The ‘silent emergency’: Dying kids
DATU ODIN SINSUAT, Maguindanao—Silent emergency. This was how the United Nations Children’s Fund (Unicef) would call the undernourished children that have, for so long, troubled the Philippines’ health advocates.
Maguindanao is home to at least 20,000 of these children, who could be considered collateral damage in conflicts between government and rebels, between clans over land and between bandits and authorities that have gone on too long.
The children, weak and stunted with chronic cough, pneumonia and diarrhea, and in the tight embrace of their mothers, await their turn for checkup at a hot and arid health clinic not far from the town’s temporary shelter for displaced civilians.
The scene is the same every week. Children too weak to walk on their own are carried by their mothers in the clinic, a facility with three rooms that could barely accommodate the number of women and children seeking medical help.
Nurses and midwives are the busiest persons in the clinic. They hop from one patient to another, fastening colored tapes around the arms of infants and children, weighing them, measuring their heights as mothers watch wearily at the emaciated bodies of their young.
At least 62 children survived the point in which malnutrition turns deadly simply because their parents refused to let them die. Some, however, are not as lucky.
Saguiara Maulana, 25, still mourns the loss of her eldest son, Benjamin, 8, in March this year. She recalls the few years that she spent with her child. Before malnutrition sapped all life out of Benjamin, he was a healthy-looking boy. But years of lack of nutrition started taking their toll. Benjamin suffered diarrhea and lost all appetite to eat. When he died at home, he was too thin that his skin was barely attached to his bones.
Saguiara and husband Akmad, who have three other malnourished children—aged 7, 5 and a year old—earn P100 a day working on a farm that they don’t own in Lambayong, Sultan Kudarat.
Food was barely enough for them. Since they can remember, all they ate every day was a cup of rice cooked into a porridge each morning. Each family member gets three tablespoons per meal. The same menu is repeated at lunch and dinner.
They had eaten vegetables, but they can’t remember those days as these are rare. Over the years, the entire family was suffering from malnutrition, making them highly vulnerable to diseases.
Saguiara’s eyes appeared sunken. Her husband barely has any muscle to show.
The suffering was most apparent among the children—Alimin, 1; Amudin, 5; and Mo’Min, 7.
Mo’Min is not your typical 7-year-old boy. He should be up and about in school, but he could easily be mistaken for a 2-year-old. There’s barely any life in his body. He stares into emptiness, could barely move his reed-thin arms.
Sanaot, his grandmother, is at a loss for words and tears well in her eyes as she carries the frail child. “How come he came into this?” she asks, addressing no one in particular.
Annalee Padilla, nurse at the clinic that services the women and children in Maguindanao, says Mo’Min’s growth was stunted. “He is unable to go to school because he could barely walk,” she says.
Sanaot is happy that she had finally convinced Saguiara to bring the children to the clinic.
“My grandchildren are always sick and they’re tiny. One has died and I can’t just turn a blind eye on that. I need to do something,” says the grandmother.
Risk of dying
Unicef sees undernourishment of children as rooted in the displacement of civilians caught in the crossfire between the government and rebels.
The national average malnutrition is 6.3 percent of children. At this level, Unicef calls for urgent intervention.
While figures are not available, the percentage of malnourished children in Maguindanao is way higher.
“There are a lot of malnourished children out there who are at high risk of dying. We need to have something for them because they do not respond to regular treatments,” says Dr. Paul Zambrano, Unicef nutrition officer.
“In times of emergency there’s displacement, then there’s an initial problem in water and sanitation. If the displacement prolongs, then you have a possible outbreak of diseases. And the malnutrition problem is triggered by that situation. Like what we’re seeing now,” he says.
Zambrano says malnutrition is the main underlying cause of illnesses among children. “It makes children more prone to diseases and stunts physical and intellectual growth for a lifetime.”
Africa solution
What’s striking is that Unicef and other international agencies, like the Doctors Without Borders and Save the Children are now applying programs in Maguindanao and other conflict areas that they have used to combat malnutrition in Africa.
Some of the programs currently run in eight sites in Maguindanao, three in North Cotabato and one in Lanao del Sur.
The World Food Programme also helps. It distributes ready-to-use supplementary food to children from 59 months to 6 years old who are suffering from severe malnutrition.
Iron-fortified rice is given to pregnant and lactating women. Volunteers move around in search of severe malnutrition cases, visit homes and apply quick, immediate help.
“If we were not here, those children we had found now with severe acute malnutrition would have died at home,” says nutrition volunteer Guianera Mamintal, 23.
In the last eight months, at least 700 children are enrolled in a nutrition program on which the Unicef spends P2,260 per child. Unicef says the cure rate was 80 percent.
In Maguindanao, the program has reached the towns of Datu Piang, Datu Odin Sinsuat, Datu Saudi Ampatuan, Datu Paglas, Giundulungan, Talitay, Sultan Kudarat and Mamasapano.
In North Cotabato, it has reached the towns of Libungan, Pikit and Pigcawayan.
Unicef will bring the program to nine more sites in North Cotabato and six more in Maguindanao.
On a recent Tuesday afternoon, inside a ward for malnourished children of Dinaig Municipal Hospital, outpatient 7-month-old Datu Ali Solaiman, is in better shape.
His mother, Baidido, is closely watching him, smiling. “I will not again lose a child from this dreaded disease,” she says.
