Mejor cobertura multimedia 2019
An investigation by Johanna Osorio Herrera / Armando Altuve, María Vallejo, Sheyla Urdaneta, Jesymar Añez, Liz Gascón, Mariangel Moro, Rosanna Batistelli, correspondent team of El Pitazo, in alliance with CONNECTAS.
Juan Luis is malnourished and the bones on his skin can be counted. His diagnosis was determined by specialists at Hospital Materno Infantil de Tucupita, in Delta Amacuro – a state with one of the largest indigenous populations in the country - where he was hospitalized in August 2018 for chronic diarrhea.
It may not be the only time he is in a hospital for the rest of his life. The aftermath of hunger before the age of five, his current age, is irreversible. In his adulthood, Juan Luis will be more prone than other men to suffer from cardiovascular disease or diabetes; also to have a poorer performance at work or have intellectual deficiencies, all as a result of the hunger he suffers today.
From conception to age five, especially the first 1000 days, 75 per cent or more of the brain tissue and its constitution develops. The neural circuitry, which allows the human being to perceive his surroundings: to see, to smell, to listen, and to react to the stimuli, is defined at this stage; this is the early childhood, according to international organizations related to the care of the childhood like the United Nations Children’s Fund (UNICEF). Juan Luis’s growth depends on what he eats. If he feeds well, his neural circuitry will be good for his adulthood. If he doesn’t, the damage caused to his body and his brain will be irreparable.
Juan Luis doesn’t eat well even though his mother tries to solve it. He can’t because his family is poor, as well as the 87 per cent of Venezuelan families, according to the Encuesta de Condiciones de Vida (Encovi) 2017 (Survey on Living Conditions), conducted by universities and non-governmental organizations. His story is the same as many children of his age. Until March 2018, in Venezuela, only 22 per cent of children under the age of five had a normal nutritional status, according to the Saman report of Caritas.
Eating properly is one of his main rights. According to the Food and Agriculture Organization (FAO), Juan Luis should have always “physical and economic access to sufficient food, safe and nutritious, to satisfy his nutritional needs”. The State must guarantee his food, but it doesn’t do it. According to Encovi 2017, 80 per cent of Venezuelan households are facing hunger (a term that includes malnutrition in all its phases) or food insecurity, as FAO calls it. And, according to what FAO suggests, this confirms the humanitarian emergency, which is reached when a country “in a given year cannot fill with its own resources the food shortages caused by a disaster and, therefore, needs external food aid.”
Child malnutrition is the evidence of the emergency in Venezuela, specifically global acute malnutrition in children under five years old, such as Juan Luis, who was born in 2013, the year that Nicolas Maduro assumed the Presidency of the Republic.
According to the World Health Organization (WHO), protocols of attention for humanitarian crisis must be activated if 10 per cent of children (under five years old) are suffering malnutrition – because they have not had enough food and those that have ingested did not have the necessary nutrients. Exceeding the 15 per cent threshold indicates a humanitarian public health emergency situation. In Venezuela, global acute malnutrition in children of this age reached ten per cent in January 2017, and exceeded the threshold of 15 per cent between September and December, when it reached 16 per cent, according to Caritas’s studies.
The children with hunger in Venezuela contrast with the “Plan de la Patria” (the Fatherland Plan), the Chavez’s key piece for his reelection that was resumed by Maduro, which establishes as one of its general objectives “achieving food sovereignty to guarantee the sacred right to food” and as a strategic goal “ensuring the healthy food of the population with special focus on early childhood”.
The figures reveal a reality that the Venezuelan government strives to deny: since September 2017 there is a humanitarian emergency which could improve if external food aid is accepted. This situation has its origin in the wrong socioeconomic policies adopted during 15 years by Hugo Chavez and perpetuated by his successor, Nicolas Maduro, who have made deeper the malnutrition since 2013.
Valentina is five years old, but her body makes her to look like a smaller girl. She is 86 centimeters long and weighs 9 kilograms; she should measure a little bit more than one meter and should weigh the double. She doesn’t speak, she isolates herself and the only easy smiles she shows are provoked by Carmen Toro, the woman who takes care of her. She is an ex-girlfriend of her father, who abandoned her some months ago, already malnourished, in the tin home where they live in Valles del Tuy, a poor town in the outskirts of Caracas. Six months earlier, Valentina’s biological mother also went away and left her with her father.
