to learn.

These children deserve an education because an education is one of the very best ways to ensure a child can look forward to a bright future; able to live an independent life and fulfil their potential.

So next week, I will be walking to and from work every day. That’s 7 miles each way, 14 miles a day and 70 miles in 5 days.

As I write this, I’m feeling quite apprehensive about it. I’ve got some important meetings in work next week which I need to concentrate on and will need to get up at 5:30am every morning; what if I fall asleep by lunchtime? How am I going to feel at 5pm when I’ll still be facing a walk home that will take over two and a half hours?

I may be apprehensive but I’m looking forward to the challenge and using it to help others understand the barriers to education that millions of children face. In keeping with the theme of the Commonwealth Games that are currently in Glasgow: bring it on!

Follow my journey @LauraMAKerr 

You can sponsor Laura on her 14 mile journey to and from Paisley to Glasgow every day here.