Working together to end severe malnutrition in Bangsamoro children

One in every two children in the Bangsamoro region is malnourished. The COVID-19 pandemic has made the situation worse as children miss out on health and nutrition services.

UNICEF Philippines
Working together to end severe malnutrition in Bangsamoro children
UNICEF Philippines/2020/Pailyn Tan
25 March 2021

One in every two children in the Bangsamoro region is malnourished. The COVID-19 pandemic has made the situation worse as children miss out on health and nutrition services due to severely limited outreach to remote barangays made more difficult by restrictions on movement within the region. Strict community quarantines have led to job loss and less income for already poverty-stricken families.

When her then 9-month-old daughter Norhata got sick, Normina, 33, braved the 5-kilometer distance to her town’s rural health center to ask for help. Her usual concoction of leaves and coconut did nothing to treat the severe cough and fever.

At the health center, Normina met Saida, a nutrition worker who immediately helped them. “They checked my daughter and gave us some medicines,” Normina said. “They told me that she had severe acute malnutrition and needed immediate help.”

Children who have severe acute malnutrition (SAM) are too thin for their height and age. SAM is a serious child health problem especially in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) where remoteness and poverty make access to basic health and nutrition services difficult.

The family lives in Datu Saudi Ampatuan, 55 kilometers from Cotabato City in BARMM. Normina’s husband is a farmer while she stays at home. All seven children were delivered at home and had never been vaccinated or checked by health workers. Normina admits that her children are unusually thin, but she believes they just took after her small and thin frame.

Norhata weighed 4.6 kilos – less than half of the average weight for children her age. Her twin sister, Norhaya, had similar health problems although not as bad as hers. Children should be exclusively breastfed from birth and then given complementary solid food starting 6 months. But the girls were only getting sugared water. If they’re lucky, they also get a small bowl of porridge.

Severe Acute Malnutrition (SAM) is a serious child health problem especially in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) where remoteness and poverty make access to basic health and nutrition services difficult.

Working together to end severe malnutrition in Bangsamoro children
UNICEF Philippines/2020/Pailyn Tan
Following the advice of the nutrition worker, Normina and her husband have started their own vegetable garden to provide their children with a diverse diet.

A long-standing, prevalent problem for children

Saida, 27, easily recognized the symptoms of SAM and gave them supplemental food and vitamins. She also encouraged the mother to give Norhata bigger meal portions, difficult advice to follow given the family’s meager income.

“Malnutrition is common in our town especially among families with many children. Food is scarce so when babies start eating solid food, they are given small portions compared to the rest of the family,” she said, adding that dietary diversity is poor and mothers often could not breastfeed because they themselves are malnourished or too busy working the farm with their husbands.

Saida knows the risks of SAM all too well. When left untreated, severely malnourished children are more prone to diseases. In her 11 years as a volunteer, she’s seen them suffer from health complications, stunted growth, and even death. When the family missed their weekly visit to the center, she got worried and visited their home to check on their situation.

Allies in full recovery

Saida worked with the family to improve the nutrition of the twins and their older siblings. But starting a vegetable garden to supplement the family’s meals, and the vitamins provided by Saida were not enough. The twin’s progress was excruciatingly slow.

But help came just in time for the twins. UNICEF, in coordination with the Health Organization for Mindanao, delivered boxes of ready-to-use therapeutic food (RUTF) to their health center. These supplies – for 20 rural health units in Lanao del Sur and Maguindanao provinces – are part of the COVID-19 response in BARMM supported by the Government of the United Kingdom and UNICEF Philippines. Under this partnership, some 90,000 children under 5 have been screened for SAM since October 2020. Furthermore, over 29,000 pregnant, lactating women and caregivers are being reached with messages about proper infant and young child feeding. 

Nutrition workers assess the nutrition status of the children by measuring the mid-upper arm circumference (MUAC) or checking the weight-for-height/weight-for-length of infants and children aged 6-59 months old. Depending on the severity of malnutrition, they provide RUTF to the children and help them recover in six to eight weeks. Moreover, nutrition workers provide information to mothers and caregivers on the causes of malnutrition and how to prevent it.

“Malnutrition is common in our town especially among families with many children. Food is scarce so when babies start eating solid food, they are given small portions compared to the rest of the family.”

Saida Teng, Nutrition worker
Working together to end severe malnutrition in Bangsamoro children
UNICEF Philippines/2020/Pailyn Tan
Volunteer nutrition worker, Saida Teng, goes around remote areas in a tricycle to reach children with RUTFs and distribute COVID-19 materials to the communities.

Investing in nutrition for every child

With the right treatment and support, a child with even the most serious SAM case can make a full recovery like Norhata and Norhaya. Thanks to the effort of Saida and their parents, the twin’s height, weight, and MUAC are now normal.

But the real challenge is maintaining their normal nutritional status.

“The twins are just two of the many SAM children here in our town. Some of them are not even reached by our services because of many reasons including armed conflict,” Saida explained. “To help these children, we need to support the provision of food commodities and supplements like the RUTF.”

Her fervent hope is that the government looks into the grave nutrition status of children in the whole Bangsamoro region and how it impacts all Bangsamoro people. “We need more investment in nutrition for every child in BARMM.”

“To help these children, we need to support the provision of food commodities and supplements like the RUTF.”

Saida Teng, Nutrition worker
Working together to end severe malnutrition in Bangsamoro children
UNICEF Philippines/2020/Pailyn Tan
Saida Teng, a nutrition worker in Datu Saudi Ampatuan checks that she has the complete set of nutrition supplies to bring to the families in remote areas.