Dayerlin, instead, is more outgoing. She has to behave on that way to be able to eat; during the day, the five-year old girl begs money and food in Monagas, an eastern state in the country; at night, she sleeps with her mother and seven siblings at a poor imitation of house, a space 5 meters long by 6 meters wide, that is room, bed and bathroom at a time.
Caritas Venezuela’s studies say that a little more than half of the households in some of the poorest parishes of Venezuela get food by looking for in garbage containers and through begging. And, according to the reports of pediatric emergency in Hospital Universitario Dr. Manuel Nuñez Tovar, in Monagas State, where Dayerlin lives, many children of those poor families don’t even reach to grow up; 42 nursing infants have died in 2018 as a consequence of malnutrition, an average of 4.6 deaths by month. 70 per cent of those babies, that is, 28, lived in the urban area of Maturin, while the rest lived in other municipalities.
Valentina and Dayerling are separated by a distance of 485 kilometers, but they are united by the poverty, the hunger, and their consequences. They are far from being women, but their adulthood is predictable because of the hunger they have faced: cardiovascular diseases, diabetes, sick children; learning disability and ease of manipulation; trend to violence and drug abuse. The damage caused by malnutrition to Venezuelan children –physically, intellectually and emotionally- is irreparable, according to the children’s development experts.
“Socially, hunger in Venezuela has caused a weakening in domestic relations. There are fights for food, there are children stealing the lunchboxes among themselves, battered children because they ate the eggs that were for other little boy. There are familiar roles inverted, parents who commit suicide because they do not feel able to buy enough food and, at a local level, the problem of hunger has generated an enormous break among us”, Susana Rafalli explains. Rafalli is a nutritionist specialized in food security management, humanitarian emergencies and disaster risk; she is also member of the researcher’s team of Caritas Venezuela.
“Once I saw a mother who hit her daughter because the girl drank water that had been reserved for preparing a soup. She was a Wayuu girl. The mother hit her because the only bucket of water they had was for the soup. This girl drank water because she was thirsty. Then, when you associate your most basic needs with mistreatment and abandonment you are going to be a human being who will grow up with a feeling of vacuum and restlessness for your whole life and you will pass into adulthood with that affective damage, with that hollow inside, and it will generate forever problems of addiction, problems of stability; they are young people who are now insatiable criminals.”
The consequences of malnutrition on children, that Venezuela is suffering nowadays, have been already studied in neighbor countries. Rafalli says that a study made in a rural population in Guatemala was published in 2012. In the study, the development of a total group of children was observed; some of them were children of malnourished mothers and others were not. When they reached adulthood, the 20-30 year old peasants who worked cutting cane were compared and their performance in the cut of cane was contrasted too. The difference in the amount of cane cut, and therefore in the income, was up to 40 per cent. Nutrition in their first thousand days of life made them more productive than others when they reached adulthood. In the case of women, they concluded that malnourished girls were three times more likely to give birth to low-weight children than those who were well fed in their childhood.
“That moment determines what will happen later(…) After two years of monitoring this situation in poor parishes of the country, we see that stunting rose from 18 per cent in 2016 to 30 per cent in 2018; it means that 30 per cent of children who were rescued from malnutrition and have already a normal weight, have stunting”, Rafalli says.
”They are children who remain in a lag forever, not only biological, but cognitive. These are children that you will not see that are distinguished, you will not even notice them. These are children who learn to read, write, play, laugh, go to school, but they will never get to college or have good productivity jobs”, Rafalli also says.
The WHO considers that the proportion of children with stunting should not exceed five per cent. Other Latin American countries were able to reduce their rate of children with weight and size retardation by offering families clean water, complete vaccination, dewormers, medical dispensaries, nutritional supplements and family food rations.
