While the world’s rich are enjoying their Argentine steaks, children in Argentina are dying of malnutrition. The province of Misiones has declared war on hunger. Too late for Rafael Díaz, who died before his third birthday.
“Everything is much better now”, says Rafael’s mother, Rosa Acosta, 32.
“We’ve got a tin roof instead of the old cardboard one, and a priest has built a toilet for us. So at least something positive has come out of the horrible thing that happened.”
She has just hung many little T-shirts and trousers on the washing line between the mandarin trees at the corner of her shack. She has five children left.
Rafael Díaz died on the 5th of September last year. The day before, he had caught a cold. Rosa Acosta was rocking him in her arms to calm him down when he became increasingly congested and had increasing difficulty breathing.
“Suddenly, he wasn’t breathing at all. I ran out into the street with him in my arms and shouted for somebody to come and help us, because we had to go to hospital. Nobody came. It was completely quiet,” says Rosa Acosta.
A police car turned up and drove them the few kilometres to Accident and Emergency in central Apóstoles with the sirens on.
“He had always been sickly and I knew that he was in a bad condition. So I suppose I realised that he could die. But I was still not prepared.”
Rafael Díaz weighed eight kilos. More than one and a half kilos beneath the threshold for severe malnutrition at his age, according to the World Health Organization’s scale. That’s why he was enlisted in the province’s new programme Zero Hunger, which aims to cure child malnutrition. He had had a check-up forty-eight hours before he died.
How can a child die of starvation while society is looking on?
The answer is that Rafael Díaz died of so much more. As a baby, he was admitted to hospital with breathing difficulties. He is suspected to have had a genetic defect which causes repeated respiratory infections. He had chronic diarrhea and coughs.
But, above all, Rafael Díaz died of poverty. He died because he lived in a shack which didn’t protect him from the heat, the humidity and the buzzing insects which seem to be everywhere, especially around the outhouse and near the flour and vegetables. Because his mother had trouble keeping him and his food clean. She gets her water from the chapel at the corner and she still doesn’t have a fridge. He also died because his parents were not able to claim his rights. Because his father didn’t want to take him to hospital, “they just torture him there”. Because his mother didn’t want to leave the other kids alone with their father, who is now in prison for sexually abusing the three older boys.
“I don’t know what I could have done differently. We have nothing. The doctors wanted to send Rafael to a specialist facility in Buenos Aires, maybe that could have saved him. But his father wouldn’t allow it and I didn’t dare speak up against him.”
Rosa Acosta and her remaining five children live off child benefits at the equivalent of around £120 a month, plus what her new boyfriend gives them from his temporary job as a builder. She had her first child at sixteen and has never worked.
“I think the future will be better now that I have someone who helps me more. He wants me to study and maybe work. We’ll see, after this,” she says, patting her belly.
She is seven months pregnant.
Many of the cases of severe malnutrition follow the same pattern: mothers who grew up poor and often malnourished themselves, who started having children as teenagers and never finished school. Big families, absent fathers, unemployment, sometimes addiction or mental illness.
“If the children are just malnourished, they recover quickly when they receive help. But most of them have far greater problems,” says Claudia Cabral, nurse and outreach health advisor at the health centre in Estación de Apóstoles.
She too has always lived in the neighborhood, where small stone houses blend with shacks. Poverty has increased during her thirty-three year lifetime. Whole families used to work as day labourers in the plantations of yerba mate, the herb used in the national drink mate. Now the law proscribes children from coming to the fields and factories, but as a result, the women also have to stay at home. “There are fewer jobs anyway,” says Claudia Cabral, indicating the men sitting in the shade in front of their houses, sipping mate or beer.
Mate has made Apóstoles one of the richest towns in impoverished Misiones province. Mate museums and topiary in the shape of drinking containers are a reminder of where the money comes from. But the riches are concentrated in the hands of a few big companies.
Humberto Fernandez de Olivera is lying in an iron cot and howling, with a plastic tube in his nose. He produces an impressive amount of noise for his size. He is three months old but only as big as a healthy one-month-old child. That’s why he has been admitted to the childrens’ hospital in the provincial capital, Posadas.
His grandmother, Narcisa Ifran de la Rosa, lifts him up and comforts him.
“My daughter doesn’t have enough milk. All her five kids eat well when they get food, it’s just that we don’t have enough to give them.”
The family lives off Narcisa Ifran de la Rosa’s husband’s pension and her daughter’s disability benefits.
“She gets some money because something is wrong with her head”, she says and rotates her finger at her temple.
In the corridor, women in their best clothes with newly-washed hair are queuing outside the social workers’ office. One of them supports her children by selling plastic flowers on the street. Another lives on the street, “just around the corner”.
Here they can receive help in contacting authorities and applying for support. Few of them know that they are entitled to child benefit, help with repairs to their housing, free health care during pregnancy and for small children, and to assistance from the new Zero Hunger programme for malnourished children.
Social worker Daniela Mercol is frustrated by her job:
“The only things they get are four kilos of milk powder, a 20 peso vegetable coupon and one weigh-in a month. We are supposed to help them improve their houses too, but we haven’t managed to find the money for that.”
“In the longer term, we do nothing for them.”
A couple of miles away, on the outskirts of Posadas, twenty-five women are staring at a uterus which gynaecologist Maria Cristina Elias is drawing with a marker on a piece of paper taped to the wall. She is explaining how sterilization works.
“The oviduct is just a place for the sperm and the egg to meet. If you have a headache or aren’t in the mood for sex it can be because you have a boring man, but not because you have been cut here” she says and points at the sketch.
