A hunger crisis forces Guatemalans to choose: migration or death

Chiquimula, GuatemalaMarimba music from a radio did little to lighten the mood as Rosalía García splashed her daughter, Floria, with water from a plastic tub one morning this spring. Puddles formed on the dirt floor. Rosalía flicked her long black ponytail over her shoulder and handed the baby to her mother-in-law, Sebastiana Amador, who pulled socks onto her granddaughter’s feet. The baby’s tiny face reminded Sebastiana of her own daughter. She was eight and weighed 37 pounds when she died four years ago. 

Now it was time to seek help for Floria. Visitors to the family’s home had remarked on the girl’s stunted size. At nine months she looked half her age. They urged Rosalía to take her baby to a government recuperation center, two towns away, established to treat malnourished children. But no one had told Rosalía how to get there or offered to take her, and so this morning she was headed to the nurse in her own village. She stuffed soap, toothpaste, and a change of clothes into a striped tote bag slung over one shoulder and hugged Floria against the other.

“I don’t know when I’ll be back,” she told her mother-in-law, setting off on foot up a steep dirt path leading to the road. 

In Tisipe, a mountainside village in eastern Guatemala, and in many communities around it, hunger is a familiar feeling. Nearly half of Guatemalan children under the age of five are underweight, according to government data, giving the country the sixth-highest rate of malnutrition in the world. And this past year, a series of droughts, hurricanes, and the economic devastation that came with the COVID-19 pandemic has left this region—known as the dry corridor, or corredor seco—in shambles.

What was once seasonal hunger is becoming an almost permanent condition here. Those who can afford to are fleeing to the United States, where the number of migrants attempting to cross the southern border has reached a 20-year high in the first six months of 2021. The majority of migrants come from what’s known as the Northern Triangle: Honduras, El Salvador, and Guatemala. Those who don’t have the means to leave are struggling to keep their children alive.

To understand the slow-motion disaster that’s pushing Guatemalans out of their homes and on the long, dangerous journey north, Tisipe is a good place to start. At first glance, the dry corridor looks lush. Mountains are covered in banana trees and coffee plants, and vivid blue and yellow birds swoop through the dense foliage. But the ground is rocky and parched. It has offered little more than subsistence to generations of farmers who tend their ancestors’ land in a region called Chiquimula, long occupied by the Ch’orti’ Maya, one of Guatemala’s two dozen Indigenous groups.

A rainy season with no rain

Floria’s home was quiet early one morning in mid-May when her grandfather, Armando Interiano, rose before dawn to check on his fields. Rain had briefly pounded the corrugated metal roof of the family’s home the previous night. It was weeks into what is supposed to be the region’s rainy season, when daily thunderstorms normally pierce the afternoon heat.

Armando, like every farmer in the region, had been waiting to plant until the first big rain. This year—and for most of the six preceding it—those steady rains hadn’t come. After one shower in early May he took a gamble, dropping corn kernels into small holes dug into the one-acre field. Then the rain stopped—until that brief deluge. These dry spells, or canículas, once lasted 10 days. Now they can stretch beyond a month. Without rain, planted seeds can spoil within a week.

This past year delivered an especially frustrating sequence of extreme weather. Just five months earlier, shortly before Armando was to harvest his family’s food for the year, two consecutive hurricanes destroyed his entire crop of corn and beans. He had to take out a loan to buy this new batch of corn seeds. Now the plants were just a finger tall with two measly leaves. The rain had barely dampened the topsoil. Armando spent the day in the field shooing away black birds pecking at the paltry shoots.

Families like Armando’s had become accustomed to a lean season between planting and harvesting, when meals dwindle to just two small portions a day. But the hunger has become more pronounced in the past six years of poor rain. “It seems the Earth doesn’t want to give anymore,” says his wife, Sebastiana.

A battle for food—in the courts

The meager harvests have barely fed their children for many years. But a decade ago the couple was offered what seemed a rare opportunity to improve their lives: Lawyers from an Indigenous rights organization called Nuevo Día, who surveyed the region in 2010, asked the family to be part of a first-of-its-kind lawsuit against the government in a legal battle for food.

“We were being awoken,” recalls Sebastiana. “We started to learn that government should help us but wasn’t. I’d never thought about it before.”

Guatemala has one of the fastest growing economies in Latin America, and yet it also has a rising poverty rate. So Nuevo Día sought out hardworking families who couldn’t earn or grow enough to feed their children. Sebastiana and Armando had 13 children, including two severely underweight daughters, Mavélita, age two, and Dina, age four.

The girls and their siblings ate two tortillas and a watery herb broth twice a day without complaint. In 2011, their story became part of four separate lawsuits Nuevo Día filed against Guatemala’s federal government. Lawyers argued that the state has a responsibility to feed and house these children according to its own child protection law, national constitution, and international conventions to which it is a signatory nation.

