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‘I didn’t eat for days’: hunger stalks Venezuelan refugees | Malnutrition

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A seemingly endless lake of cardboard and tin shacks surrounds the perimeter of a former airport runway in Colombia’s desert-like city of Maicao. Known locally as La Pista, the area is home to more than 2,000 families, and is one of 44 informal settlements to have emerged around the city in the past two years.

The old airport has become a landing strip for desperate migrants and bi-national indigenous Wayuu people fleeing the economic and political crisis in Venezuela, where the basic essentials of life are hard to come by.

Maicao is in La Guajira, the most northern region of Colombia, and sits on the border with Venezuela. It is the second busiest entry point for migrants after the main border city of Cúcuta.

The stench of urine fills the air inside the roasting hot tin shack where Elaine Rojas lives with her family. There is no toilet so the family of six go where they can. Rojas, 27, came from the Venezuelan city of Maracaibo four years ago in search of a decent life for her children.

Her frailty is a sign of malnutrition; food was in short supply in her homeland and has been since she arrived in Colombia.

“It’s not better [than Venezuela] but at least we have some food, though sometimes we don’t have enough,” says Rojas. “When it rains it’s awful, the whole place floods.”

Yulexi del Carmen, 16, outside the shack where she lives with Valeria, her seven-month-old daughter. She has lost two babies to malnutrition.
Yulexi del Carmen, 16, outside the shack where she lives with Valeria, her seven-month-old daughter. She has lost two babies to malnutrition. Photograph: Nadège Mazars/Guardian

Rojas and her husband, who both survive by recycling plastic, built their hut themselves, starting out with plastic bags and pieces of wood before getting some corrugated iron. As no running or drinkable water is available in La Pista, everyone relies on water-sellers who charge a fee to distribute untreated barrels of it, carried between the homes on donkeys.

Many people in Maicao are suffering from malnutrition. Organisations such as Save the Children and Action Against Hunger are supporting families La Pista but the majority of families still eat only one meal a day, mostly made from flour but occasionally rice. Few can afford meat, fruit and vegetables. One tomato can cost an unaffordable 800 pesos (15p).

Such a diet is one of the main causes of malnutrition, says Mabis Mercado, who is in charge of looking after migrant patients at Maicao’s main hospital. She believes there are about 8,000 people in La Pista, and says cases of malnutrition have shot up since last year. The hospital dealt with 152 cases of chronic malnutrition in 2020; 68 among Venezuelans and 25 among indigenous communities.

“Those most affected are the indigenous populations,” Mercado says. “The water in La Pista is horrible; it causes a lot of intestinal problems, which add to the issue of malnutrition.”

In 2018 doctors started seeing more serious cases of malnutrition as Venezuela’s crisis intensified, she says. The pandemic has made the precarious situation even worse.

Venezuelan refugees living in La Pista must use cardboard for their shacks until they can find some metal.
Venezuelan refugees living in La Pista must use cardboard for their shacks until they can find some metal. Photograph: Nadège Mazars/Guardian

“Last year it was really critical because a lot of the migrants have informal jobs. With the pandemic lockdown, they couldn’t do anything, everything was closed down, so many people were going hungry, unable to afford food,” Mercado says. “We found newborns with malnutrition and children who, because of lack of access to milk … started to fall into malnutrition too.”

The hospital are giving out supplements. “But we’ve run out. We only had supplies for three months,” she says.

Data from Colombia’s authorities says 51,361 migrants live in Maicao, but Mercado and others working on the ground told the Guardian that these numbers were a conservative estimate. They say it is almost impossible to control migration, due to the many informal and dangerous border crossings, known as trochas, which are used to smuggle weapons, medicine and petrol.

“There are 180 trochas, and no control,” says Mercado. “It’s difficult to regulate and the data is not accurate.”

Inside the hospital, Rosa Primera, 29, sits with her 18-month-old son, whose light-coloured hair is a clear sign of malnutrition. Primera has been in Maicao for three months and has the same story as most: “I left [Venezuela] because of the crisis,” she says. “I didn’t have money for food.”

