Global acute malnutrition is a cold, dry bureaucratic take on a hot, messy human horror. The concept was crafted up by humanitarian aid officials to dispassionately quantify just how bad a hunger emergency has gotten. GAM — of course the bureaucrats were going to give it an acronym — is designed to help concentrate minds and target resources as a country careens toward famine. 

You can think of GAM as the ghastly, famine-time doppleganger of the Body-Mass Index familiar to [email protected] everywhere.

GAM is a measure of the proportion of children aged between 6 months and 5 years old who suffer acute malnutrition. Acute malnutrition is considered “moderate” if a kid is at 70-80% of where he should be for his height. It’s said to be “severe” if a kid is at less than 70% of the right weight for his height. GAM — the global figure— includes both moderate and severe malnutrition. This includes the type of hunger we colloquially think of as morirse de hambre level: malnutrition severe enough to carry a high risk of death.

You can think of GAM as the ghastly, famine-time doppleganger of the Body-Mass Index familiar to [email protected] everywhere. Like BMI, GAM is built out of weight-to-height ratios. Unlike BMI, GAM describes a population — not a person. You measure an affected group’s weight-to-height ratios and compare them to those for the standard reference population. GAM, broadly, tells you how much less kids in a given group weigh relative to what they ought to for their height.  

The poorest communities in Zulia and Vargas States are already at or above the Serious Humanitarian Crisis threshold. 

GAM is one of the basic indicators for assessing the severity of a humanitarian crisis. According to the World Health Organization (WHO), when GAM reaches the 10% threshold, the crisis can be considered “serious”; and when 15% of kids are acutely malnourished, the crisis can be considered “critical”.

Now, thanks to a new study we know how bad things are getting in terms of child hunger in Venezuela’s hardest hit areas. In 25 of the poorest and most vulnerable parishes in Distrito Capital, Miranda, Vargas and Zulia, GAM reached 8.9% between October and December 2016, which just over 1 percentage point below the threshold for a “serious” humanitarian crisis.

The poorest communities in Zulia and Vargas States are already at or above the Serious Humanitarian Crisis threshold.

If all forms of weight loss are considered —from the child who lost one gram of weight to the most severe malnutrition— the number reaches a staggering 52%.

These troubling facts were identified through a Nutrition Surveillance System —known as SAMAN— put forward by Caritas Venezuela, the Catholic church charity, since September 2016.

Official data on child malnutrition used to come from the National Nutrition Surveillance System by the National Institute of Nutrition, but the last official posting from this source was in 2007.

SAMAN no a research tool, it’s a guide to action.

Unicef showed some preliminary figures in 2011 and FAO included Venezuela in the last report on the Food Security Situation of Latin America using figures from 2009. Due to this poor accountability from the official sector, as well as from the UN System in country, local NGOs have become an invaluable source of information to put our crisis into proper perspective.

SAMAN is a monitoring system based a sentinel surveillance system: it’s no research tool. Rather, it’s a guide to action, designed to guide relief efforts rather than to just observe the crisis. It was put in action back in September 2016 in 25 parishes in the four states where Caritas Venezuela is strongest on the ground. The parishes selected are relatively isolated and have poor access to public services and poor housing conditions, high records of poverty and chronic malnutrition and a recent history of disturbances and social unrest.

Working through volunteers, including pastoral youth and pediatricians, the system sets out to identify children at risk of malnutrition. It provides timely and prioritized care from a preventive and therapeutic approaches to reduce morbidity and protect children from malnutrition-related mortality; and coaching and support for the  families affected by malnutrition.  

The whole point of SAMAN is to detect malnourished children so it can put them under a proper care scheme, as well as to generate information for planning and mobilizing humanitarian responses. The results of SAMAN will be publicly displayed every two months.

SAMAN’S first results also showed that GAM in these 25 parishes reached 22.1% among kids between 6 months and 24 months of age and 14.3% among kids under 6 months old.

According to Caritas Venezuela, “malnutrition among young children predisposes them irreversibly to childhood diseases, educational lags in the short term, and to social, productive and psycho-affective lag in the medium term. It also leads to family destitution and fragmentation, and social tension and violence in society”.

And this is not a recent problem. SAMAN’s first results show that 1 in 5 kids not only lost weight recently, but already has a cumulative growth retardation (stunting) of at least 4 or 5 years. Children who fall below the fifth percentile of the reference population in height for age are defined as stunted, regardless of the reason -though malnutrition is generally the first cause considered. And according to UNICEF, “stunting is associated with an under developed brain, with long-lasting harmful consequences, including diminished mental ability and learning capacity, poor school performance in childhood, reduced earnings and increased risks of nutrition related chronic diseases, such as diabetes, hypertension, and obesity in future”.

In the words of Susana Raffalli, nutritionist with experience in emergency food security and humanitarian responses,  and Technical Coordinator of the project, “it’s not true that this [malnutrition] happened because oil prices fell, it is not true that this is due to the collapse of crops due to El Niño. Those threats have been there, but it has been the inadequate control of the food system by the State the main fuel for the installation of this slow onset crisis”.

Every malnourished child we find here will have protection and will come out of this.

Raffalli added: “we had a double responsibility. We had the responsibility of not evaluating children without being able to attend to them…and to break silence if the reality that we find surprises us”.