The court agreed. In April 2013, Judge Elvin René Gutiérrez Romero ruled that the government had violated four families’ rights to food, health care, and decent living conditions, which were supposed to be guaranteed by law. He ordered a dozen government agencies—from the Ministry of Health to the Ministry of Agriculture—to give them parcels of farmable land and provide the families with monthly nutritional checkups. He also ordered the distribution of filters for potable water, as well as new stoves that didn’t emit unhealthy smoke.

Nutritionists and doctors who examined the couple’s daughters for the trial evidence had declared them to be acutely malnourished. Mavélita’s health continued to deteriorate. In July 2017, four years after the verdict, Sebastiana took eight-year-old Mavélita to the small health clinic in their village. She was feverish and vomiting. The nurse on duty called an ambulance.

For the next month and a half, Mavélita was shuttled between three different hospitals, where she underwent surgery for an intestinal block, developed septic shock, and had a seizure. Mavélita died late at night on August 14, 2017, in a hospital bed in the capital of Guatemala City. Her cause of death was listed as bilateral pneumonia. Doctors also said her intestines were riddled with holes from parasitic worms, often caused by malnutrition and contaminated water.

Now, four years later, Sebastiana fears her fragile granddaughter, Floria, will suffer the same fate.

“If she doesn’t go to the hospital, she could die,” Sebastiana says.

Solving a problem like hunger

Across Guatemala, organizations like Save the Children, UNICEF, and Catholic Relief Services deliver cash wire transfers to desperate families, send brigades of volunteers house to house looking for malnourished children, and study whether one egg a day can keep a kid healthy. But these groups know that fixing a problem at the scale of malnutrition can’t be done without also providing at least a dozen other services—from clean drinking water to quality education.

Embedding long-term in small communities, a group called the Maya Health Alliance has calculated that it takes two to three years of holistic programming to reduce malnutrition by 20 to 40 percent. Without the whole package, charity offerings are only a temporary fix.

This is incredibly frustrating for advocates such as Sofia Letona, who has been organizing monthly food distributions in two dry corridor communities since 2019 with Antigua al Rescate. The volunteer corps, originally formed to respond to a volcanic eruption that killed nearly 200 people in central Guatemala, now focuses on hunger.

Last year, 75 Guatemalan children under five officially died of malnutrition, according to the government. But the true number is almost certainly much higher. Letona says most children don’t technically starve to death. Rather, hunger weakens their ability to fight other illness. “I retrieved the bodies of dead people buried under the volcano, but for me this is even worse,” she says. “These kids are walking around as if dead, but they’re alive.”

For the most part, the Guatemalan government relies on aid organizations to develop and fund programs addressing malnutrition. The government-led program that experts say has been most effective stems from a law passed in 2017 that requires schools to feed students.

The congressional Food and Nutritional Security Commission has existed for 15 years. But hunger rates haven’t changed, in part, says its president Juan Francisco Mérida, because there’s never institutional follow-through. A new commission president is appointed every year, and presidential elections are held every four years, ushering in a new administration.

Each incoming president arrives with a new plan, and for the current president, Alejandro Giammattei, it’s called the Grand National Crusade for Nutrition. Under it, the Ministry of Health started stocking a free protein supplement in health outposts earlier this year. By October, the Ministry of Education is expected to launch nutritional training programs called Centros Nutreme at facilities across the country.

The only way to fix the hunger crisis, Mérida says, is to solicit more commitments from aid organizations. “It’s the government’s requisite to be able to give people access to life, health, and education,” he says. “But because of how the situation of malnutrition is, it has gone over what the government can do.”

If malnutrition continues at its current rate, he warns, Guatemala will face “total collapse.”

Signs of migration

The road up to the tiny village of Cimarrón, where Dany Gáldamez headed on a sticky spring day, looks over dry riverbeds and grazing horses. It’s so steep and rocky that even his four-by-four seemed to defy gravity.

For years, Gáldamez, an agricultural engineer, has been helping farmers coax the most food they can from this land. He’d hoped it was enough to keep hunger from driving them across the border and onto the path north. Now, as he drove through a rural municipality called San Jorge, Gáldamez took stock of the freshly painted homes.

Elsewhere in the country, generations of Guatemalans have gone to the United States, but until a few years ago, migration was rarer here in the dry corridor. Now, wages sent from recent migrants to the U.S. are producing a bloom of brightly painted cinderblock homes throughout the countryside. Remittances now make up 14 percent of Guatemala’s GDP.

“Migration,” Gáldamez reflected, “is all about seeking resources to feed yourself.”

For six months, he had been surveying dry corridor communities for a new World Food Programme (WFP) project that aims to make this part of the country more livable in the face of increasingly hostile weather. According to a WFP report last year, only seven other countries in the world are more at risk for natural crises than Guatemala—particularly when it comes to water access.

The conditions were worse than Gáldamez expected when he began his survey: Parents had pulled children out of school to work; families ate fewer meals per day; farmers sold off livestock to purchase food. An estimated 3.5 million Guatemalans—more than a fifth of the country—are currently going hungry, according to WFP, a United Nations agency that addresses global hunger.

