Focus Question: How are malnutrition affecting children from indigenous groups in Latin America?
Baker PT, Little MA. Man in the Andes: A Multidisciplinary Study of High-Altitude Quechua. Stroudsburg, PA: The Institute of Ecology; 1976.
This focuses on the indigenous group known as the Quechua, specifically those who have migrated and situated themselves on high-altitude areas in the Andes Mountain. This source investigates what measures of adaptations the Quechua had to achieve in order to survive in this environment. The authors explored different environmental factors (atmospheric pollution, modified nutrition, and changed housing) that affected their standard of living. They explore theories by other scholars in the literature about possible adaptations that the Quechua may demonstrate in their new environment, including assumptions of native hypoxic adaptation due to acclimatization to low oxygen pressure and cold adaptation due to the high-altitude. Those residing in the Peruvian Andes lived with good weather conditions that allowed agriculture and domestication of animals. This source targets a specific group of indigenous group and provides a thorough investigation of their way of living. However, I believe that this source needs to be updated and compared to present day Quechuas. This would better describe the changes that the Quechua have experienced since this book’s first publication. We can then see the bigger picture of how civilization has impacted this indigenous group and give us a scale of how much they have adapted or benefited from the changes they observed from our society. Has the Quechua adapted to the growing modernization around them while keeping their traditions intact? Furthermore, how are the rates of anemia back then versus present day?
Bartell EJ, O’Donnell A. The Child In Latin America. Notre Dame, IN. University of Notre Dame Press; 2001.
This source provided sufficient information on biological, social, cultural and economic influences on children of Latin America. It investigated their nutritional status, the cause and effects of undernutrition, and complications due to micronutrient malnutrition. Before reading this, I was already aware of the detrimental effects of chronic malnutrition and how this goes on to “stunting” growth, which is low height for their age. This is highly prevalent in Latin America, more so in rural areas than urban areas. This source provides me a more in-depth look at potential causes to stunting or growth retardation such as poor nutritional, health and environmental conditions. Certain degrees of malnutrition in those areas can then produce an increased risk of mortality of infants and children. Micronutrient deficiency is a common cause and effect of malnutrition, most often observed with the low dietary intake of iron. This results in iron deficiency anemia that has, in fact, very disastrous complications as it effectively reduces the child’s capacity for daily, spontaneous activities. This finding led me to a study done by Khambalia indigenous children suffering directly from anemia. Furthermore, women in Latin America were affected by gender discrimination, which leads to income poverty and poor decision-making on the child’s welfare. In 2001, a big concern for women is their lack of education and involvement in the work force are contributing factors to children malnutrition. Gender equality is no longer as big of an issue as it did back in 2001 when this book was published; however, this was a viable concern because women are central to providing and ensuring the health and development of the child. Overall, this source was very helpful in providing me with the background knowledge I need to start my research. Its emphasis on child malnutrition in Latin America helped me form a general idea of what indicators or factors I would like to explore further. Certain limitations I need to address is finding current data on the status of women and whether there has been any significant changes in the nutritional status of children.
Eversole R, McNeish JA, Cimadamore AD. Indigenous People and Poverty. New York, NY: Zed Books Ltd; 2005.
This source is another international perspective of nutritional vulnerability specifically found in indigenous children of Latin America. Indigenous peoples are vulnerable to poverty and health issues as a result of limited access to basic necessities, formal education, equal opportunities and political influence. Basis of interests are infant mortality rate and stunting in children. Land is their source of income, food, livelihood and economical survival. Therefore, land is essential for the continuing survival of indigenous groups. Indigenous people are vulnerable to various diseases and chronic conditions due to nutritional deficiencies, which leads to stunting. There are also high levels of stunting found in indigenous groups residing in the Andean region and in Mesoamerica as a reflection of limited resources and poverty. Children are at risk of being undernourished and the potential of developing obesity when they get older. They suffer from a ‘double burden’ disease wherein, one and the same population, high levels of so-called poverty related diseases exist side by side with diseases that are usually associated with wealthy countries and have generally sedentary lifestyles. Obesity is a result of poor nutritional diet as more food is being produced consisting primarily of refined flour, sugar, and saturated fat. Indigenous children are at high risk of developing obesity as they grow older and developing comorbidities such as diabetes and heart conditions. Most importantly, this source explores the legal aspects in assisting these groups. There are concerns about providing these indigenous groups with just their ‘basic needs’ or ‘human-rights’. Right to health can be difficult to achieve if there is a lack of proper patient-healer communication can lead to confusion and mistrust in the relationship. Cultural differences increase the likelihood of professional errors and patients are more likely to disregard diagnoses and medical counseling or testing that they don’t understand or agree to. It is important to get these groups more involved in decision-making through participatory and culturally sensitive approach to health care. Overall, this is a great source for considerations that have been made about changes and policies that may be implemented to improve certain outcomes. I plan on using the legal aspects described in this source and connecting it back to anemia. I hope to find more sources that will describe laws that have been implemented in order to decrease the burden of anemia on these indigenous children.
