The hair on broomstick-thin children has turned patchy and orangish, their stomachs have ballooned to the size of their heads and many look half their age -- the tell-tale signs of malnutrition.
Mabriole town official Geneus Lissage fears that death is imminent for these children if Haitian authorities and humanitarian workers don't do more to stem the hunger problems.
"They will be counting bodies," Lissage said, "because malnutrition is ravaging children, youngsters and babies."
Three years after an earthquake killed hundreds of thousands and the U.S. promised that Haiti would "build back better," hunger is worse than ever. Despite billions of dollars from around the world pledged toward rebuilding efforts, the country's food problems underscore just how vulnerable its 10 million people remain.
In 1997 some 1.2 million Haitians didn't have enough food to eat. A decade later the number had more than doubled. Today, that figure is 6.7 million, or a staggering 67 percent of the population that goes without food some days, can't afford a balanced diet or has limited access to food, according to surveys by the government's National Coordination of Food Security. As many as 1.5 million of those face malnutrition and other hunger-related problems.
"This is scandalous. This should not be," said Claude Beauboeuf, a Haitian economist and sometime consultant to relief groups. "But I'm not surprised, because some of the people in the slums eat once every two days."
Much of the crisis stems from too little rain, and then too much. A drought last year destroyed key crops, followed by flooding caused by the outer bands of Tropical Storm Isaac and Hurricane Sandy.
Haiti has had similarly destructive storms over the past decade, and scientists say they expect to see more as global climate change provokes severe weather systems.
Klaus Eberwein, general director of the government's Economic and Social Assistance Fund, said: "We are really trying our best. It's not like we're sitting here and not working on it. We have limited resources."
He attributed Haiti's current hunger woes to "decades of bad political decisions" and, more recently, to last year's storms and drought. "Hunger is not new in Haiti," Eberwein said. "You can't address the hunger situation in one year, two years."
In the village of Mabriole, Marie Jean, a 33-year-old mother of six, looked helpless as her naked son Dieufort sat cross-legged in the dirt, a metal spoon in hand that was more toy than tool. The 5-year-old boy barely looked 3, his gaze unfocused and glassy eyes lifeless. His stomach was distended.
Jean said she lost 10 goats and several chickens to Isaac. The goats could have sold for about $17 apiece, the poultry for about $2.80. She could have used the animals for food or the money to hold her over until the new harvest season.
"You depend on this, because it's all you have," Jean said.
Many people have been forced to buy on credit, or look for the cheapest food available while eating smaller and fewer portions. Some families have asked relatives to take care of their children, or handed them over to orphanages so they have one less mouth to feed, humanitarian workers say.
Political decisions already had hurt the ability of Haitian farmers to feed the country. One example: Prodded by the administration of U.S. President Bill Clinton, Haiti cut tariffs on imported U.S. rice, driving many locals out of the market.
Eighty percent of Haiti's rice -- and half of all its food -- is imported now. Three decades ago, Haiti imported only 19 percent of its food and produced enough rice to export. Factories built in the capital at the same time did little to help: They led farmers to abandon their fields in the countryside in hope of higher wages.
At the same time, Haiti has lost almost all of its forest cover as desperately poor Haitians chop down trees to make charcoal. The widespread deforestation does little to contain heavy rainfall or yield crop-producing soil.
With so much depending on imports, meals are becoming less affordable as the value of Haiti's currency depreciates against the U.S. dollar. Haiti's minimum wage is 200 gourdes a day. Late last year, that salary was equivalent to about $4.75; today it's about $4.54 -- a small difference that makes a big strain on the Haitian budget.
One hard-hit area is Gauthier, an arid stretch between the dense capital of Port-au-Prince and the Dominican border a few miles (kilometers) to the east. It's among 44 areas identified by the government as "food insecure," meaning too many tables are bare.
Here, villagers tell of an elusive rainfall that stymied crop production and then the hurricane that followed.
"That is when the misery began," said pastor Estephen Sainvileun, 63, as he sat with friends in the shade of a rare tree.
Hurricane Sandy ravaged the bean crops, leaving a three-month gap until the harvest resumed in December. With no beans to sell, farmers couldn't buy rice, corn or vegetable oil.
"Some people eat by miracle," said Falide Cerve, 51, a part-time merchant and single mother of five.
