Treating Filipino children with severe malnutrition

Joemar Bacaltos’ weight increased from 3.3 kg in August 2016 (left) to 6 kg in December 2016 (right) after beginning treatment for severe acute malnutrition. ©UNICEF Philippines/2016

By Lotta Sylwander, UNICEF Philippines Country Representative

Joemar Bacaltos, two years old, was born under some of the most unfortunate circumstances. The youngest child of poor and sickly parents, living as a Tagbanua deep in rural Palawan, he is the perfect example of a child deprived of many of the rights and opportunities he is entitled to. Because of those deprivations, he became a severely malnourished child — all skin and bones — just inches from death.

I met Joemar by chance on a field visit to see indigenous communities. Little did I know that meeting this little fighter would stir very personal memories for me. I am a proud Lola to four grandchildren, two of them born too early and had nutritional challenges themselves. Seeing and holding Joemar in my arms touched a very personal experience for me. I was almost reliving those difficult months and years looking after my own grandchildren.

UNICEF Philippines Representative Lotta Sylwander carries Joemar as his mother looks on. ©UNICEF Philippines/2016

Joemar is the face of the 300,000 severely malnourished children who might never reach their fifth birthday. Acute malnutrition or wasting is a life-threatening form of malnutrition due to inadequate diet, disease, or their combination. Children with severe wasting, called severe acute malnutrition (SAM), are 9 to 12 times more likely to die compared to normal children.

The effect of malnutrition on individual children and on society as a whole deprives children and nations of their full potential. That is shocking in a middle income country where severe inequalities persist despite high economic growth. It means that many in the Philippines are being left behind, and that economic gains do not reach the poorest of the poor.

Joemar eats ready-to-use therapeutic food, one of the interventions in treating severe acute malnutrition. Joemar’s weight increased from 3.3 kg to 4.6 kg one month after beginning treatment. As of September 2017, his weight has reached 9 kg. ©UNICEF Philippines/2016

Leaving Joemar behind to die was not a choice. You cannot abandon a child. The severe injustice he has experienced, living as an indigenous child and the difficulties of his family in accessing services is something a child should never have to live through. I felt disappointed and frustrated.

Thankfully, Joemar’s case generated a lot of movement within the Department of Health (DOH). In 2015 and early 2016, UNICEF helped the DOH with national guidelines, the development of standard training modules, and conduct of SAM management trainings to more than 300 health and nutrition workers to deal with severe acute malnutrition cases in 17 initial provinces.

UNICEF Philippines Nutrition Officer Dr. Rene Galera measures the circumference of Joemar’s upper-left arm to check his nutritional status in September 2017. Joemar has nearly reached his optimal wight one year after beginning treatment for severe acute malnutrition. ©UNICEF Philippines/2017

With support from UNICEF this year, DOH began scaling up SAM management services in 21 additional provinces — now including the Province of Palawan — enabling frontline workers to have the knowledge and skills they need to detect, treat or refer children suffering from severe malnutrition.

Meeting Joemar made the issue of malnutrition and challenges faced by their families so clear to me and my colleagues in UNICEF. His story helps explain a complicated problem in an understandable way, so issues become human and close to the heart. I became invested in the future of this child, personally checking up on him and the progress being made to ensure all severely malnourished children will be given proper care and nourishment.

I’m happy to share that on my fifth visit to Joemar in September 2017, he has nearly reached his optimal weight. He is able to walk, say “mama,” “papa,” and “ate” [big sister], and play with his three older sisters. The happy and healthy Joemar now has beautiful round eyes and chubby cheeks. And I am a proud lola [grandmother] all over again.

To learn more about UNICEF’s work in the Philippines, visit