In Guatemala, the search for cases of child malnutrition are hidden by the pandemic

Chancol, Guatemala, 15 October 2020 – Although Erick Samuel lives in the middle of a mountainous area two hours from the departmental capital and seven hours from the national capital city, reaching this young, 20-month-old boy is a matter of life and death. Erick Samuel is one of the many children suffering malnutrition in Huehuetenango, a department where the pandemic has exacerbated isolation, unemployment and lack of access to food.

“He couldn’t walk on his own, he wasn’t so active. I was afraid and wondering how he could recover from this malnutrition,” Flor Clemente, the child’s father and a local farmer, recalls.

Accessing medical care is a challenge for the family: the nearest, basic health center is two hours away whilst the nearest hospital is a full four hours away. 

In March, the COVID-19 pandemic added difficulty to an already complex situation. “When the coronavirus reached Guatemala, it had a strong impact on food security because of existing difficulties securing basic income: a lack of both formal and informal employment opportunities and a downturn in remittances received by families from abroad. The result is less food in homes, leading to a decrease in available food for children”, explains Maria Claudia Santizo, a UNICEF specialist in nutrition, who adds, “child malnutrition is Guatemala’s greatest problem”.

Joining forces

The pandemic and isolation made accessing health services even more challenging for certain populations, added to the fact that many health professionals had to focus on the health crisis and leave other duties unattended. Hence, while the country was paralyzed by a curfew, UNICEF decided to join forces with the government in the active search of cases of acute malnutrition: if families could not reach health centers, then UNICEF brigades would go out and find them.

Since July, 2020, thirteen brigades - each made up of one nutritionist and three assistants - have analyzed 14,433 children under the age of five in Huehuetenango, detecting 257 cases of acute and severe malnutrition. “68 per cent of the cases we have found had not been previously detected by health services. This shows how effective the brigades are” Santizo concludes.

The specialists diagnose malnutrition by measuring the mid-arm circumference of each child with a disposable tape measure to avoid potential COVID transmission - a change brought about by the pandemic when the traditional method of measuring height and weight had to be replaced. When a malnourished child is detected, health services are notified, a medical record is prepared with the child’s information, and the patient is offered a treatment of vitamin supplements and deworming. 

“When we find a case of acute malnutrition, the first thing we do is ask if the child has been ill to understand what might have provoked the reduction in food intake,” explains Elisa Anleu, a nutritionist and coordinator of the nutrition brigades in Huehuetenango. “We then explain to the parents or guardians that the child has low body weight and discuss some of the potential dangers if the case goes untreated,” she adds. Such was the case of Erick Samuel, whose encounter with a UNICEF brigade changed his destiny.

The brigade members that travel the area promote exclusive breastfeeding, provide important advice on the ways to prepare and serve food for children, and -- in the midst of the COVID pandemic - offer general tips on hygiene and additional precautions: “In most communities, people are using face masks. Sometimes we see that hygiene inside some homes is not optimal, and that’s something we have to consider now during the pandemic” Anleu explains.

Looking to the future

To ensure that all of this information has a real impact in the community, the brigades seek to involve different actors, such as the local Community Council for Development - which brings together local leaders - the ministries of Public Health and Food, Agriculture, and Livestock, and the Secretariat of Food and Nutritional Security.

The work is being done in the context of the pandemic, but the functioning of the brigades may prove valuable even after COVID-19: “The most important thing here is the emergence of a model that can be used to respond more quickly in the event of an emergency,” claims the UNICEF specialist.

Meanwhile, Erick Samuel’s parents are looking to the future. Brenda Alva, the child’s mother, is pregnant with her second child and is sure that the information she has received from the nutritional brigades is helping her take better care of herself and prevent the child from being born with deficiencies or health problems.

Her husband Floro has become more involved in his son’s nutrition. “I’ve learned how to feed him, what you can and cannot give him, depending on his age. If it hadn’t been for this, my baby might have become ill.”

Floro proudly shows his son taking a few steps -- slowly but surely. “We’ve noticed a change in him, compared to before. Thanks to [the nutrition brigades] we were able to treat him for his low weight and malnutrition”. The family moved from uncertainty to hope, planning to take Erick Samuel to school when he turns five or six. “We’ll fight so that he can at least finish primary school or middle school, maybe even study a profession” Floro imagines.

KEY FIGURES:

Thirteen brigades visited 13,433 children under the age of 5 in the department of Huehuetenango in Guatemala.

In Guatemala, 1 in every 2 children suffers chronic malnutrition.

So far in 2020, a total of 20,924 children under the age of five with acute malnutrition have been counted. 2019 statistics for the same period count 11,087 cases - nearly half.

UNICEF brigades detected 257 cases of acute and severe malnutrition in Huehuetenango. 68 per cent of the cases found had not been previously detected by health services - demonstrating the effectiveness of the brigades.