When an illness from iron deficiency anemia threatened to derail her studies at Brown University, Rajvi Mehta wasn't satisfied with just following the doctor's prescription. She wanted to know more, and what she learned was the basis of an effort that has helped thousands back home in India.
Now a second-year medical student at Duke, Mehta continues to build upon her 2011 initiative in India that is succeeding where many previous anemia educational efforts have failed.
A native of Mumbai, India, Mehta came to the United States in 2009 to pursue a bachelor’s degree at Brown University.
“I wanted to explore African dance classes, music, and art to get a feel for what direction I wanted to go in,” said Mehta. “I eventually took science classes and it was a better fit.”
During her sophomore year, she "began to feel sick and pale,” said Mehta in an interview at Duke's Trent Semans Center, the Duke School of Medicine's new educational building. “I didn’t know what was happening. I went back home to India and got a blood test and I found out I had iron deficiency anemia.”
Iron deficiency anemia occurs when the body doesn’t have enough iron to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color and enables the cells to carry oxygen.
Mehta said she was unaware of iron-deficiency anemia and didn’t know how prevalent it was and still is in India. Mehta said her diagnosis prompted her to start Let’s Be Well Red.
Mehta works with local "health scouts" who go into their community to share information about iron-deficiency anemia.
Let’s Be Well Red is a social venture that combats the widespread prevalence of iron-deficiency anemia in India that disproportionately affects pregnant woman, children, and infants. Iron deficiency anemia affects 80 percent of India’s population, Mehta said.
“The program will spread awareness and test people's hemoglobin so that they can know that if they have low hemoglobin and are anemic,” said Mehta. “I will also provide them with some nutritional guidance.”
Mehta said she researched programs to understand why they failed. One assessment was that programs that only provided education without offering real-life solutions didn't bring positive results. Her hope was to find a method that the government could replicate.
“Some just provided nutrition information or some would give free iron pills,” Mehta said. “Many of the government programs never provided the whole package.”
“I thought that to be effective, a program had to provide nutritional guidance, and free iron pills for three months and then follow up with people to show them that their hemoglobin is improving. I wanted to cover, all the loopholes that previous efforts had failed at.”
At 19, Mehta said she had set up cooking camps to demonstrate how to introduce iron into a daily diet.
“When I had a follow up session, some of them weren’t coming back,” said Mehta. “And when I asked them did they change their diet, they instead asked me was there one food product of iron to supply their iron needs. “
This question led her to think about finding “an Indian delicacy that people normally like I could modify and make iron rich,” she said. “I wanted to create something that was a culturally sensitive solution to the problem.”
Mehta said it took a year for her and her team to come up with a solution. Mehta said they created the GudNess bar which is based on an Indian delicacy called a chikki that would provide iron.
GudNess bars contain jagery that holds the bar together and adds sweetness. It also contains Nachani or finger millets, which are the nuts that are a rich source of iron and calcium. It also contains sesame seeds that have beneficial minerals. GudNess bars are sold at many retail outlets and schools in 12 cities in 4 Indian states. According to Mehta, they sell 200,000 bars a week.
The project also looks for ways to involve the community in iron nutrition education. Through a health scout program high school students spread awareness about anemia in their local communities.
Mehta said she loves learning from the community about problems that they have faced with anemia and knowing a simple solution like GudNess bars has changed them.
"It’s always good hearing stories about improving hemoglobin levels and the consumption of Gudness bars,” said Mehta. “That makes you realize what you have is an actual solution that is appreciating advocacy and improvement of life.”
Shakira Warren is a rising junior at NC Central University who is working this summer with Duke's Office of News and Communications.