Acute malnutrition a reality

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Tuesday, July 29, 2014


MARINEL, a mother of three children, fed them with rice and salt for dinner since her contract in a mall as a saleslady expired.

She said she has no money left from the salary she received from the company before her contract expired because she had debts to pay.

The rice-and-salt fare has been their regular has been the usual food she serves to her children recently.

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As a single mom, she said she engages in “last-two” to at least feed her family.

Her children—Andy, 5, Rose, 4, and Michael 1— fight the battle of malnutrition almost every day.

In 2013, the Davao City Health Office (CHO) recorded a total of 2,014 children with severe acute malnutrition (SAM) as of 2013, mostly are in downtown area where there are informal settlers.

CHO head Dr. Josephine Villafuerte said they are able to identify these children through their program “Operation Timbang”, wherein every child, aging six years and below are weighed.

Severely Acute Malnutrition (SAM) is defined to be a deadly form of malnutrition. The risk of dying is nine times higher and intervention is narrow.

The CHO 2013 briefer states that nine out of 16 admin districts in the city have at least 100 children with SAM.

Based on the data provided by the CHO, Talomo south district has 340 children with SAM, recording the highest number in the city.

Barangays in Talomo south district are: Bago Aplaya (52 children with SAM), Bago Gallera (six), Baliok (40), Catalunan Pequeno (68), Dumoy (16), Langub (16), Ma-a (100), Magtuod (four), and Talomo Proper (38).

Talomo north district recorded 141 children with SAM -- Bucana (40), Matina Crossing (23), Catalunan Grande (38), Matina Aplaya (27), and Matina Pangi (13).

In the first congressional district -- District A (Barangays 1-10) has 89; District B (11-20) - 26; District C (21-30) - 30; and District D (31-40) - 64;

In the second congressional district -- Agdao has 187; Buhangin - 147; Bunawan - 171; Paquibato - 131; and Sasa - 67.

Third congressional district - Baguio District has 55; Calinan has 81; Marilog has 180; Toril has 165; and Tugbok has 174.

Villafuerte said they already recorded one death in the city in 2013.

She said the cause of death of the child, however, was not directly linked to SAM but to pneumonia and diarrhea.

"Children with SAM need immediate attention. Acute malnutrition has effectively addressed in the last decade through an intervention called integrated management of Acute Malnutrition," the briefer read.

Villafuerte said ready-to-use therapeutic food, also known as “pagkain gamot”, is "found to be an important element of the intervention."

The briefer states that: "The intervention is recognized by UNICEF and WHO as the only established, evidence-based intervention which successfully addresses the problem of acute malnutrition."

With the initiative of the Unicef, ACF, and CHO, Villafuerte said they hope to record zero-case of SAM by next year.

She is optimistic that the parents of the children with SAM will be motivated to help them address the problem of acute malnutrition.

Villafuerte said Unicef is allocating P5,700 per children with SAM for its intervention and rehabilitation.

According to the World Health Organization (WHO), malnutrition is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause.

The common cause of malnutrition includes lack of access to highly nutritious foods, especially in the present context of rising food prices,” the WHO said.

Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, and not ensuring that the child gets enough nutritious food, contribute to malnutrition.

Infection – particularly frequent or persistent diarrhoea, pneumonia, measles and malaria – also undermines a child's nutritional status.

A recently developed home-based treatment for severe acute malnutrition is improving the lives of hundreds of thousands of children a year.

Ready-to-use Therapeutic Food (RUTF) has revolutionized the treatment of severe malnutrition – providing foods that are safe to use at home and ensure rapid weight gain in severely malnourished children.

The advantage of RUTF is that it is a ready-to-use paste which does not need to be mixed with water, thereby avoiding the risk of bacterial proliferation in case of accidental contamination.

The product, which is based on peanut butter mixed with dried skimmed milk and vitamins and minerals, can be consumed directly by the child and provides sufficient nutrient intake for complete recovery.

It can be stored for three to four months without refrigeration, even at tropical temperatures. Local production of RUTF paste is already under way in several countries including Congo, Ethiopia, Malawi and Niger.

Following the consensus on community-based management for severe malnutrition reached in a informal consultation in 2005, WHO has worked with UNICEF on the development of a field manual on community-based management of severe malnutrition, and the IMCI guidelines have been revised to take account of the new home-based treatment.

“Unta mapansin mi sa gobyerno nga kinahanglan pud namo ug tabang diri. Ako, walay trabaho. Akong mga anak, gutom (I wish government will notice us. I am jobless, my children are hungry),” Marinel said.

Published in the Sun.Star Davao newspaper on July 30, 2014.

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