“The Latin-American average of declining proportion of children with stunting is 1.5 percentage points per year. So, if you already have it at 33 per cent (like Venezuela), lowering it to 5 per cent that WHO deems appropriate, takes 25 years. 25 or 30 years are three generations (…)This reality hinders thoughts of freedom toward future. These children will be mothers and fathers of poverty and will vote again for a populist president. It is a situation that is perpetuated. This has generational implications, everlasting implications. This means many years of backwardness, at least three generations”, Rafalli warns.
On September 10th 2018, the UN High Commissioner for Human Rights, Michelle Bachelet, said that the agency, since June, has received information on cases of deaths related to malnutrition and diseases that can be prevented in Venezuela. On that month, June, the Office of the High Commissioner for Human Rights (OHCHR) examined the Venezuelan food crisis, collected evidences, interviewed experts and concluded that “the Government refused to recognize the magnitude of the health crisis and did not adopt the measures and reforms that were urgently needed to cope with the crisis and its root causes, thus failing to fulfill its international obligation to make every effort to guarantee the rights of health and food, even calling for international cooperation and assistance.”
Hunger in Venezuela is evident. FAO, which in 2013 awarded the Venezuelan government by “halving the percentage and number of people with hunger or under nutrition in the country before 2015”, called negatively Venezuela in 2017, as the country with the highest rise in undernourishment, and responsible for “the overall decline in the region’s performance in its fight against hunger”: more than half of the people who increased the malnourishment index in Latin American since 2015 were Venezuelan. A year later, in November 2018, the picture is even more serious: the FAO director of statistics said that the average rate of undernourishment in Venezuela, between 2015 and 2017, was 11.7 per cent of the population (3,7 millions of Venezuelans eat badly), almost four times more than in the 2010-2012 period. The number of poorly fed Venezuelans is superior to the population of Uruguay, which, according to its last census, does not reach three and a half million inhabitants.
On the other hand, in its latest report on the country, Human Rights Watch warned that “people affected by food insecurity are less likely to meet their medical treatments because they have limited resources and must meet diverse human needs.” In Venezuela, where 87 per cent of families are poor, the majority cannot meet basic needs, such as food or health. There are sick and malnourished children and parents who, in the midst of an adverse economic context, cannot escape from hunger.
Ingrid Soto de Sanabria, a pediatrician and nutritionist at Hospital Pediátrico J.M. de los Ríos, says: “Malnutrition already looks like an epidemic, a contagious disease”. Hunger in Venezuela started a difficult cycle to break.
Maikel was born on December 29th 2012, in Portuguesa State, a place that is also called the Barn of Venezuela. He was one of the 619,530 children born in that year, the last birth figure that was published in the country.
The state, located in the plains of Venezuela and recognized in the past for its high agricultural production, and where food is scarce nowadays, is the home of the child, who was born just one day before Nicolas Maduro, then vice president of Venezuela, warned in a TV national chain that Hugo Chavez was critically ill after having surgery to try to cure the cancer he suffered. He was born also 21 days after Chavez himself addressed to the Venezuelans, on December 8th, to say to them that if anything became him incapable of exercising power, they would elect Maduro as his successor. “I ask you from my heart”, he said. Three months later, on March 5th, Maduro announced the death of Chavez.
When Maikel was born, he weighed 1.440 kilograms, more than one kilogram below the appropriate minimum weight (2.500 kg) according to the WHO; and he was almost four months old when Maduro was elected as president of Venezuela, as Hugo Chavez asked for, and inherited the country and its economic problems.
In 2002, a decade before Maikel was born, the expropriation of companies, undertaken by Hugo Chavez, began the fall of the country’s productive capacity. The Venezuelan oil boom that took place from 2004 to 2013 was not used either to stimulate national production or to design and fulfill economic strategies that kept the nation’s stability in times of economic recession. Money was allocated for populist policies, including social missions which strengthened government acceptance, but increased the public spending up to 50.7 per cent. This strategy was admitted in 2014 by former minister of Planning and Finance Jorge Giordani, who said that it was “crucial to overcome the challenge of October 7th, 2012”; referring to the elections that Chavez won thanks to an economic and financial effort which led the access and use of resources at extreme levels.
