Saturday 10 January
2009, San José, Costa
Rica
BOLIVIA:
Mothers Teaching Mothers
to Combat Malnutrition
By Julia Velasco
Parisaca and Wendy
Medina
BETANZOS, Bolivia (IPS)
- One of every two
children under the age
of five in the
southwestern Bolivian
highlands municipality
of Betanzos suffers the
effects of chronic
malnutrition.
Betanzos, a rural
municipality of Quechua
Indians located 3,500
metres above sea level
in the north of the
department of Potosí,
has the worst child
malnutrition rates in
Bolivia, South America’s
poorest country.
According to the
National Nutrition
Survey conducted in 2007
by the Health Ministry,
municipalities where 38
of every 100 children
are malnourished are
classified as having a
high degree of food
vulnerability. In
Betanzos, the rate is 50
out of 100.
Dr. Braulio Escalante,
the municipality’s top
health authority, told
IPS that the living
conditions of Quechua
families have a major
impact on their
children’s nutrition and
health.
"Most families are
involved in agriculture,
but they only raise
enough food for their
own subsistence and a
small amount to barter
(for other goods) or to
sell in order to acquire
other foodstuffs, such
as sugar or rice," he
noted.
Almost 80 percent of the
population of Potosí
lives in poverty, which
is exarcebated by
environmental problems
like drought. Out of the
10 poorest provinces in
the department, nine are
Quechua, according to
figures from the 2001
census.
The Quechua are the
largest indigenous group
in Bolivia. A total of
1,557,689 respondents
identified themselves as
Quechua in the 2001
census, out of a total
population of 9.2
million.
The extreme poverty in
this region is combined
with another problem:
local eating habits are
not based on the
high-protein foodstuffs
that are grown and
harvested here, such as
fava beans, corn,
potatoes and wheat, nor
on fruit like peaches,
said Escalante. Instead,
local peasant farmers
prefer to trade or sell
this fresh produce for
processed flour-based
products like pasta.
"They consider rice and
pasta easy to prepare,
and will often only cook
mote (boiled corn
kernels) and potatoes
with a bit of spicy
flavouring, because of a
lack of knowledge about
how to prepare
nutritious food," he
said.
Zero malnutrition
The United Nations
Convention on the Rights
of the Child, in force
since 1990, states in
article 6 that "every
child has the inherent
right to life," and that
states that are parties
to the Convention must
"ensure to the maximum
extent possible the
survival and development
of the child."
One of the main goals of
the Zero Malnutrition
National Programme
launched in July 2007 by
the administration of
indigenous President Evo
Morales was to improve
the nutrition of
pregnant women, nursing
mothers and children
under five.
As part of the programme,
Betanzos set up the
Municipal Nutrition
Commission (CONAM), the
first of its kind in the
country, in November
2007. The Commission is
made up of monitoring
committees formed in
each of the
municipality’s ten
districts, which
comprise teachers, local
government authorities,
the Departmental Health
Service and civic
committees, among other
social and governmental
entities.
To pursue its goal of
combating child
malnutrition, CONAM
created the Integrated
Nutrition Unit, staffed
by a nutritionist and
nurse who are
responsible for
monitoring the nutrition
and health of the
municipality’s children,
as well as distributing
food supplements for
children under two.
This local initiative
contributes to
fulfilling Bolivia’s
commitment, under
article 24 of the
Convention on the Rights
of the Child, to take
appropriate measures to
combat malnutrition,
including within the
framework of primary
health care, through the
application of readily
available technology and
the provision of
adequate nutritious food
and clean drinking
water.
"Mindful mothers"
As part of the
initiative, women from
communities throughout
Betanzos, such as Buey
Tambo, with a population
of around 600, have been
organised and trained to
act as "madres
vigilantes" -- "mindful
mothers" -- who are
responsible for
monitoring child
nutrition in their
communities and teaching
other women.
"Our task is to weigh
and measure children
from the time they are
newborns until they are
five, to see whether or
not they are
malnourished and whether
or not they are gaining
weight and growing. As
madres vigilantes we
train other women how to
feed their kids so that
one day malnutrition
will disappear," Eva
Juchani from Buey Tambo
told IPS.
Juchani and the other
1,500 madres vigilantes
throughout Betanzas also
work to inform and
educate their
communities about better
eating and cooking
habits.
"It’s hard to get people
organised. We started
with meetings, markets
and festivals. We teach
women that as mothers,
we must keep ourselves
very clean, and give our
children food that is
well prepared and
nutritious," commented
Reyna Caba, a community
health worker and madre
vigilante in Buey Tambo.
The women’s training was
sponsored by Plan
International, a
UK-based
non-governmental
humanitarian
organisation that is
collaborating in the
implementation of
Community Integrated
Management of Childhood
Illness (C-IMCI), a
programme that targets
children under the age
of five.
C-IMCI was developed in
1996 by the World Health
Organisation (WHO) and
the United Nations
Children’s Fund
(UNICEF).
"Madres vigilantes are
trained about children’s
growth, development and
nutrition, and at the
same time, they pass on
this training to other
mothers in their
communities, while
monitoring the growth
and development of their
children," explained
Aurora Gutiérrez, the
health programme
coordinator for the Plan
International branch in
Bolivia, based in Sucre.
Many of the more than
100 indigenous
communities in Betanzos
are not served by public
transportation, because
of the long distances
that must be covered and
the lack of decent
roads. People get around
on foot or by bicycle.
Clean water is
frequently in short
supply.
"Until recently, our
community did not have
drinking water or a
health centre.
Organising the community
members has made it
possible to gradually
improve living
conditions. Many
communities still depend
on rainwater or well
water," said Marcelino
Caba, a community leader
from Buey Tambo.
The people of Buey Tambo
organized, and with the
support of organisations
like Plan International
and in coordination with
the municipal government
they have succeeded in
providing their
community with a supply
of drinking water.
Impressive but
insufficient efforts
Another effort aimed at
fighting child nutrition
is the National
Programme for the Care
of Children Under Six
(PAN), a programme
implemented by
departmental governments
since 2005, which
encompasses the areas of
health, nutrition,
protection and early
childhood education.
Although this initiative
was scheduled to
conclude in 2007, the
government has extended
it to 2012, thanks to an
agreement signed with
the World Food Programme,
which contributes five
basic foodstuffs: rice,
lentils, cooking oil,
flour and salt.
"The children’s centres
run by PAN provide the
children who go there
with four meals a day --
breakfast, lunch and two
snacks -- and they
operate from eight in
the morning until five
in the afternoon," said
Ximena Chacón Quispe,
head of the PAN Unit in
Potosí.
In the department of
Potosí there are 360 of
these centres in 35
municipalities, which
serve 7,600 children.
However, despite the
efforts of the Potosí
departmental government,
which even increased the
funding for PAN almost
sevenfold, the programme
reaches only around 20
percent of children in
the most vulnerable
municipalities, because
it does not reach the
children living in
scattered, isolated
communities.
Out of the more than 100
communities in the
municipality of Betanzos,
the programme only
operates in 17.
The Zero Malnutrition
National Programme is
creating community
family health care
brigades to reach these
currently unserved
communities. With the
support of doctors sent
to Bolivia by the
government of Cuba, the
brigades will travel to
isolated villages and
hamlets without health
posts, reported Maria
Julia Cabrerizo, head of
the Health Ministry’s
Department of Nutrition.
In order for the
programme to succeed, it
will require health
professionals with a
devotion to service and
a commitment to helping
children, willing to
work in impoverished
rural areas like
Betanzos. |
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