Feb 07 2014
Bethesda O'Connell, East Tennessee State University
I spent my first night in Guatemala City with Christian Aponte, director of CAFNIMA, my host organization. He helped me review the report I have been working on of the household survey data. We have been fine tuning it to be the most helpful to the organization and people. From there, I took a five-hour bus ride to Cobán and a two-hour truck ride to the Ulpán Valley.
The major project I have been working on since my arrival is a malnutrition study. We are using the WHO program Anthro to determine which children are chronically and acutely malnourished and require intervention. This determination is based on the height, weight, and age of each child. So far, I have identified fourteen children who were moderately to severely acutely malnourished at the last visit. We will be visiting as many of these children as possible to remeasure them and provide nutritional supplements as well as education to the family on their care. The supplements given with the supervision of a physician based on the United Nations recommendations for in-home recuperation of malnourished children. These interventions have been shown to work—an additional eighteen children were previously acutely malnourished and improved in subsequent measurements following intervention.
The first child we visited as a part of this study had not been previously seen, but a CAFNIMA employee, Ricardo, had been told about him. At our first visit to the home, it appeared that no one was home. We heard noise behind the house and found a six year old boy chained to a post. It was immediately apparent that this was a case of abuse rather than simply lack of food in the home. Because this organization works with the community, this situation needed to be handled delicately. We returned to the home when the adults were present including a mother, aunt, and grandfather. The other four children in the home appeared healthy. We got permission to weigh and measure each child with the intention of focusing on the six-year-old’s situation. After discussion, we found out that this one child was mistreated because of a superstitious belief of the Maya that if the mother experiences trauma during pregnancy, the child is cursed. This belief was further encouraged when he was born early at four pounds. He is currently only 21.8 lbs. We provided the family with supplemental food and vitamins and watched the child eat as fast as he could. Ricardo was communicating with the community authorities to see what could been done to change the situation from an authority standpoint.
The following day, we returned to the home with clothing for all of the children and more food. We gave the boy food again while we were there, and he vomited immediately. We then found out that he had been vomiting and had diarrhea with the food provided the previous day. He also had a cough. We told the family the protocol we were using and the organization physician both advised that with such complications the child be taken to a hospital. They agreed to allow us to take the mother, the sick boy, and a younger sibling who was still breastfeeding to the hospital. It was a long night of trying to get help because it took about three hours to get to the first clinic (with several stops when he would vomit or have diarrhea again) and then we had to take him to another facility. There was a long delay before he was actually registered and began receiving care. We stayed the night in the city to get a few hours of sleep and returned to the hospital the next morning to check on him. They would not allow the younger sibling to stay in the hospital, so we took the mother and baby back to the community and convinced her to leave the baby with the aunt and return to the hospital to stay with the sick boy. All of this was in an effort to reconnect her to her child and learn to care for him again. Additionally, an organization employee filed an official abuse report to the government. The church the family attends has also been involved, and we hope that there will be encouragement from them as well for the family to change their treatment of him as “special.” For now, the child is receiving care and food and the proper actions have been taken to get him legal help as well as to encouraging the family to change their views of him.
All this happened in my first three days in the community. It has been a rude introduction to the needs of the people and the complexity of cultural situations. We have fourteen more children to find and follow up with. I am also providing the organization with further data on all of the children involved in the study. Chronic malnutrition is rampant, with 63% of those measured fitting guidelines for moderate to severe stunting. I pray that we are able to make a difference for these children and families.
Tomorrow my hosts and I will attend a community meeting to promote upcoming dental health fairs.