Showing posts with label indigenous peoples(Guatemala). Show all posts
Showing posts with label indigenous peoples(Guatemala). Show all posts

Thursday, 1 December 2011

MALNUTRITION: Guatemala: Chronic Malnutrition Crosses Borders

November/December 2011 : Wende S. DuFlon and Maxine Hillary
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credit: Alfredo Calderón, USAID
A boy helps his father prepare the onion harvest for market in Sololá in the Western Highlands region of Guatemala.

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credit: Wende DuFlon, USAID
A brother and sister by the family adobe oven in a rural highlands village in Quiché, Guatemala, where the USAID/Save the Children food security program is increasing income and improving nutrition. image descr credit: Wende DuFlon, USAID
Felix Mayor, a Kaqchikel Maya leader of a Guatemalan farmers cooperative, holds freshly picked strawberries.

The soil is fertile and the people have been farming it for generations. The climate is right for several growing seasons of corn, wheat, beans, and myriad other crops. Why then does Guatemala have more chronically malnourished children than any other country in the Western Hemisphere, ranking sixth among nations globally for this human development indicator?
Food insecurity is not only a barrier to development in Guatemala—it has direct implications for neighbors in Central America and, ultimately, points north.
Guatemala’s crisis has been the subject of international press in the last couple of years—finally, the world is learning that one out of every two Guatemalan children younger than 5 years old is chronically malnourished. The national data mask an even worse situation among indigenous populations (mostly Maya people) where malnutrition stunts the growth of 65.9 percent of indigenous children ages 3 months to 59 months, compared with only 36.9 percent among non-indigenous children.
In Guatemala, leaders are just beginning to see how this situation holds everyone back, not just the malnourished and the poor who make up 51 percent of the population. Kevin Kelly, USAID/Guatemala mission director, explains: “Public awareness is growing that high levels of chronic malnutrition have far-reaching repercussions, including poverty and crippled economies that result in large numbers of disenfranchised youth migrating or engaging in criminal activities.”
How does this happen? Malnutrition stymies cognitive and physiological growth in the first 1,000 days of life—from a mother’s pregnancy through her child’s second year of life. This irreversible stunting dooms children to repetitive illness, inhibits them intellectually and physically, and ultimately reduces their productivity as adults by roughly a third. For society, this adds up to a dire scenario: Results from a recent UNICEF study show that chronic malnutrition costs Guatemala $8.4 million each day in reduced productivity, hospitalization, student failure, and repetition in the first three years of primary school.

