In a sunny hospital room with Disney characters painted on the walls, an emaciated baby can barely muster the strength to cry. Her tiny frame is cloaked in ill-fitting, wrinkly skin. Around her, cribs are filled with children with swollen bellies and limbs. Both extremes indicate the most severe stages of acute malnutrition.
This is not Africa or Afghanistan, though, where the need for food aid has been widely reported. It is Jutiapa, in eastern Guatemala, one of the focal points of a growing Central American nutritional crisis that has international aid organizations scrambling for funding from a world whose eyes are set on other hunger-stricken regions.
"One of the problems we have in Latin America is that there is a perception among media, among donors, and among the general public that hunger is not as bad in Latin America as it is in Asia or Africa, when in fact in some parts it is," says Jordan Dey, Latin America spokesman for the World Food Program (WFP).
This is what officials will try to impress upon the international donor community Wednesday when the WFP announces a drive to raise $66 million for a three-year relief effort targeting 690,000 hungry people in Guatemala, Honduras, El Salvador, and Nicaragua. The crisis is in its second year.
Last year, the WFP was forced to launch a six-month emergency operation in Guatemala aimed at helping 6,000 children in danger of dying from malnutrition-related illness. Guatemala's situation is the most critical in the region, and it was the first country in Latin America where the WFP has had to implement this kind of operation. But it was not the last.
The WFP extended the emergency operation in Guatemala for six additional months in September, and a similar program was launched in Honduras earlier this month. Officials are gearing up to implement one in El Salvador as well.
For two years running, drought has affected a corridor of land that is home to 8.6 million people in four Central American countries.
Exacerbating the problem is the worldwide record low in coffee prices. Many of those suffering work as seasonal laborers on coffee farms to supplement their subsistence agriculture. The three-year coffee crisis has resulted in the loss of some 600,000 jobs, according to the World Bank.
Lack of access to clean drinking water and health services have also contributed to the problem.
But according to the Nutritional Institute of Central America and Panama (INCAP), the single biggest factor contributing to a child's potential for acute malnutrition is the education level of the child's mother. Central America's literacy rate for adult women is lower than the rest of Latin America, and Guatemala's is lowest in the region.
"The issue of food security is a short- and medium-term one," says Juan Alberto Fuentes of the Guatemala office of the United Nations Development Program. "What we also need is long-term and sustainable responses to the problem of poverty."
One of these responses has been an increased effort here and around the world to direct food aid to the classroom. Some of US government's donations to the WFP are earmarked for school lunches and rations students can take home. This way, the program not only addresses the short-term issue of hunger, but is persuading parents not to pull kids out of school, even in the toughest economic times.
According to statistics from INCAP, over the past two decades, the rates of chronic malnutrition among all Latin American children have plummeted by nearly half. But statistics from the Central America subgroup have not budged significantly. Just under half of Guatemala's children suffer from chronic malnutrition, the highest rate in the region.
"We are talking about people who have lived at a subsistence level, just surviving for a long time," says Patricia Palma, director of public policy for INCAP. "The issue is the vulnerability of these people.... You don't need a coffee crisis or a drought to have what we see now. These people are so vulnerable you just need a little wind or rain to push them over the edge."