A New Way Forward

Though they lie thousands of miles apart, the countries of Guatemala and Peru continue to fight against the same seemingly unconquerable struggle: childhood malnutrition.

In both countries, nationwide data masks the severity of the problem. In Guatemala, childhood stunting affects around 50% of children under five, yet the prevalence soars to 70-80% in many indigenous communities. The disparities in Peru are equally as stark. In fact, the country is often overlooked by agencies providing nutritional support as the overall prevalence of childhood malnutrition is only about 15%, even though indigenous communities continue to see rates of 40, 50, even 60%.

As you can see, the problem of childhood stunting in Latin America is extremely prevalent, but it is not widespread. It is concentrated in impoverished indigenous populations that have faced years of racism, marginalization, and abuse. How can we begin to solve the nutrition crisis that was created by decades of political, economic, and social oppression?

The answer is not easy or immediately obvious. As you can quickly see from examining the data on stunting over the last few decades, the world has struggled to make significant progress despite the best efforts of governments and bilateral aid organizations. For example, malnutrition rates in rural Peru fell 0.3% in the ten years from 1996 to 2005. Even though change seems to be accelerating in the majority of countries,  it is not fast enough, nor consistent in its reach. In fact, as of 2010, fifteen countries now have a childhood malnutrition prevalence that is higher than it was in the 1990s.

Luckily, hidden in the shadows cast by governments and foreign aid, small grassroots organizations have been hard at work achieving remarkable success at improving the nutritional health of their communities’ children. For the past month, I have had the remarkable privilege and honor to investigate some of these programs first hand. Though their strategies are incredibly diverse, their passion for nutrition is identical.

For example, Wuqu’ Kawoq runs a patient centered nutrition program completely in the indigenous language of Kaqchikel, the language of many Mayan Guatemalans. In one community named Paya, the mothers of the children enrolled run the program themselves, taking all of the height and weight measurements to be recorded in the system. In another one of their communities, the director of the nutrition program was unable to find additional children to be admitted, at they were all growing adequately. This is what success looks like.

Close by in the highlands around Panajachel, Mayan Families runs an innovative and unique nutrition preschool program. Mothers are able to drop off their children for a daily program of Spanish lessons, supervised playtime, and a healthy breakfast and lunch. Looking at the data, many kids aged three to five years have made substantial growth gains, a big step toward overcoming the infantile malnutrition that many suffered. This is what success looks like.

An entire hemisphere away in the high altitude mountains of Peru, a young organization called Sacred Valley Health is training women to become health promoters in their communities, providing basic primary care and education about nutrition, sanitation, and disease prevention. They have more than doubled the number of health promoters in the last two years, allowing for important lessons about nutrition to be disseminated to more and more communities. This is what success looks like.

Toward the middle of the country, Future Generations is proving that a nationally sponsored health program called Community Health Administration Associations (CLAS) can be reformed to provide citizens with first class primary care. By developing accessible and accurate materials to train nurses to train community health facilitators, Future Generations has increased the rate of exclusive breastfeeding in Huancayo from 71.8% to 95.3% and has decreased the rate of malnutrition in children under two by almost 7% in just one year. This is what success looks like.

And last, but certainly not least, Feed the World is re-imagining agriculture in Northern Peru, one of the world’s most arid areas. By distributing loans of seeds and agricultural tools to farmers, along with providing extensive education on dry farming techniques, Feed the World equips farmers with the tools necessary to cultivate nutritious crops to feed their families even working within difficult circumstances. After the first year of the program, the regional and local government, along with the local university have taken over 74% of the project’s costs, a substantial investment in a previously ignored problem. This is what success looks like.

As I hope is clear by the examples above, the power and impact of small community based organizations to affect change cannot be underestimated. If we wish to make a profound difference in the prevalence of malnutrition around the world, we must not only wholeheartedly embrace the lessons on how to achieve large scale impact with a small scale, community approach, but we must continue to invest in these grassroots organizations and their fearless leaders who are working day in and day out to create a way forward.

If you are interested in learning more or inspired to support one of the causes above, you can access their websites at the embedded links throughout this post.