The oil price and the Venezuelan economic model, dependent on this activity, gave an apparent stability to the government, but the consequences of the wastefulness were evident after the decline in oil prices: The State’s expenditures began to be higher than earnings by oil’s exports and the taxes (fiscal deficit), and this situation caused a growing inflation as well as the fall of the purchasing power of Venezuelans.
“When Maduro assumed power in 2013, the Venezuela’s economic situation was rather precarious in terms of external deficit and imports (…) What did Maduro decide, instead of offering a plan for stabilizing the economy, solving this imbalance, or seeking international financing? He opted for a constraint policy. As there was an external gap, he decided to strongly reduce the country’s imports. 2012 was the last year in which Venezuelan economy grew, obviously because of the fictitious bonanza offered by the government of Hugo Chavez who was pursuing his re-election. They spent what they had and what they did not have; there was a huge financing of imports. In 2013, the contraction began to grow, at first with quite handy numbers. We are talking about contractions that didn’t exceed five per cent. But, over time, the level of contraction of Venezuelan economy was widening”, Asdrubal Oliveros explains. Oliveros is an economist (Summa Cum Laude) of the Universidad Central de Venezuela and he is the director of Ecoanalitica, an economic environment analysis company.
In the houses of Juan Luis, Valentina, Dayerlin and Maikel there are no fridges, or if any, do not work. They don’t miss them because they don’t have anything to fill them, either. The empty fridges, which are reflected in the pronounced cheekbones, exposed clavicles and slender hands of Venezuelan children, were predicted several years earlier, but the Venezuelan State did not seem to care.
In 2013, the International Monetary Fund (IMF), in its annual study Perspectives of the world economy, warned the downturn of the Venezuelan economy: “It is expected that the growth of private consumption in Venezuela will decrease in the short term after the recent devaluation of the currency and the implementation of stricter exchange controls.” That year, Venezuelan Gross Domestic Product fell from 5.5 per cent to 1.3 per cent, while Latin America and the Caribbean remained at 2.9 per cent.
Two years later, once again, the IMF warned of the potential economic crisis that was looming. In its annual world report of 2015, it pointed out: “According to forecasts, Venezuela will face a deep recession in 2015 and 2016 (-10% and -6%, respectively) because the drop in oil prices that takes place since mid-June 2014 has exacerbated the internal macroeconomic imbalances and the pressures on the balance of payments. It is estimated that Venezuelan inflation will be quite higher than 100% in 2015.”
The forecast was overcome by reality. The Venezuelan economy started a five-year fall that already reaches 57% and has not stopped yet. It is the deepest deterioration a country has suffered in the last 50 years, Oliveros says. “In addition this is a highlighted fall because it happens in a country that is not experiencing a war or internal conflict or with its neighbors, and has not faced a natural disaster. It is a fall that has been the result of the poor management of the economic policies which has significantly reduced the size of the Venezuelan economy.”
The lack of government attention to face the fall of the economy during several years, as well as the decline of imports, the drop of national production, the closures of companies, and the denial of foreign exchange for acquiring raw materials, triggered a serious shortage and inflation, which affected the availability and access to food. Without food or money to buy it, Venezuelans’ diet began to deteriorate.
- Mum, we are hungry! - , exclaim Maria Victoria and Maria Veronica.
- I have nothing, let’s go to bed. Tomorrow I will see what I can give you- replies their mother Dayana, heartbroken. And while the girls obey and sleep, Dayana remains awake and weeps.
The five-year old twins and their two siblings sleep hungry most of the nights. During the day, they don’t eat well: their diet is rice, pasta, flour, sugar and grains. These foods are distributed by the government in boxes that arrive every 15 days to La Batalla, a quarter in Barquisimeto, Lara State. The family has not eaten meat or chicken for five months. The twins, who were born on January 5th, 2013, weigh 14 kilograms and measure 1.02 meters, four kilograms and six centimeters below the weight and size appropriate for their age. Their diagnosis is the same as Juan Luis, Maikel, Valentina and Dayerlin: they are malnourished, like almost half of the Venezuelan children of their age. They belong to the generation marked by the crisis, the generation of hunger.
