By Ashley Aue
Ashley is Timmy’s Medical Programs Coordinator in Xela, Guatemala. She arrived in Guatemala 2 years ago and has served in a variety of capacities at Pop Wuj – from coordinating the family support center to student coordinating, to developing and implementing educational curriculum for at-risk students. Now she is helping to manage Timmy’s Nutrition Program, which aims to eliminate the issue of chronic malnutrition in Timmy’s communities. This blog post reflects on the history of this program as well as the successes and challenges of implanting this initiative.
With nearly 50% of children under age 5 suffering from chronic malnutrition, Guatemala currently has the highest rate of childhood malnutrition in the Western Hemisphere. The Nutrition Program – dreamed up in 2011 by Dr. Meg Sullivan – has been working to identify and support at-risk infants in the Western Highlands of Guatemala, the most severely affected area in the country. After working for over a year in the communities of La Victoria and Buena Vista, the community of Llanos del Pinal was identified to be the first area of expansion.
Through the hard work of our 2 dedicated Guatemalan doctors, Dr. Carmen Alvarado Benitez and Dr. Barbara Amado, we developed clear parameters for measuring malnutrition as well as determining socioeconomic risk factors. The doctors communicated with local health centers and compiled population information, and then contacted all 73 families in the region with infants between 6 and 24 months of age. The Pop Wuj/Timmy team evaluated the positive aspects of the program over the past year, as well as the challenges faced, and made a plan to increase effectiveness. We hope to achieve this by incorporating the local doctors in data collection, and by addressing misuse or misunderstanding of the “Nutri-butter” supplement by participants.
With the new expansion, all families will receive not only Nutri-butter for the malnourished (or at-risk) infant, but will also receive prenatal vitamins for mom, children’s vitamins for all siblings, and Incaparina, a popular local product which is vitamin-fortified and can be used by the entire family. We hope these new additions – along with increased education – will support and encourage health in the whole family, while also reducing the risk of the infant-supplement being shared among other family members.
All of the identified families were invited to the kick-off event, and then we set about preparing for the big day with promotional materials, education presentations, medical staff, volunteers and equipment.
On June 6, 2013, we arrived to Llanos del Pinal – the Pop Wuj social worker, nurse, 3 doctors, the Timmy Medical Program Coordinator, and a group of medical and social work volunteers from the Pop Wuj program – and waited expectantly. In a matter of minutes, there was a long line of mothers with infants on their backs waiting at the registration table.
As the moms filed through, we crowded the small space to capacity, and the Pop Wuj staff and volunteers began an educational presentation. These presentations are a critical part of the nutrition program, and topics range from feeding and dietary information for infants and toddlers to disease control and prevention to safe food preparation to family planning and women’s health. Each presentation is planned carefully to encourage participation and engagement with the mothers.
Following the presentation, moms and babies filed into the small classroom where the babies were weighed and measured – much to their displeasure! Each child’s picture was taken for their nutrition chart, and their height, weight and head circumference was noted. The charts were then analyzed by the Guatemalan doctors, who determined each child’s nutritional diagnosis, and completed a brief consult with each mother.
Finally, the social work volunteers conducted a socioeconomic interview with each mother, with the goal of identifying potential risk factors for malnutrition. The medical and social work staff worked together to determine which children would enter the program, and in the end 23 infants were diagnosed with chronic malnutrition, while another 15 entered the program strictly due to socioeconomic risk. Out of the 43 babies evaluated, 38 were enrolled.
While waiting for the diagnoses and the entrega of nutritional supplements, the mothers received a recipe for use of Incaparina, and moms and babies (and volunteers!) all got to try a sample of the delicious, nutrient-filled soup. Other recipes have included fruit smoothies, and hot drinks.
After their snacks, everyone passed by the last table to receive a bag full of Nutri-butter, 3-5lbs of Incaparina (depending on the size of the family), prenatal and children’s vitamins, and information about the next monthly meeting.
Since the kick-off day, the families of Llanos del Pinal have welcomed the Nutrition Program 3 more times – each time with a handful of new participants – bringing the current enrollment number up to 56 babies. Mothers have shown interest and increased awareness during the educational programs, and as we head into the 5th month since enrollment, we are eager to see how children’s health, nutrition and development have been affected.
With the proper nutrition early on, the children of Llanos del Pinal will have stronger bodies, minds and immune systems as they join their community in fighting for a brighter future.