A burger for $295 is plain wrong

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The world’s greatest unexploited resource is not oil or gold but the minds of hungry children.

ANTIGUA, GUATEMALA Raúl is a happy preschooler, tumbling around among 4and 5-year-olds, but something is off.

 A child at the Casa Jackson Hospital for Malnourished Children in Antigua, Guatemala.

It’s not his behavior, for it’s the same as that of the other little kids. Rather, it’s his face. The baby fat is gone, and although he’s only 3 feet 5 inches tall, the height of an average 5-year-old, an older face seems grafted on.

Sure enough, Raúl turns out to be 9. Malnutrition has left his body and mind badly stunted. He’s one of almost one-quarter of all children worldwide who are stunted from malnutrition.

Here in Guatemala, almost half of children are stunted. In some Mayan villages, it’s 70 percent. In another world, on the Upper East Side of Manhattan, the restaurant Serendipity 3 offers a $295 hamburger. Alternatively, it sells a $214 grilled cheese sandwich and a $1,000 sundae.

“Stunting is probably the best marker of child health inequality,” Dr. Kirsten Austad of the Maya Health Alliance told me. “Stunting is a key driver of intergenerational poverty.”

The big problem with stunting from malnutrition isn’t that people are short but that they often have impaired brain development.

“He’s like a 5-year-old,” Rina Lazo Rodríguez, director of the Casa Jackson Hospital for Malnourished Children, said of Raúl. He is now living at the hospital and has never attended school, and staff members aren’t sure to what extent he can recover physically or mentally.

Studies find that malnourished children do less well in school, and the mental impairment is visible in brain scans. The implication is that billions of I.Q. points are lost to malnutrition, and that the world’s greatest unexploited resource is not oil or gold but the minds of hungry children. For the diner who has everything, restaurants offer gold in food. A Dubai restaurant, for example, has sold a cupcake enveloped in gold leaf. The gold is tasteless (and nontoxic), so its only purpose is extravagant novelty and a I’m on my annual win-a-trip journey, in which I take a university student with me on a reporting trip. This year the winner is Mia Armstrong of Arizona State University, and we’ve been dropping in on villagers in rural Guatemala — and seeing stunning levels of malnutrition. The problem isn’t just shortage of calories but of vital micronutrients, like zinc, iron, iodine and vitamin A.

Alas, the most boring word in the English language may be “micronutrients.”

And boring causes don’t get addressed.

One girl we met, Ingrid, was 14 years old and 4 feet 7 inches tall. I asked her if she was in school.

“I dropped out in the first grade,” she said.

I asked her to write her name in my notebook.

“I can’t write my name,” she responded.

Shawn Baker of the Bill and Melinda Gates Foundation refers to “the 45 percent-1 percent disconnect.” As he explained: “Malnutrition is the underlying cause of 45 percent of deaths in children under 5, yet less than 1 percent of global foreign assistance goes to addressing undernutrition.

“The bulk of the damage is done in the first 1,000 days — from conception through two years of life — and that damage is largely irreversible.” Besides cognitive impairment, stunted children have more health problems in adulthood, and stunted women deliver smaller babies, at times perpetuating the poverty cycle.

Nutrition programs are extremely cheap, often among the most costeffective ways to fight global poverty.

School feeding programs promote education as well as nutrition, and cost just 25 cents per child per meal. Deworming costs about 50 cents per child per year to improve both nutrition and health, yet pets in the U.S. are more likely to be dewormed than children in many other places.

As Mia noted in a separate article, one nutrition initiative could save up to 800,000 lives a year and requires no electricity, refrigeration or high technology. It’s simply support for breastfeeding.

Fortifying foods with iron, zinc, iodine and vitamin A is transformative. Ensuring that children are screened for malnutrition and promptly helped with supplements that are similar to peanut butter is fairly straightforward. Yet malnourished children aren’t a priority, so kids are stunted in ways that will hold back our world for many decades to come.

If some distant planet sends foreign correspondents to Earth, they will be baffled that we allow almost one child in four to be stunted, even as we indulge in gold leaf cupcakes, $1,000 sundaes and half-million-dollar bottles of wine. Something’s wrong with this picture.