JALAPA, Guatemala -- Some children check in. Others don't get to.

Those who make it to the Nicolasa Cruz hospital do so because a parent cobbled together enough money. Others leave because the cash ran out. And others avoid the general hospital altogether because their parents can't afford the pennies it takes to travel here.

These tales are part of the larger national discussion that has emerged in Guatemala after 14 children died in July of malnutrition and related causes. The worst drought in 30 years in Guatemala's dry corridor, where the city and department of Jalapa are located, killed almost 80 percent of the country's crops and depleted the food supply of subsistence farmers. President Alvaro Colom announced a ``public calamity.''

The children's deaths were in keeping with the more than 460 people who died this year of malnutrition in Guatemala, government officials say. Malnutrition is a perennial problem here; almost half of Guatemala's children under 5 suffer from chronic malnutrition, among the highest rate in the world, according to UNICEF.

Still, the focus is on Jalapa. About 130 children in the province are at risk of dying from malnutrition, says Catholic Relief Services.

On Sept. 26, Miami Herald photographer Carl Juste and I toured the Nicolasa Cruz, the Jalapa hospital that pushed Guatemala's malnutrition issue back into the public spotlight. Amid the Winnie the Pooh decorations on the walls and newly donated cribs, a few dozen mothers -- including one who was 16 -- rocked their tiny children in their arms. We were told the fathers were out searching for work.

These children were the lucky ones.

In the hills above the city of Jalapa, some children of subsistence farmers will never see a hospital -- even if the signs of malnutrition are obvious to outsiders. Mothers told us they couldn't afford medical treatment for their children or understand why a child was ill.

At house after house, children emerged from their adobe dwellings. They each displayed varying symptoms of malnutrition, according to a nutritionist who led the way.

Olga Gonzalez Lopez was 8 but looked 5. Chronic malnutrition.

Her younger sister, Jennifer, was also stunted: Two years old but looking just 5 months, she had swollen cheeks, a blank gaze and bloated legs speckled with large mosquito-like bumps, likely stemming from lack of hygiene or a bad diet. Grandmother Victoria said the toddler stopped eating. Acute malnutrition.

Neighbor Doris Gonzalez was 9 but looked much younger at 43 inches. Chronic malnutrition.

Her 6-month-old sister, Nely, had thin hair. Acute.

A pair of boys had cheeks with white splotches.

In response to the reports, the government and relief agencies delivered emergency food supplies to Guatemala. Venezuela, Ecuador, Chile and other countries have followed suit with shipments of beans, corn, and other food supplies.

But the relief won't last forever. The World Food Program warns that aid will end by the end of September if more money is not made available.

Meanwhile, families such as the Lopez's look to the sky for showers.

``We're going to pray to God that there will be rain,'' said Victoria Lopez, the grandmother of Jennifer, ``so that there will be a harvest.''

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