In its March 2018 report, Caritas Venezuela concluded that 44 per cent of Venezuelan children under the age of five were malnourished, a figure that doubles the cases reported in January 2017. Another 37 per cent of children of the same age were at risk of malnutrition. In March 2018, only 22 per cent of Venezuelan children under the age of five were well fed.
The hunger of children of this malnourished generation goes hand in hand with the lack of food. According to the Observatorio Venezolano de Seguridad Alimentaria (Venezuelan Observatory for Food Security) the consumption of meat and poultry in children under the age of five decreased from 41 per cent to 22 per cent, between 2016 and 2017; the eating of fish decreased from 24 per cent to 12 per cent in the same period; the consumption of milk products fell from 59 per cent to 26 per cent; and that of eggs (the most economical protein) fell from 47 per cent to 29 per cent.
According to the Venezuelan company Econometrica, the shortage increased from 68 per cent in September 2017 to 83.3 per cent in 2018. Semi-empty dishes are the proof of the diet’s deterioration.
- We didn’t used to eat well before, but we could do it. We could sometimes have chicken, little beans, rice, pasta with sauce. Now we can’t – Dayana regrets.
On March 7th 2018, the executive director of the United Nations World Food Program (WFP), David Beasley, described the food crisis in Venezuela as “catastrophic.” At that time, the Venezuelan government, which had just commemorated the fifth anniversary of Hugo Chavez’s death, did not make any pronouncement. Three months earlier, on January 26th, UNICEF’s warning about child malnutrition in the country was also ignored.
An increasing number of children in Venezuela are suffering from malnutrition as a result of the economic crisis who affects the country. While no accurate figures are available due to the lack of official data on health and nutrition, there are clear evidences that the crisis is limiting children’s access to quality health services, medicines and food. The children’s agency calls for the implementation of a rapid short-term response against malnutrition.
Although the concern of international organizations is recent, malnutrition is not, says Marianella Herrera, who is a nutritionist at the Centro de Estudios del Desarrollo de la Universidad Central de Venezuela (Center for Development Studies of the Central University of Venezuela), director of Fundacion Bengoa, and member of the research’s team of the Sociedad Latinoamericana de Nutrición (Latin American Society of Nutrition). “This has been longer than it seems. I remember we did an investigation when the Mision Mercal existed in Caracas. We found that there was a close relationship between being obese, buying in Mercal and being member of a home with food insecurity. Obesity is hidden hunger. Mercal offered more economical, but nutrient-poor products (…) This crisis began around 2011, 2012. It was a slow-installation food insecurity crisis, so it has been very difficult to convince the world about it. It started with obesity, and then, when the calories ran out, this drastic change occurred.”
Herrera says that hunger goes hand in hand with economic fall. “When the State guarantees a proper income, it guarantees the satisfaction of basic needs. Food is one of those. The crisis of national production, which came forward after the expropriation of lands, caused the depletion of local products (…) The radicalization of socialist model led to the loss of the economical structure.”
Carlos’s mom is not an expert in economics or socialist models; she barely writes her name with difficulty. But this is not necessary to know that her children do not feed well. She is 22 and she has to take care of her four children while the father works. What the husband earns is only enough to buy some carbohydrates, like pasta or rice, and some cheese, chicken or sardines. It never reaches for buying everything or enough.
It’s not the only family that suffers from these conditions. According to Encovi, in 2017, 89 per cent of Venezuelan households, such as Carlos’s home did not have the money they needed to buy food. Despite the state does not offer official figures on poverty based on income, the available data at the Instituto Nacional de Estadística (INE) confirms that between 2012, the last year of Hugo Chavez’s mandate, and 2014, year of the last published report, the poor households increased from 21.2 to 31.3 per cent.
The increase in poverty does not stop. Oscar Meza, who is an economist and director of the Centro de Documentación de Análisis Social (CENDAS), says: "The food basket of August, annualized between August 2017 and August 2018, showed an inflation of 57,978.9 per cent. For the first time, this country is facing a problem of hyperinflation. For 21 years, between 1951 and 1971, Venezuela had an annual inflation of 1.5%. At this moment, we have a daily inflation of 2.4.”