Dr Alberto Galue, who heads the children’s ward at Maicao’s hospital, says the malnutrition levels are “very serious … We are overwhelmed.”

Rosa Primera’s son Juan David is measured at Maicao’s hospital to gauge his malnutrition. In the week since he was admitted, he has gained a kilo in weight.
Rosa Primera’s son Juan David is measured at Maicao’s hospital to gauge his malnutrition. In the week since he was admitted, he has gained a kilo in weight. Photograph: Nadège Mazars/Guardian

In May 2019, the UN refugee agency, UNHCR, set up its first camp in Colombia, providing a temporary respite. In the last six months, though, dozens more makeshift dwellings have sprung up around the UN camp.

UNHCR’s Colombia representative, Jozef Merkx, says the agency is working with the authorities to address the “urgent needs in various informal settlements with many refugees, migrants and host families”.

“A large part of the population in the new, informal settlements are of Wayuu origin, mostly coming from the Venezuelan side of the border,” he says.

Wayuu people make up 56.4% of the overall population in La Guajira, and they do not recognise the border between Colombia and Venezuela.

One Wayuu girl who crossed into Colombia from Venezuela says she had lost two babies to malnutrition.

“They were sick. They had diarrhoea and vomiting and I had no resources,” says Yulexi del Carmen, 16, in her Wayuunaiki language, while her cousin translates into Spanish. “One died after a month, and the other when he was a year old.”

Two boys deliver water to a shack in La Pista.Water costs 3,000 pesos (about 5560p) a day for those who can afford it.
Two boys deliver water to a shack in La Pista. Water costs 3,000 pesos (about 60p) a day for those who can afford it. Photograph: Nadège Mazars/Guardian

Del Carmen and her family were preparing rice for lunch when the Guardian visited. In the evening they drink chicha, a traditional beer made from fermented maize. Their plastic water barrel was empty as they had run out of money.

Osmer José, a 20-year-old water-seller, says being in La Pista is “like being in Venezuela but money goes further”. Water costs 3,000 pesos ( 60p) a day for those who can afford it.

Many Venezuelans live in similar corrugated-iron shacks in Maicao’s city centre, including 33-year-old Ana Josefina Gutiérrez, from Los Puertos de Altagracia, over the river from the bigger city of Maracaibo, a few hours drive away. She has lived in precarious conditions here for about 18 months.

When she was pregnant she was penniless and at times had to sleep on the street with two young children in tow. “I didn’t know what to do,” says Gutiérrez, who is at a Maicao health clinic with her baby son. “I slept outside. I didn’t eat well. Sometimes I didn’t eat at all for two days.

“He had malnutrition because I was going through a rough time and I didn’t have anything to give him,” she says. “Never in my life did I think I’d be living like this.”

Gutiérrez, who is diabetic, received some emergency funds from Save the Children and has been able to get herself off the street and into basic housing. She says it costs her about 7,000 pesos (£1.35) a day to get by.

Florinda Uriana, finishes preparing lunch
Florinda Uriana, mother of Yulexi del Carmen, finishes preparing lunch for the seven members of the family present. It is a single dish of white rice. Photograph: Nadège Mazars

Her only furniture in the one-room shelter is a second-hand foam mattress and a crib. The home is made of tin and is surrounded by rooms housing other Venezuelans. The metal makes for a sweltering interior in daytime, but at least she is safe here for now. Her funds are likely to last for three months, she says.

Colombia’s border with Venezuela recently reopened, after closing in March 2020 to curb the spread of the pandemic. More people have already started to flood across, says Mercado.

As September’s rainy season approaches, concern is growing for the people living in La Pista. Their cardboard and tin houses will undoubtedly flood, and water will be further contaminated, causing more illness.

“I’ve asked God for no rain this year,” says Mercado. “It’s already been so tough for people, with the pandemic. Their homes will be destroyed.”

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Malaria kills 180,000 more people annually than previously thought, says WHO | Global development

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The World Health Organization has called for a “massive, urgent” effort to get the new malaria vaccine into the arms of African children, as it warned that about 180,000 more people were dying annually from the disease than had previously been thought.

