The Menace of Malnutrition

Meet José, a ten year old from Santa Rosa.  He has cerebral palsy, and weighs fourteen pounds. 

Pat writes,

While we were in Santa Rosa, I once again held a starving child in my arms. . .and realized once again how helpless I am in the face of human suffering.  José is one of the most unresponsive children I’ve ever held.  Usually, when I look into the eyes of a malnourished child, I feel as if they are pleading for help.  As I look into the vacant eyes of José, I fear I’m looking at a child who has given up. . .who has lost hope of receiving human contact or understanding or love.

José’s mother and grandmother are estranged, and he has been living with his grandmother.  For years she has refuse to admit him into any malnutrition program.  She would say that it was because she would miss him too much, but as I watched her with him, in the two plus hours it took Dick and John to fit his chair, I never once saw her talk to him or caress him.  He lay in her lap staring off in one direction as she stared off in another.  While I don’t pretend to understand her life, the mother in me believes José needs more than Grandma is able or perhaps willing go give.

A year ago, a family from Omaha agreed to sponsor this little one and we have been providing food assistance to the family on a monthly basis.  Flori, the social worker from this area who has been taking the food to them, had concerns that José might not be receiving the food, since he was still not gaining weight. We began sending only formula.  Still he was not improving.  Yet grandma refused to bring him into Hermano Pedro for an exam, saying at for years missionaries have told her he would die, and here he is, still alive.

When I faced José at the distribution, I did something I have never done before. . .I told grandma that if she would not allow José to be examined at Hermano Pedro we would stop sending help.  I detest when North Americans think they know better than families how to care for their children, but, after talking extensively with Dick and Flori, I couldn’t help but feel that we were contributing to the neglect of this young boy if we did not set some limits.  I explained to Grandma that I was not saying that José needed to stay at Hermano Pedro, but that I needed to make sure there was not a medical reason (other than his severe Cerebral Palsy) why he was not gaining weight. 

Grandma reluctantly agreed, but Flori told us that she had talked with Hermano Pedro about José and they had said that in this instance his mother would have to be the one to admit him.  It was hard not to feel like we were fighting a losing battle here.  Grandma said she did not know how to reach her daughter.

Enter Vitalina, the amazing office manager for the mayor’s office.  She knew the mother.  She told us Mom lived on the same piece of land on which Grandma lived.  She told us she would handle this.  And she did.  She talked to mom, and explained that Dick and I would drive her to Antigua with José if she could come the next day.  She could not, since she needed someone to care for her younger child. . .and evidently Grandma would not do so. 

Mom did agree to come in the following day with a group that Flori was bringing to Hermano Pedro from their area. Vitalina found space for her in the van, and they did come in.  Without hesitation, Mom agreed to admit him to Hermano Pedro when we agreed to assume the financial responsibility for any lab tests he might need. 

So, our little José is in the malnutrition ward.  I wish I could say that he is thriving, but that is far from the truth.  Dick has been told that it is almost impossible to get him to eat, but they are trying before they use a feeding tube.  I can’t help but feel that he’s just given up.  Still, when he’s held, he does not make eye contact.  He does not cuddle in the way many children, even those with CP, do when they are held.  And my heart breaks anew. . .

Did we do the right thing?  Was it too little too late?  Did we just make a bad situation worse?

Those are hard questions to contemplate, and they are impossible to answer. 

I trust, though, that Vitalina and Flori knew the situation better than we do, and used us as the “clout” to get the family to do what was needed for this child. 

I trust, too, the expertise of the staff at Hermano Pedro to provide the best possible care for this child.  Their track record speaks for itself.  (Click here to read about other children they’ve cared for.) 

Most of all,  I trust that God will honor what we did our best to discern what he wanted us to do for José. 

Please pray for this little one, and the dozens of other like him around this country. 



I often want to ask God how he can allow these children to suffer and often die from lack of proper nutrition.  But I don’t dare, because I know the answer.  He has provided enough for all his children.  It is we who need to see that they receive what they need.  I can’t end the menace of malnutrition, but, I can respond to each child God puts in my path.  I pray I will be faithful.

In February of 2009, as I was considering my move to Guatemala, I met my first child with malnutrition.  Her name was Lisvi, a six year old who was starving, and she changed my life forever.  Reflecting on our meeting I wrote:

As I prayed on the plane coming home yesterday, God showed me that Lisvi did not need to meet me. I needed to meet Lisvi. I needed to willingly let my heart be touched, and wounded, and trust that He will give me everything I need to heal. I needed to learn again to risk letting my heart be touched, knowing it might be broken, but trusting it will heal.