The organization that was founded 41 year ago compares, monthly, the Venezuelan minimum wage with the cost of the food basket to evaluate its coverage. Between 2008 and 2013 (at the end of the year), the minimum wage went from covering 53 per cent of the food basket, to 46 per cent. It differs from the government’s estimate: according to the cost of the food basket published by the INE, the minimum wage could cover 91 and 89 per cent, respectively. On the other hand, the CENDAS noted that in 2014 that food basket coverage was only 28 per cent and, at the end of 2017, only 2 per cent of the food basket could be purchased with the minimum wage. In the same period, the State did not publish the cost of the food basket.
The Venezuelan ran out of food and money to buy the little expensive food available.
UNICEF Venezuela’s view on the causes of child malnutrition, evidenced by non-governmental organizations, is neutral. This agency adheres to the official figures provided by the State. However, Dagoberto Rivera, a nutrition and health specialist for UNICEF Venezuela admits that the lack of purchasing power is one of the causes of malnutrition, although he warns that it is not the only one.
"When prices go up and the purchasing capacity decreases, the option of accessing a full basket is restricted. This affects all levels of the family. To point out how much it has fell would be risky, but yes, we have read the signs in partial reports, which indicate that there is deterioration and a tendency towards deterioration and that is why we are making intervention. We are seeking collaboration, and concreting collaboration, not only with the non-governmental sector, but also with government institutions, specifically with the Instituto Nacional de Nutrición (National Institute of Nutrition). We are supporting an intervention to help with micronutrients and some additional nutrition inputs at the nutritional recovery centers, an in regular UNICEF programs. This is the reality we are living and that we want to change, caused by this situation of high prices and a reduced purchasing capacity.”
That is the reality that Juan Luis lives in the delta, Maikel in the plains, Dayerlin in the east, the twins Maria Victoria and Maria Veronica in the center, Carlos in the south, Valentina in the metropolitan area: that is the reality of a whole country, which was investigated by the correspondents of El Pitazo in alliance with CONNECTAS.
Jhender would have been five years old on September 20th 2018, but he died almost six months earlier, on April 7th, because of hunger. The child died in the dawn, at the same hospital where Hugo Chavez expired five years before. That place where the president was hospitalized during his last days of life, did not have the necessary inputs to treat the bacterial infection suffered by the child’s digestive system, besides aggravated by his malnutrition. Thus, Jhender became part of an unknown statistic.
In Venezuela, the silence of the State is overwhelming. The epidemiological bulletins of the Ministry of Health, from July 2015 to December 2016, were published in May 2017, with a delay of one year. The Anuario de Morbilidad (Morbidity Yearbook) is not published since 2015, when the last report of 2013 was disclosed. The Ministry of Health published its last Report and Accounts in 2015; those of 2016 and 2017 have not been disclosed.
The Ministry of Food does not publish the Hojas de Balance de Alimentos (Food Balance Sheets), since 2007, or the Anuario del Sistema de Vigilancia Alimentaria y Nutricional (Yearbook of the Food and Nutritional Surveillance System) since 2008. The INE, attached to the Ministry of the Office of the Presidency, does not make public the Encuesta Nacional de Seguimiento al Consumo de Alimentos (National Survey on the Monitoring of Food Consumption) since 2015. And the Mortality Yearbook, to which Jhender should belong, has a delay of four years: the 2014 edition was published in August 2018.
Pablo Hernandez, who works as a nutritionist at the Observatorio Venezolano de la Salud (Venezuelan Observatory of Health), says: “Unfortunately, figures in Venezuela have not been published since around four years ago. There is a quite dark overview on the statistics. The Venezuelan State considers information as a political tool and does not disseminate it, so it makes difficult to plan and organize public policies, because for us, the researchers, it is vital to know where we are in order to make plans for the future.”
The State also has not disclosed figures on malnutrition and child mortality to UNICEF for a decade, according to the databases published in the World’s Children Report of this body.
