Friday, November 16, 2012

Bad teeth, bad diet and hunger in Honduras

Early on, I was struck by the number of little kids here with bad teeth, often with a strange pattern of decay around the edges of their baby teeth.
A story in the newspaper offered a possible clue. Funazucar, the umbrella association of sugar producers, proudly announced it's donating 40 tonnes of sugar to a school lunch program for poor kids and to help nursing mothers with nutrition. Some 21,000 people, about 16,000 of them children, will benefit.
That works out to about 1.9 kilos of sugar per person. It's not a lot. The average North American consumes about 60 kilos of sugar a year, thanks to a heavily sweetened diet of processed foods and soda pop.
But the Honduran donation will be mainly used to add sugar to children's milk in the school lunch program. That seems like a bad idea.
The standard Honduran diet is already high in carbohydrates. About 70 per cent of the calories consumed - higher in rural areas - is from corn, used for tortillas, and beans.
People like both - it's a rare meal, breakfast, lunch or supper, that doesn't include tortillas and beans. They're cheap. And subsistence farmers can grow their own corn and beans, even on the steep, generally poor-quality land they can access.
That dependence is a problem. Poor farmers don't have irrigation, of course. They plant, as people have for hundreds of years, when the rainy season is supposed to start. If it doesn't, or there isn't enough rain, the crops do badly, as they did in southern Honduras this year. And when the crops are poor, people go hungry until the next year.
(Which, given the coming impact of climate change on corn and bean production, is very bad news for Honduras, and much of Central America.)
In Canada, kids seem big for their age. Here, I found myself guessing children were two years younger than they really were. About 29 per cent of Honduran children under five are stunted - they’re significantly too short for their age - and eight per cent wasted - they weigh significantly too little for their height. (Even the terms convey a certain desperation.)
Partly, it’s a matter of limited diet - too few fruits and vegetables. People are reluctant to give up any of a tiny cornfield for unproven crops.
Partly, it’s a symptom of more complex problems. Water sources in rural communities - home to about half the population - are often unreliable and impure. Diarrhea and parasites take a toll on everyone, but especially on little children. Families cook over smoky wood fires, often inside buildings. Children suffer from respiratory illnesses as a result.
People are working on the problems. Mission groups are installing water systems - though many fail within five years - and helping families build latrines to protect water sources. Agencies, including the one my partner works with, are helping families build ecostoves that use less wood and don’t fill the house with smoke. But progress is slow.
And partly, people just don’t have enough to eat. So sugar, with its quick energy and big calories, is a welcome addition - to kids’ milk, everyone’s coffee.
But sugar as a healthy additive to kids lunchtime milk?
I was already surprised, when I bought a bag of sugar at Bodega Gloria, to find the package proudly proclaimed “With added Vitamin A.” It seemed like trying to market soft drinks with added fibre. (Which Coke and Pepsi both already do in Japan.)
Back to bad teeth. That’s not just a question of diet. Toothbrushes and toothpaste are too expensive for poor families and dental care out of the question.
There are solutions. A U.S. university did a project where they taught kids in a poor rural community to clean their teeth with their fingers and salt and instructed teachers on twice-a-week fluoride rinses. A prominent community member was designated ‘Keeper of the Rinse’ and distributed it to teachers. There were problems, of course.
The baseline study, done before the program, found 83 per cent of the six to eight year olds had cavities. Eighteen months later, it was down to 14 per cent. (The samples were small; you can read about the study here.)
When you don’t have enough to eat, you take calories in whatever form you can get them. But sugar-laden milk - even when the sugar has added Vitamin A - doesn’t seem like a great nutritional step forward.


Debbie said...

It is sad and strange that we never hear these stories in El Norte.

Rick said...

The study is a good one. We do similar things in Santa Barbara where we have Honduran dental techs apply varnish 3-4 times per year. What they did in this study is old science (3 times in a two week period) and now it is a much easier protocol. Also, we apply dental sealants. Fluoride prevents decay on the smooth surfaces of teeth, only. For the chewing sides, we need to use sealants.

paul said...

Thanks for the update. Anything on the web on the work you're doing? I'd link to it.