Crisis Cross-Pollination
In an increasingly globalized world, one country’s crisis quickly penetrates the borders of another. “When large numbers of people in a society cannot meet their basic needs, the situation evolves to political instability, social conflict, and violence as Guatemala’s neighbors, trading partners, tourists, and citizens are discovering,” says Casey de Vides, USAID/Guatemala democracy and governance adviser. Since 2008, each year nearly 30,000 Guatemalans who have migrated north to look for work have been deported by the United States, according to Guatemalan Government migration statistics.
The country counts itself an important U.S. trading partner, with ties that stretch back to the early 1800s during the Jefferson era. Speaking before Congress last February, Mark Feierstein, USAID assistant administrator for the Bureau for Latin America and the Caribbean, highlighted the connection: “We help each other not only because it is the right thing to do and is an expression of our [American] values, but because our well-being is linked to that of people throughout this vast and diverse hemisphere.”
While undernutrition is widely recognized in other parts of the world, Guatemala’s crisis went relatively unnoticed until international media began to expose the direct connection between the sharp rise in chronic hunger and malnutrition, the world economic crisis, and global climate change. In the case of Guatemala, this means floods and droughts exacerbated by severe deforestation. The international coverage brought the high prevalence of undernutrition to the attention of Guatemala’s opinion leaders, development organizations, and informed citizens.
But to those most affected, chronic malnutrition is just part of life. Among the rural poor, who are mostly indigenous, mothers and fathers and community leaders will tell you: ’We’ve always eaten frijol and tortillas, and drunk coffee. Babies get sick and mothers die in childbirth—it has always been this way.’
“It’s also been elusive to Guatemalan economic and political leaders who are just beginning to understand how the ’other half’ of our nation—rural, indigenous, and marginal urban populations—lives, and that Mayans [Guatemala’s majority indigenous population] are not genetically short in stature,” reflects Dr. Baudilio López, USAID/Guatemala health officer.
For development leaders, chronic malnutrition is usually considered another ingredient in a statistic stew along with natural disasters, rapid population growth, a faltering economy, increased crime, maternal and infant mortality, urbanization, and poverty.
So how did chronic malnutrition come to be invisible? History holds part of the answer: Guatemala is a post-conflict society that emerged from a 36-year civil war in December 1996—a war that shredded the delicate fabric of an already divided society—and a recent democracy that adopted its current constitution in 1985.
It is the land of the ancient Maya who still wear traditional clothing and speak 22 indigenous languages. When the Spanish conquered the Maya 500 years ago, they retreated to the hills and mountains to avoid the injustices of colonization. In the highlands, they built communities with market and political systems that were insulated from central government and mainstream commerce and social life. They followed their ancestors’ slash-and-burn practices to cultivate beans and corn, and they became migrants working on non-native coffee, banana, and sugar plantations.
Basic services, such as electricity, water and sanitation, health and education, and new technologies like agricultural diversity and cultivation practices did not reach the isolated communities. The civil war further severed relations between the disenfranchised rural indigenous and the urban, largely Ladino (non-indigenous and officially recognized as a distinct ethnic group) landowners and government leaders.
Another part of the equation is that chronic malnutrition was never identified as a root cause of other development challenges.

Feeding for a Stable and Secure Future
The average citizen in the United States spends approximately 10 percent of family income on food while the poorest of the world spend over 50 percent. Improving nutrition in developing countries, and particularly during the critical 1,000-day window beginning with a woman’s pregnancy through her child’s second birthday, has long-lasting positive effects and can help break the cycle of poverty. Strong evidence demonstrates that providing better nutrition within that window could save millions of lives and increase a country’s gross domestic product by at least 2 to 3 percent annually.
Guatemala has 14 eco-regions with climate and soils that produce an abundance of food. However, the basic diet among the rural poor, who are mostly indigenous, is beans (frijol), corn in the form of tortillas or broths, and coffee with little use of fruits, vegetables, or sources of animal-based protein. This derives from a history and culture of subsistence farming using slash and burn techniques. Even communities that produce crops such as carrots, onions, strawberries, or squash prefer to sell the produce rather than consume it. They are often not aware that their produce is any more nutritious than that in their regular diet.

Food security
 credit: Sonia Dominguez, USAID
A farmer from Sololá shows his snow peas fresh from the vine. Snow peas are a non-traditional export that Guatemala began producing with USAID agriculture value chain alliances.

Food security is composed of three elements: Food access is adequate resources to obtain appropriate foods for a nutritious diet, which depends on income available to the household, the distribution of income within the household, and the price of food. Food utilization is proper biological use of food, requiring a diet providing sufficient energy and essential nutrients, potable water, and adequate sanitation as well as household knowledge of food storage and processing, the basic principles of nutrition, and proper management of childcare and illness. Food availability is having sufficient quantities of food available from household production, other domestic output, commercial imports, or food assistance.
Unlike other countries where malnutrition is largely a problem of availability, the malnutrition situation in Guatemala stems from people, particularly women’s lack of access to the money needed to buy nourishing food, and the improper use of food. In the book, Finding the Ties that Bind: Beyond Headship and Household, the Population Council’s Judith Bruce and Cynthia Lloyd explain how in Guatemala, an additional $11.40 per month in a mother’s hands would achieve the same weight gain in a young child as an additional $166 earned by the father.

