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Curbing malnutrition in North Cotabato and Maguindanao

© Paul Zambrano
Dr. Paul in a light moment with children in Maguindanao.

by Dr. Paul Andrew Zambrano
UNICEF Nutrition Officer for Emergencies


The nutrition of children in conflict-affected areas in Mindanao continues to be a serious concern for us at UNICEF.

Recurring emergencies due to armed conflict and natural disasters in this region – combined with challenges on appropriate infant and young child feeding practices, and high incidences of diseases – threaten the well-being of young children here.

I personally wish to thank UNICEF donors and supporters, and tell them how they help improve the lives of children in Mindanao.

Malnutrition among Filipino children

I manage a program that treats severely malnourished children in Maguindanao and North Cotabato, two conflict-affected provinces.

Malnutrition is caused by a number of factors related to health care, food intake, with underlying socioeconomic and cultural factors.

While some progress has been reached in the past decade, stunting has only decreased from 37 per cent to 32 per cent between 1990 and 2008, increasing to over 33 per cent in 2011. If not prevented, the long-term effects of stunting on a child’s development are not reversible by age two. Wasting, a deadly form of malnutrition, increased to over 7 per cent for the whole country in 2011. In ARMM, this increased to more than 10% which is a serious level. Vulnerable groups – like the children we care for here – also suffer from very high anemia rates.


Accompanying UNICEF Special Advocate for Children Daphne Osena Paez in Mindanao to see Fahad, a malnourished child.©UNICEF Philippines/2010/Arcayan

In the Philippines, only 63.2 per cent of children 6-23 months old reach the minimum variety of foods for a good diet. Twenty-eight per cent of children under 5 were moderately or severely malnourished in 2003-2008. It is also estimated that malnutrition is an underlying condition in more than a third of deaths of children younger than five years. Severely wasted children have a high likelihood of dying if they don’t receive appropriate treatment. The long term effects of malnutrition are impaired learning and development and reduced income earning potential as adults.

Rewarding experiences in the field

Despite the negative perceptions people have of Central Mindanao, we have seen the leadership and drive of government to ensure that this pioneering program succeeds. Working with various partners, we were able to establish a nutrition program that has benefitted thousands of children. I believe what the local health staff has accomplished in both areas also serves as an example for the rest of the country to follow.

Every child we’re able to cure successfully is an emotional experience for us. When we first see them, they’re very thin and wasted, hardly moving, hardly interacting, and looking very close to dying.

But in just a couple of weeks, they begin to move much more, smile, and look and act like regular children. Sometimes a child changes so much in just one week that I could hardly recognize him or her.

It’s not just seeing the life coming back to these children that makes the experience very moving. We also see a change in their mothers and fathers, who show renewed hope in their faces and a sense of pride in their role in their child’s recovery.

I have also seen dramatic changes in the attitudes of community health staff in our target areas who now view their role as health workers with a stronger sense of relevance and purpose.

The stories of all these children, parents, and community workers continue to touch and motivate me. I believe I have also changed so much as a person, and for the better, with these experiences.


Fahad before and after: Children severely malnourished likeFahad survive and thrive just weeks after being enrolled in the community prorgam for treatment of severe acute malnutrition. (After picture care of Save the Children.)

UNICEF on the ground

I enjoy working with UNICEF because we are able to take global innovations, work with global experts, and access the most relevant studies and research in order to establish programs localized for the Philippines – interventions that make a tangible impact.

This impact is not only felt at the level of each child. Working with UNICEF has provided me the opportunity to influence positive, long-term change at the level of the household or barangay on one hand, and the highest levels of government on the other.

One day I could be in a small health center in Maguindanao, teaching barangay health workers how to properly measure the weight and height of children. A couple of days later, I would be in a meeting with the Secretary of Health, discussing national guidelines on the treatment of malnutrition.

The work is challenging, exciting, occasionally surreal, yet intensely gratifying in reaching the most vulnerable Filipino children. It also allows me to continuously learn and develop, while helping me achieve my personal goal, which is to make a lasting difference in the lives of my countrymen.

Our gratitude

Again, I would like to express my heartfelt thanks to you, our donors and supporters.

I have personally experienced how your support has translated into life-saving interventions and programs for the most vulnerable children and their families.

We have achieved a lot, but there is still much to be done, as we face challenges both old and new. With the support of people like you, we will continue to give more children in need the chance to live and grow normally, study, play, laugh, and experience the joys of childhood, far from dangers or threats.

 

 
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