Providence caregiver volunteers in Guatemala (photo courtesy of Medical Teams International)
[7 MINUTE READ]
In this article:
- Malnutrition is prevalent in Guatemala and has adverse health effects, especially on mothers and young children.
- Providence is partnering with Medical Teams International to provide care and solutions that are making a difference in the lives of mothers and children in Guatemala.
- Community empowerment and locally led initiatives bring greater community health and lasting change.
Guatemala has one of the world’s highest rates of malnutrition and while it impacts people of all ages, malnutrition creates additional challenges for children and mothers. This chronic deficit of energy and nutrients combined with other factors like poverty, lack of sanitation resources, and lack of clean water creates a cycle of worsening health, further perpetuated by illnesses like pneumonia and diarrhea. Thanks to efforts from local leaders and organizations like Medical Teams International, progress is being made to respond to the prevalence of malnutrition and improve the quality of life of families through community empowerment and locally led initiatives.
A joint effort fights malnutrition for mothers and children in Guatemala
In February, Medical Teams International hosted a virtual event, presented by Healthy Women, Healthy World, to delve more deeply into the complex situation around nutrition in Guatemala and how Medical Teams and Providence are partnering to address these challenges. Healthy Women, Healthy World is a Medical Teams’ initiative that brings people together to advocate for and support women’s and children’s health globally.
For this event, Medical Teams brought together three speakers: Amie Bockstahler, RN, Team, Guatemala; Walter Lopez, Medical Teams Country Manager, Guatemala; and Brittn Grey, Executive Director, Global & Domestic Immersion Programs, Providence. Over the course of the hour, Bockstahler, Lopez, and Grey shared the co-occurring challenges facing families and children that lead to malnutrition while also illuminating the resiliency of these communities and the impact of these partnerships.
“We have never had a moment in our lifetimes where the call to global solidarity has been stronger,” said Grey.
“These times of great challenge like ours call us to deconstruct silos and to strengthen in partnership.” This event, called “Fighting Malnutrition in Our Changing World,” featured three speakers who told a story of partnership and hope for ending malnutrition in Guatemala.
The state of malnutrition in Guatemala
“There are many factors that cause malnutrition here in Guatemala. Many families struggle day-to-day just to make ends meet – and that was true even before the pandemic,” panelist Amie Bockstahler says. Bockstahler lives in Guatemala City and has been serving as a missionary nurse with Team for the past six years. She works in a clinic near the Guatemala City garbage dump and helped establish a nutrition program there.
“Unfortunately, the cycle of poverty is very hard to break, and children living here have a very difficult life,” Bockstahler says.
Most families subsist on beans, rice and tortillas, and the lack of variety in their diets can lead to malnutrition. In addition, most homes here have no running water or bathrooms and for many, it’s a daily challenge to provide their children with healthy food and keep their children in school.
Though Guatemala is roughly the size of Kentucky, it has nearly triple the population, with over 17.4 million people calling Guatemala home. Fifty percent of Guatemala’s population lives in poverty, and 18% live in extreme poverty. While there are many longstanding reasons for poverty in Guatemala, including the lingering effects of civil war and natural disasters, the Covid-19 pandemic has greatly exacerbated poverty throughout the country.
Poverty and malnutrition often go hand in hand. Over 46% of Guatemalan children are affected by “stunting,” a low height for their age and failure to reach full growth potential, which is a sign of malnutrition.
Guatemala has the highest rate of stunting in Latin America and some of the highest rates in the world.
This isn’t just an urban problem, either. For families in rural areas or mountainside villages, finding access to diverse foods can be a challenge as well. And remote communities struggle with access to clean water and sanitation, too. Because half of Guatemalans live in rural areas, our partners have also been focusing efforts on those populations.
Malnutrition is a multidimensional issue, and it has far-reaching consequences for a community. “Malnutrition is affecting not only health but also the opportunities for economic development capacities in this population,” says Dr. Walter Lopez, the Medical Teams International country manager for Guatemala.