“Every malnourished child we find here will have protection and will come out of this,” Raffalli says. However, this is not a crisis CARITAS can address on its own.

The Government must do something and we should demand action. To borrow the words of Maduro recently to a high school senior complaining about the the suspension of the school lunch program, “ustedes no se pueden quedar en la solicitud, ustedes se tienen que movilizar, ir a la calle, que se sienta su palabra”.

“And you, what are you doing?” the President asked to the girl, demonstrating a catastrophic contempt for accountability, as he faced a child in acute hunger.

In addition to protesting, we can support the daily work of charities such as Caritas Venezuela. And to be truly helpful, check with them on how you can be of real service by going to their web page, by calling them up or by sending an email.


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  1. Different international medical studies have established a relationship between child malnutrition , deficient mental development , indexes of bad health and lower IQ levels .

    The child as it develops in its mothers womb and latter during the first years of its life has a developing brain that needs much greater nutrition than the brain of young people and adults to grow normally and healthy , the effect of malnutrition (that of the expecting mother and its child) is that kids health and intelligence suffer irretrievable damage as a result , the ultimate effects are life long .

    During WWII severe malnutrition specially affected two areas of europe during some episodes of the war where normal food supplies were cut off leading to starvation of large swathes of population , one happened in holland when the sabotaging of nazi trains caused the nazis in reprisal to stop all food supplies to local civilians for several months …..the other happened in finland where war conditions while finland battled soviet russia cause widespread starvation …medical studies followed the health of children born to mothers who had suffered starvation in both episodes , the conclusive results showed high incidences of bad health and mental underdevelopment in those children as they grew up and became adults and even old .

    Another international study has correlated malnutrition , poor health indexes and lower average IQ’s in different countries (icluding among them: Cuba).

    This problem already exists in Venezuela , and has for several years now among marginalized segments of our population , a relative who some 6 years ago worked as a physician in the barrios noted how many young mothers were unable to follow even the most simple of instructions for the care of their sick babies or even basic tips on how to take care of them generally …..they for instance gave their babies foods that while perhaps filling their stomachs had no nutritional value whatsoever harming the childs health directly.

    The problem as grown to critical propportions as per this piece and is fast becoming a ticking time bomb silently sabotaging the countrys future…….meantime the regime allows corrupt officials to make money from the purchase and distribution of food items and in one case known to me refused an international charity to bring food into the country unless they channeled it through Cuba so that Cuba could take credit for the food contributions ……( The name of Delcy is mentiond in these reports) .

    • “in one case known to me refused an international charity to bring food into the country unless they channeled it through Cuba so that Cuba could take credit for the food contributions ……( The name of Delcy is mentiond in these reports)”

      Can you elaborate a bit more on this? I find this story interesting (as well as disgusting at the same time).

  2. I’ve certainly seen far more people here losing weight than gaining. Recently, there wasn’t a can of sardines to be found in town. Honestly, I don’t know how most of these folks make it. Should be interesting by about April when all of the country’s corn supplies have been exhausted.

  3. Anabella, tragic beyond tears. Most Venezuelan adults have lost something like an average of 20 lbs. body weight in the last year, not to mention many subsisting on yuca, which amarga version has caused an estimated dozens of deaths recently. What’s incredible is that, of the political powers that be, especially the military contingent, virtually all sit idly by as this humanitarian crisis deepens–Venezuelans have traditionally been low on real patriotism, as they (over-)fill their pockets with a me-first mentality when they can, but what’s happening today in the Country is criminal, y no tiene perdon de Dios.

  4. Tragic, alarming and not surprising. Wasting is what we generally see in pictures as undernourished kids: rail thin and sick. But it’s more acute (happens quickly, resolves quickly) which is why stunting is a better measure of longer term malnutrition because it represents poor nutritional intake and growth over a longer period of time, and its effects are so much harder to address/reverse.

    What this article doesn’t say but seems obvious is that these rates represent only a small fraction of the actual extent of the problem nationwide, esp. in rural, hard-to-reach, indigenous and otherwise vulnerable communities. And the compounded effect of malnourished women having babies – not to mention mosquito-borne and vaccine-preventable diseases that they’ll be exposed to. Venezuela has become a public health catastrophe.

    And what NET. says above about people eating bitter yuca and dying means they might be getting konzo, a kind of cyanide poisoning from undertreating/underpreparing cassava:

  5. And it is for the reasons in this article that attempts of reconciliation with the chavistas would be a breakdown of my personal values and integrity. With this happening there can be no doubt that chavistas are truly evil.

  6. If reading this article was painful, I can’t imagine how it must have felt to write it. Hence, I am thankful that you did. This said, would you be open to write a follow-up piece comparing these statistics to those of other nations?

    I did a little research and found that Venezuelan GAM statistics are almost three times higher than those of Syrian refugees in Lebanon, Iraq and Jordan. Read study here:

  7. […] Caritas SAMAN –a monitoring system based on sentinel surveillance– showed global acute malnutrition (GAM) levels of 8.9% in kids between 6 months and 5 years of age in 25 of the poorest parishes in the Capital District, Miranda, Vargas and Zulia between October and December 2016. After including 6 new parishes between January and February 2017, GAM levels reached 10.2%, surpassing the 10% threshold that defines a “serious humanitarian crisis.” […]


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