Dr Pedro Alonso, director of the WHO’s global malaria programme, said the RTS,S vaccine, recommended for widespread rollout in October, represented a historic opportunity to save tens of thousands of lives, mostly those of under-fives in sub-Saharan Africa.

But he warned that the global community risked “massive failure” if funding commitments aimed at boosting production and helping deployment of the vaccine were not rapidly made.

“What I think is the real barrier [is] international solidarity,” he said. “Is the world going to allow that there is a first malaria vaccine that can save the lives of tens of thousands of African children every year and they’re going to let it sit on a shelf? Or are they going to step up?”

The British pharmaceutical company GlaxoSmithKlein, which developed the RTS,S vaccine, has committed to donate up to 10m doses for use in the pilot programmes already under way, and to supply up to 15m doses annually.

However, with more than 240m cases globally last year, the potential demand could reach 80 to 100m doses annually, Alonso warned. “Therefore, this is a prime example of where international mechanisms will need to come into play,” he said.

“A vaccine that could save somewhere between 40 and 70-80,000 lives every year, of African children, is something that needs to be treated with the utmost ambition and sense of urgency. And therefore, a slow, gradual scale-up, if you ask me, would not be acceptable. This needs to be a massive, urgent operation to ensure that we can reach as many children as possible and as soon as possible.”

He added: “If the global health community does not respond to this challenge, it will represent a massive failure. I cannot imagine how different leaders, leaders of philanthropy or of financing institutions, are going to go to Africa and advocate for efforts to prevent childhood deaths if they don’t, first and foremost, support the deployment of this vaccine.”

Last week, the global vaccine alliance, Gavi, said its board had approved an initial $155.7m (£117m) for the rollout of RTS,S. The funding would help the introduction, procurement and delivery of the vaccine for eligible countries in sub-Saharan Africa from 2022 until 2025, it said.

Dr Abdourahmane Diallo, CEO of the RBM Partnership to End Malaria, said the announcement would give the private sector “a crucial motive to scale up” the rollout.

“We now call on leaders to step up investment to accelerate the development and delivery of more effective, transformative tools to combat the ever-evolving malaria parasite,” he said.

New figures released by the WHO on Monday underlined the scale of the problem, with a new, “more precise” method of counting estimating that 627,000 people died of malaria last year, 180,000 more than the total would have been according to the old methodology.

The vast majority of all malaria deaths – 96% – were in sub-Saharan Africa.

In its annual malaria report, the WHO said the “doomsday scenario” some had predicted at the beginning of the Covid-19 pandemic – that deaths from malaria would double as a result of disruption to treatment and services – had not materialised.

Nonetheless, it said, deaths had risen by nearly 70,000 last year, an increase of 12%, of which nearly 50,000 were attributable to disruptions during the pandemic. One main cause of disruption was that more than a quarter of insecticide-treated bed nets – the backbone of WHO efforts to combat malaria – were not distributed in 2020.

Faced with a slowing of progress in the fight against malaria, the WHO believes the vaccine could be a crucial new weapon, even though questions have been raised over its limited efficacy. Over four years of trials, RTS,S was found to prevent 39% of malaria cases and 29% of severe malaria cases.

But Alonso rejected concerns. “A reduction of 30% [in] severe cases of malaria means a massive public health impact, larger probably than any other vaccine against any other disease being used right now,” he said.

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Fresh violence at anti-vax protests in Brussels

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Belgian police fired water cannon at violent anti-vaccination protesters outside EU buildings in Brussels for the second weekend in a row on Sunday. More than 40,000 people also protested against lockdowns in Vienna Saturday. Several thousand people also protested in Utrecht, in The Netherlands, as well as in Berlin and Frankfurt, where German police used batons and pepper spray after being attacked by a radical minority in the demonstration.

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‘They see it in corridors, in bathrooms, on the bus’: UK schools’ porn crisis | Pornography

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Barnardo’s works directly with children who are victims of abuse or display signs of harmful or risky sexual behaviour. In 2020-21, they worked with 382,872 children, young people, parents and carers.