At the entrance to Cimarrón, residents gathered to take Gáldamez on a tour. None of the town’s 75 families had migrated yet. But life had become untenable. One farmer told Gáldamez that he was harvesting 70 pounds of corn each year from land that used to give him 800. On a whiteboard in the two-room schoolhouse, Gáldamez outlined a plan that the WFP was going to consider for the village: new trees to plant, stone terracing on the mountainside to conserve water, vaccines for the poultry.

“Before this dry period people here always had reserves to live on,” he said. “But climate change came and they started seeking other options.” Gáldamez understood their desire to flee: His own daughter paid a coyote—human smuggler— to sneak her into the U.S. six months earlier. Now working as a server in a restaurant in California, she’s making five times more than her salary as an agronomist in Guatemala.

In June, Kamala Harris visited Guatemala to identify the root causes of this migration in her first foreign trip as vice president of the United States. “Most people do not want to leave the place where they grew up,” she said during a press conference. They leave, she said, because “they cannot simply satisfy the needs that they have to raise their children by staying at home.”

In an attempt to mitigate that, the Biden administration unveiled a $48-million investment in the country. In the past three months, the U.S. government has begun sending emergency cash transfers to thousands of poor Guatemalan families to replace the corn and bean harvest lost in last year’s storms. But the struggle is far from over.

No escape for some

From his home in Tisipe, Armando can see men hammering away at a half-built house on the facing mountainside. His neighbor left for the United States last year and has already sent enough money to build a new home.

“I see something like that and I wish I could have it,” Armando says. “But how?”

The price for a trip across the U.S.-Mexico border costs as much as $12,000, often paid in loans or by borrowing cash from relatives abroad. When Armando’s 10-year-old son begs to go to the U.S., Armando asks how he’ll pay for it. Both he and his elder son, Wilmer, baby Floria’s father, travel annually to Honduras to work in the coffee plantations for $5 to $7 a day.

Wilmer is there now, away from his daughter and Rosalía, his spouse.

Rosalía’s parents didn’t support their relationship. “He comes from a poor family who doesn’t have enough to eat,” her father said of Wilmer. But three years ago, at age 15, Rosalía left her home to move in with her new family. What her father said is true: sometimes they eat only two meals a day.

Now Rosalía’s baby needs medical care. The government-run nutritional recuperation center, two towns over, is set up for cases like this, but Rosalía hasn’t yet received a referral from the village nurse. The nurse has already said in previous visits that Floria is malnourished and instructed her mother to bring her back for more checkups.

On this visit to the two-room health outpost, the nurse plopped Floria on a scale and stretched her along a wooden measuring board: 11 pounds and 27 inches. She plotted the measurements on a growth chart, making a dot at the bottom of swooping lines showing the averages for her age. She had gained only one ounce since her last visit two weeks ago and is more than four pounds under her ideal weight. Floria has had continuous diarrhea, which may be one reason why.

The nurse handed Rosalía a referral, not to the nutritional recuperation center, but to a closer hospital. Yes, she’s malnourished, she said again, but first her diarrhea must be treated. If she needs to go to the nutritional recuperation center, known by its Spanish acronym CRN, she will be sent by the doctors there.

Rosalía walked out of the outpost and onto the road that winds down from the mountain into town. If she had been referred to the CRN, the cost of her transport and stay would be covered. But now she doesn’t have the 10 quetzals—$1.50—to pay for a ride to the hospital. The roundtrip cost would be more than a half-day’s work for Wilmer.

So, visiting journalists drove her the 20 minutes to a town called Camotán, where a doctor in blue scrubs looked at the referral and gave Floria a checkup. If it were up to him, he said, he would send her directly to the CRN, one town over. But he pointed to where it says she’s being referred for diarrhea, not malnutrition.

“It’s not that I don’t want to send her,” he said, looking at the child. “It’s that I can’t jump steps in the process.”

Empty beds

That same week, at the clean white hospital complex in the neighboring town of Jocotán, the CRN was nearly empty. If he surveyed the whole region, the nurse on duty said, he’d want one in every five children admitted. Instead, he was treating just two mothers and their nine-month-old sons—the same age as Floria, but both weighing more than her.

One reason for the empty beds, points out Omar Jeronimo, one of the founders of Nuevo Día, is that three years ago, the Ministry of Health eliminated the “at risk” category on the scale of malnutrition that would trigger an intervention by nurses at health outposts. “What is an emergency?” Jeronimo asks when he’s told about Floria’s condition. “An emergency is when you’re about to die. And possibly Floria is very ill but isn’t dying.”

At a small pharmacy window at the hospital in Camotán, Rosalía was able to fill a prescription for an antibiotic to treat her baby’s diarrhea. She hoisted Floria onto one shoulder and her unused overnight bag onto the other. On the way out of Camotán, words stretching across a large white archway wished her a happy journey.

Then the road forked: A few miles to the right was the CRN, where 14 beds sat unused. To the left lay a rocky incline up the mountain. There, Floria’s grandmother waited for the baby to return to the home with a dirt floor.