the amount of food provided was insufficient to satisfy, even moderately, the basic daily dietary needs of any individual.234 201. The inadequate nutrition of the members of the Community has had an impact on the growth of the children, because “the minimum rate of growth atrophy was 32.2% […], more than double what would be expected for the population in question (15.9%).”235 Also, the Community’s health care promoter indicated that at least “90% of the children are malnourished.”236 202. Consequently, despite what the State has indicated, there is no evidence that the assistance provided has met the nutritional requirements that existed prior to Decree No. 1830 (supra para. 191). 1.3. Health 203. Regarding access to health care services, the Commission argued that the children “suffer from malnutrition” and, in general, the other members of the Community suffer from diseases such as tuberculosis, diarrhea, Chagas disease, and other occasional epidemics. In addition, it indicated that the Community has not been provided with adequate medical care and the children do not receive the necessary vaccines. The representatives agreed with the Commission’s arguments and clarified that the new settlement (the village of “25 de Febrero”), is located 75 kilometers from the nearest health clinic, which operates “deficiently and does not have a vehicle that could, eventually, reach the Community.” Consequently, “the seriously ill must be attended to in the hospital in Limpio, which is more than 400 km from the Community’s settlement, and the bus fare is beyond the means of the members of the Community.” 204. The State indicated that the “complaints of the Xákmok Kásek leaders concerning medical care and medicines have been attended to” and indicated that the public health-care service is free in Paraguay. It reported that, since October 2009, the State has been employing an indigenous health care promoter to provide services to the Community, and a Family Health Unit had been assigned.237 Additionally, the State indicated that it had provided health-care assistance to the Community in its habitat and that the General Directorate for Vulnerable Groups provided medical assistance and had designed the health-care policy to be implemented. 205. The case file indicates that, prior to Decree No. 1830, the members of the Community had “receiv[ed] […] minimal medical assistance”238 and the health clinics were few and far apart. In addition, for years “the children had not received general the Republic) / 268 (number of members of the Community) = 87.89 Kg per person. This result 87.89 kg / 300 days, the period of time during which the State provided assistance = 0.29 Kg per day per person during that time. 234 The Committee on Economic, Social, and Cultural Rights considers that the core content of the right to adequate food is: “The availability of food in quantity and quality sufficient to satisfy the dietary needs of individuals, free from adverse substances and acceptable within a given culture.” (United Nations, Committee on Economic, Social and Cultural Rights. General Comment No. 12, supra note 223, para. 8). 235 Cf. Health evaluation in four Enxet Communities, supra note 218, folio 2649. 236 Cf. Testimony of Gerardo Larrosa, supra note 75, folio 606. 237 Cf. Report of December 16, 2009, signed by María Filomena Bejarano, General Director of the General Directorate for Assistance to Vulnerable Groups (file of attachments to the answer to the application, attachment 1(4), folios 3307 to 3308). 238 Cf. CEADUC Anthropological Report, supra note 55, folio 1742. 47