The women giggle.
“And if you want to do it, it’s completely up to you. Your husband, mother-in-law, mother and all her neighbours have nothing to do with it. You are the only ones who have the right to decide what is done with your bodies. It’s the law.”
Maria Cristina Elias has a private clinic in town and works for free at the centre, which is run by the national NGO Conin. They spend several years working with every of the now thirty-five families at the centre, on everything from literacy for the mothers and computer skills for the older children to frequent health checks for the little ones. The money comes from donations. Their aim is to fight child malnutrition.
“Children have always died of malnutrition here. If the politicians would have been interested, they would have done something about it earlier”, says Maria Cristina Elias.
The door flies open:
”You have to come and help now!”
The women put out tables and serve food to a group of children who have been slaloming around cones or playing with letter blocks.
As soon as the heaped plates of chicken stew and mashed potatoes land on the table, the children pounce on them. They are talking and making a lot of noise, but at the same time they deliberately stuff themselves until it’s all gone. When everybody has finished, there are no signs of food on the plates or the table.
Most of the children used to be malnourished; many still are. As far as the staff knows, none of them benefit from the Zero Hunger programme.
Maria Ferreira, 34, is one of today’s kitchen staff. She was here baking at four in the morning. She sells bread for the equivalent of around £6 a day. She gets the staples at the centre, even if the usual policy is to educate rather than to offer charity. But this is an emergency. Her husband has recently lost his job.
On the short walk home with two of the youngest of her eight children, she talks about when a social worker referred her to the centre six years ago.
“When they explained that the children could get help, I had to give it a chance. But at the beginning I felt that I didn’t have time to help out at the centre, I already had enough with my own problems.”
The big children are already at home. Maria Ferreira continues to talk about the time before Conin, how, on most days, they only ate corn polenta, “a little heap each,” she says, cupping her hand to show.
”Do you remember that?”
The teenagers stare at her and at each other. There is embarassment in the air.
“I don’t want to think about that,” says Dario, 14.
Twelve-year-old Julio seldom says anything at all. He still can’t read or write and goes to a special school.
“They say he is retarded because he was malnourished as a toddler. He will never be normal.”
Julio is silent. He has an open and friendly gaze.
His sister Gloria, 15, contributes to the household budget by cleaning for other families three times a week.
“I’m not having children for a long time. I want to work and make money. Maybe as a kindergarten teacher. Then I have to finish school and then university. It’s going to be tough, but I think I can make it.”
This – a wider horizon, dreams, better conditions for future children – is Conin’s long-term goal. And Zero Hunger’s goal, too.
“It’s not as if we realised now that children are dying”, says Edmundo Soria Vieta, ultimately responsible for Zero Hunger, at his office in town.
“But what we did before was too little and too short term. Many people say that our project is about buying votes in the elections this winter. That makes me angry. We are achieving great things.”
He shrugs off the allegations that all the families get is food and weight checks. “Some people just want to destroy everything,” he says, referring to the election again. Then he talks fervently about parental education, vegetable plots and sponsors. He shows pictures and tables in a brochure: 3952 children have recovered since the start of the programme in June, but are still receiving follow-up support and monitoring. 1079 malnourished children are still left in the programme.
“It is a human right to not die of lack of food”, he says, vigorously waving the brochure.
“But malnutrition is only a symptom. The real problem is poverty.”
It is obvious that Edmundo Soria Vieta understands the problem and wants to do something about it. As a child he himself sometimes went to sleep hungry, and before going into politics he worked for 25 years as a doctor in a small, poor village on the Brazilian border.
It is also obvious that there is a huge gap between aspirations and reality. Widespread corruption is a well known problem, but the authorities also seem to lack the means to reach those who live outside of society.
In March, an appeal was published on one of the province’s news websites:
“Urgent call for beneficiaries of the programme Zero Hunger. The following people must present themselves urgently at the health centre in Villa Schuster, open Mondays to Fridays 6.00-11.30am.” Below, a phone number and a list of twelve children, together with their addresses and a parent’s name.
In the case of the last three children on the list, even that information is missing. Their names are written alone:
Benjamin Lautaro Ayala.
… happens because the amount of energy in the body is insufficient to cover the body’s needs.
… causes lowered immune response and a diminished ability to tackle diseases.
… delays brain development in small children, which can cause retardation.
The WHO has diagrams of normal weight and thresholds for malnutrition.
4.6 million children die of malnutrition every year.
195 million children under the age of five years are malnourished, most of them in South Asia.
68 children under five years of age died of malnutrition in Argentina in 2009, according to health ministry statistics. Most of them were from the impoverished northern provinces.
Several respected Argentina doctors and researchers claim that the number is significantly higher, since malnutrition is often the indirect cause of death for children who die of diarrhea or respiratory infections. The lowest of these estimations, from Buenos Aires University, is around 2,900 children a year. That accounts for almost one third of all deaths in that age group.
Child mortality in the under fives in Argentina has decreased steadily during the last 30 years and was 14 out of every 1000 born in 2009. In neighbouring country Chile the number was 9 out of every 1000, according to Unicef.
3.7 percent of Argentine children are malnourished, according to the latest health ministry survey, which dates from 2005. In the region of which Misiones is part, 5.8 percent of children are malnourished.
Argentina is the world’s 9th biggest food exporter and sold food abroad for 47 447 million US dollars (around £89,5 million) in 2007.
The main exports:
1. soy beans.