A few weeks ago, on November 7, a devastating earthquake hit the San Marcos area of Guatemala. It's not typically a headline-making part of the world, and news of the earthquake came and went pretty quickly from the international media. But thousands of people had their lives thrown into chaos.
San Marcos is a beautiful part of the world. It's a large area that includes both misty mountains and the beautiful Pacific coastline. It's also an extremely poor part of Guatemala with 87 percent of the population living in poverty. It's hard for many people to wrap their heads around statistics like that, but this is the reality of daily life for the families of San Marco.
While the global media spotlight shone on San Marcos for a few days, the region was already an area of focus for the Government of Guatemala. The Ministry of Health has made it a priority to reduce malnutrition and improve health among the children of the region. Now, thanks to a Stars in Global Health grant from Grand Challenges Canada recently awarded to me, I'm going to be a part of this path to progress. And it's very exciting.
Through the Ottawa-based Micronutrient Initiative I am working with our partner CeSSIAM, a renowned Guatemala nutrition research institution with over 25 years experience, and the Ministry of Health. We are conducting research to help scale up a relatively new and potentially tide-turning treatment for diarrhea -- namely zinc supplementation, given in combination with oral rehydration salts (known as ORS).
With a staggering 2.5 billion cases of diarrhea per year around the world, diarrhoeal disease affects more children than any other childhood illness. It leads to hospitalizations, weakened immune systems, and long-term nutritional consequences for children. It also kills, as young bodies literally have the energy and life drained out of them. In Guatemala, 22 per cent of children under the age of five suffer from at least one episode per year.
A few decades ago, the introduction of ORS for families to use when children had diarrhea was a great breakthrough. The introduction of ORS was monumental in saving lives, but its use eventually reached a plateau. Recent advances in micronutrient nutrition have given hope in the management of diarrhea. Using zinc, along ORS, not only helps children get better faster, it can prevent future episodes and even save their lives. This combined treatment, which costs as little at 50 cents per episode, provides an opportunity to revitalize treatment programs throughout the developing world.
Guatemala has taken significant steps to ramp up the use of zinc and ORS through health centres, but not all health care workers and families know about the treatment, its benefits and full use. I'm trying to figure out if and how much additional investment in training, behaviour change communication, packaging and marketing will reap significant gains in improved health and survival of children.
We will hear about mothers' needs and motivations around managing their children's diarrhoea when it hits, and what the physical and perceived barriers are that might be preventing them from providing treatment. We will also learn from the experiences of health workers in these rural communities.
Already a team of Guatemalan researchers from CeSSIAM has begun talking to mothers and health workers in San Marcos. In fact, they were in interviews when the earthquake hit a few weeks ago. After a very big scare and a short interruption, they are back at it again.
Our work will also explore new packaging options to help health workers easily present zinc and ORS as a combined treatment, despite them being separate stock items. This package might be as simple as a special bag, or something like a cajita salvavida (life-saving box), that is covered with promotional images and messages.
As our work continues, I'll keep you posted on what we learn from the families in San Marcos and the health workers that support them and how we proceed to reach more children with zinc and ORS for the treatment of diarrhoea.
Hasta pronto!