By Fiorella Calderon. GAMA Newsletter, No. 23, 4 October, 1995
/** gen.newsletter: 132.0 **/
** Topic: GAMA: NL23: Malnutrition in Bolivia **
** Written 9:58 PM Oct 4, 1995 by ASTA.UNIH@OLN.comlink.apc.org in cdp:gen.newsletter **
Global Alternative Media Association - GAMA presents:
SIZE: 8,800 bytes
DATE: October 4, 1995
SOURCE: NEWSLETTER - ICP / FIC
Seen from a political perspective of nourishment, Bolivia bears all the signs of a Third World country; no autonomy concerning basic nutritional supplies for its population and instead dependence or massive import of wheat.
The following article approaches the problem of malnutrition based on an analysis of the related facts and figures and takes into account the social and political development of Bolivia's latest past. We believe that both are important in exploring the problem in its full depth.
The neoliberal policy designed for the countries of the South did not bear that desired and awaited fruit for the impoverished majority of their population. This is particulary true for Bolivia. As Silvia Rivera once so clearly described it, the so-called "Economic Democracy" drove us only into the following situation: , . . .what we see is not a society capable of producing a common and just wealth for all its members, but the proteins of a native diet are being replaced by industrially manufactured carbohydrates. Furthermore we are talking about the reciprocity between an unsecured income and irregular 'activity in the informal sector'. For the evergrowing number of impoverished people driven into the informal sector the rich choice of goods offered on the market must be experienced as an offencive especially when taking into consideration their most limited access even to basic food. In this context the market once again contributes with its mechanism to the polarisation of the society. This is a consequence of the segregation of segments of society regarding their different consumption opportunities."
Over the past 20 years, indicators for poverty have not decreased but, on the contrary have continuously grown in number. Diseases like Cholera which were already believed to be phenomena from the ancient past, returned more infectious than ever. According to ALDHU (Associac on Latinoamericana de Derechos Humanos = Latin American Human Rights Association), in Latin America more than 55 million people show symptoms of underfeeding. Every year 1 million people die from hunger. In the entire region the average income has decreased by 32 percent. The fundamental factors that cause this bitter reality are: politics, economics, and the education system.
Acknowledging that change in the economy and in the field of education requires political will of the government, those two aspects need to be particularly emphasised. Without these efforts little can possibly be achieved. However, the health and nutritional policy is only of a mediocre eve and suffers greatly from corruption. The waste of resources leaves nothing more than a good dose of TV advertisement to those in need.
Even though official data on infant mortality might be euphemised, it still indicates that between 1976 and 1992 the mortality rate went down from 151 per 1000 live births to 75 per 1000. In 1993, however, the rate went up again to 89 per 1000. Compared to the previous year, 14 more children had to die.
In 24% of the cases death was caused by diarrhoea (Health Secretariat official Fernando Finot published the figure 36%), and 21.4% were caused by infections of the respiration system. Taking into consideration that 80% of the children are chronically undernourished we can assume that the cause for the high infant mortality is exactly this malnutrition. As Dr. Torres Goyta of the Bolivian Society for Pediatry states: ,Malnutrition minimises the immunity for the child, which is why illnesses can often cause death."
Although the mortality rate had decreased over the past 16 years, some rural provinces like Oururo (113), Potosi (118) and Beni (90) still maintained much higher rates. Apparently, the rural population remains disadvantaged in this regard.
The regional level within the provinces exposes the following picture. According to GTZ data in Cochabamba (in particular the Valle Alto) the situation is as follows: symptoms of underfeeding in the beginning state show 28% of the population, medium state 12%, and heavy cases appear at 4% of its population. Making a comparison of the situation for the city, the leader of SEMAPA (Servicio Municipal de Agua Potable y Alcantarillado de Cochabamba / Municipal Watersupply for Cochabamba) states: ,In the south-western sector of the city, where the inhabitants consume an average of 50 litres of water per day, infant mortality is 160 children per 1000. In the north-western sector, where the water consumption is 160 litres per head per day, the rate is only 50 per 1000." Public hygiene therefore influences directly the infant mortality rate. However, this data on malnutrition of the rural population of the Valle Alto cannot be simply extrapolated to the entire rural population of Bolivia.
The data on meat consumption in the capitals of the different provinces (not including the consumption figures for the rural population) expose the following situation: for Beni 43 kilos per head per year, for Potosi 14 kilos, Chiquisaca 14 kilos, La Paz 24 kilos, and Santa Cruz 42 kilos. Calculating this down to the daily consumption we end up with ridiculously small amounts. In Bolivia one is in fact forced to become semi-vegetarian. But not consuming the daily amount of protein which is essential for the healthy development of our body leads to the phenomenon that every generation of Bolivians becomes weaker and weaker. We are growing less tall and becoming thinner. The central axis of Bolivia, La Paz-El Alto-Cochabamba, in average consumes 1600 kcal per head per day, while 2000 kcal are recommended.
Although newspapers often operate with contradicting figures on malnutrition, existing alternative nutrition models are hardly ever projected. An exemption from the rule is an essay of Bolivian sociologist Ruth Villegas, head of INE's (Instituto Nacional de Estad stica = National Institute for Statistics) control office for food consumption. She wrote that nutrition in Bolivia lacks protein and does not include enough legumes and combinations of crops. An employee of the health department in Santa Cruz called it ridiculous that a region growing large amounts of beans and soya cannot supply its population with enough carbohydrates to satisfy the daily demand.
We agree with Villegas in saying that ,The decision making people so far responsible for this country have paid no attention to the factors leading to the problematic nourishment situation. This means blaming economists, ecologists, social workers, cultural officials, and politicians." The only thing that the state does and will provide, now and then, is a free supply with breakfast and food donated to the pupils.
Given that the desktop politicians and nutrition scientists remain in decision making positions, the future will turn even darker. If we do not work towards the opposite direction, meaning from the bottom to the top, we will hardly make any progress in Bolivia. What is the use of employing health promoters who suggest to the people to buy food they cannot afford. If we do not pay respect to the cultural aspects of their diet, if we do not try to include regional habits or conditions into a promoted nutrition culture, we will not succeed in getting mothers, who live in poverty and grew up with a certain education, to change their food consumption patterns. Additionally, these suggestions for change cannot address only the women but have to include also the men and children. We believe that a simple and modest plan can be more successful in changing people's consciousness for appropriate nutrition patterns, and that this consciousness should also be expanded to include other necessary demands regarding human dignity.
The main task of the work of the "Team for Alternative Nourishment" is to educate colleagues working in street kitchens in city margins and on the country side on how to cook with plants (legumes and crops) in order to substitute animal protein. We do not intend to advertise for vegetarianism. We simply want to show that it is better to eat a well balanced mixture of all three nutrition groups than eating only a trace of meat a day. If you eat meat, then eat a sufficient amount.
In this context we also wish to emphasise the variety of crops we have inherited from our ancestors, like Quinua, Kanawa and Tarwi, vegetable with a lot of protein.
1) Rivera, Cusicanqui Silvia, Violencias encubiertas en Bolivia, CIPCAARUWIYIRI, La Paz 1993.
2) Alan Court (UNICEF) published these figures in March 1994.
Programa Nutrici n Alternativa Pastoral de Salud del Arzobispdo de La Paz
Correo Central La Paz
tel: +591-2-341920 interno 120
fax: 32 65 54