That has hurt education, too. The Gauthier schoolhouse, with its tin walls and dirt floor, can hold 100 students, but only 43 enrolled. The children are too hungry to learn.
"They're too distracted, and I have to send them home," said Sainvileun, the pastor who runs the tiny schoolhouse.
Especially hurt are children in Haiti's hard-to-reach villages. Directly south of Gauthier is one of the most remote zones in Haiti. The area is one of craggy mountains, the highest in the country at 8,772 feet (2,674 meters). Only the sturdiest off-road vehicles can climb the steep, twisting and rocky roads.
Some villages, such as Anse-a-Boeuf on the southeastern coast, are solely accessible by foot or donkey.
On a recent oven-hot afternoon, a team of Associated Press journalists hiked down a hill, past a thicket of mangroves and into the beachside hamlet. They found several dozen children waddling among the wood huts with the usual signs of malnutrition.
"This child is not malnourished," insisted 45-year-old grandmother Elude Jeudy as she held in her arms 2-year-old Jerydson, naked and crying, too frail to stand a few minutes earlier. "I feed him."
The mother had left the little boy so she could find work in Belle Anse, a nearby village on the ocean.
Neighbor Wilner Fleurimond added: "People shouldn't be living like this."
Villagers say they vote for people they hope will improve their lives but in the end find disappointment.
"We vote for the deputy we know and nothing works," Fleurimond fumed. "We vote for the deputy we don't know and nothing works."
Shortly after taking office, President Michel Martelly launched a nationwide program led by his wife, Sophia, called Aba Grangou, Creole for "end hunger." Financed with $30 million from Venezuela's PetroCaribe fund, the program aims to halve the number of people who are hungry in Haiti by 2016 and eradicate hunger and malnutrition altogether by 2025. Some 2.2 million children are supposed to take part in a school food program financed by the fund.
Eberwein, whose government agency oversees Aba Grangou, said 60,000 mothers have received cash transfers for keeping their children in school. A half million food kits were distributed after Hurricane Sandy, along with 45,000 seed kits to replenish damaged crops, he said. Mid- to long-term solutions require creating jobs.
But the villagers in the Belle Anse area say they've seen scant evidence of the program, as if officials have forgotten the deaths in 2008 of at least 26 severely malnourished children in this very region. That same year, the government collapsed after soaring food prices triggered riots.
USAID has allocated nearly $20 million to international aid groups to focus on food problems since Hurricane Sandy, but villagers in southern Haiti said they have seen little evidence of that.
Despite the discrepancy, one public health expert said there's sufficient proof that at least some of the aid is reaching the population. Were it not, Richard Garfield said, Haiti would see mass migration and unrest.
"Overall aid has gotten to people pretty well. If aid hadn't gotten to people that place would be so much more of a mess," said Garfield, a professor emeritus at Columbia University's Mailman School of Public Health and now a specialist in emergency response at the U.S. Centers for Disease Control and Prevention. "You'd see starvation and riots ... The absence of terrible things is about the best positive thing that we can say."
Government officials concede that not all of the 44 areas have received food kits and other goods as part of the Aba Grangou program.
"It hasn't arrived here yet. It's nothing but rhetoric," said Jean-Marc Tata, a math and French teacher and father of two who lives in Mabriole.
His 18-month-old son's hair began to turn orange after Tropical Storm Isaac knocked down trees, chewed up crops and killed livestock, leaving the family with little to eat.
"We had beans that were ready to pick but everything was lost. This has been a major cause of malnutrition," Tata said in a courtyard ringed with stone homes.
Tata said he had given his son a cup of coffee with a bit of bread, his only meal so far that day as dusk began to fall. The day before: a single bowl of oatmeal.
Haiti in general and the mountain villages in particular have long suffered from chronic hunger. Child malnutrition rates have been high for years. The United Nations' World Food Program reports that nearly a quarter of Haiti's children suffer from malnutrition, though the figure is higher in places such as Guatemala and the Sahel region in Africa.
Isolation doesn't help. A doctor in Belle Anse said his hospital has treated five children who were diagnosed with malnutrition this year. He said more parents would come if they could afford transportation and hospital fees, or take away time from work to make the journey on foot.
"The future is really threatened here," Tata said. "Our life is really threatened here."
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