A father’s love: one man braves long journeys for his baby’s health

Aries readies to leave the Looy Barangay Health Station for the three-hour journey back home, just before the monsoon rain started to fall. ©UNICEF Philippines/2018/Mike Saycon

Under the sweltering heat on a Tuesday morning, Aries straddles his horse for three hours for seven kilometres on a barely paved path just to get to the health clinic to receive supplies and tests for his daughter, Jade. She just turned a year old and had been SAM (severely acute malnourished) since her mother died in July, when she was only five months old.

Aries juggles farming, which does not earn much, and taking almost a whole day’s trip to the clinic for Jade to receive vaccines, monitoring and treatment. “I’m now both their mother and father. It’s difficult but I need to keep up so they do not get sickly,” he says, tearing up, as Jade plays on his lap. They sit resting under a tree, mid-way through the ride from Kitadtad to Looy, South Upi. “The lack of resources and hardship are really beyond me, but I have no one to turn to but Allah,” he says. His responsibility as parent and the hope for Jade to improve her health are what keep pushing him to make the long and rough journey twice or three times weekly.

At the clinic, nurse Michelle eagerly welcomes them. She is always happy to see Jade because “she has had it rough as a SAM case but is now well on her way to recovery, thanks to close monitoring and regular feeding with ready-to-use therapeutic food (RUTF),” which she hopes will inspire other parents to keep to regular checks of their children’s health at their barangay clinics.

With rosy cheeks and more intense stares, Baby Jade now measures ‘yellow’ with the mid-upper arm circumference (MUAC), a drastic improvement from her previous ‘red’. But her yellow measure is also now very close to ‘green’, which indicates a fully normal weight. Dr Sally Bataclan (right) has been following Jade’s case in close coordination with the local health staff and social workers of Looy, South Upi. ©UNICEF Philippines/2018/Mike Saycon

Undernutrition is always a close call

If Jade’s condition was not treated immediately, she could have suffered irreversible conditions–or worse, death.In January, she could barely hold her head up without her father’s hand supporting; her arms and legs were very thin, and she had very low energy. She was pale and stared blankly.

“Undernutrition, if left untreated, can have lasting effects on a child’s life. That’s why after our visit to South Upi in January, our team of nutrition specialists made sure to check with the barangay clinic on the availability of supplies, especially vaccines and RUTFs for undernourished children in the area,” says UNICEF Philippines Representative Lotta Sylwander.

She adds that UNICEF’s new focus in its work on under-served and vulnerable areas in the Philippines, particularly in Mindanao, responds to the needs of marginalised areas like where Aries lives with his two daughters.

Aries and Jade’s three-hour journey to the barangay health station takes them through the hills and creeks, and across farms and unpaved paths spanning seven kilometres. But Aries has persevered to take his daughter regularly to the clinic, despite the heat and through the rain, just to ensure she can recover her normal weight after having been classified as a severely acute malnourished (SAM) case. ©UNICEF Philippines/2018/Mike Saycon

The land-locked town of South Upi is in the hilly terrain of Maguindanao’s vast fields, mostly coconut and corn; and many families toil their farms far from the town centre. As in the case of Aries, most of Maguindanao’s 1,173 SAM cases (as of 2016) are from faraway villages; many only detected when the children are brought to clinics for what parents assume to be looming sickness.

Partly because parents in far-flung villages are not compelled to bring their underweight children for testing immediately; and partly because they simply do not have enough understanding — especially indigenous families who are usually not very aware — of the risks and consequences of malnutrition. In many cases, too, Michelle laments, they are too poor to travel to town for their children’s health checks; and instead work the fields for long hours to sustain their families’ needs. Access to clinics is difficult for poor parents, especially those from far villages. This makes it an even bigger challenge for local governments to deliver services for mothers and newborns.

“Some parents think their children are losing weight because of common sickness like fever or cold, and simply give medication like paracetamol; but in many cases the child is already malnourished or stunted without them knowing. That is why we set up clinics or do regular visits to far-flung villages, just to reach them more pro-actively,” says Michelle.

