by Michèle Joie
A few weeks back, I came across a heart-wrenching clip of a two-year-old child afflicted with malnutrition. Thin to his bones and skin appears flaky and straw-like, Roel is not like any other toddler. His eyeballs were nearly scooped out its sockets. His body appeared too fragile — like that of a newborn — even if at his age, he should’ve been running. He struggled to move and wailed all throughout. The child is suffering from his condition so bad that watching the clip felt like a cross to bear.
Being a mother of a nearly two-year-old boy closely aged like Roel, the clip hit home. I could feel how he struggled trying to crawl with his elbows. Roel is still unable to talk despite his age — only communicated to his parents and eight other siblings through cries of help and could hardly utter the words papa and mama. “Kung ‘yan ay nakakasalita, masasabi niya sa akin ang totoo [niyang nararamdaman],” his father said. (If only he could talk, then he would be able to say [what he really feels.])
At 24 months, Roel weighed 4.1 kg, roughly a kilo more than my son’s birth weight of 3.4 kg.
According to World Health Organization, children aged like Roel should have at least weigh 9.8 kilograms. At 24 months, children of developmentally sound health should already be able to walk, recognize things and people, and speak at least 25 words and coordinate them correctly. Unfortunately, Roel has hit none of these milestones as he is severely malnourished.
Poor provincial life
Roel lives in the remote area of Camarines Sur together with his parents, Sonia and Pablo Acunin, and six elder siblings. The matriarch only knew how to weave leaves and this has been her way to earn a living. She was only able to finish primary school, and apparently, her elder children are following her footsteps. Roel’s elder siblings help in their parents’ livelihood and with this, the family earns a meager 100 pesos (6 cents) — an amount that could only save an individual from a day-long hunger, let alone a family with 11 grumbling stomachs.
If a family could hardly meet three filling meals a day, how could they even afford to buy the nutritious food they ideally need? Apparently, Sonia’s family is left with no choice. To get through their hunger, Sonia cooks rice and sinigang na talbos ng kamote (sweet potato tops) with nothing else but a touch of vetsin (monosodium glutamate).
On lucky days, Roel gets his bottle or two of one of the cheapest powered milks available in the market, roughly priced at 10 pesos each pack (2 cents). The amount of water in his feeding bottle overpowers the hint of milk so as they could stretch the days Roel gets a “nutritious” drink. It’s not surprising that families aren’t thriving in terms of health. With a scarce income, the first thing they’ll deal with is how to get over the day without dying starved.
Economic cost of malnutrition
Unfortunately, Roel isn’t the only one battling severe malnutrition in the nation. In fact, the Philippines leads in the number of malnourished and stunted children in ASEAN countries. Despite the government’s persistent effort in combating malnutrition, it appears that it’s still not enough to eradicate hunger.
One in three children below five years of age is affected by malnutrition. Meanwhile, 26 percent of two-year-olds suffer chronic malnutrition, an all-time-high rate in the last decade. When a child continues to be malnourished for a long time, this will eventually lead to childhood stunting — the most common form of undernutrition that generally affects a child’s overall growth and development.
Childhood stunting post vast effects on the economy. It’s easy to think that it’s only the child who could bear the negative effects, but unknown to most, malnutrition and stunting are economic costs to all of us. In 2013, the country lost about 384 billion because of malnutrition and stunting, or about 2.84 percent of the nation’s GDP.
How? Through so many things. First off, education. When a child has been malnourished or stunted in growth, the cognitive development becomes compromised. This results in repeating school levels. Based on a report submitted by the Department of Education, some 48,000 students who repeated their grade levels in Academic Year 2013-2014 were a result of stunting at age under five years. That’s roughly 15 percent of the entire number and this meant the government covering an additional PhP 1 billion for the children’s education.
Productivity in the workforce is also affected when children get stunted. In 2013, roughly PhP 320 billion is compromised as a result of undernutrition. This lost of productivity is made up of two classifications: reduced productivity among stunted workforce and complete loss of productivity due to premature deaths resulting from undernutrition.
According to a data provided by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST), over 800,000 deaths due to undernutrition weren’t prevented in the previous years. If the deaths (of these people who could’ve been of working age) were averted, the economy could’ve been more productive and generated an additional PhP 160 billion.