Growing Opportunity
There are significant opportunities to simultaneously increase the income and nutritional status of rural households and increase the efficiency of poverty-fighting municipal services.
One of the most promising opportunities is Guatemala’s leader status in non-traditional agriculture, horticulture, and coffee exports in Central America. For example, USAID programs have engaged thousands of small-scale coffee growers in the highlands to develop production and marketing skills and participate in a global market niche for high-quality, specialty coffees. Guatemalan coffee production creates 2 million jobs every year for rural families.
Recognizing the opportunities and challenges, in 2010, USAID realigned its resources to focus on reducing malnutrition as the root cause of poverty—which drives people to seek work in other countries or with the growing drug or human-trafficking trades.
The new presidential initiatives, Feed the Future and Global Health, are timely for Guatemala; they facilitated the design of a multi-year, multi-sector strategy for food security and nutrition in support of the Government of Guatemala’s inclusive country-led food security plan.
The USAID strategy focuses on the poor, food-insecure Western Highlands region. It is embraced by a wide-range of Guatemalan stakeholders including national government officials, municipal authorities, private sector leaders, rural poor community leaders and families, civil society organizations, and other international donors, who have not historically sat around the same planning table.
“The goal,” says David Delgado, senior food security adviser for USAID/Guatemala, “is to sustainably reduce poverty and chronic malnutrition in Guatemala by focusing on agriculture, local governance, and nutrition.”
Horticulture and coffee hold the strongest potential for small-scale farmers and cooperatives where lands are managed and worked collectively and the proceeds are shared. Linking health and nutrition education interventions, particularly with mothers and small children, with agriculture value chains, and incorporating the support of municipal leaders is vital for the sustainability of this ambitious development venture.

The Feed the Future Foundation
Based on USAID best practices, this is how it is expected to work: Feed the Future will strengthen municipal governments’ economic development plans to reduce poverty and chronic malnutrition, improve their capacity to deliver basic services, especially water and sanitation, and support community-based advocacy to ensure that food security is sustainable. USAID will continue support to NGOs that advocate for improved health and nutrition, and is working to ensure that local governments are accountable and responsive to the needs of vulnerable groups.
“Our experience shows that increased income for farmers and job creation for day laborers that comes from the production of high-value crops, complemented by better access to basic health services, nutrition education, potable water, and comprehensive hygiene, improves food security and offers rural families a ticket out of poverty,” says Julia María Asturias, USAID/Guatemala food security officer. Targeted environmental and climate change-mitigation activities will further reduce food insecurity.
The strategy aligns USAID resources and integrates programming with other U.S. Government agencies; leverages investments from other donors, the private sector, and the Government of Guatemala; and includes an active monitoring and evaluation component and a diplomatic strategy to advocate for policy changes that increase the likelihood of sustainable poverty reduction in Guatemala.
“In short,” continues David Delgado, “our strategy takes a wide angle-lens view of what causes chronic malnutrition and concentrates our joint efforts on one geographic area, always in partnership with Guatemalan Government and community leaders. It is strategic to build on synergies between the USAID Feed the Future and Global Health Initiatives so that we can offer the rural poor an integrated set of tested solutions. We will commence work with those people who are most affected and most likely to be change agents: women and small-scale farmers.
“We know that raising income to increase access to food and improving nutrition practices are the best ways to attack chronic malnutrition. To improve nutrition practice, behavior change in rural households is needed—from selection and cooking of nutritious foods to food allocation within the family and care giving. Because these are traditionally women’s responsibility, an active and more empowered role of women—wives, mothers, mothers-in-law, and grandmothers—is essential to reduce chronic malnutrition. Women must learn to increase essential vitamins and minerals in the family diet, they must practice immediate and exclusive breastfeeding of newborns and learn complementary feeding of young children as well as the prevention and early detection and treatment of childhood illnesses.”
The change in women’s role and behavior will be sustainable if it is supported by male community leaders and family members. Local governance is an effective way to engage men in behavior change around nutritional choices and the use of scarce financial resources for nutrition during the first 1,000 days during a woman’s pregnancy and her child’s second birthday.