Baby Jade in January 2018, when she was still a severely acute malnourished (SAM) case at the Looy Barangay Health Station; awaiting her turn for monitoring, treatment and release of the ready-to-use therapeutic food (RUTF) from the health workers. ©UNICEF Philippines/2018/Mike Saycon

One stunted child is one too many

About 3.4 million children in the Philippines are stunted or shorter than normal for their age; every day, up to 95 children under 5 years old die from malnutrition or chronic diseases. Stunting and weak nutrition service delivery are common in poor, marginalised communities. Many families, especially those from indigenous groups, face exclusion across the poorer areas of the country and this perpetuates a close inter-linked cycle of poverty and undernutrition.

Thirteen of the Philippines’ 17 regions have over 30% stunting rate; with some having prevalence of over 45%. This makes the country one of the top 10 in child stunting globally.

“If untreated, undernutrition seriously harms human development — especially the child’s brain — resulting in lower productivity and less earnings later in life. This can perpetuate the cycle of poverty,” warns Sylwander.

Responding to one child’s case is on its own a great task, but UNICEF has taken up the challenge with the Department of Health and National Nutrition Council both at the national and local levels. From 2015 and 2016, UNICEF and its local partner, Health Organization of Mindanao (HOM), helped health staff to identify, treat, and refer SAM cases to South Upi’s central hospital; and provide weighing equipment and supplies such as RUTF, vitamin capsules, iron-folic acid tablets and micronutrients.

UNICEF also worked with the DOH and the NNC to launch this year the Economic Consequences of Undernutrition in the Philippines, a costing study on undernutrition that estimates the Philippines loses about PHP 220 billion per year due to the effects of undernutrition. That is equivalent to a 1.5% loss in our national GDP.

“Malnutrition deprives children of their foundational health and fundamental right to survive, thrive and reach their full potential. Although we can now treat SAM cases, it is very important to address the causes of undernutrition and find solutions to the multi-dimensional issues that hinder children’s optimum health and overall development. Only healthy children can have the chance to succeed in life,” Sylwander emphasises.

After such improvement in her weight and nutrition status, Baby Jade is now more interactive and highly responsive to sound and visual stimulants. Here she gets playful with Barangay Looy’s Nurse Michelle at the SAM/MAM treatment room. ©UNICEF Philippines/2018/Mike Saycon

Real-life success story, one child at a time

Jade’s long journey every time she is brought to the clinic has been nothing short of inspiring to all nurses at the clinic — rain, neck-level floods and strong current, high tide, extreme heat and all — which Aries braves with no regret. “Despite not having been breastfed since her mother died, Aries never gave up. He makes sure she gets vaccines and eats RUTFs regularly,” Michelle says, smiling.

Aries gets emotional when he talks of those months that Jade’s condition was worrying, to say the least. Now that she is recovering her normal weight, he is both relieved and thankful for the support that the health workers have given his daughter. He wishes nothing for Jade and her sister but grow healthy, finish school, and to live decent lives.

“All this time I have never been so scared; and now I have also never been as happy to see Jade get back to her normal health,” Aries says, teary-eyed.

Jade’s eyes twinkle as Aries kisses her on the head to calm her. She excitedly plays with the mid-upper arm circumference (MUAC) measuring scale, which has been used to monitor the girth of her arms to see if she has re-gained her normal weight. From the time we visited her in January when her MUAC was still on the severely underweight level, Jade is now close to the normal measurement — and she seems to be aware of this.

She can now stand, though still assisted; has started eating mashed vegetables and RUTFs with such appetite; laughs and mumbles; and responds well to visual stimuli such as the colourful posters in the clinic. As they leave the clinic and Aries readies his horse’s saddle, Jade glances back at us with a smile — something that has drastically replaced the sad look on her face when we met her in January. It’s like she tells us how much loved she feels; ready for another three hours of the journey home.

By Mike Saycon, Communication Specialist at UNICEF Philippines

For more information about UNICEF’s work in the Philippines, visit www.unicef.ph.

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