Also, undernourished children who managed to overcome it in later life also affect the economic stability. Studies show that these children were likely to attain lower educational achievement, therefore translates to fewer job opportunities and reduced income. In 2013, the Philippines lost an estimated PhP 166 billion due to lower educational attainment as a result of childhood undernourishment.
Solution to malnutrition
For Roel’s case, I couldn’t help but think that the nearest solution to his severe malnutrition is breastfeeding. Truthfully, Roel wouldn’t be severely malnourished if he was breastfed. As per World Health Organization’s recommendation, children should be breastfed for at least two years in order to receive proper nutrition. During the first six months of life, mother-and-child pair should practice exclusive breastfeeding — this meant no vitamins, no solids, not even water in the first 180 days of a child’s life.
It’s nearly been two years since I started breastfeeding my son and while the financial burden of buying formula milk is a factor, the very reason I chose to breastfeed my son is because of its health benefits. Scientific consensus states that breastmilk is the superior food for infants and the best supplement when toddlers start eating their solids. Breast milk contains all the nutrients an infant needs apart from the germ-fighting properties that help fight infection. It’s a perfect food and potent medicine all-in-one and best of all, it’s sterile and free.
When a child reaches six months of age, it’s best to complement the diet with indigenous and nutritious food. The reason it should be indigenous is that it can cater to a child’s health needs. During hot summer days, we can easily get seasonal fruits such as watermelon or turnips (singkamas) and, amazingly, these fruits are here for a reason: to help in hydration. The same idea goes for other fruits and vegetables.
The country’s weather is extremely conducive for growing different nutritious whole foods unlike in the Western countries. On the other hand, breastfeeding shouldn’t be a problem because only a small percentage of women around the world are clinically unable to breastfeed. In Africa, there are malnourished mothers who are still able to breastfeed despite the lack of food and water. Believe it or not, the nutrients that an African malnourished mother can provide through her breastmilk could equally be the same as the nutrients I provide to my son. That’s how functional our bodies can be. Natural feeding does so many wonders than we can imagine.
With the abundance of fruits and vegetables we have in the Philippines and the access to breastfeed, it’s hard to wrap around my head why malnutrition remains a problem when all of these things could be free.
Looking at the roots
Watching Roel with an awful condition begs the question: where does this problem sprout from? Is it right to blame these people that they remain poor? I still don’t know. I don’t know who’s at fault if, despite their efforts, they won’t be enough to lift them out of poverty. Roel’s family personifies “isang kahig, isang tuka.” From hands to their mouths, they’re living one day at a time because that’s all they could afford to get by. When surviving is tough, how else could they think of thriving?
I cannot blame them that they’re born poor. Not a lot of us are lucky to be born with a comfortable life waiting ahead. But, personally, I think this shouldn’t justify Filipinos’ attitude of complacency — that if we’re born poor, we’re stone-etched destined to die poor.
I believe this kind of problem, like all others, comes from extreme poverty and the lack of education. With proper education, Roel and his family’s life could be a lot easier to bear than what they have. Education may not instantly give them a comfortable life but it can enlighten them — awaken their senses that there is more to life than just surviving.
When we become educated, we look at what’s beyond our resources and we think of ways to that can improve our lives. Sadly, education in the Philippines remain not as a right, but a privilege, for families like Roel’s.
Had Roel’s parents received proper education, they will be be informed of the consequences of having a big family. Sonia and Pablo were high likely not introduced to the ideas of family planning, which lead them to having seven mouths to feed despite their lack of money.
Just enough is fine
The sad reality about some of our fellow Filipinos is that we have been too complacent whatever the situation is. We choose not to go beyond greater heights and just settle for something that’s just enough. This kind of mind setting, unfortunately, gets in the way of improvement and hinders the realizations of our goals. Like a quicksand, complacency locks us up and when we’re at our most helpless, we give into our unescapable “fate.” What makes complacency more lethal is when it’s coupled with lack of determination.
Poverty surely cripples a person but it doesn’t paralyze, unless someone lacks the determination to stand up and brave the odds coming through. Roel’s parents, just like the rest of us, are only victims of third-world circumstances but that shouldn’t be what defining us in the end.
“I am not a product of my circumstances. I am a product of my decisions.” – Stephen R. Covey