Five years later (is it really that long?) I still struggle when faced with malnutrition.  I fall back into feeling,  “Lord, I want to serve you but it hurts too much.”  And I still hear Him saying, “It’s not about you.”

I wish I could tell you that my first encounter with malnutrition, up close and personal, had a wonderful outcome.  But it didn’t.  Lisvi died about six weeks after I met her.  (Click here to read more of her story.)  And I’ve spend many hours contemplating the “why?” of our meeting. 

Through Lisvi I began to learn that our ministry cannot be judged based on results.  We must measure our effectiveness by obedience to what God calls us to do; by serving the one He places in front of us at each moment; by faithfulness in the face of what looks like defeat; by our willingness to be broken by a broken world.

My recent experience with José has led me to spend time recalling the children with malnutrition who have touched me so deeply.  Thinking about how God has let us be part of what He is doing in these families.   Realizing how God has used them to grow me into who I am becoming.

Some of these children have recovered and gone home to not just survive but thrive.

Jessica waiting to see the doctor before she was admitted to the malnutrition project at Hermano Pedro in September, 2012.

Dick met Jessica at a Hope Haven wheelchair distribution.  He called me to tell me he was on his way into Antigua with “Lisvi’s twin,” and could I meet them at Hermano Pedro.  My flesh cried out, “NO, not again.”  But I went in spite of my fear, and have been blessed beyond measure by this little one and her whole family.  She is back home and doing well.  It is a treat when we get to visit her, and she continues to grow, two years after her discharge from the malnutrition project.  Her family has become our family, and I am honored to be called her adopted “abuela” (grandmother).

This is Jessica and her mom when we visited them last January.

Valentina shortly after she was admitted 
to the malnutrition project.

And little Valentina, who we just “happened” to meet when we were out visiting in Santa Rosa (the same area José comes from).  She came into the malnutrition project at a few weeks old, got “fattened up” and had surgery to correct her cleft lip.  She’s at home and continues to grow until she is old enough to receive her final surgery.  Valentina taught me that we must be willing to respond when the need presents itself. . .even if it’s inconvenient. . . even if we must change “our” plans to follow His plan.

Here she is, ready to go home. What a little chub!

These seem like successes. . . at least by my worldly standards.

Others are not so clear.  Little José Antonio (also from Santa Rosa—are you seeing how poor this area is?) was in and out of malnutrition over the years.  A few months ago, after living at home for more than a year, he died suddenly. It sounds like he had some complications from a kidney problem.  He brought much joy to all who knew him---though he was seven, he looked like he was only about a year and a half old. Oh how he knew to use his cuteness to get what he wanted.  José Antonio teaches me how great an impact even a small child can have on so many people. He is greatly missed. 

This is Leonel, shortly after I moved to Guatemala in 2010.

Then there is Leonel, who Dick brought into malnutrition before I even moved down here.  He grew stronger and healthier, and was moved down to the children’s unit at Hermano Pedro shortly after I moved here.  His parents just couldn’t care for him at home, though he was doing so well.  And now we watch him withering away once again.  This time not for lack of food, but we believe from loneliness.  Dick, especially, tries to see him whenever possible, but it’s just not the same as being with his family. 

A more recent picture of Dick holding Leonel. 

It is hard to watch him deteriorate.  And we wonder how much longer he will be with us.  And I wonder why, when he is receiving such good care, he’s not doing well.  This ISN’T how it’s SUPPOSED to be.  Leonel continues to teach me about surrender.  But it’s hard and it hurts. . .

Now there is José. . .I don’t know yet all that he will teach me.  He has already taught me, though, that sometimes I must be the voice for one who cannot speak for himself.  That I must, after much prayer, draw a line in the sand when I believe it’s His will.  And it’s scary.  We still don’t know what the outcome will be. 

Will his family blame us if he does not do well?  Will they be willing to take him home again if he does grow strong enough? Did we do the right thing?  Did we wait too long before we did something?

He is teaching me already to trust in doing our best to be obedient as we understand God’s direction—even when the consequences of our obedience are still unclear.  He is teaching me to love someone who doesn’t seem to care if I’m there or not.  To love without expecting anything in return.  To love at the same time I let go.  Hard lessons—all learned from one who cannot speak, but who has purpose. 

Pat

               Thanks Pat.

               Goodnight,
<><  Yours in Christ: Dick  ><>