National civil organizations, such as Caritas Venezuela, Fundacion Bengoa and Provea, as well as research teams from Venezuelan universities have tried to investigate and show results on malnutrition. Nonetheless, the irregularity in the registration of child deaths makes it difficult to generate data on mortality. Hernandez says: “We have received allegations from physicians that they are not allowed to point out malnutrition as a cause of death in the patients´ death certificate, even though malnutrition may be associated with infectious diseases. It is unfortunate, because malnutrition figures have to be part of the statistics and there are no figures on deaths from malnutrition, especially those of children under five years of age in the last epidemiological bulletin of 2016, which was published in 2017.
The Venezuela Mortality Yearbook of 2014 (published in 2018) registered that 153 children under the age of five, died from starvation; five children more than in 2013, when 148 children died. The greatest increase in deaths occurred in children less than one year old: between 2013 and 2016, the death of babies increased 28 per cent, according to the State’s epidemiological bulletins. Although there is no official, concrete and updated data on the children’s death from starvation; UNICEF has been measuring and projecting statistics based on old State records corresponding to several years, and it points out that Venezuela has a stable child mortality under five years old, which stands at 17 per cent, even below the average of Latin America and the Caribbean (21 per cent). This figure is unreal because it is based on outdated data.
The lack of child mortality figures is not the only irregularity of the Venezuelan State, The method used to measure malnutrition – of which there are no official figures- is obsolete, compared to that used by the rest of the regional countries.
In 2006, following to a multi center study carried out on the five continents, the WHO generated and established new references patterns for well-nourished children. The pattern of the years 70 and 90 indicated that a child was malnourished when his weight was three times below what he should weigh, and he was acutely or severely malnourished, when he deviated four times from the pattern. But the pattern approved in 2006 ran the cut-off point. According to these patterns, the health records of States can assert that a child is severely malnourished if he is two measures below the ideal weight or height for his age.
Susana Rafalli, the nutritionist in charge of the Saman report of Caritas Venezuela, explains: “When you measure 600 children here, and compare their measurements with obsolete patterns, the results can throw 48 malnourished children because you expect them to be severely malnourished for being considered as part of the public health statistics of a country. Whereas, with the pattern of 2006, it maybe that you count them and the result is not 48, but 78 or 80 malnourished children. So the difference is that with obsolete patterns you get fewer malnourished children.”
She also warns: “Since these patterns were approved, almost all countries assumed them as their patterns to assess their children’s population and Venezuela is one of the fewest states in which this has not been assumed. The formats left by the National Institute of Nutrition to gather information in the health centers keep the cut-off points of the past patterns, so you have to expect that a child is seriously malnourished to include him within the official statistics. And this is very serious because malnutrition is one of the indicators par excellence to assume and recognize that there is a public health emergency in a country. Then, you would have to wait for the child to deviate four times from what he should weigh and be already in the skin, you would have to wait that he is on a condition that requires hospitalization, to say that there is a public health emergency.”
- How can he go to school if he is hungry? How is he going to understand the explanations if he doesn’t eat? How is he going to understand if he is hungry? Katiuska wonders, desperate. She is Alexander’s aunt and lives with the boy in Zulia State, in the west of Venezuela; a region where oil exploitation gave the country options for growth and development, but today has the poorest municipality in the country: Guajira. Their home is a shanty made of zinc where 11 children and 12 adults live overcrowded. Katiuska’s concern is well-founded, though for her it is only a suspicion.
In Venezuela, the lack of official figures is not only concerning to anthropometric measures of children (what their weight, height and left arm’s circumference are). According to the Children’s World’s Report, Venezuela does not register the scope of vitamin A coverage, nor does the consumption of iodized salt since 2008. The lack of these minerals is the main cause of micronutrient malnutrition. For this reason, the iodization of salt was decreed in the country in 1993 and the fortification of corn flour with vitamin A in 1994. Today, these decrees remain in force but they are dead letter in a hungry nation.
A major symptom of iodine’s deficiency is goiter, a thyroid disease that despite it was eradicated in Venezuela more than 30 years ago, has reappeared without the authorities take any action. Since 2017, an increasing number of cases of this disease have been registered in Portuguesa State, and even though there are not studies to certify it, the reappearance of this illness could evidence irregularities in the coverage of this micronutrient, according to Gerardo Rojas, who is endocrinologist and president of the Sociedad Venezolana de Endocrinología, capítulo centro-occidental (Venezuelan Society of Endocrinology, central-western chapter).