An Uphill Climb
There is far to go before chronic nutrition stops stunting half of Guatemala’s future. But raising public awareness of the problem and making its profound and far-reaching effects visible comes at a strategic time for Guatemala and its neighbors, providing an opportunity for new partners to work in innovative ways toward mutual prosperity, security, and stability.
Felix Mayor, leader of the Utz-Ajticonelá association in Zaragoza, Chimaltenango, reflects on the changes that USAID/Mercy Corps-led agriculture value chains have brought his community: “When our land is healthy, then our people are healthy and can grow up strong like our crops to feed us so that we can work; then we thrive. When we thrive, our youth stay home….
“Now we have a high school so they can work and go to school and stay here with the family. When the technicians first came to offer to help us learn to diversify our crops our land was sick—our strawberries no longer grew as they used to and we suffered—we did not know what to do. The technicians taught us how to take care of our environment, plant new crops, and nourish the soil with rotating these new plants with our strawberries. We learned to recycle our plastic, to build latrines, and to fence in our collective plots.
“Our women now work in the new packing plants. Not only do they have incomes for the first time in our history, they learn hygiene and to use the crops we produce for family meals. We no longer have to sell to the coyotes on the side of the main roads. Now we sell with dignity to buyers who pay us a fair price that we learned how to negotiate. We earn more. So, like the land, with opportunities we can thrive and take better care of our children and our community.”
http://www.usaid.gov/press/frontlines/fl_nov11/FL_nov11_FOOD_GUATEMALA.html

Sunday, 24 July 2011

MALNUTRITION: Guatemala: The drain of malnutrition

Lomi KrielJuly 18, 2011
Isabella Hernandez and her children stand outside their home high in the mountains in Cajola, Guatemala. Hernandez, 37, is a single mother who must support her children on less than $1 a day.
PHOTO BY: Arturo Godoy

CAJOLA, Guatemala — High in the mountains, a narrow and practically impassable mud trail leads to the dirt-floor shack where Isabella Hernandez is rhythmically patting tortillas, the main source of sustenance for her nine children.
A wisp of a woman, clothed in her community’s signature colorful dress, Hernandez is illiterate and a single mother who ekes out her family’s existence on less than $1 a day. Nearly 60 percent of this mostly indigenous Mayan town lives in such extreme poverty.
On this day a health worker had come to weigh and measure the children while delivering a nutritional supplement for the poor. A veteran in the hunger wars, Julissa Garcia knew what she would find. Sure enough, they were not only underweight but about half a foot shorter than the minimum recommended height for their age. Known as stunting, such a height deficit is a key indicator of chronic malnutrition.
“Almost all the kids here are malnourished,” said Garcia, who has pioneered a support group for Cajola mothers with stunted children.
