CHILD malnutrition in the Philippines is now a national emergency recognized by the Department of Health, some legislators (but not enough), United Nations agencies, and religious and civic groups, as well as local government officials who see it on the ground. They are all trying to reverse it, but so far the numbers are too daunting for the resources available.

Child malnutrition causes stunting. It is the result of poverty and constant unaddressed hunger, which is only too prevalent here. If, somehow, there are survivors, they are unhealthy and unfit adults.

Unicef statistics for the Philippines state that 95 children die from malnutrition in this country daily. That one out of three children suffers stunting and 27 out of 1,000 children do not live past five years. This comes down to 20 percent of the general population not getting enough nutrients. One result is the prevalence of anemia in 50 percent of the adult population from iron deficiency which in turn causes fatigue and decreased immunity. Adults with this condition have not had the necessary nutrients in their early and present lives. It translates to missing school by children and therefore a lack of education, which in turn translates to low income from poor jobs in the future. It is estimated that the country loses 3 percent of GNP a year from this general state of malnutrition.

The following are categories of malnutrition: Stunted, too short for age; wasted, too thin for height; severely wasted, both height and weight inadequate and brain is affected.

I think the above are convincing enough for all of us to take note and do something in whatever possible way. Government agencies, unilateral institutions like Unicef and the World Bank, religious organizations, civic groups and private citizens are becoming involved. Among them is the Management Association of the Philippines, which recently recognized the situation and is mobilizing to help out. From the legislature, a law sponsored by Sen. Grace Poe, among others, provided for feeding programs in public schools. We have not seen much of its implementation, perhaps because of budget reasons.

There is, however, a glimmer of hope in a new substantive government program on stunting and malnutrition through a four-year $178.1-million World Bank loan known as the Philippine Multisectoral Nutrition Project. Lead implementers are the DSWD, DoH and the National Nutrition Council. This is through a new loan signed by then-Finance secretary Carlos Dominguez 3rd toward the end of the previous administration, which was revived last December and officially launched in March.

This Multisectoral Nutrition Project aims to reduce stunting under age 5, which was 26.7 percent in 2021 (the baseline) to 17.9 percent in 2028, an 8 percent reduction, which is a meaningful initial goal. The thrust is beyond feeding programs to a more holistic engagement with assessments of the quality and quantity of food distributed to indigent children and for the local governments in their locality to provide and maintain clean water sources, proper sanitation and housing conditions. Local governments are key partners and will be provided with grants and assisted in implementing them through the resources of the loan and monitored as to their performance in the matter of grants given. The DoH will get 70 percent of the budget and the DSWD, 30 percent. These are the two lead agencies in partnership with local governments.

Meanwhile, civic groups like Negrense Volunteers for Change, established in Bacolod in 2010; Angat Buhay of former vice president Leni Robredo; private charities through churches and professional groups are trying to stem the tide.

One of the stark facts that come with malnutrition is the poverty and ignorance that abet it. There are many local food items available in rural areas like mongo (mung beans), malunggay (moringa) which could give the necessary nutrients but are passed over in favor of rice (mostly in inadequate supply for poor households), junk food equivalents, or sugary concoctions.

The Negros Volunteers for Change, for example, concentrates on organized feeding programs by identifying undernourished children and feeding them Mingo Meals once a day i.e. food predominantly made with a mung beans mix. The children in the program are measured and checked for before and after results. Included here are instructions and demonstrations for the mothers in the use of local food items that are nutritious and adequate for growth and health.

As part of the education of mothers and their households, particularly for those who are not aware or are too lethargic about the problem, this group initially used cash incentives for the mothers to take their children to the health centers of the feeding program so they could be fed and measured. But they soon changed the cash incentives to food vouchers which are more useful to the community. A food voucher allows a family to source the necessary local ingredients for good nutrition (mongo, malunggay, squash, ube, etc.) from local farmers who in turn will be paid through the food vouchers. It turned out to be more practical as cash would sometimes buy cigarettes or liquor for some still in the dregs of poverty and ignorance. Also, part of the program on nutrition education that they have promoted is growing one’s own nutritious vegetables in just 10 square meters of land. Demonstrating this successfully results in the production of nutritious food.

The above is just one example of what a volunteer group is doing. Government help on a national scale is still vital to the success of the fight against malnutrition. This is not to say that local governments are standing idly by. The feeding groups report that local officials are the most useful and committed to fighting malnutrition in their localities when these groups come to help. They just need more resources because the malnutrition problem is bigger than the resources they have.

Angat Buhay, one of groups in the malnutrition fight, estimates that P8,000 per year would be needed for a child to win the fight against malnutrition. The figure is not only for food through food vouchers or

mingo meals but also for the personnel like barangay nutrition scholars who administer the program, educate the mothers and measure the results. They need to have expenses incurred paid.

There are many hotspots of malnutrition in the country, particularly in the Bangsamoro area in Mindanao that need help to fight malnutrition. Basilan is said to be one. But they go beyond Mindanao. Badiangan in Iloilo province is one with an ongoing program. Malabon City has been called a hotspot though let us hope that situation is being addressed. Angat Buhay is busy in Camarines Sur in the kindergarten schools. One volunteer noted that 6-7 year-old children in these schools showed low energy and lethargy. They also had serious reading comprehension problems which were causing anxiety in their teachers who felt they were not doing enough to reverse the situation. But in my opinion it is the result of malnutrition which brings on lethargy, which means the latter has to be addressed before better reading comprehension comes about.

Other countries like us have malnutrition problems but they are addressing them on a national level with government attention and funding. Peru, for example, has institutionalized feeding programs. Chile has nationwide centers for children to be brought into feeding programs whose progress is observed by weighing and measurements. Somehow they found the resources to do so. It is time we do too.