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As a 19-year-old Mormon missionary in Ecuador in 1980, Bradley Walker couldn't avoid seeing the poverty, disability and diseases afflicting converts he was bringing into his church.

On a return visit as a Brigham Young University student in 1983, Walker was again struck by the members' needs. He saw a woman he had baptized coughing up blood. Her tuberculosis could be cured with a $200 treatment, but she couldn't afford it. Walker, who had spent four times that much on his airfare, considered giving her the money, but didn't. Three years later she died.

Now Walker is a public health physician in Las Vegas and on a new mission: to improve the health of LDS Church members in Third World countries.

"The church could easily modify its welfare program to provide each faithful member with minimal nutrition and access to health care," said Walker in a phone interview from his Nevada clinic. "That would bring the church closer to its goal of being a Zion society."

With the help of more than 30 LDS stake presidents and other leaders in Mexico, Guatemala, Ecuador, Peru and Brazil, Walker spent years collecting data on the health problems, particularly malnutrition, of Mormon children in Latin America.

Extrapolating from membership statistics, church financial statements and wide-ranging interviews, he concluded that at least 375,000 "faithful and active Latter-day Saints" in Latin America live in "dire poverty," including 50,000 children under 15 who are malnourished and growth-stunted, 2,000 who have annual cases of severe, preventable disability, and 900 annual preventable deaths.

"In some wards, 80 percent of the children are chronically malnourished and/or dying of malnutrition," Walker wrote in a 2002 essay in Dialogue: A Journal of Mormon Thought. "Most of this suffering could be relieved by a reallocation of less than 10 percent of the $400 million received annually by the church in cash donations for welfare."

Walker proposes that the LDS Church adopt a "second welfare program," focusing on Third World malnutrition and medical needs. It would be funded by member donations around the world and administered by professionals, not by LDS bishops.

Some think, though, that the cost of what Walker is proposing would be much greater than he expects. And others worry that offering health care to Third World members would encourage people to join the church for its economic benefits.

"The gospel raises people out of poverty and dependency, but only when gospel culture, including the faithful payment of tithing even by the very poor, prevails over tradition and cultures of dependency," said LDS Apostle Dallin H. Oaks at last year's General Conference. He was referring to his experience living in the Philippines for the last two years.

Kirk Dearden, a BYU health science professor whose specialty is malnutrition, applauds Walker's efforts but says the church should work with established nongovernment organizations rather than establish its own program.

"To ignore what other groups are doing is both arrogant and ignorant," Dearden said. "We should find out what is working locally and help them do that. And we shouldn't just focus on Mormon kids."

Walker has answers for all his critics, he said. He will be in Utah next week, presenting his research and proposals during the 2004 Sunstone Symposium, an independent forum for Mormon thought which has no official connection to The Church of Jesus Christ of Latter-day Saints.

The four-day meeting, which kicks off on Wednesday night at the Sheraton Centre Hotel in downtown Salt Lake City, will feature presentations on everything from new research on Noah's flood to black African Jews and the LDS priesthood, problems with the Book of Mormon, television shows that enhance spirituality, the so-called DaVinci code and the divine feminine and "Internet Mormons versus Chapel Mormons."

On Saturday, Walker will be joined by three Ecuadoran Mormons -- two physicians and a health-care educator -- for a panel: "50,000 Malnourished LDS Children?

How Can We Help?

A history of service: The LDS Church has long had an interest in members' economic well-being. In the 19th century, it experimented with communal living and shared resources. It first asked members to give all their means to a common storehouse, receiving back their basic needs. When that was too difficult, the church asked members to tithe, or give 10 percent of their income.

By the late 19th century, the church also had established a monthly "fast day," when members would forgo three meals and give the money saved to the church to help the poor. Today, tithing goes to church headquarters to be used at leaders' discretion. But the "fast offerings," as they are known, stay within a local area to meet the needs of its members.

In the midst of the Great Depression of the 1930s, the LDS Church established its own welfare system to supplement the U.S. government's efforts. Donated food, clothing, furniture, appliances and cash were distributed to the needy in exchange for some hours of work. Mormon volunteers work in canneries, bakeries and farms to produce the food.

That is a model that still works in North America, Walker said, but not in Third World countries.

In 2002, the church launched a pilot program in Ecuador with an annual budget of $100,000 to provide a ration of food staples like beans, oil, flour, sugar, oatmeal, powdered milk and noodles every 15 days to faithful, needy members, as certified by the bishop.

It was deemed a failure, Walker said, for several reasons:

* Demand far exceeded supply and congregations competed for the goods, causing bad feelings and increased dropout of members and even leaders.

* Fraud occurred in some instances via diversion of food to nonmembers and from children to adults.

* Bishops experienced intense pressure to assist members who questionably qualified for assistance (not enough guidelines regarding who should qualify).

* The transportation of the food supplies was inadequate -- food was purchased on the coast then shipped to a central storage site, then moved to bishops' homes, costing 40 percent of the funds.

* Many malnourished children never were identified as needing assistance nor received it.

* Attempts to initiate "work" programs were unsuccessful and the program was subsequently limited to "short-term" assistance only.

"Simply transferring the church's U.S. welfare system to less developed countries cannot possibly succeed, and even if successfully implemented, would leave the large majority still malnourished and untreated," Walker said.

What he proposes is a "second welfare program" that would be professionally operated and managed, rather than rely on bishops to administer.

Food supplements, manufactured locally at a cost of 15 cents a day per person, could be distributed on a monthly basis in LDS chapels or during home health-care visits. Bishops could require some level of church attendance and work to get the supplements.

A corps of trained health-care workers could visit LDS homes to educate members on nutrition, water sanitation and other health issues. LDS chapels could be opened monthly for "health fairs," where nurses and other professionals would not only educate the people, but offer periodic services such as de-worming and vaccinations.

Walker sees such efforts as "an investment in our children," rather than a new kind of welfare.

Self-sufficiency, gospel practice and future leadership are impossible, he said, unless the child "survives into adulthood with a functional body and a functioning mind."

LDS children in Ecuador wait to have their health-care needs evaluated at their Mormon chapel. Malnutrition is widespread in developing countries.; Lorenzo Qaraycoa This LDS child in Ecuador was hospitalized for malnutrition and later died.; Teresa Fuentes Health-care workers in Ecuador measure the growth of LDS children who might be malnourished.; Jump Page C2: Teresa Fuentes Health-care workers evaluate the needs of LDS children in Ecuador.

Teresa Fuentes

Jump Page C2: Graphic: Elements of LDS Welfare System (table) The Salt Lake Tribune