Between half-truths… malnutrition persists

For: Paola Cano

There is so much said on the issue of malnutrition in Guatemala and the information is so often manipulated – that in this instance I would like to address the presidential press conference that took place on the 18^th of November, in which Alejandro Giammattei flew the flag for the success of the programme ‘The Great Crusade for Nutrition’. From my experience as a nutritionist, I would like to explain the reasons why the president’s declarations only reveal half the truth:

1. The president stated that 932 cases of acute malnutrition were registered, which corresponds to 0.55% of all children registered.

This is only a half-truth, as he did not acknowledge the fact that according to the National Information System for Nutritional Food Security (SIINSAN) – of the Secretary for Nutritional Food Security – 24,364 cases were registered (see the following image) in the period between the 1^st of January and 31^st October, at a rate of 105.4 children per 10,000. Compared with the same period over the previous year, the number of children at risk is elevated and the numbers have increased by more than 10,000 cases.

*Cases of acute malnutrition, 2016-2020, -collected in the same week-. SE 44*

Foto de SINASAN

SIINSAN indicates that this is ‘preliminary data’, but this should be confirmed in the field in the days following the diagnosis, to verify that the health professional accurately recorded the child’s weight, height, size, and clinical measurements. I say this because acute malnutrition relates to current weight in relation to height, and here I emphasise current because I want to stress that the 24,364 children reported ate an accumulation of the number of weekly cases since January. However, the figures from the Crusade for Nutrition that the President spoke of only began in August, by which time some of the children would no longer be counted as acutely malnourished or may have died. Therefore, the cases identified in recent data do not confirm, but add to the System, and show a worryingly slow response to the continuing problem of malnutrition.

It is deceitful to fly the flag of success whilst the journal Epidemiological situation of acute malnutrition of week 44 of the Ministry for Public Health and Social Assistance (MSPAS) features a report (see the following image) that shows that the number of case s of acute malnutrition, month upon month, is located in the red area of the graph. That is to say that the situation is alarming and should have begun to be treated as an emergency in January.

*2020 weekly endemic corridor

Acute malnutrition in children under 5 years of age

Guatemala, 2014-2020*

Imagen tomada del portal de epidemiología del MSPAS.

*As of 2020, the automatic transfer of data from notebook 5a has been implemented, so Health Areas must validate and verify this information. *

2. The president claims that only 16 children have died due to malnutrition.

Every time deaths caused by malnutrition are mentioned, I find myself becoming very indignant because they are only half of the truth. Every boy or girl who is acutely malnourished is at risk of death, because it is a critical situation that lowers immune responses and therefore it is possible for them to die from something so simple as the flu or diarrhoea. In this sense, it is hard for me to believe that of the 24,364 cases reported there have only been 16 deaths.

The protocol for the epidemiological surveillance of acute malnutrition has been modified since the government of Otto Perez. It was altered to remove from the list the deaths of children who, although they were malnourished, were less than 29 days old, or children who were born underweight or with a disability.

I am outraged because these criteria are not found in other parts of the world and are clearly implemented in order to hide and minimize the deaths – because when an infant is underweight at birth it is at risk of death, and the evidence is that the malnutrition began in the womb of the malnourished mother. Likewise, a child born with a cleft lip or palate cannot feed properly and this also indicates that the mother has been suffering from malnourishment since before the pregnancy. These criteria are a lie that hides the vulnerability of infancy and mothers.

I know that there are nutritionist colleagues with great capacity and experience of nutrition at different levels of MSPAS and SESAN. This leads me to believe that the President’s statements are not due to some technical issue, but that they are a political manipulation and a manifestation of the terrible corruption and bureaucracy that prevents rapid progress.

Now, amid this situation that demonstrates the awakening of the Guatemalan peoples, I too raise my voice through this medium to affirm that such manipulation of information is a violation of Guatemalan women and children’s right to food, a systematic violation created by recent governments.

It is urgent that the nutritional surveillance protocol is changed in order to clear the way for the truth and to start again with a genuine commitment to urgently prevent the shameful problem of malnutrition.

– Paula Cano is a nutritionist with a master’s degree in Social Sciences. She is a feminist and permanently dedicates herself to the study of critical issues in nutritional food. She is a lover of travel, photography, and traditional food that preserves people’s culture.