It is communities like these that President Barack Obama’s Global Health Initiative (GHI) is focusing on in Guatemala. Slow in its implementation and hampered by little new money, GHI is targeting Mayan women and children in the mostly indigenous Western Highlands, a mountainous area with a single maize harvest per year. The strategy’s cornerstone is reducing one of the highest rates of chronic malnutrition in the world. According to the United Nations Children’s Fund, only Afghanistan and Yemen fare worse. Half of all Guatemalan children under five are stunted and in the Western Highlands, it's seven out of 10.
“These children have been lost. They can’t learn, they can’t be productive.”
~Dr. Baudilio Lopez, project development specialist at USAID office in Guatemala City.Called the “invisible killer,” chronic malnutrition isn’t necessarily a lack of food but a shortage of the right kind. Faced with insufficient nutrients, especially protein, the body compensates by simply stopping to grow. More importantly, brain capacity and productivity is reduced by as much as 40 percent. That can’t be recouped.
Such a lack of nutrients is obvious in Hernandez’s small shack. Lunch is their highlight, when the children fall silent as they shovel down tortillas flavored by salt, potatoes, and plants their mother picked in the fields. They eat while they can. Their bellies will predominantly rely on hot maize drinks for the rest of the day.
There are no beans or eggs. Meat is a rare luxury.
Garcia gasped when she saw how the three middle boys, each more than a year apart, essentially weigh and measure the same — at or below the minimum recommended amount for the youngest. It’s difficult, however, to gauge the effects of stunting on their cognitive development. None of the Hernandez children have ever attended school and all are illiterate, most speaking mainly their indigenous language of Mam.
The magnitude of the problem is stunning, as are the consequences. Such children are particularly susceptible to diarrhea and other illnesses. Chronic malnutrition is the single biggest contributor to the deaths of children under five. As concerning is the effect on their brains, thus the consequence on Guatemala itself.
“These children have been lost,” said Dr. Baudilio Lopez, a project development specialist at the Guatemala City office for the U.S. Agency for International Development (USAID.) “They can’t learn, they can’t be productive.”
GHI, which Obama unveiled two years ago, has been slow to implement, according to critics. And, due to the U.S.’s own budget woes, it has been hampered by less funding than expected. In Guatemala, USAID received basically the same level of funding, about $14 million, over the past two years, and just over $16 million for FY 2011. Cuts are likely ahead, given Washington’s budget crisis.
Nutrition efforts will also benefit from funding to Obama’s global food security initiative, which channeled about $25 million annually into Guatemala over the past two years.
The amount of funding pales in comparison to the seven other GHI focus countries. Guatemala’s GHI program receives by far the smallest amount of aid, just 1/37th received by Kenya, which has a $600 million GHI budget.
Still, officials at USAID and the Centers for Disease Control and Prevention, GHI’s two main implementing actors here, remain buoyant. They say the tightened focus on specific global health issues in a targeted geographic area combined with better collaboration among U.S. agencies is revolutionary.
For their part, Guatemalan health officials say they have never worked so closely with U.S. agencies.


