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SHORTAGE OF MIDWIVES
962
leaf could be used as the raw material in those countries where the need is most acute; and how would the protein be fitted into the diets eaten in those countries ? The first is probably the more important because the world’s immediate need is for more sources of locally made protein rather than for protein made for export by industrialised communities. There already appears to be surplus dried skim milk. In each area of need it would therefore be well if the three main types of leaf were surveyed. These are: Wild leaves.-On a small scale these are satisfactory but, because they usually grow on land that is unsuitable for cultivation, large-scale collection is difficult. Water plants such as papyrus and water hyacinth are an exception; they would not only be easy to collect but the collection would improve the amenities. It is a pity that, with so much effort being put into eradicating these and other pests, so little is put into finding a use for them. Waste leaves.-In temperate regions pea haulm and sugarbeet tops are satisfactory protein sources. Attention should be given to leaves from such crops as sweet potato, sugar cane, banana, and cassava. Difficulties may well arise with some of them; but they can be discovered, and perhaps overcome, cheaply in the laboratory. Special crops.-Only about 100 of the third of a million known plants play a significant part in nutrition. Many of the neglected plants grow luxuriantly, but they cannot be used by normal methods of food technology because they do not produce large seeds or tubers and their leaves are unpalatable to stock. At present, and for convenience, we generally make leaf protein from normal farm crops harvested while young, but, when large-scale production starts, plants or varieties new to agriculture will probably be used. Research has already begun on the selection of plants that would be useful in temperate climates; it has hardly begun in the tropics. For this work it is necessary to have only a pound or two of leaf and the normal equipment of a biochemical laboratory; it would therefore be easy to study a wide range of tropical plants in many different places. Until this has been done it would be premature to think of setting up extraction machinery, but it will not be done until some interest is shown in the possibility of making protein in a locality and setting up machinery there. Specially grown crops, unlike the other two types of raw material, would compete directly with conventional methods of using land. Their advantages are that, even with the crops we have already tried, a greater or more valuable yield can often be got in this way from a given area in a given time, and that a crop, harvested in the vegetative state, is less vulnerable to some pests and diseases than one that has to mature.
at first at any rate, is opposed to a dark green soup or stew. We have therefore concentrated on what may be loosely called " cocktail snacks " in which the protein is encased in thin pastry or batter. It has little or no flavour of its own, and what it has is easily masked by the normal flavouring agents. This type of presentation is not altogether unrealistic because a novel protein should not be expected to satisfy more than 10% of the daily protein need; this amount goes into 5 to 10 of these " snacks ". On this scale the protein has been eaten by scores of people, generally with satisfaction and never with more than the routine complaints that one must expect to find levelled against a new foodstuff. Scotsmen are familiar with this reaction on the part of the English towards haggis, and there are reciprocal reactions. If 20 g. or more is eaten at one time, part of the chlorophyll escapes destruction in the gut and appears in the fseces. Again there is, in principle, no objection to a green colour, but anyone intending to eat the protein in bulk should be forewarned so that the green will not be taken as evidence that the protein has not been digested.
So far there have been few trials with the protein incorporated in the foods eaten in the undernourished parts of the world, because people in Britain tend not to be interested in this type of food whether it contains leaf protein or not. This is an aspect of the work on which I would welcome cooperation. Air transport, or some form of refrigerated surface transport, makes it easy to send protein made at Rothamsted in 5-50 kg. lots to many parts of the world, and material made here is probably better than what would at first be made by a new unit working on new types of leaf. We will very willingly send protein to anyone who wishes to undertake a serious study of its acceptability and nutritive value in man, especially in a region that is now undernourished. This article has dealt with only one deficiency protein. It is probably the most widespread and important nutritional deficiency in the world today, so that it could be argued that most research should be concentrated on it. But the argument does not depend on that being true. So long as it is agreed that protein deficiency is widespread there is a strong case for searching for new sources of edible protein. Leaves are not the only such source, but they are one potential source which is at present being investigated too little. My aim here has been to describe the present position and point out what can usefully be done immediately without expensive or elaborate organisation.
PRESENTATION ON THE TABLE
type of food can be thought of as something for a temporary emergency; ideally it should tiding then have little colour or flavour so that it can, according to the usual tradition, be added to bread. If such a product were being made from leaves it would have to be made in an industrialised community and would then be given or sold to the community suffering the emergency. By extraction with fat solvents, leaf protein can be given this form. I have already argued that this is not the present-day position; the need is likely to be permanent, and what is needed is something that can be made in the region where it is to be eaten. This probably means that the leaf protein used in practice will be intensely green. There is no reason why a food should not be green, but it is so unusual as to raise some xsthetic problems. Most of our experience in presenting leaf protein on the table has involved meeting British prejudice; and this, A
new
over
SHORTAGE OF MIDWIVES FOR some time past the Central Midwives Board have forecast that the rising birth-rate would soon strain the maternity services. In their report for 1958-591 they are unhappily able to record the truth of their prophecy. During the past year shortages of trained midwives in hospitals approved as trainingschools were continually brought to their notice, yet these hospitals are more fortunate than non-training schools in attracting staff. There are also widespread shortages of domiciliary midwives, and the Board reiterate the importance of a fully staffed domiciliary and hospital midwifery service. Their warning is reinforced by last year’s figures; for, though on March 31, 1959, there were 67,768 names on the Midwives Roll (an increase of 3046 on the preceding year), during 1958-59 only 16,445 midwives notified their intention to practise261 fewer than in the previous year. 1. Obtainable from the Pp. 16.
