Nutritionist

By Jeffrey Kluger, Melanie Wetzel / Tegucigalpa

Well-nourished babies in Honduras look like well-nourished babies everywhere--plump, active, alert. In rural Honduran towns, there's now one more way to identify them: look for a little blue pin next to their names on one of Vicky Alvarado's healthy-eating charts. A child earning one of those is a child getting a fair shot at life.

For too many Honduran children, a fair shot--ensured by a full stomach--has long been out of reach. Up to 40% of the population under age 5 suffers from malnutrition. In the poorest villages, that number jumps to 70%. Honduras is hardly the only country that does such a dreadful job of feeding its babies. What makes it different is that it has the resources to do better. Only 2% of Honduran families are so poor that they can't afford at least some food every day. The rest have it; they just don't know how to make the most of it.

That never sat right with Alvarado. A native Honduran, she graduated with degrees in primary school education and nursing, then traveled to the U.S. to earn her master's in nutrition at the University of Nebraska at Lincoln. All this made her uniquely qualified to tackle the dearth of nutrition education in her home country--something she got a chance to do in 1999.

That year the Honduran Secretary of Health began a pilot program--partly sponsored by the U.S. Agency for International Development (USAID)--to improve the welfare of children by taking care directly to their villages rather than making them travel for it. Alvarado, who had accepted a job with USAID as a childhood-nutrition consultant, argued that it was imperative that the new program include a comprehensive tutorial in food handling, hygiene and meal planning. She put together her curriculum and dispatched teams of health workers into the countryside to teach it.

The response was electric. Instructors would visit a village, and all the local mothers would turn out. At the next village, not only would the resident families attend, but ones from the surrounding communities would too. Later, when the workers returned for periodic weigh-ins and measurements of the kids, all the same families were there again.

Alvarado doesn't know which nutrition lessons the mothers began practicing in their homes, but it was clear that they were doing something different. "The people in the health clinics started saying 'We don't see so many sick children from those towns,'" reports Alvarado, now 55. "They bring their children in for vaccines or checkups but not for malnutrition sicknesses."

In case the improvement in the children's health didn't motivate the mothers, Alvarado started posting her pin charts in each community. Children who reached their height and weight goals were awarded the blue pins; those who didn't got red ones. "The mothers can see the goal," Alvarado says. "They say, 'I don't want my child to have a red pin; I want him to grow.'"

Growing is precisely what the kids are doing. There are now regular nutrition programs in 2,000 Honduran communities, out of a total of 30,000. But success breeds success, and the program is expanding, thanks to funding from the World Bank, CARE, Save the Children and others. Well-spent aid dollars, it appears, can mean smarter parents. And smarter parents have the tools to save their kids.