Thursday, March 16, 2017

Causes of Malnutrition in Guatemala

Text by Mary Gramiak and photos by Emily Rempel

Throughout March, Pop Wuj is spotlighting our Nutrition Program and its mission to create lifelong opportunities for Guatemalans via treatment of early childhood malnutrition.

¡Gracias por su apoyo! Thank you for your support!

A Nutrition Program participant in La Victoria plays peek-a-boo with his truck.
With one of the highest rates of chronic malnutrition in the world, and the single highest rate in the Western Hemisphere, it’s important to address not only treatment but also root causes of malnutrition issues in Guatemala. With an official population of 16.3 million, and estimates ranging closer to 18 million, Guatemala faces a chronic malnutrition rate of about 47 per cent – sixth highest in the world. Within indigenous communities these numbers reach closer to 65.9 per cent, with about 80 per cent of indigenous children suffering from stunting. While there are a multitude of issues contributing to the malnutrition issues throughout the country, some of the main contributors are environmental issues, inappropriate nutrition practices, and poverty. 

When people think about chronic malnutrition, they often picture starving children in desolate regions. However, this is a misconception which rests on the assumption that malnutrition and starvation are the same thing; when in reality, malnutrition and starvation have very distinct definitions. As opposed to starvation, malnutrition is the inadequate intake of any of the required nutrients, even if someone is receiving an adequate amount of calories throughout the day. In Guatemala the cycle of malnutrition can begin in pregnancy among women who are stunted, obese, or anemic; issues which reflect their own experiences with malnutrition throughout childhood. After birth, infants often receive breast milk which lacks appropriate nutrients, and children under five often do not receive an adequate diversity of nutrients to support their development. 

In a country such as Guatemala, with countrysides often overflowing with vegetables during the rainy season, it can be difficult to understand how malnutrition is such a prevalent problem. However, for the nearly 60 per cent of Guatemalans living in poverty, and the 23 per cent of Guatemalans living in extreme poverty, the cost of vegetables and meat is often too high. Because of this, families often are surviving off a high-calorie, starch-based diet of maize, beans, and rice. These are foods which are cheap, readily available, and can make someone feel full without having to eat a large amount. While poverty and lack of access to a diversity of nutrients accounts for a large portion of this phenomenon, a lack of education surrounding the importance of diversity within diet also contributes to the issue. 

Students in the Medical Spanish Program carry out a monthly check-up with a Nutrition Program participant and his mother in La Victoria.
Environmentally, changes in climate and reduced crop yields contribute to malnutrition in more ways than one. More than 40 per cent of the country’s labour force relies on the agriculture sector, but climate change has contributed to increased hurricanes, droughts, and decreased crop yields. Over-exploitation of natural resources through slash-and-burn agriculture, illegal deforestation, and mono-cropping are also contributing factors in decreased crop yields, presenting two issues which contribute to malnutrition in the country. The first is that the 40 per cent of the population which relies on agriculture as their primary source of income are not making as much money as they are used to, making diverse, nutrient-rich food, even more difficult to procure. The second is that the nearly 50 per cent of the country who live in rural communities, and rely either on their own crops or the crops of their neighbours for food, are producing less for themselves and for market, forcing them to spread already thin resources even further.

Politically, indigenous peoples who are the worst hit by conditions of poverty and malnutrition have been systematically disadvantaged throughout colonization – which makes providing nutrient-rich food to their families even more difficult. Within the last century indigenous peoples have been systematically displaced due to violence, war, and resource scarcity. Throughout the thirty-year civil war which plagued the country, more than one-million primarily indigenous people were displaced from their lands, and tens of thousands more killed. While the civil war officially ended with the Peace Accords of 1996, the democratic transition began in the mid 1980s, right in the midst of the the conflict. The Peace Accords mandated resettlement of displaced populations, integrated programs for human development, sustainable infrastructure and agricultural development, modernization, and an emphasis on the rights of indigenous communities, rights of women, as well as greater social participation. While the intention of the Peace Accords was honourable, implementation has been slow and uneven. Displaced indigenous peoples were resettled onto dry, useless lands in favour of leaving the arable lands for export based crops owned by wealthy landowners or multinational corporations. These lands make agriculture and subsistence farming for individuals and families difficult, further driving malnutrition rates throughout the country. 

Malnutrition is a complex issue which can reflect conditions of poverty, systemic oppression, a lack of education, or environmental issues. Throughout Guatemala’s complex history malnutrition rates within indigenous communities have hit nearly crisis levels, costing the country USD 8.4 million everyday in lost productivity, increased hospital costs, and academic setbacks. While nutrition programs like Pop Wuj and others operate throughout the country to try and correct for some of these setbacks in children under five, fundamental change will have to come through large scale initiatives which address the underlying factors driving malnutrition throughout the country.

Within our own Nutrition Program at Pop Wuj, we work to address some of these underlying issues by providing education and resources to the participants within our program. This includes the importance of a varied diet, and low-cost ways to incorporate different nutrients into daily life. We also treat malnutrition in as many children as we can so that their families, at least, have a chance of breaking the generational cycle. No single organization can solve the deeply ingrained problem of malnutrition for all of Guatemala. But we can transform individuals, and those changes mean everything to their families.

"Guatemala," World Food Programme.
"Our Neighbors, Ourselves: Guatemala’s Chronic Malnutrition Crosses Borders," USAID, 2011.

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