WFP's Latin America spokesman Jordan Dey recently returned from eastern Guatemala where some 60,000 children are suffering acute malnutrition.

In this eyewitness report, he describes a visit to the San Ixtan therapeutic feeding centre in Jalpatagua, one of 41 receiving WFP food aid.

Jalpatagua, April 16 - Rosita captured my eyes first. She was waddling along a blisteringly hot sidewalk, her two legs frozen in an inverted V, incapable of bending.

As a volunteer held her , the six-year old struggled to simulate the motion of walking. Her eyes were staring blankly ahead into the 90 degree heat, and her head was swaying listlessly from side to side.

"We've always dealt with chronic hunger. But since Hurricane Mitch, everything has gotten worse."
Doctor Aura Reyes, director of the San Ixtan therapeutic feeding centre

Unable to walk or talk, Rosita can hardly feed herself. When she sat down to eat, her emaciated arms had to fight to lift the spoon to her mouth.

Rosita is just one of 24 children currently staying at Jalpatagua's San Ixtan therapeutic feeding centre.

With toys and small chairs littered across the floor, the spotless clinic looks like a schoolroom. Instead its mission is to provide treatment for severely malnourished children.

DRY AND DESOLATE

Jalpatagua lies in a dry and desolate town in eastern Guatemala, along the El Salvador border, where a lethal combination of Hurricane Mitch and two years of drought have conspired to wipe out harvests for some of the country's poorest farmers.

Families once reliant on daily work in local coffee plantations to pay for their families' food have watched helplessly as the plummeting price of world coffee has undercut the job market.

In total, some half-a-million people have been laid off leaving families too poor to buy food - and, after years of natural disaster, nothing to fall back on.

The result is that nearly 60,000 children are suffering from acute malnutrition, with 6,000 close to death.

"We've always dealt with chronic hunger," said Doctor Aura Reyes, who oversees the San Ixtan feeding center. "But since Hurricane Mitch, everything has gotten worse."

Acute malnutrition in Guatemala has shot up from two percent three years ago to nearly 16 percent this year.

While Rosita tried to rehabilitate her legs, the newest patient in Jalpatagua clinic was a 13-month old girl, whose arms were finger-width and her belly distended.

She could not laugh, frown, or even cry. She laid motionless in the bed, with only her eyes occasionally moving.

PARENTAL FEARS

Dr. Reyes explained that many families are unwilling to bring their children to the nutritional feeding center, because they do not want to lose their child for the three months it takes to nurse them back to health.

Other families fear the children will be "kidnapped" and sold to illicit adoption agencies, while many others are simply incapable of recognising the tell-tale signs of malnutrition - until it is too late.

Dr. Reyes must send out her team to meet and talk with local residents and determine whether there are any malnourished children in the family.

If they find such a child, a difficult negotiation ensues to make sure he/she gets the necessary emergency treatment at Jalpatagua's feeding centre.

"If the children are not admitted to the centre, they run the risk of dying," says Dr. Reyes.

WFP EMERGENCY OPERATION

While long-term social investment is necessary in this isolated part of Guatemala, especially in health care facilities, education and agricultural infrastructure, WFP has begun an emergency operation to deal with the immediate danger to the lives of 60,000 acutely malnourished children.

In total, the Agency is working with 41 therapeutic feeding centres to provide the food for the special diet needed for rehabilitation (see box).

The Guatemalan Ministry of Health has established 29 centres while non-government organisations manage another 12.

WFP will also provide take-home food rations for the mothers and families.

• Families with severely malnourished children will receive supplementary food rations at home for four family members.
  
  
• Families with moderate and mildly malnourished children will receive food rations to supplement the family diet.
  

"The current situation in Guatemala is the result of many factors that have worsened the precarious nutritional status of this population," said Francisco Roque Castro, WFP's regional director for Latin America and the Caribbean, recently.

Regrettably, it is the children who are suffering the most.