TWN Info Service
on Health Issues (November 06/3)
6 November 2006
Guatemala: Devoured by malnutrition
The following article
reports on malnutrition in Guatemala, which has the worst malnutrition
problem in Latin America and is most acute among the indigenous population.
The causes of this situation are many.
news is reproduced with permission from South-North Development Monitor
(SUNS) # 6125, 23 October 2006.
Guatemala: Devoured by
By Alberto Mendoza, IPS,
Guatemala, 19 October 2006
The ambulance pulls off the
road, just where a steep rocky track leads up to the remote Guatemalan
village of Shumpa. The health professionals' mission is to save the
life of a malnourished two-year-old girl.
Celi Aldana is just one of many. Fully half of Guatemalan children under
the age of five suffer from chronic malnutrition, which endangers their
physical and mental growth and thus compromises the future of this country,
which has the worst nutrition indicators in Latin America even though
it is not the poorest country in the region.
The ambulance, which was donated by Japan, has driven out from the town
of Camotan, where the majority of the population belongs to the Chorti
indigenous community, in the eastern province of Chiquimula.
Maria Santos, a village resident who has been trained as an outreach
worker by the National Women's Office in Camotan, gets out of the ambulance
and heads towards the last house in the village, located at the top
of the hill. She knows that Celi, one of the 11 children of 42-year-old
Cornelia Gutierrez, has been showing signs of malnutrition.
A lethargic Celi and her three-year-old brother Bibiano, who is covered
in mud, are outside. Their seven-year-old sister Elisa is watching over
them. Two cows, several hens and a pig with her piglets, which are being
raised for market, mingle with the children and a few skinny dogs in
Inside the adobe house, which has no electricity, Cornelia is taking
care of her 11th child, just nine days old.
Cornelia, worried about Celi, says that this is the first time that
one of her children has been in this condition. "She's been sick
for three months. But the last time I went to the health clinic in Camotan,
the doctor only said that we had a lot of kids, which is why they're
Santos explains to the mother that the ambulance is waiting, and urges
her to allow Celi to be taken to the nutritional recuperation centre
in Jocotan, a town near Camotan. But Cornelia says that she needs to
get permission from her husband, who is out harvesting corn.
After waiting for the husband until 5.00 pm, Santos has to go home to
take care of her six children, but promises to return the following
The ambulance heads back to Camotan, and returns the next day. However,
Celi's father refuses permission to take her to the health centre.
Unfortunately, this is not atypical, says Juan Manuel Mejia, the only
doctor at the Health Ministry's nutritional recuperation centre in Jocotan.
He explains to IPS that the majority of the mothers are unable to leave
their homes, their husbands and the rest of their children to accompany
a sick child to the health centre.
Furthermore, the prevailing 'machismo' or male chauvinism does not allow
women to make their own decisions, as was seen in Cornelia's case.
Mejia says machismo is clearly visible at mealtimes: "First, the
father, who has come home tired from work, is served, and then the boys,
and finally the girls and the mother eat."
Nevertheless, the state-run centre is not empty. By August it had treated
159 cases of acute malnutrition, which indicates that this year's total
will surpass last year's 197 admissions.
And in the Belen children's hospital run by the parish church in Jocotan,
214 cases of acute malnutrition were treated last year, although three
of the patients died, staff there told IPS.
The malnutrition in Chiquimula made international headlines in 2002,
when serious food shortages aggravated a problem that already existed.
In villages near Camotan and Jocotan, up to 25% of children were found
to be malnourished.
The causes were various. As world coffee prices plummeted to historic
lows, Guatemalan exports fell in 2001. That, combined with drought,
the poor quality of soils and the already fragile peasant farmer economy,
The severe drought that hit eastern Guatemala and the drop in coffee
production led to the loss of nearly 190,000 jobs between 2000 and 2001,
reported ANACAFE, Guatemala's National Coffee Association. Wages also
took a nosedive.
From 2000 to 2001, coffee prices plunged from $90.60 per quintal to
$56.80, and revenues from coffee exports - the country's main export
commodity - in 2001 were 46.7% below the 2000 total.
The crisis accentuated the problem of malnutrition. The United Nations
Development Programme's (UNDP) Human Development Index reports that
49% of Guatemalan children below the age of five are under-height for
their age. And according to the UN Food and Agriculture Organisation
(FAO), 22% of the population is undernourished.
The problem is at its most acute among indigenous people. Just under
70% of indigenous children are malnourished.
In Guatemala, indigenous people officially make up 40% of the population.
However, non-governmental organisations like Refugees International
put the proportion closer to 65%. The rest of the population is mainly
of mixed-race (indigenous and European) heritage, with a small minority
of European descent.
The United Nations children's agency, UNICEF, reports that Guatemala
has the worst malnutrition problem in Latin America, even higher than
the 35.2% average in Africa.
According to official statistics, 56% of the Guatemalan population of
13 million lives in poverty. But non-governmental organisations estimate
that up to 80% of the population is poor.
UNICEF representative in Guatemala Manuel Manrique said the effects
of malnutrition on child development are like "a life sentence,"
because it "compromises their health, their ability to learn, and
Referring to the causes of this situation, Manrique noted that more
than 60% of families in Guatemala cannot afford an adequate diet, people
living in rural areas have limited access to health services, clean
water and sanitation, and parents in these areas have little-to-no formal
Malnutrition is also a result of "structural factors, such as limited
social spending, extreme poverty and social marginalisation," he
Manrique said that some successful projects, such as the fortification
of domestically-produced sugar with vitamin A, are currently threatened
by the Central American free trade agreement signed with the United
States, which will allow the entry of cheap non-fortified sugar from
However, in the last year, the government of the conservative Great
National Alliance has begun to incorporate the problem of malnutrition
in its public policy agenda.
The Secretariat of Food and Nutritional Security (SESAN) was created
in 2005 to plan strategies to improve nutrition and coordinate actions
among public institutions, non-governmental organisations and international
Andres Botran, the head of SESAN, told IPS that malnutrition is "a
challenge for the state" and that "in order for public policies
to be successful, society must be involved."
To that end, the National Food and Nutritional Security Council was
created, which includes seven representatives of civil society.
In July, SESAN presented a Programme for the Reduction of Chronic Malnutrition,
which covers 41 municipalities, and focuses on questions of health and
reproductive health education. Botran projects that the programme will
cut malnutrition levels in half within the next 15 years.
A free fortified complementary food named Vitacereal is also currently
distributed to more than 40,000 babies and toddlers between the ages
of six and 36 months, and to 13,000 pregnant women and nursing mothers.
But Manrique said that to significantly reduce the rate of chronic malnutrition,
these programmes should reach more than 170 municipalities and over
one million children, for which more funds would be needed.
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