"It's the first time that U.S. agencies sat at a table with the Ministry of Health to jointly plan" health strategies, said Dr. Edgar Gonzalez, who is heading GHI efforts for the Ministry of Health.

The initiative faces challenging obstacles. The percentage of Guatemala’s total population that is chronically malnourished has barely budged for more than a decade, despite efforts to reduce it. Guatemala is in many respects a tale of two countries. It is ranked 13th among the nations with the greatest level of income inequality, according to the United Nations Development Program. A semi-feudal society, 2 percent of the population owns about 70 percent of productive land. And though Guatemala’s average per capita income is $2,700, half of its 14 million residents live on less than $2 a day.
Most of the poor work as sharecroppers and are vulnerable to effects of global warming and natural disasters. As one of the top 10 countries most affected by both, Guatemala over the past two years experienced the heaviest rains in decades and severe drought as global food prices increased and remittances from the U.S. dropped.
Moreover, Guatemala’s notoriously weak government hasn’t made many inroads in addressing the problem, partly owing to one of the lowest tax collection rates in the world and a history of corruption. The impending presidential elections will likely overhaul government for the fourth time since 1996 making continuity in programs yet another challenge.

The plight of the Mayans
Most affected by malnutrition are the Mayans, who make up 40 percent of the country and have twice the rate of stunting of the non-indigenous. All poor health indicators basically double among the indigenous. They have lived in entrenched exclusion for decades, since before a leftist government effort at social reform, particularly land redistribution, sparked a U.S.-backed military coup in 1954 and catapulted the country into decades of civil war. More than 200,000, the majority indigenous civilians, were killed in one of Latin America’s most violent armed conflicts.
The 1996 peace accords made some advances, but more than 70 percent of Mayans continue to live in poverty. Many are geographically isolated, pushed into remote areas either fleeing persecution or seeking space to farm. They predominantly speak one of 24 Mayan languages. High illiteracy rates and traditional Mayan beliefs further complicate health efforts.
El Quiche is one of Guatemala’s poorest and most populous states, indelibly stained by the civil war. Of the indigenous civilians killed during the civil war, eighty-three percent of all identifiable victims were Mayans from this mountainous region. There’s only one factory here and, as one of the most food insecure regions in the country, agricultural yields are slim.
Seventy percent of children under five are chronically malnourished. Families migrate between the sugar and coffee harvest seasons to survive, but the economic crisis has meant less work. It is here that USAID, through its implementing partner Save the Children, has overseen a promising program in combating malnutrition. Similar efforts are occurring across the Western Highlands.
Faced with finite resources, protein and vegetable consumption is virtually non-existent among Mayan families. More than a fifth of all Guatemalan pregnant mothers have anemia, which is caused by a lack of iron and increases the risk of hemorrhage and the chances that infants will be born underweight and suffer cognitive impairment.
For years, aid workers concentrated mainly on food distribution and still, in Quiche, a majority of families receive donated beans and rice to help them survive.
In 2006, Save the Children surveyed their target communities here and found, to their surprise, that they didn’t recognize malnutrition as a problem. Their concerns were a new road or clean water, a school. This is a national phenomenon. In a study conducted last year, less than 1 percent of Guatemalans, who tend to believe they’re naturally short, identified malnutrition as a concern. Stunting, however, is not genetic. A World Bank study found Mayans in southern Mexico are taller than in Guatemala. Those raised in the United States reach normal heights.
In Quiche, Save the Children devised a strategy to tackle chronic malnutrition on a broader scale: education on what foods to eat, assistance with providing those foods, and most importantly, the election of community leaders to head the process, encouraging ownership to make it self-sustainable. In Chacaguex, for instance, Antonio Acabel was given several goats. With milk high in protein, goats also require far less land and food than cattle. As his herd multiplies, Acabel spreads them among the community, prioritizing families with young children.
“Before,” Acabel said, “no one drank milk because it’s too expensive.”
As the local farm leader, Acabel was trained how to more efficiently farm maize and which plants within his reach are high in protein. Instead of fertilizer, he uses goat manure – longer-lasting, better for his crops, and saving him $20 every three months. Today he hosts community workshops on better farming practices. His tiny vegetable garden is meticulously organized with each plant carefully labeled – proof of a man proud of and grateful for his work.
Such a simple premise, really: supply a bit of capital and show how to use it.
“It changed my life and that of the community,” Acabel said. “Before we didn’t have anything.”
Another initiative is a rigorous training process for “mother leaders” in the community. A liaison between health care workers and indigenous mothers, they teach women how to cook high-protein plants within their reach. Using bright diagrams of women in traditional dress, they show what kinds of food to provide children, in what quantities, and when. They urge the necessity of exclusive breast-feeding up to sixth months and how to combine it with food after that – key in preventing chronic malnutrition. Only half of Guatemalan infants under six months are solely breastfed.
“Before we didn’t know these things,” said Alma Cecilia Real Ajcot, 27, a mother leader who oversees food distribution. “Now that they have taught us how it is, we can do it.”
The concept of mother leaders has been wildly successful. They are friends and neighbors, inspiring trust, and familiar with traditional Mayan beliefs that might cause or worsen health problems. The phenomenon of mal ojos, for example, the idea that you can get sick if someone gives you a bad look, means mothers often only seek medical attention once it’s too late.
Most importantly, the women speak the same language.
“Sometimes we can’t even pronounce their names correctly,” said Marta Picasa, a nurse at a tiny health center outside of Quetzeltenango. “With us they will not have the same level of confidence.”