Board, 39, Harrington Gardens, London, S.W.7.
leaf could be used as the raw material in those countries where the need is most acute; and how would the protein be fitted into the diets eaten in those countries ? The first is probably the more important because the world’s immediate need is for more sources of locally made protein rather than for protein made for export by industrialised communities. There already appears to be surplus dried skim milk. In each area of need it would therefore be well if the three main types of leaf were surveyed. These are: Wild leaves.-On a small scale these are satisfactory but, because they usually grow on land that is unsuitable for cultivation, large-scale collection is difficult. Water plants such as papyrus and water hyacinth are an exception; they would not only be easy to collect but the collection would improve the amenities. It is a pity that, with so much effort being put into eradicating these and other pests, so little is put into finding a use for them. Waste leaves.-In temperate regions pea haulm and sugarbeet tops are satisfactory protein sources. Attention should be given to leaves from such crops as sweet potato, sugar cane, banana, and cassava. Difficulties may well arise with some of them; but they can be discovered, and perhaps overcome, cheaply in the laboratory. Special crops.-Only about 100 of the third of a million known plants play a significant part in nutrition. Many of the neglected plants grow luxuriantly, but they cannot be used by normal methods of food technology because they do not produce large seeds or tubers and their leaves are unpalatable to stock. At present, and for convenience, we generally make leaf protein from normal farm crops harvested while young, but, when large-scale production starts, plants or varieties new to agriculture will probably be used. Research has already begun on the selection of plants that would be useful in temperate climates; it has hardly begun in the tropics. For this work it is necessary to have only a pound or two of leaf and the normal equipment of a biochemical laboratory; it would therefore be easy to study a wide range of tropical plants in many different places. Until this has been done it would be premature to think of setting up extraction machinery, but it will not be done until some interest is shown in the possibility of making protein in a locality and setting up machinery there. Specially grown crops, unlike the other two types of raw material, would compete directly with conventional methods of using land. Their advantages are that, even with the crops we have already tried, a greater or more valuable yield can often be got in this way from a given area in a given time, and that a crop, harvested in the vegetative state, is less vulnerable to some pests and diseases than one that has to mature.
at first at any rate, is opposed to a dark green soup or stew. We have therefore concentrated on what may be loosely called " cocktail snacks " in which the protein is encased in thin pastry or batter. It has little or no flavour of its own, and what it has is easily masked by the normal flavouring agents. This type of presentation is not altogether unrealistic because a novel protein should not be expected to satisfy more than 10% of the daily protein need; this amount goes into 5 to 10 of these " snacks ". On this scale the protein has been eaten by scores of people, generally with satisfaction and never with more than the routine complaints that one must expect to find levelled against a new foodstuff. Scotsmen are familiar with this reaction on the part of the English towards haggis, and there are reciprocal reactions. If 20 g. or more is eaten at one time, part of the chlorophyll escapes destruction in the gut and appears in the fseces. Again there is, in principle, no objection to a green colour, but anyone intending to eat the protein in bulk should be forewarned so that the green will not be taken as evidence that the protein has not been digested.
So far there have been few trials with the protein incorporated in the foods eaten in the undernourished parts of the world, because people in Britain tend not to be interested in this type of food whether it contains leaf protein or not. This is an aspect of the work on which I would welcome cooperation. Air transport, or some form of refrigerated surface transport, makes it easy to send protein made at Rothamsted in 5-50 kg. lots to many parts of the world, and material made here is probably better than what would at first be made by a new unit working on new types of leaf. We will very willingly send protein to anyone who wishes to undertake a serious study of its acceptability and nutritive value in man, especially in a region that is now undernourished. This article has dealt with only one deficiency protein. It is probably the most widespread and important nutritional deficiency in the world today, so that it could be argued that most research should be concentrated on it. But the argument does not depend on that being true. So long as it is agreed that protein deficiency is widespread there is a strong case for searching for new sources of edible protein. Leaves are not the only such source, but they are one potential source which is at present being investigated too little. My aim here has been to describe the present position and point out what can usefully be done immediately without expensive or elaborate organisation.
PRESENTATION ON THE TABLE
type of food can be thought of as something for a temporary emergency; ideally it should tiding then have little colour or flavour so that it can, according to the usual tradition, be added to bread. If such a product were being made from leaves it would have to be made in an industrialised community and would then be given or sold to the community suffering the emergency. By extraction with fat solvents, leaf protein can be given this form. I have already argued that this is not the present-day position; the need is likely to be permanent, and what is needed is something that can be made in the region where it is to be eaten. This probably means that the leaf protein used in practice will be intensely green. There is no reason why a food should not be green, but it is so unusual as to raise some xsthetic problems. Most of our experience in presenting leaf protein on the table has involved meeting British prejudice; and this, A
new
over
SHORTAGE OF MIDWIVES FOR some time past the Central Midwives Board have forecast that the rising birth-rate would soon strain the maternity services. In their report for 1958-591 they are unhappily able to record the truth of their prophecy. During the past year shortages of trained midwives in hospitals approved as trainingschools were continually brought to their notice, yet these hospitals are more fortunate than non-training schools in attracting staff. There are also widespread shortages of domiciliary midwives, and the Board reiterate the importance of a fully staffed domiciliary and hospital midwifery service. Their warning is reinforced by last year’s figures; for, though on March 31, 1959, there were 67,768 names on the Midwives Roll (an increase of 3046 on the preceding year), during 1958-59 only 16,445 midwives notified their intention to practise261 fewer than in the previous year. 1. Obtainable from the Pp. 16.
Board, 39, Harrington Gardens, London, S.W.7.