On nutrition and disasters

Fritzie Rodriguez
'The problem is that we don’t maximize our past experiences with disasters'

NUTRITION. How do disasters affect the nutritional status of Filipino families? File photo by LeAnne Jazul/Rappler

MANILA, Philippines – “The Philippines is at high risk of artificial feeding during emergencies – which is why breastfeeding becomes a life-saving intervention,” said Allesando Lellamo of Unicef Philippines.

Lellamo, a specialist on Infant and Young Children Feeding (IYCF), emphasized that children aged 5 and below are the most vulnerable group during disasters. “In Zamboanga, they count newborn deaths every day.”

Super Typhoon Yolanda (Haiyan) alone devastated over a million children and women, including breastfeeding mothers. It left around 21% of affected communities with insufficient breast milk.

“Emergencies increase the risk of not breastfeeding,” Lellamo stressed. This places more infants at higher risk of illnesses and death.

This is one of the reasons why the National Nutrition Council (NNC) chose “Kalamidad Paghandaan: Gutom at Malnutrisyon Agapan” (Prepare for Calamities: Cope with Hunger and Malnutrition) as the theme for this year’s National Nutrition Month.

“The Philippines is a nation at risk. We are rich in natural resources, but also in poverty, armed conflict, and natural calamities like earthquakes, typhoons, deforestation, and warmer ocean waters,” Hygeia Gawe of the National Nutrition Council (NNC) said.

All these affect livelihoods, agriculture, hospitals and markets; hence, straining food and nutrition security. (READ: Hungry 6 months after Yolanda)

Mother’s milk

BREASTFEEDING. Exclusive breastfeeding for the first six months and continued breastfeeding with adequate complementary feeding alone were estimated to prevent almost one-fifth of under-five deaths in developing countries like the Philippines. File photo by Ted Aljibe/AFP

Exclusive breastfeeding is recommended for infants from birth up to 6 months. Complementary foods can then be introduced after the 6th month, while breastfeeding continues until a child’s second year or beyond.

During disasters, breastfeeding is disrupted either because children are orphaned, mothers get sick, or mothers are misinformed.

“Some mothers complain that they lack breastmilk. They may actually just don’t know proper breastfeeding. We can counsel and help them lactate,” Gawe said.

Gawe emphasized that evacuation centers should have breastfeeding rooms, mother-baby friendly spaces, breastfeeding and IYCF support groups. (READ: Role of dads in breastfeeding)

She also reminded LGUs to strictly implement the Milk Code, which encourages breastfeeding and prohibits the donation of substitutes like infant formula.

“Emergencies are exempted from the law? No. We need to educate businesses, parents, and LGUs. Monitor and report milk code violations to NFA or regional DOH offices,” Lellamo suggested.

SANITATION. Illnesses can spread because of unsanitary environments and unsafe water. Photo by Fritzie Rodriguez/Rappler.comDuring emergencies, water is scarce and evacuation centers are often crowded and unsanitary. Preparing infant formula may be difficult and may expose mothers and babies to unsafe water and utensils.

Lellamo shared that in Indonesia, before they prohibited the donation of infant formula, those who received donations during disasters were at higher risk of diarrhea.

“When we see mothers during emergencies, let’s encourage them to properly breastfeed,” Gawe said.

“It’s not just knowledge we need, but also behavioral change,” Lellamo added. He recommended that LGUs start human milk banks and for mothers to practice surrogate breastfeeding which involves nursing children who are not their own.

Role of LGUs

The Philippines, in fact, has policies on nutrition during emergencies. One of these is an NNC resolution from 2009 which adopted the “national policy on nutrition management in emergencies and disasters.”

The policy sets guidelines on nutrition interventions, planning, and evaluation for concerned government agencies, local government units (LGUs), and non-government organizations (NGOs). (READ: Hunger and governance)

Gawe explained that the country’s nutrition cluster is divided into 3 levels: national, regional, and local – pertaining to the provincial, municipal, and barangay levels.

National Nutrition Cluster

Chair: NNC
Co-chair: UNICEF

Member organizations
PH Government Agencies

Local NGOs and International Organizations

DOH (HEMS. NCDPC, NCHFD, NCHP) ACP International
DOST-FDA Arugaan
DOST-FNRI Child Fund
DSWD (DRRROO, CWC) Helen Keller International
DILG Medecins Sans Frontieres
DTI Merlin
DepEd Philippine Red Cross
CHED Plan International
  Save the Children
  UN World Food Programme
  World Health Organization
  World Vision

 

Each LGU should have a “nutrition committee,” working together with the local disaster coordinating council. The committee may include those from the local health, nutrition, and social welfare and development offices, schools, and NGOs.

Nutrition planning identifies a community’s nutritional status, socio-economic, cultural, and demographic factors, target groups, potential allies and donors, nutrition and calamity funds and resources, and the types of assistance needed.

Communities must also ensure the supply of “nutrition packages”:

  • Food rations for mass and supplementary feeding
  • Micronutrient powder
  • Vitamin and mineral supplements, antibiotics
  • Tools for nutritional assessment: height boards, weighing scales, MUAC tapes
  • Necessary infrastructure, communication, and transportation facilities:
  • Ready-To-Use-Therapeutic Food (RUTF)

Preparedness is key. Preparedness is different from response. You don’t orient people during response, this happens before emergencies,” Lellamo stressed.

Source: National Nutrition Council

Each LGU should train its service providers and provide them with “physical, psychological and emotional support” during and after operations.

“LGUs should have a plan, local ordinances should be passed. Put theory into practice,” he added. These ordinances may include:

  • Micronutrient supplementation
  • Mandatory fortification of rice, flour, sugar, cooking oil, salt
  • Regulation of the marketing of breastmilk substitutes
  • Zinc supplementation for diarrhea management
  • Deworming, vaccination

LGUs are also advised to conduct emergency school feeding programs, food or cash for work programs, and sanitation services.

Citizens should be assisted in developing their skills and coping mechanisms, hence helping them become self-governing and self-reliant.

“Families should also be prepared for emergencies, and not always dependent on LGUs,” Gawe advised. She asked families to stock non-perishable and easy to prepare food, high energy snacks like peanut butter and crackers, and clean water. (READ: Disaster kit)

The Philippines has been experiencing different types of calamities for years, and yet each time a new typhoon comes, many people still remain clueless. “The problem is that we don’t maximize our past experiences,” Lellamo argued. – Rappler.com

How can we help fight hunger, especially at times of disasters? Report what your LGU is doing, recommend NGOs, or share creative solutions. Send your stories, ideas, research and video materials to move.ph@rappler.com. Be part of the #HungerProject.

Also visit #ProjectAgos for more information on disaster preparedness, response, and recovery.

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