In a recent survey of their frontline workers across England and Wales, staff reported a rise in the number of children participating in acts they have seen in pornographic videos, despite feeling uncomfortable or scared. They describe porn as having a “corrosive” effect on child wellbeing.

Child sexual abuse expert Sarah works with children who are displaying signs of inappropriate sexual behaviour. She also trains other professionals who work with children

“I started out as a primary school teacher eight years ago, and I’ve been worried about children seeing porn ever since. Children don’t have to be able to type to see porn – it can be sent to them or shown to them on someone else’s phone. They see it at school, in the corridors, in the bathrooms, on the bus. There is just no censor on any of it – one video leads to another. If you can imagine it, it exists as porn, and children are seeing it.

“I am working with a teenager who was sexually abused by a family member. This young person had been exposed to porn and it was perpetuating what the abuser told them – that this is normal, that it’s not abuse.”

She is particularly concerned, as are her colleagues, about the increasingly extreme nature of the porn freely available on mainstream sites.

“A common role play theme on porn sites is intra-familial abuse – on mainstream sites you will see fetishisation of grandad and granddaughter sex, or stepfathers and stepdaughters. This may lead to a young person not disclosing or getting the support they need. From both angles it is dangerous; it puts the child at risk and encourages the perpetrator.

“The impact of porn shows in children harming others or themselves because they either don’t understand or are so ashamed of sexual urges. Shame is very prevalent and is often hidden.

“We are working with a seven-year-old who has been exposed to porn and is now displaying sexualised behaviour. They had free rein on a device, and someone hadn’t deleted a browser history. Once a young person sees porn, they may feel a need to come back again and again – porn is designed to meet a need. That is a form of sexual abuse against that child.”

Brian* is a senior social worker who has worked with children for over 30 years

“Unfortunately, porn is a feature for the majority of the children who come into our service. The children we support are very damaged. They would be likely to have experienced multiple forms of abuse – sexual, physical and domestic. Porn in and of itself is not the cause of their behaviour but it becomes a compounding factor when it hits that history of vulnerability.

Adult sex offenders can give children a distorted rationalisation for their behaviour, and the messages that are given through porn then fit with that distortion.

Lucy* has worked within the field of child sexual abuse for 16 years.

“We know children find porn distressing – they are telling us that themselves. We have done research with children in schools so that we have a cohort to compare our vulnerable children to, and they are saying the same thing.

“This is not what could be described as erotic or soft porn. They may start on porn sites and quickly begin to see very hardcore material. Or [extreme material] lands in their social media feeds, and they can then feel compelled to go back and look again.

“Children are less able to manage sexual arousal, and this material is designed to be arousing. Lots of children can feel guilty and distressed by what they see. We have 14-year-olds telling us they have to watch it as soon as they wake up. They describe being preoccupied with accessing porn to an extent that impacts upon their day-to-day life.

“We also regularly work with children with learning disabilities, another group vulnerable to the harm of porn. They may be shielded from sexual information and then reach 13 or 14 and take away the wrong learning from porn. They may learn that no means yes, that if you persist, women will enjoy forced sex. These messages are harmful for any child but for children with learning needs or who have developed unhealthy beliefs around sex as a result of abuse, it’s particularly bad.

“After lockdown, we began to get more calls from parents where there is no other obvious trauma, just the exposure to porn. I’ve been doing this 16 years, and children have far more access to porn now.”

* Names and some details have been changed to protect identities

In the UK, the NSPCC offers support to children on 0800 1111, and adults concerned about a child on 0808 800 5000. The National Association for People Abused in Childhood (Napac) offers support for adult survivors on 0808 801 0331. In the US, call or text the Childhelp abuse hotline on 800-422-4453. In Australia, children, young adults, parents and teachers can contact the Kids Helpline on 1800 55 1800, or Bravehearts on 1800 272 831, and adult survivors can contact Blue Knot Foundation on 1300 657 380. Other sources of help can be found at Child Helplines International

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