Nutrition and the Philippines: ‘Nation at risk’

MANILA, Philippines — “Undernutrition is the single greatest threat to a child’s life.” 

Dr Martin Parreño, National Program Officer of the World Food Programme-Philippines, called on Filipinos to pay more attention to child malnutrition at all times — with or without disasters. 

Latest statistics from the National Nutrition Council (NNC) showed that 67% of Filipino families are not eating enough even when there are no calamities.

In the Philippines, malnutrition is seen across all age groups — from infancy to adulthood, the 2013 National Nutrition Survey revealed. 

“At the center of malnutrition’s underlying causes is inadequate childcare and feeding practices,” Parreño added. “And we don’t have a structure curriculum addressing this,” he said during the 2014 Dr Juan Salcedo Memorial Lecture organized by the Nutrition Foundation of the Philippines (NFP) on Thursday, October 9.

Children who grew up in homes where parents did not care or invest in proper food and hygiene will most likely grow up to become the same kind of parents, hence perpetuating the cycle.

The Department of Education has been working on integrating health and nutrition lessons in school curricula. More recent strategies also try to involve parents in classes and school-based supplementary feeding programs.

Such efforts, however, will remain fruitless unless more parents realize the value of nutrition and their roles as primary caregivers.

Plenty but weak

“Even if the Philippines has many good legislations, they are not well-implemented,” said Florinda Panlilio of NNC. (READ: Pending PH bills related to nutrition)

She cited the Milk Code as an example, “During disasters, when it comes to donations, we should also look at proper food habits and the community’s needs.”

In the aftermath of Super Typhoon Yolanda (Haiyan), survivors received donated powdered milk; this, however, is prohibited by the Milk Code — which promotes exclusive breastfeeding for infants under 6 months. Post-disasters, water and sanitation become problematic, placing the preparation of infant formula at higher risks of contamination, which can then lead to diarrhea. 

Adding another layer to the problem is the lack of awareness among some parents. “Evacuation centers are actually a good place to advocate nutrition. We can counsel parents to pay attention to nutrition during emergencies,” Panlilio added.

“If we can address those at the bottom first, we can secure the next level better. We can help prevent further complications like diseases,” Panlilio explained. “This way, we can prevent people from crowding hospitals.”

“Imagine if the pyramid is inverted and we start with everyone in hospitals, and the only cure is food and nutrition. Isn’t that a worse situation? That’s why nutrition is at the bottom, it’s the most important one,” she added.

‘Nation at risk’

Malnutrition occurs even before disasters hit. Post-disasters, however, nutrition-related problems may increase. (READ: On nutrition and disasters)

“Malnutrition problems usually come a few months after disasters. We can’t reverse climate change anymore. What we can do is to put a hold on it; it’s a global effort,” said Dr Willibald Zeck, Health and Nutrition Chief of Unicef Philippines.

Children, pregnant or lactating women are among the most vulnerable groups during disasters.

Zeck cited the following ways climate change can directly impact nutrition:

• Accelerates population displacement
• Threatens agriculture and food security
• Threatens use of nutritious food
• Affects livelihood and income
• Contributes to the global burden of diseases, further affecting the malnourished 
• Lessens access to safe water and sanitation

Meanwhile, Panlilio added that on top of climate change, poverty and conflict are also compounding the situation in the Philippines, which she called a “nation at risk.”

To achieve “zero casualty” during times of emergencies, the NNC came up with a strategy dubbed as “10Ps” — focusing on preparedness, policies, planning, partnerships, PESO (Public Employment Service Office), people, practice, package services, performance, and preemptive evacuation.

“After disasters, we report deaths. But let’s look at the survivors too. How are they doing?” asked Panlilio.

The NNC advised LGUs to invest on easy-to-understand educational materials informing the public about nutrition in emergencies. It also suggested that LGUs hold capacity-building workshops among barangays and put up milk banks among devastated areas.

“But we need electricity, transportation, and funding for all that,” Panlilio stressed. “We need a multi-sectoral action among governments, NGOs, health workers, and individuals.”

‘Doers, not talkers’

Although the Philippines has been trying to improve its health and nutrition programs, many are still left behind. Ironically, those left behind are the people who are doing the actual work.

Daryl Dy of NNC Region IV-B asked how come Barangay Nutrition Scholars (BNS) and Barangay Health Workers (BHWs), although serving at the frontlines of nutrition work, still lack tenure and benefits.

“It’s because services are devolved. For now, we can say that the national government cannot do much for us. We all know what the situation is,” Parreño said.

Although there is a law stating the benefits for BHWs, there are no fixed rates on their allowances. Bills proposing better work conditions for BHWs are all currently pending.

Panlilio also observed that some local nutrition programs are not well sustained. “Whenever there’s a change in leadership — for example in mayors or barangay captains — BNS are also replaced, they’re co-terminus.”

LGUs also differ in the amount of money they put in for health and nutrition programs. There are some which do not prioritize such programs. (READ: Malnutrition and poor governance)

“I’ve lost my dependence on government. I’ll go to the NGOs instead. Let’s just depend on those who really want to help people,” said Dr Jesus Inciong of NFP. “We need more doers, not talkers.”

To help address such concerns, the NNC advised the Sanggunian ng Lalawigan and local chief executives to also think of nutrition when coming up with policies and programs concerning the public’s welfare.

“Right now, we’re seeing a fight. Policy versus practice,” Panlilio said. — Rappler.com

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