1,000 Days {Bolivia, part 1}

10813481274_2653d2d50f_bMy Pumpkin was born at 40 weeks, 6 days, weighing 10 lbs, 11 oz.  I knew he was big because the doctor, post 38 hours of labor to a c-section, excitedly exclaimed, while I was laying on the operating room table, “10 LBS, 11 OZ!  He’s TODDLER SIZE!”

At 1 year, he weighed 32 lbs, and I knew he was in the 120th percentile because the pediatrician, in the room with the white walls, told me as much.  If perchance I missed that check up, I would have known my son was ‘off the charts’ because of all the other babies around us — because of the community of friends and family who would comment: “Wow, your baby is BIG!” and I could see with my own eyes, he was noticeably fatter and taller than the lot of tykes about his age.

But imagine a community of infants where nearly half of the children are severely malnourished.  A community where there is no healthy — only 44% small, skinny, and sick.  What if a community of babies were underweight and no mothers knew it because there was no doctor telling them as much, and there was no ‘healthy’ measure in which to compare?

Can you wrap your mind around it?

How would you know your child was sick if the norm was sick?



We flew first to Miami (5 hours), then to La Paz (6 hours), then to Cochabamba (1 hr), then drove 5 hours on a bumpy, windy road into the interior of Bolivia because we wanted to see.

We wanted to see what life was truly like for women and children in one of the most impoverished countries in Latin America.

Why are over 40% of the children under 2 years old (in the Potosi region) suffering from malnutrition?  Is it a lack of food?  A lack of access?  A lack of balanced diet?

I sat with Food for the Hungry‘s regional director, Rueben, as he explained:

“The first 1,000 Days in the life of a child are the most important.”  

For brain development.

For the central nervous system.

For emotional and psychological development.

“If we can turn around the first 1,000 days of a child’s life — how the mother takes care of herself when she is pregnant, medical care, nutrition, breastfeeding, and hygiene — it can change the entire trajectory of that child’s future.”

Being an adoptive mother, I get this.  I’ve read how the in-utero experience can dramatically alter the physiological, psychological, neurological, and emotional development of children.  I’ve read that in the 3rd month of pregnancy, a baby can taste bitter, sweet, and sour flavors in the amniotic fluid surrounding his body.  The eyes, once sealed shut, start to open in the 7th month of gestation, and the baby reacts to light.  Around 32 weeks gestation, he experiences REM sleep.  Yep.  Babies dream.  In their mother’s womb. I’ve researched how Mother and baby share hormones.  If Mother has high stress hormones, the baby’s brain development can be affected.  Mother’s diet and nutrition affects how her baby grows.  Mother’s emotional state, exposure to toxins, exercise frequency, and any substance abuse directly affects the life growing inside of her.

It starts then, as Rueben says, with educating mothers about the value of LIFE, the gift of children, the blessings of being made in the image of God Himself, male and female He created them and said, “It is good.”  This little life growing inside you, Mother, is a blessed gift from the Giver Himself.



In Bolivia, babies are birthed by 21 year old mothers (average age) with the help of midwives (by experience, not schooling) usually in homes constructed of brick or mud.  There is 1 doctor per 1,000 people in Bolivia, but in the rural areas, doctors are a day’s walk or more, up the rocky terrain, through the shallow creek, over the ridge, down the other side, with little shade from the elements, at 13,000 feet, in the 75 degree heat where olive-skinned people like me, who never burn, turn bright red in 30 minutes flat.

I complained about the bumpy, windy road where I almost lost my lunch, but Rueben tells me Food for the Hungry built that road with the help of the community, one stone at a time, pounded into the dirt, and the whole community celebrated because finally there was access — a way in (and out) — a luxury they never had before.

With very poor sanitary conditions and limited access to clean water, diseases like yellow fever, TB, malaria, hep A, and intestinal bacterias thrive.  The ever present crops of corn, wheat and potatoes leave women with round bellies in the midsection, and tiny legs, skin thickened and darkened by the sun. {I’m pretty sure I looked like a giant to the lot of them — all 5 feet 9 inches of me}.

We sat in a healthcare clinic while a Food for the Hungry representative explained in Spanish, then translated into Quechua and English, “This is a place where the mothers can come and have their child weighed and measured, and where we teach the mothers how to cook and clean their houses.”

We are not so very different.The woman beside me is breastfeeding her infant.  She’s missing her two front teeth and wearing a white hat.  I imagine her age is around 25, but she appears much older.  I ask her in Spanish, “Is your baby a boy or a girl?”  She stares into my face and I realize she speaks Quechua, yet she still answers, “Hijo.”  “Felicidados,” I say, wishing I knew how to engage her.



I’m taught many mothers did not breastfeed their children until the clinic began the important work of educating the benefits.  I put myself in their shoes: if nobody I knew nursed their baby, it would seem quite the unnatural thing to do.  I learn many mothers do not want to nurse their children for fear of becoming emotionally attached, since it’s highly possible the baby won’t survive the first 2 years of life anyway.  My heart hurts.

I ask the women how they get their children to eat vegetables.

“How do you prepare them?” I inquire, because don’t mothers everywhere struggle to get their children to eat broccoli?

“The children have only been eating potatoes and corn.  So they actually like how vegetables taste.  They like the flavor and variety,” she offers.

We have so many choices, do we not?


I cannot begin to explain how impressed we were with the work of Food for the Hungry.  It would be easy for them to dump thousands of thousands of dollars into the area — little parachutes of goods and services and materials.  But relationship building, educating, earning the right to speak into the culture of the community, this takes time and energy and trust.  Consider: how many of us follow the unsolicited advice of strangers?  I venture to say most of us will not.  So then, how can we help the poor when we have no credibility to speak into their lives?

We become their friends.

In my next post I’ll share a bit more about our trip, including a highlight for me — praying with two Bolivian pastors.  Stay tuned.  And in the meantime, for more information about Food for the Hungry, visit their website: www.FH.org.  Grace.


  1. I happened upon your blog via FH’s Twitter feed. What a beautiful post – I’m a registered dietitian, so I’m all too familiar with childhood malnutrition; but I had never before considered the impact that “normal = malnourished” has on a group of people not recognizing a need for change. It’s amazing what building relationships and sharing simple truths about breastfeeding and feeding vegetables can have on the health of an entire community! Kuddos, FH, and thanks for writing this, Karen!

  2. Loved reading what you experienced and saw through your time in Bolivia. I love the convos you had and just living life like the locals for a bit. SO much to process for you I am sure. I loved reading this glimpse!

  3. Dear Karen:

    I loved to read about what this experience meant to you. Eventhough I was there too, to see things from your perspective opens mine. Thank you for your words, your support and your sweet smile.

    1. Abi, I SO loved our time with you! Thank you for being such a gracious, flexible, engaging host and friend! <3

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