Fátima’s son, José, was severely malnourished. At two years of age, he was so small that Fátima wasn’t able to buy him shoes. For months Dr. Felipe, CREN’s paediatrician, tried relentlessly to fight off José’s recurrent infections with antibiotics and anthelmintics, without any success. One day, Dr. Felipe decided to visit the family home. Here he identified the main cause of José’s non-stop infections: the neighbours’ open-air sewage passed in front of Fátima’s house. This was barefoot José’s playground. Assuming that the family were too poor to find a permanent solution, Dr. Felipe suggested to lay planks of wood on top of the most contaminated areas in order to decrease José’s exposure to infections. Fátima “woke” up to the doctor’s suggestion and actively searched for resources, something that she had never done before. She decided to restructure her whole shack (barraco) and also bought a new sofa. The following month she went to tell Dr. Felipe: “Now my shack is beautiful.”
What is extreme poverty, a condition that affects Fátima and at least another 1 billion people in the world (World Bank, 2011)?
Our experience at CREN (Centre of Nutritional Recovery and Education) has shown that being poor means to be exposed to a range of adverse conditions that go against, limit, or put obstacles to the fulfillment of the person, to their “coming-to-be” themselves. People in poverty suffer from pain. It attacks a person not only materially but also morally, eating away at one’s dignity and driving one into total despair.
According to the World Bank (2000), pains caused by poverty include:
  • physical pain that comes with too little food and long hours of work;
  • emotional pain stemming from the daily humiliations of dependency and lack of power;
  • moral pain from being forced to make choices such as whether to pay to save the life of an ill family member or use the money to feed their children.
Thus, while poverty is material in its origins, it has psychological effects such as distress at being unable to feed one’s children, insecurity from not knowing when the next meal will come, and shame at having to go without. All these situations have strong symbolic value. People in poverty are also more likely to develop non-specific psychopathological manifestations and become mentally ill.
Frequently parents tell CREN’s staff that they deal with food insecurity by going hungry so that they won’t have to see their children starve. Poverty brings a humiliation for the parent who is unable to feed their children. In this sense, material poverty reinforces a sense of personal limitations and inhibits the fulfillment of the person. Living in this situation is to live inhumanly, deprived of something more than food or money. The vicious cycle of this existential malnutrition is rendered inevitable by the effects of lost confidence in the ability to earn a living or to fulfill an ideal.
In addition to this, the place to where one belongs is also the place that provides one an identity. In the ’70s, mass migration from the north to the south of Brazil caused a boom in the number of urban slums. Millions left their homelands for the urban cities in search for better conditions, education and work, places in which they had no historical, cultural, or social roots.
Over time, people in these conditions understand that they are not human beings like others, that they are not as valued. The person becomes fatalistic and powerless, believing that if happiness exists, it is not meant for him or her. Poverty provokes a sort of amnesia: the person forgets who he or she is and merely accepts their dehumanizing conditions. This double composition of poverty explains why paternalistic interventions, focused only on improving material conditions, fail.
As such, our treatment at CREN attempts to make a friendship, a companionship, in which an equality of needs (both those of the patient and the professional) is acknowledged and made visible. For the wound of poverty to be treated, it is not enough to undo the material disadvantage, which has been inflicted; it is also necessary to reach out to the wounded person and welcome him back into the human family. “Exclusion,” then, is not primarily an economic phenomenon, but an existential one.
This brings us to the following questions: what promotes the awareness of who we are? How can we experience dignity again? How can we overcome poverty?
Experience shows that several elements are crucial in this pathway, we must:
  • be part of a family and a community that recognize the value of the person;
  • be able to contribute to the construction of something with our own skills and work;
  • have an ideal for which it is worthy to live — an ideal of beauty, justice, truth and/or love.
The basic material conditions to achieve this are:
  • access to good quality education, health, nutrition and housing;
  • ability to express our religious experience freely;
  • ability to constitute groups and associations;
  • protection from all sorts of violence.
In order to guide collective human development, it is necessary:
  1. The promotion and development of local social network supporting the creation and existence of local businesses, social interventions, communitarian associations, schools etc., that should be rooted in the local culture and traditions, while at the same time promoting the common good of those communities.
  2. The elimination or at least control of mechanisms that rob community wealth, such as corruption and financial use of capital by persons that do not own the capital itself.
Innovative ideas and approaches that will lead us to a meaningful change in our world today are ones that are locally rooted and are successful in promoting common good and constructing and strengthening local communities. This coming year, it is hope that leads me to Davos — hope that the strategy to construct a global alliance can be found, where all are involved in the aim to ensure that everyone has enough to live, always, where “enough to live” considers all the human needs that are far more than the basics. I am hopeful to find stakeholders and potential partners that want to construct this global movement that will lead us to fight against the suffering originated from poverty.
This article is published in collaboration with Medium.
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Author: Gisela Bernardes Solymos is the General Manager of CREN (Centre of Nutritional Recovery and Education).
Image: Residents are seen in the Villa 31 slum, which censuses show has grown 50 percent in the past four years to currently house some 40,000 people, near the 100-year-old railway station Retiro in the heart of Buenos Aires, February 9, 2014. REUTERS/Enrique Marcarian.