Gender wars
In Totonicapan, Guatemala’s poorest region, where 82 percent of all children under five are malnourished, USAID is funding a similar program aimed at educating Mayan men, who control most family decisions. Women, for instance, can’t seek medical attention without spousal permission – a critical contributor to Guatemala’s high maternal death rates. Men may also not understand or support why their wife wants to buy vegetables, say, instead of corn or rice.
They are taught the necessity of birth control as experts say chronic malnutrition and poor family planning are closely linked Indigenous families in some regions average 10 children but support them on an income barely enough for two. Malnourished mothers give birth to malnourished babies. Though Guatemalan’s use of birth control has doubled to 50 percent, many indigenous women still use it secretively, as men tend to equate contraceptives with infidelity.
Yet behavioral change can only accomplish so much if poor families can’t buy food. In conjunction with Feed the Future, Obama’s global food security initiative, officials said they would continue linking rural farmers directly to bigger markets to improve their income. Near the tourist attraction of Lake Atitlan, for example, USAID helped indigenous farmers form an agricultural cooperative, building a storage shed to prepare their vegetables. Before, these farmers worked alone and hawked their wares in the village market, which were purchased by middlemen, transported to Guatemala City, and sold to international vendors. Now the farmers sell directly to Wal-Mart.
Officials said they would also expand on programs encouraging employment for Mayan women. An extra dollar per month in a Guatemalan mother's hands achieves the same weight gain in a child as roughly 14 times more earned by the father, according to the Population Council, an international non-profit. USAID is also teaching communities how to organize to demand potable water from local governments. In rural communities, access to safe drinking water is scarce.

Making do with scarce resources, the success of GHI depends to a large degree on Guatemala’s Ministry of Health. One of the most fragile arms of a weak government, its slow collapse has been the subject of continuous media reports. Many health workers haven’t been paid in months and in some areas medical supplies simply stopped arriving. Patients transported by ambulance must often pay their own gas. Part of the problem is that its budget has been slashed to fund a conditional cash transfer program aimed at poor mothers, a cornerstone of the government strategy to combat malnutrition. The program has been widely criticized for the lack of oversight and transparency. Guatemala’s upcoming presidential elections will likely also affect GHI implementation.
In the dirt-floor shacks of Cajola, the scramble for survival continues. One of the biggest sources of help to Hernandez have been Peace Corps volunteers, who built her a stove so she no longer cooks on open fire. At 37, Hernandez’s breezy humor lights up her delicate features. Two months ago, she nearly died after hemorrhaging during her last pregnancy, arriving at the emergency room bruised from a fight with her ex-husband.
Like their community, the lives of the Hernandez family are isolated. None attend school because, while it’s free, the mother said the extras on books or pencils would break her budget. So the effects of their malnutrition remain unknown, likely forever.
Her spouse pays her $25 a month though it varies depending on his drinking. She relies on handouts, water from her neighbor’s well and nutritional supplements from the health center. She has a small maize crop. Life here continues like it always has, with the same limited future. Recently, however, Hernandez saved up money to buy two piglets, which she hopes to breed.
“I don’t have the capital right now,” she said in her native language of Mam. “But I would like a good business with my pigs. That way I can maintain my kids.”
She smiled. Then the youngest cried, so she sat down to breastfeed, leaving her teenage daughter in charge of lunch – tortillas, the same as yesterday, all the days before that, and what tomorrow would bring.
http://www.globalpost.com/dispatch/news/health/110714/ghi-targets-chronic-malnutrition-guatemala

Tuesday, 3 May 2011

MALNUTRITION: Guatemala: Child malnutrition caused by more than lack of food

Susan Martin : American Academy of Pediatrics
DENVER –- Giving poor families land on which to grow crops has been shown to improve child nutrition. New research also shows that giving families non-agricultural land and better housing also is beneficial for children's growth and nutrition. Study shows living conditions, sanitation and community organization play role in child growth

