Reflections on a year of malnutrition

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Kate Douglas

Kate Douglas

Kate Douglas has worked in Guatemala for the past year with Maya Health Alliance | Wuqu Kawoq, as an intern for research and nutrition programs. She will begin medical school in St. Louis this summer.
Kate Douglas

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Malnutrition is frustrating. I often sit in the office, analyzing data from our programs, and feel helpless. Children who stay the same height for two or three months, gaining not even a millimeter, even as they receive micronutrients and protein supplementation. Kids who, instead of gaining weight with treatment with food supplementation, see their growth curves drop steadily downward, thanks to diarrhea and illness. Water is undrinkable from the source and often not boiled long enough or otherwise treated, leading to diarrhea and infections and essentially negating all the efforts at supplementing children’s diets. High fertility rates mean the supplements meant for one toddler often are shared among many siblings. Although the land is rich and fertile, so much is exported that the nutrient-dense fruits and vegetables produced within the community are often not available for those same producers. It feels sometimes like putting a bandaid on a gushing wound.

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But then I go into the field, and I realize why we do what we do. When I see baby Gio: his mother after 8 babies no longer can produce breastmilk, and when we met him at 3 months old he weighed merely 10 pounds. After supporting the family with 3 months of formula that they could not afford on their own, he is approaching a normal weight, and his height curve has spiked. He is beginning to crawl and no longer has the sickly look that so worried me on first meeting him. When I see Jorge, a baby who entered our program with a height-for-age z score of -4 (that is to say, shorter than 99.9% of kids the same age) and now has grown and grown and is at a score of -2 (no longer considered moderate/severe stunting by WHO standards). When I go into a home and see a baby that 3 months ago had no energy, and now wears his mother out running around with a grin on his face, something she comments that he would never do before. When I see the first malnutrition patient I met, Julia, who at 15 months was smaller than most 6-month-old babies, who is being treated for her drastic anemia and improving day by day.

So yes, treating malnutrition can be discouraging at times. The odds seem to be stacked against you. And maybe the data doesn’t always show dramatic improvements. But then, when you go to a patient’s home and see just how much that one child improved, just how grateful the family is for the change, the extent of the difference you can make if the circumstances line up; that’s what makes it worth it.