“In 2017, the figure in Portuguesa reaches three thousand cases. We wanted to make a roundtable, but never went beyond a meeting because the government of Portuguesa State did not allow any further progress. Biopsies were taken in some cases, or laboratory tests were done. However, due to the high costs of the tests, these samples were not all processed and some of them are frozen, apparently. We are not sure what the result was, but it was said that the goiter outbreak was associated with lack of iodine. Nowadays, and among many theories, it is assumed that it is associated with the food shortage, because of the lack of proteins, like meat and chicken, in the daily diet, and the increasing consumption of foods which can cause goiter, such as yucca and the rest of the tubers. In Venezuela, all salt was iodized many years ago in order to avoid this disease. The problem is that there is not even salt in the country. Something as common as salt is very difficult to find now and some salts are imported and no iodized.”
This lack of iodine, evidenced by the recurrence of goiter, irreversibly marks this generation of children facing hunger. Not consuming iodine causes brain injuries during childhood. Its most devastating effects include the alteration of the cognitive and motor development that influences the child’s school performance, and the loss of up to 15 points in the IQ. At their adulthood, they will be less productive and therefore they will have less ability to find jobs. It will more difficult for them to have appropriate incomes for supporting their families, to buy the food they need, to be well nourished, to live well: it will be more difficult for them to break the merciless cycle of hunger.
Hunger of Venezuelan children is also related to corruption. Foreign foods, purchased by the State to distribute them through the CLAP boxes (Local Supply and Production Committees boxes) – and whose purchase is linked to economic groups close to the president, according to a local media investigation, Armando. Info - may also be the cause of vitamin A deficiencies. There are neither studies nor official figures showing an overview of the coverage of this micronutrient in recent years, but hair discoloration evidences it, the nutritionist Marianella Herrera says. She also explains that Venezuelan precooked flour is enriched with vitamin A, but there is no guarantee of this fortification in brands that are imported by the government. In addition to hair discoloration, also known as flag syndrome, vitamin A deficiency weakens the immune system, increases the risk that children get infections such as measles and diarrhea, affects the skin’s health, and, in extreme cases, can cause blindness. “In Venezuela we are seeing this alteration of hair coloring (…) This happened in Cuba during the special period, when many people became blind.”
Those brown locks of hair, a little lighter than the rest , which are seen in the heads of the twins, Maria Veronica and Maria Victoria, could show that, in addition to her weight and size, both of them are also malnourished due to lack of micronutrients. If so, it could mean that their immune systems are and will be weaker than those of other children of their age. But, even if the damage to their health stops, their future is almost a certainty: damages caused by hunger are irreversible.
In his book Mass destruction, Jean Ziegler, the former UN Special Rapporteur on the Right to Food, argues that hunger and its perpetrators are murdering in the midst of abundance.
“Every five seconds, a boy less than ten years old is starving, on a planet that, however, is brimming with wealth. Today, indeed, world agriculture could feed 12 billion of human beings, almost twice the current population. So it’s not a fate. A boy who starves to death is a murdered boy.”
From 2004 to 2013 – the year in which Juan Luis, Maikel, Maria Victoria and Maria Veronica, Carlos, Dayerlin, Valentina, Alexander and Jhender were born – Venezuela lived the biggest oil bonanza of its history. But the State did not allocate the necessary resources to protect them from misery. Now, Maduro’s government denies the existence of the humanitarian emergency and does not accept the regional aid. Instead, its lack of action ensures that these children, and thousands more of their age, will grow up at disadvantageous conditions, be sick adults, and suffer their entire lives the consequences of hunger to which they were subject by the government’s irresponsibility. But Jhender, the boy who died of starvation, could not even find out what his life would be. He rests in a grave without a tombstone, in a poor cemetery of a poor neighborhood, such as his home was from the day he was born until the day he died, or was murdered, by hunger.