Results of the study of child malnutrition in rural Guatemala will be presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting in Denver.
Guatemala's rural populations suffer from one of the most unequal land distributions in Latin America. About 2 percent of the population owns 70 percent of all productive farmland. To remedy this, non-governmental organizations (NGOs) have raised money to buy private land and donate it to poor farmers so they can grow crops. However, urbanization and lack of land have led NGOs to distribute land for housing instead of farming.
Asya Agulnik, MD, MPH, and her colleagues looked at the effects of this change in land distribution on child health in coffee-growing areas of Guatemala. Researchers compared child malnutrition rates in five villages, four of which received non-agricultural land and brick houses in organized communities, along with improved sanitation. Families in the fifth community continued to live in squatter settlements on plantations.
Using WHO growth curves, investigators compared weight-for-age measurements of 242 children in these communities before and after the land distribution.
Before the moves, about 37 percent of children younger than 38 months were moderately malnourished, while just over 7 percent were severely malnourished. Twenty months after families received land and houses, malnutrition rates dropped among children in the same age group; roughly 19 percent were diagnosed with moderate malnutrition, and 5 percent were severely malnourished. Older children who were not breastfeeding at the time their family received land allotments and housing experienced the greatest nutritional benefit.
Meanwhile, children who remained in squatter settlements experienced worsening malnutrition.

"Malnutrition is a major problem for the health of children under 5 years of age in rural Mayan Guatemalan villages," said Dr. Agulnik, lead author of the study and a resident at Children's Hospital Boston. "This study demonstrates that in areas where land scarcity is a major problem, land distributions supporting improved housing and community organization can improve child nutrition without changing a family's income. It also suggests that in our population, living conditions, sanitation, crowding and community organization play a major role in causing child malnutrition."
The study underscores the fact that childhood malnutrition is not only about food, said study co-author Paul Wise, MD, MPH, FAAP, who created a program at Stanford University in California called Children in Crisis to improve health care to children living in politically unstable regions. "While this study documents the terrible toll of poverty on child health, it also emphasizes the interaction between the child, infections, community life and the exercise of political power."


The Pediatric Academic Societies (PAS) are four individual pediatric organizations who co-sponsor the PAS Annual Meeting – the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. Members of these organizations are pediatricians and other health care providers who are practicing in the research, academic and clinical arenas. The four sponsoring organizations are leaders in the advancement of pediatric research and child advocacy within pediatrics, and all share a common mission of fostering the health and well being of children worldwide. For more information, visit www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.
http://www.eurekalert.org/pub_releases/2011-05/aaop-cmc042711.php

Monday, 18 April 2011

MALNUTRITION: Guatemala: Malnutrition, Violence, and Investment

April 14, 2011



Several recent reports do not put Guatemala in a positive light. First, the European Union published a study that found that Guatemala has the highest rate of child malnutrition in all of Latin America. Almost 50% of children under the age of 5 suffer from chronic malnutrition. The EU's Rafael Señán Llarena added that Guatemala's malnutrition rate is higher than that of Haiti and among the five worst in the world.
Second, the Mutual Support Group (GAM) voiced its preoccupation with the continued violence in the country. During the first three months of the year, there were a total of 1,240 victims of violence, including 116 women and 3 girls. 874 of the victims were killed while the remaining 366 were "only" injured.
On the positive side, this number is a decrease from the 909 deaths reported during the first three months of 2010. However, on the negative side, both February (295) and March (304) murders increased after a "calm" January (275). GAM is also worried about the increase in massacres and the number of lynchings.
These numbers include some of the 22 police officers who have died so far this year (some off duty). At least 60 officers were killed last year.
Finally, Guatemala fell eight places (86th to 94th) in the World Economic Forum's Global Information Technology Report's rankings. 138 countries were in the survey.
According to the report, the country is at a disadvantage in terms of the number of days to enforce a contract, the perception of the effectiveness of the laws, the preparation of ICT staff, the quality of education in mathematics and science as well as the quality of the educational system in general.
[The country] also received low scores on the issue of the importance of these technologies in the vision of the Government, intellectual property rights, the acquisition of technologies, production of computers as a percentage of imports and the number of procedures to open a joint-stock company.
One last thing - Rigoberta Menchu's Winaq Political Movement officially became the 27th political party certified by the Supreme Electoral Tribunal (TSE) for this year's election. I thought that this had already occurred, but I guess not. Menchu sees Winaq's successful formation as a poltical party as an achievement for the indigenous people of Guatemala and all the Americas.
http://centralamericanpolitics.blogspot.com/2011/04/malnutrition-violence-and-investment.html