Suffer the children
Malnutrition amid growing plenty

Jan 10th 2008 -

LLIUPAPUQUIO, Peru ---KICKING a football around a dusty lot, Judin Quicaño looks like any other boy of four. But stand him against a standard growth chart and he is almost a head shorter than he should be at his age. His mother says that is just his natural build. Health officials say he is among nearly 30% of Peruvian children in his age group who suffer from chronic malnutrition. The figure rises to 90% in places such as Lliupapuquio, a village in Apurímac department in Peru's heavily Indian southern Andes where Judin lives.

The picture is similar in neighbouring Bolivia and Ecuador. What makes the stunting of children's lives and bodies more shocking in Peru's case is that the country is enjoying a boom. The GDP expanded by 8.3% last year alone, and is some 45% bigger today than it was in 2001. Many of the poor benefit from social programmes. The government spends around $250m a year on food-aid schemes alone, which reach three-quarters of families in poor rural areas.

So why does malnutrition remain so prevalent? One reason is that in the Andes it generally manifests itself as stunted growth. Many Peruvians, often including the parents of the children concerned, believe that people of Andean Indian descent are naturally short. Malnutrition is thus "invisible" because the children are not "super-thin or dehydrated", says Ian Walker, a social-protection specialist at the World Bank. But children who do not eat well in their first two years will face learning difficulties.

Although governments have increased spending on social programmes, they have done little to improve their effectiveness. In Apurímac, mayors complain of duplication, corruption and lack of local control. But the biggest problem is that economic growth is not reaching many parts of the Andes. Official figures put poverty in Apurímac at 74.8% in 2006, having increased slightly since 2004. In such places, a lack of transport, education and health care all conspire against progress.

When he took office in July 2006, President Alan García pledged to cut the incidence of child malnutrition by eight percentage points by the end of his term in 2011. The World Bank and other development agencies are trying to help. Last year the World Bank approved a $150m loan for streamlining social programmes and to enhance their impact on malnutrition, health and schooling, especially in Andean Indian villages.

There are reasons for hope. In Santa María de Chicmo, a district in Apurímac, the incidence of malnourishment in children has been cut from 80% to 30% since 2000. Most of the credit belongs to a scheme pioneered by Kusi Warma, an NGO whose name means "Happy Child" in Quechua, and whose work is backed by the municipal council and Unicef, the United Nations' children fund. It revolves around a small centre where new mothers bring their children for pre-school education and information about nutrition and health. The task facing Peru is to replicate this success, and go beyond it.