Farming isn’t an easy way to make a living, regardless of location, but growing coffee has been particularly frustrating for the past two years in the Sierra Madre mountains of rural Chiapas, Mexico. A fungus known in Spanish as la roya has spread rapidly among coffee plants throughout Central America and significantly hampered their productivity. Families typically gather 30 bushels of coffee beans during the two-month harvest; now they’re pulling in less than five.
Whatever profit families make depends on fickle global coffee prices. Lately, that annual lump sum just hasn’t been enough.
“They have to live the entire year on the money they used to earn in one or two months,” says Dr. Héctor Carrasco, community programs coordinator for Compaňeros En Salud (CES), Partners In Health’s sister organization in Mexico. “It’s really diminishing their capacity to live and buy food.”
Protein-rich and fatty foods such as meat and dairy products are hard to come by and expensive in rural Chiapas, partly because refrigeration is scarce to non-existent. Small neighborhood shops are more prone to stock items with long shelf lives, such as prepackaged cookies and soda, than fruits and vegetables. And Coca-Cola is cheaper than bottled water in most communities.
In an average year, rural Chiapanecan families grow a good portion of what they eat. Corn for tortillas and beans are staple crops and, when prepared in combination, provide a good source of protein. But there’s little variety beyond that. What families don’t grow, they buy with profits from the coffee harvest.
“This year was a one-two punch because bad weather decreased food crop harvests and the roya decreased coffee income,” says PIH Mexico Program Officer Lindsay Palazuelos. “When people have less food and less income, they buy the food that is cheapest per calorie, such as pasta or cornmeal mix for tortillas.”
Cultural practices do not always align with good nutrition either. When children are weaned, they are often given caldo de frijol, or bean broth, which has the flavor of beans, but none of their nutritional benefits.
Children’s health reflects this nutritional deficit in rural Chiapas, where CES operates in 10 communities. Mexico’s 2012 National Health Survey found that 44 percent of children in the region suffer from chronic malnutrition—six times the national average. It’s a grave concern for CES doctors, nurses, and community health workers. They know, and see firsthand, that chronically malnourished children are at an immediate disadvantage. Not only is their growth stunted, but their brains fail to develop at a proper pace, making it more difficult for them to learn and concentrate. They’re also more likely to get sick than well-nourished children.
Health equity through nutrition
Dr. Héctor Carrasco (right), CES community programs coordinator, says children in rural Chiapas are six times more likely to be chronically malnourished than those living in the rest of Mexico.
When he began working in Chiapas three and a half years ago, Carrasco wasn’t fully aware of the difficulties his patients faced growing and purchasing nutritious food. He thought families merely lacked proper nutrition information, so he launched educational workshops and sat down with families to discuss how they could change their diets. But the workshops failed to spark change at home, and doctors continued to see stunted children in their clinics. It was only after he’d spent more time in the communities that he figured out the importance of having reliable, high-quality sources of food.
That’s when Carrasco looked for outside help and found Heifer International, an Arkansas-based nonprofit focused on ending hunger and poverty through sustainable agriculture and commerce. He, CES volunteer and Argentine dietician Clara Perdomo, and César Durantes, Heifer’s program coordinator in Mexico, started talking in 2013 about a two-year pilot program that could improve Chiapanecan families’ access to nutritious food, reverse childhood malnutrition, and spark the local economy. Their plan? Provide 14 hens and one rooster to each family with a chronically malnourished child under 5.
Over the short term, they thought, the Heifer chickens would provide families with a daily source of protein through the eggs they produced and, on special occasions, a meat dinner. Whatever the families didn’t eat, they could sell for extra income. The long-term goal was to improve local diets and the economy by “Passing on the Gift” originally given by Heifer, Durantes says. Should all go well, the families’ chickens would reproduce to the point of doubling their flocks. Those extra chickens would then be passed along to family, friends, or neighbors in surrounding CES communities who could use the extra source of food or income.
“All this goes hand-in-hand with equity,” Carrasco says. “We can’t talk about health equity when half of our children are malnourished.”
A pilot packs on pounds
Their plan swung into action last August. Carrasco and his colleagues identified 68 children in two CES communities, Soledad and Matasano, who would be their first participants. While raising chickens is common locally, not all Chiapanecan families have the resources to have tried it in the past. So Durantes and his staff invited the family of each child to attend small-group trainings that covered a variety of topics, from the chickens’ proper shelter and nutrition to vaccinations and locally sourced cures for common avian ailments. Once Heifer staff deemed families ready to receive their chickens, they were invited to the clinic to pick up their “package” of 15 birds.
The past year was one of constant collaboration. Durantes and his crew made monthly home visits to follow up on the families’ progress and troubleshoot. And families occasionally reached out to Heifer so staff could admire their latest hatchlings or assess why their chickens lowered their heads to their chest and “were sad.” (Turns out, the chickens were sick.) Meanwhile, CES nutrition community health workers visited the families once or twice a week to talk about diet, hygiene, disease prevention, and how to know when a doctor’s visit was necessary.
The ultimate test, though, came each month during check-ups with the children. CES doctors and nurses measured and weighed them, carefully charting whether a change in diet was having a positive effect.
Halfway into the pilot, Carrasco is proud of the results. At least 14 of the 68 children have grown enough to rise out of chronic malnourishment. There’s been a 15 percent reduction in the number of families who experience moderate-to-severe food shortages. And during especially lean months of the year, families at least have eggs to eat for protein, and they can sell a chicken or eggs to buy other essential goods. These are small victories, but they may be what’s needed to prove the pilot’s worth and garner additional funding. He would like to extend the program to all 10 CES communities, where he could reach as many as 600 children over a three-year period.
Selena Herrera has firsthand knowledge of the pilot’s success. Her family was among those to receive a package of chickens from Heifer last summer after a CES doctor diagnosed her children with chronic malnutrition. She prepares eggs every day now. Whatever her family doesn’t eat, she sells for extra cash to buy milk and other items formerly considered a luxury.
“This one,” Herrera says, pointing to her daughter standing nearby, “has already gained weight.”