Khambalia AZ, Aimone AM, Zlotkin SH.Burden of anemia among indigenous populations. Nutr Rev. 2011 Dec; 69(12): 693-719. 693-716.
This source is a systematic evaluation of clinical research papers addressing the global prevalence, severity and etiology of anemia in indigenous groups from an international perspective. This article connects back to the book by Bartell as it discusses how precipitating factors like iron deficiency as the primary and most common cause for the prevalence of anemia in indigenous groups. Indigenous groups are at increased risk of developing anemia for a number of reasons, such as inadequate access to healthcare services, employment, housing, and food security. This article interested me the most because it speaks loudly to what I have frequently done in my major, which is to do a systematic review of the literature for reliable and sufficient data. This article allowed me to look at my topic from a more clinical perspective in terms of who are the patients involved (indigenous children), what is the problem (anemia), where is this problem prevalent (specifically in Latin America), and why is this topic significant. The prevalence of malnutrition in Latin America has proven that it significantly impacts their health and longevity as they become vulnerable to certain diseases, like anemia. It also revealed that certain indigenous groups that do have lower rates of anemia gets sufficient amounts of protein in their diet, primarily from vegetables. This is an important staple that some indigenous groups living in dry, arid areas do not have the luxury of having. Nutritional factors like protein deficiency were also briefly mentioned in Bartell’s book. The studies observed large environmental variation between the indigenous groups, which greatly influenced their location and access to food. One group may experience poor agriculture with restrictive diets. Vegetables, fruit, and meat may be scarce. While there are other groups, that may live in fertile land with plenty of vegetables, fruit and domesticated animals. After reading this source, I can tell that I am pushing past just the effects of malnutrition but really starting to explore what those effects are doing to the indigenous groups. I believe that my interest is slowly turning towards a more specific effect of malnutrition, anemia.
Verhagen LM, Incani RN, Franco CR, Ugarte A. High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and Creoles: Significant Associations WITH Intestinal Parasites and Anemia. PLOS One. 2013; 8 (10): 1-11.
This source is a recent description of the Yanomami’s standard of living in rainforests. This study investigates malnutrition in children caused by parasitic infections. The Yanomami get their water supplies from unprotected wells and river streams. Furthermore, there is limited access to healthcare. Outcomes were determined through collection of stools from 390 Venezuelan children (aged 4-16). Findings revealed that 68% of these children had at least one type of parasite. There is greater prevalence of these parasites in the Yanomami children when compared to other indigenous groups.
The authors also discovered through blood samples that 24% of the Yanomami children in the Amazon Region were anemic making them more susceptible to hookworm infection. Hookworms are parasites that travel through the bloodstream and affect the lungs and small intestines, feeding off the host’s blood. Prolonged and chronic exposure to hookworm infection can lead to severe anemia because of low red blood cell count. There is a strong correlation between malnutrition, anemia, and parasitic infections because these are prevalent in least-developed nations with poor sanitation, inadequate access to clean water and poor health education to promote the dangers of these circumstances. This study also relates to how environmental condition like land temperature and climate contribute to the dissemination and distribution of intestinal parasites in human communities. Indigenous groups like the Yanomami residing in rainforests are at greater risk of infection because of the hot climate allowing these parasites to breed and thrive. This article covers another aspect of malnutrition affecting indigenous groups and it is once again connected to anemia. There is very limited number of studies on the Yanomami in association with malnutrition. This case study is also the most recent one I could find on this topic. For better comparison between the Yanomami and the Quechua, I would need to find studies that also explored the same indicators for malnutrition.