20 July 2020 Cagayan de Oro City- Currently, malnutrition remains one of the biggest threats to the well-being of less than five (5) years old Filipino children being one of the vulnerable groups. This occurs when the body’s dietary or food intake is not in balance with its nutritional needs, failing to maintain healthy tissues and organ function. In the municipality of Opol, Misamis Oriental, a suspected severely acute malnourished child was recorded based on the list of Operation Timbang Plus (OPT Plus) conducted early of February this year. Immediately, an active-case finding was done by Kate Marie Perales, DOH Nutritionist-Dietitian assigned in the area, the BNS, and barangay Kagawad for health, to validate the OPT results on 7 February 2020.

Nardo, a 35-month old child from Brgy. Igpit, Opol was visited by the team and assessed his nutritional status. The height and weight measurements was taken, including the Mid-upper arm circumference (MUAC) of the child. His weight was 8.5 kilograms, 78 centimeters of height, and with Mid-Upper arm circumference of 11.3 centimeters. The weight-for-height Z score was <-3SD. Based on his measurement, the team confirmed that child is suffering from severe acute malnutrition (SAM). 

Severe acute malnutrition and moderate acute malnutrition (MAM) are the two classifications of wasting which can be identified through the three (3) parameters/assessment methods namely, mid-upper arm circumference (MUAC), z-score for the weight for height (WFH), and edema. (See Table 1: Identification of Acute Malnutrition). Wasting is the manifestation of the weight-for-height/length or thinness of a child. It is also referred to as a deadly form of undernutrition which increases the risks of a child’s death if not treated immediately. 

 Table 1. Identification of Acute Malnutrition

Nardo is from a marginalized family of six. He is the fourth child of the family. They mainly rely on the wage of the head of the household who works as a construction worker while the mother, who is pregnant, is a plain housewife. It is suspected that the child does not receive adequate nutrition as he was seen eating only rice from the pot in their kitchen when the team arrived.

Since the child was identified as SAM, the child together with his mother, was brought to the rural health unit of the municipality of Opol, for admission to the Outpatient-therapeutic center (OTC), a community-based outpatient care of SAM without complications of the PIMAM program.

The child was examined by the Municipal Health Officer, Dr. Emily Grace Banal. History taking and physical examination were done. The child had a cough and diarrhea for a couple of days. After undergoing medical check-up and provided with routine admission medication, the nutrition personnel performed appetite test to Nardo. The child ate more than 3 spoonsful of Ready-to-use Therapeutic Food (RUTF), a nutrient-dense peanut paste for treatment of severe acute malnutrition which ensures rapid weight gain. This means that he passed the appetite test and he will be admitted to OTC, and with RUTF provided on a weekly/biweekly basis. 

The mother as the firsthand care provider of the child was informed of Nardo’s current nutritional status. The team also discussed the process of rehabilitation, and provided nutrition counseling on how to properly feed her child as well as her pregnancy. Moreover, she was advised that her son should consume two (2) sachets of RUTF per day based on his body weight.

The first weekly monitoring was done on 14 February 2020 with remarkable significant changes. Nardo was able to consume the allotted daily ration of RUTF and his weight increased from 8.5 to 9.5 kilograms, and MUAC changed from 11.3cm to 11.5cm. This improvement in the nutritional status of the child within 7 days’ duration was the result of consuming RUTF daily. After six (6) weeks of monitoring, the child achieved normal nutritional status. His height and weight increased to 7.9 cm and 10.8 kilograms respectively, and the mid-upper circumference also improved to 15cm. He was discharged from Outpatient-therapeutic-care, but still being monitored once a month by the BNS even the child was declared as cured.

The success of rehabilitating a case of severe acute of malnutrition in Opol is due to the dedication and hard work of nutrition workers as well as cooperation of the caregiver and family. The LGU considered the PIMAM as effective nutrition intervention for children suffering from acute malnutrition. The local chief executive being the chair of the municipal nutrition committee understands the importance of nutrition program, to have a well-nourished children and productive citizenry. In fact, he approved the proposal to increase the 2020 budget for nutrition a total of Php881, 000.00 instead of the initial Php350, 000.00. Besides, the case of Nardo became an eye opener to other barangays to prioritize nutrition.

Safeguarding the health and nutrition of children is more imperative given the current COVID-19 pandemic. But with the correct intervention and concerted efforts of the nutrition workers during emergency situations, success can be achieved. Together let’s become a nutrition champion and sama all labanan ang malnutrisyon! (ND II Kate Marie Perales and ND II Angelique Jean Maggay)