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.

Tuesday, November 13, 2012

Long bus rides, and the high cost of lousy infrastructure in Honduras

A new bridge installation didn't go so well in Olancho last month; communities will continue to be isolated in the rainy season
I’ve made the trip to Tegucigalpa, the capital, a couple of times in the last few weeks. 
It take about eight and a half hours from Copan Ruinas, with a stop in San Pedro Sula to change buses.
It’s comfortable. Cuso encourages people to use Hedman Alas, a high-end bus line that makes a big deal about security. Airport-style check-ins, with hand baggage checks, a metal detector and a digital snapshot of every passenger. (I’m not sure how that is supposed to increase security, but I smile for the camera.) No stops along the way. And the buses are new, with comfortable seats, and an odd selection of movies. (Coming home on the weekend, I had Furry Vengeance with Brendan Fraser, whose presence is a reliable indicator that a movie will be bad, and The Reunion, a WWE-produced action vehicle for wrestler John Cena.) For a few dollars more, you can even go Ejecutivo Plus - sort of a bus business class.
Eight hours is still a long time. The distance between the two cities, as the crow flies, is about 220 kilometres. But Honduras is mountainous, and the roads follow the valleys where possible. 
The total travel distance is actually 435 kms.
The mathematically astute will have realized that means the average speed for the journey, mostly on the country’s main highways, is about 55 km/h.
The long trip to Tegucigalpa is no big deal for me. But for businesses that need to get there or make deliveries, it adds cost and time. For small producers, it’s a big barrier to getting goods and crops to urban markets. 
The problem is even worse off the main roads. By official count, Honduras has 14,296 kms of roads. Less than a quarter of them are paved - about 3,200 kms. A Peruvian economist who spoke in Tegus last week, Enrique Cornejo Ramírez, estimated that only 10 per cent of the road network is in fair condition.
The paved roads, with some exceptions, aren’t good: Potholes, washouts, never-ending construction.
Trucks ease by with two wheels on those logs
And the unpaved roads are much worse. They wind up steep hillsides and ford streams, and wash out in the rainy season and turn to dust in the dry. I was at a workshop on adding value for small farmers and co-ops. It was hard to talk about expanding markets or product differentiation when people’s first problem was that they couldn’t get their honey eight kms to the nearest town because the road was frequently impassable. When they can only sell locally, they face competition from all the other farmers growing the same things, and get lower prices.
Why are things such a mess? Hondurans point to Hurricane Mitch as a big factor, and it did result in massive damage to roads and wiped out bridges across the country in 1998.
Corruption is a problem. A newspaper story last month reported up to 25 per cent of government spending - including on infrastructure - is lost to various forms of corruption.(Before Canadians get too smug, remember the current Montreal construction corruption scandal.)
And Honduras just doesn’t have enough money. Work has halted on many of the current projects because the government hasn’t paid the companies in a couple of months. Tax loopholes and evasion reduce the money coming into government. (Teachers, for example, are exempted from income tax; companies show paper losses year after year and don’t pay tax.) Spending is routinely over budget. And IMF aid deals limit government borrowing. (Which, at interest rates around 11 per cent, is problematic anyway.)
It’s not just roads. The country’s main port is inefficient and outdated. There’s been talk of an airport for Copan Ruinas - which would make a huge tourism difference - for a decade, with no progress. 
And it’s not just transportation. The country’s phone company, Hondutel, is broke. Rural schools are substandard. In San Pedro Sula, with 1.9 million people, the Rotary Club is raising money to build the first public library. It’s been better lately, but for a couple of months power outages were routine in Copan, to the point that a group blockaded the road to Guatemala in protest. (Which seemed to help.)
And I’m writing this offline, because Internet service has been erratic for about 10 days.
This all goes far beyond inconvenience. Imagine trying to run a business, or any economic activity, when electricity is unreliable and transportation dodgy.
Once, it might not have mattered quite as much. Honduran businesses were local, shared the same handicaps and worked around them.
But Honduras, like so many countries has embraced freer trade as a route to more prosperity. Which means its businesses often face competitors operating in places with every infrastructure advantage.
Infrastructure tends to be a boring topic. Until it’s not there.