Physically, malnutrition can cause many complications including anemia, developmental issues, and higher maternal and infant mortality.
In children, malnutrition is part of a vicious cycle of diarrhea and pneumonia, the top two killers for young children. “Each of these individually are risks, but combined and in relationship, they layer their attack on the most vulnerable,” says Grey.
A multi-pronged approach to defeating malnutrition
Medical Teams has been working since 2010 to implement maternal and child interventions to reduce chronic malnutrition. In 2012, Providence joined these efforts, and since 2014 our focus has been on population health and capacity building in El Quiche, one of the most populous and largest departments, located in the central highlands of Guatemala.
Working closely with the local government, communities, and volunteers, Medical Teams and Providence are making strides in addressing malnutrition, diarrhea, and pneumonia in this area. The focus areas are improving health status for pregnant and lactating women and children under 2 and improving access and quality of healthcare service delivery.
Since 2012, more than 700 Providence employees have volunteered with Medical Teams. This work has impacted our own understanding of population health and rural healthcare in profound ways. Providence caregiver volunteers have focused on working with the Ministry of Health, strengthening the local health system, and improving home infrastructure, including working side by side with families to build water catchment systems, latrines, and clean burning stoves.
Medical Teams is also partnering in the community to increase access to health and nutrition information in addition to providing supplies and training to health staff.
They are focusing on interventions including improvements to water, sanitation, and hygiene (WASH) infrastructure, supporting improvements to health facility infrastructure, and training hundreds of Ministry of Health staff and community volunteers. This type of partnering to build capacity is critical to the long-term success of these efforts.
Community empowerment inspires lasting change
Medical Teams’ method works because they empower community members to take ownership of their health and the health of their families. They also ensure there are local leaders who speak the language and understand the culture.
“Medical Teams’ model is founded on neighbors helping neighbors,” Grey says. “Providence is proud to support this work because Medical Teams actualizes a community empowerment and community capacity building model that honors the leadership, the heroism, the strengths, resiliency, creativity, drive and service orientation of the individual community members.”
They’ve taken this community approach by training community members to weigh children, as well as training mothers on how to improve nutrition for their babies or how to treat pneumonia or diarrhea.
“Community health workers increase capacity for recognizing danger signs, addressing symptoms, and breaking the cycle of illness,” Grey says.
Thanks to these efforts, we’ve seen some incredible results. Highlights include:
- Increased health knowledge and augmented primary care access to 2,269 families in 12 villages
- 369 water systems, 481 improved latrines, and 370 improved stoves installed/built
- Incidence of pneumonia reduced from 29% to 4%
- Families receiving health, nutrition and hygiene education increased from 45% to 96%
But beyond the data, what really matters is improvement in individual human lives. “When we talk about statistics or data, it can be possible to lose sight of human dignity, of resiliency of the powerful passion of the individual members of the community for making a difference,” Grey says.
Dr. Lopez shared a quote from Marcela Cal, a Guatemalan woman living in Chicamán with her family, who received a water system in her home.
“Before the Water System Project, I had to walk two hours to get water. Now everything has changed, since we have the water system to keep water near the house, I’m cooking with clean water, I’m washing my hands, my children are drinking clean water, and they get sick less of diarrhea. With this project, I have more time to take care of my children and to help them to attend the school every day.”
A future without hunger in Guatemala
“The work of Medical Teams International is steeped in subsidiarity, which within our Catholic social teaching and within Providence, is a term that talks about decision making happening at the local level by those most impacted,” said Grey. “That necessitates local ownership which is what we see within this program.”
This focus on local ownership and keeping decision making at the local level is critical to the effectiveness of these partnerships and will ensure that our combined efforts contribute to long term, sustained improvements.
Over time, as malnutrition and associated illnesses like pneumonia and diarrhea are alleviated, communities will also be strengthened and will have more capacity to address the challenges they are facing, which truly is the goal.
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