BOLIVIA'S TITLE II ASSISTANCE HELPS SLASH

UNCLAS LA PAZ 003071

SIPDIS

SIPDIS

STATE FOR WHA/AND LPETRONI
USAID/LAC/AA FOR AFRANCO AND MSILVERMAN
USAID/LAC/SA FOR JBAKKEN
USAID/DCHA/FFP FOR WHAMMINK AND JDWORKEN
USAID/DCHA/FFP/DP FOR JMAJERNIK, MNIMS, AND BBURNETT
COMMERCE FOR JANGLIN
TREASURY FOR SGOOCH

E.O. 12958: N/A
TAGS: EAID EAGR ECON PREL PGOV BL
SUBJECT: BOLIVIA'S TITLE II ASSISTANCE HELPS SLASH
CHILDHOOD MALNUTRITION


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SUMMARY
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1. (U) Tens of thousands of Bolivian children, many in
isolated rural areas, suffer from chronic malnutrition. Many
simply lack appropriate food, while others suffer from
parasites and infectious diseases that hamper the body's
ability to retain nutrients. With PL 480 Title II support,
administered through USAID, four non-governmental
organizations are fighting the problem - with remarkable
results. In the next few months, we will work to overcome a
frustrating lack of media attention and increase our efforts
to publicize the positive impact of Title II assistance.

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BACKGROUND
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2. (U) A recent World Food Program/GOB survey of 166
municipalities in Bolivia's nine departments indicated that
40 percent of children under five suffer from chronic
malnutrition. Many simply lack appropriate food, often
consuming too many carbohydrates and too few vitamins and
minerals, while others suffer from parasites and infectious
diseases that hamper the body's ability to retain nutrients.
Of the more than 4,500 households surveyed, 63 percent fell
short of recommended daily calorie intakes. The consequences
of chronic malnutrition, according to child health
specialists, include slowed growth, diminished learning
capacity, and low future labor productivity. All of this has
negative implications for children's potential to become
healthy, productive adults.


3. (U) With support from the PL 480 Title II Food for Peace
program, administered through USAID, four non-governmental
organizations are fighting the problem. The organizations'
food security programs share an emphasis not just on health
and nutrition, but also on income generation and natural
resource management; each is marked by variations according
to the organization's unique approach to aid.


4. (U) All four organizations use food aid to improve food
access and utilization in Bolivia's most food insecure areas,
directly supplementing the diets of young children and
pregnant women and operating food for work programs, which
provide food to vulnerable families in exchange for
participation in local infrastructure projects. The four
organizations also monetize donated commodities, using the
proceeds to support basic health services, nutrition
education, and agricultural extension, training, and capacity
building programs. Together, the four have achieved
remarkable results, assisting tens of thousands of families
in hundreds of communities across Bolivia and significantly
reducing childhood malnutrition.

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PROGRAMS AND RESULTS
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5. (U) Active in Bolivia since the mid-1980s, Save the
Children today works in seven municipalities in the
department of La Paz, focusing its food security strategy on
196 critical risk communities. Food Security Advisor
Margarita Clark noted October 26 that an estimated 50,000
people have benefited from the organization's health and
nutrition, income generation, and natural resource management
programs, with 3,500 children under three participating in
the organization's growth monitoring and promotion programs.
The latter encourage mothers to weigh children monthly and
help parents take corrective action if children fail to meet

minimum adequate weight gain standards; the programs employ
volunteer monitors, nutritionists, and health promoters to
educate and advise parents on improved hygienic practices,
proper nutrition, and effective disease prevention. By June
2006, five years after program initiation, Save the Children
had reduced chronic malnutrition among children under five
from 38.3 to 32.7 percent.


6. (U) CARE Bolivia has had similar results in its two and a
half years of work, cutting chronic malnutrition among
children under three from 43.3 to 33.6 percent and lowering
chronic malnutrition among children ages three to five from
51 to 41.4 percent. The organization works in 217 high-risk
communities in several municipalities in the departments of
Potosi, Tarija, and Chuquisaca, emulating Save the Children's
growth monitoring and promotion programs and simultaneously
working to improve access to potable water and sanitation;
like Save the Children, CARE Bolivia has constructed water
collection and distribution systems and built latrines and
showers in several communities, thereby helping to reduce the
spread of water-borne illnesses and significantly improving
community health. Also like Save the Children, the
organization often supports construction through Title II
food for work programs, an important means of completing
large-scale infrastructure projects.


7. (U) Another organization, the Adventist Development and
Relief Agency (ADRA),is active in four critical risk
municipalities in the department of Chuquisaca, distributing
food aid (including flour, corn-soy blend, vegetable oil,
lentils, and other products) to approximately 3,000 families
per month; mothers use the provisions to ensure children
achieve minimum adequate weight gains every month, as in
counterparts' growth promotion programs. According to ADRA
Acting Country Director Guillermo Lizarraga, this is only one
component of the organization's three-pronged food security
strategy, which includes income generation and natural
resource management programs to ensure communities have a
sustainable means of raising living standards. Thanks in
part to ADRA technical assistance, an estimated 2,200 farmers
in 78 communities today export sweet onions, beans, and other
non-traditional crops to Europe and Japan, frequently
altering the mix of goods to respond to consumers' changing
preferences. Farmers have adopted new agricultural and
irrigation practices, and entire communities have benefited
from resource management and land use plans designed to
improve soil fertility, prevent erosion, and conserve water
resources.


8. (U) Food for the Hungry International (FHI) has introduced
similar practices in four high-risk municipalities in the
departments of Cochabamba and Potosi, in many cases providing
new seeds and technologies, expanding and improving
irrigation systems, and assisting communities with
environmental management plans. Efforts to enhance crop
production, improve roads, and expand access to potable water
and sanitation systems have complemented the organization's
health and nutrition programs, which, like those of its
counterparts, focus on reducing childhood malnutrition
through growth promotion programs. In the last five years,
FHI has slashed chronic malnutrition among children under
five from 59 to 38 percent, assisting an estimated 3,400
children and encouraging long-term participation in community
health programs.

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COMMENT
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9. (U) The Title II program aspires to be a comprehensive
development program, with food and local resources supporting

municipal, community, and individual efforts to enhance
household food security, overcome development constraints,
and achieve sustainable improvements in real income.
Although food rations are distributed to vulnerable
households through maternal and child health and nutrition
programs, food resources are used primarily in conjunction
with training and technical assistance activities that help
build a foundation for sustainable development.


10. (U) Title II assistance has had a remarkable impact on
the lives of hundreds of thousands of Bolivians, not only
through health and nutrition programs, but also through
income generation and natural resource management programs;
today, children and their families are better nourished,
former subsistence farmers are players in international
markets, and communities are increasingly capable of raising
their standards of living. The organizations' work has
generated tangible, real results, and many have benefited.


11. (U) Despite its incredible success, the Title II program
has received frustratingly little media attention. Maternal
and child health and nutrition programs, along with efforts
to boost rural incomes and improve access to water and
sanitation, represent a key means of demonstrating USG
interest in the health and well being of Bolivia's people; in
the next few months, we will increase our efforts to
publicize the positive impact of this assistance.
GOLDBERG