Real Life 2

Mothers suffer the most when families go hungry.

By Vinia M. Datinguinoo
Philippine Center for Investigative Journalism

    The last time Lina Macaurog visited her youngest child Fatima, the 4-year-old was running a fever and had cried violently when her mother was preparing to go. “I had a hard time leaving,” recalls Lina. But she had to go home to Culiat in Quezon City, where she works and lives with her two older daughters.Two years ago, Lina’s husband and Fatima went to live with relatives in Pasig City because their family of five was barely eating. The husband had lost his job and Lina’s income could not feed them all. Today, she is still the sole breadwinner – and she remains hard-pressed stretching her income of less than P100 a day selling trinkets at the talipapa (market).

    Most days, Lina and her two children eat only rice and instant noodles. On bad days, it is rice with soy sauce. Yet, whatever food she manages to put on the table, Lina makes sure her children have their fill first. “I can make do with just coffee,” she says.In many parts of the world, women, especially mothers, are always the last to eat when the family faces starvation or food shortage.

    Today, despite poverty alleviation measures that have been in place for the last two decades, millions more families have slipped below the poverty line, and even more mothers are going hungry as their husbands and children make do with less and less food on the table.That women bear the brunt of poverty is hardly a new observation. But indications are that the situation has gone from bad to worse, with far too many families now surviving on rice and “surrogate ulam,” such as salt, bagoong or soy sauce.

    Mothers bear the psychological stress of having to find ways to stretch meager budgets and scrounge around for food when their husbands don’t have jobs. Filipino women have traditionally been the keepers of the family purse and it is they who have to devise ways of dealing with crises. These include eating less or not eating at all and sending off children to live with relatives. Observes Lina, who looks older than her 34 years: “When the children no longer have anything to eat, the mother is the first one to go crazy thinking where to find food. The man just smokes outside.”

    Five years ago, Lina’s family could still afford two pieces of pandesal for each member each day. “There was also leftover rice to fry for breakfast,” she recalls. “Nowadays, even the tutong (rice burned black) is eaten.” Far too frequently, she has gone without eating just so her children and her husband could have a few more bites.

Worsening poverty

    Ill health among women is already evident in studies done by the Food and Nutrition Institute (FNRI).Anemia, for example, continues to impair 43.9 percent of pregnant women and 42.2 percent of lactating women. Severe anemia among pregnant women is the leading cause of death during childbirth; low iron in lactating women, in turn, manifests in ill health in the child.Lina’s predicament and that of millions of other mothers can be traced to worsening poverty. In Southeast Asia, the Philippines has one of the highest poverty incidence rates, with 15.5 percent of its population living on less than $1 (P56) a day, compared to Laos (39 percent), Cambodia (34.1 percent), Vietnam (13.1 percent) and Indonesia (7.5 percent).The Philippine government defines the poor as those who fall below the per capita poverty threshold of P32 a day. That is 40 percent of the population, about the same figure 20 years ago. In absolute numbers, there is a significant increase, given the population growth: In 1985, there were 4.36 million families who were poor; by 2000, the estimate was 5.14 million families, or over 31.2 million people.

Combating malnutrition

    The World Bank says the Philippines is reducing malnutrition much slower than most of its Asian neighbors. The World Bank defines the malnutrition rate as the prevalence of underweight children under five years of age. The latest National Nutrition Survey also says that despite a decline in the prevalence of undernutrition between 1998 and 2003, malnutrition persists.Malnutrition occurs when a person’s diet is lacking or in excess of one or more of the basic nutrients that include protein, carbohydrates, fats, vitamins and minerals. In a poor country such as the Philippines, the problem is largely undernutrition, although obesity is being observed in certain age groups.Malnutrition reduces the working capacity of adolescents and adults and makes them vulnerable to chronic illnesses, such as hypertension and tuberculosis. But malnutrition affects children the harshest, retarding their growth and making them more prone to infectious diseases, such as diarrhoea and pneumonia.

More than meets the eye

    Experts say the plight of these children is largely invisible. According to the United Nations’ 2002 World Health Report, more than seven of every 10 children who die from causes related to malnutrition were only mildly or moderately malnourished, showing no outward signs of their vulnerability; such as reed-thin limbs and bloated bellies.Aside from rice and instant noodles, the staples in the poor Pilipino farnily’s table are the surrogate ulam that are often salty: soy sauce and bagoong, as well as plain salt. Yet in the latest National Nutrition Survey, the FNRI says there has been “general improvement” in the Pilipinos’ nutrition and food intake in the last decade. There is an increased intake of most of the basic food groups, except fruits, higher contribution of animal foods to total food intake and protein intake, and increased intake of energy and most of the nutrients, except iron and vitamin C.Dr. Ma. Regina Pedro of the FNRI explains the seeming disparity: “What the survey is looking at is the mean intake. One income class is probably eating more. Class E are probably eating less, but this (survey) is mean.”In a 2001 study, marketing guru Ned Roberto found that in Metro Manila, over a third of Class E and over a 10th of Class D had begun resorting to eating various “new viands,” among which he included coffee, pork oil, brown sugar and Pepsi. In Cebu, the proportion was more than 66 percent of Class E and over a third of Class D, and in Davao, almost 75 percent of Class E and nearly a fourth of Class D. Those proportions may have since increased, considering that initial results of the latest Family Income and Expenditures Survey show average household incomes in real terms have fallen by 10 percent from 2000 to 2003.Inquirer Nov29, 2004

Looks can be deceptive

    Many families have turned to carbohydrate-heavy diets to keep their stomachs from churning. Short on nutrients but packed with calories, these have also helped keep them from looking thin and gaunt. Indeed, Lina is rather plump, as are her children. But that is no indication of good health. Overweight people are at higher risk of acquiring illnesses related to high cholesterol levels, such as hypertension.FNRI experts worry over the popuiarity of salty surrogate ulam and sodium-laden instant noodles. They say that although the body excretes salt through normal processes, such as sweating, there is still a chance it will retain more salt than it needs, which can then affect vital organs, such as the heart and kidneys.”The guideline is to eat a variety of foods,” says Pedro. Except for breast milk, no single food can provide all the nutrients a person needs. Pedro thinks that “if money is spent wisely,” even families with low income can fix their budgets in a way that proper food remains a priority.

Recommended menu

    The FNRI has prepared a menu for children that would fit. a budget of what it calls the “national food threshold,” which Pedro says is the “least cost to meet your nutritional requirements.” This threshold is estimated at P8,037 per year or P22 per day for each person.The food guide includes about four cups of rice or its alternatives, such as bread and macaroni, a slice of fruit, a third to half a cup of green, leafy vegetables, and a glass of whole milk. At least three times a week, the FNRI says mothers should serve children meat or poultry (30 grams) or other protein-rich sources, such as fish (about 55 grams) and cooked dried beans (1.5 cups).Families like those of 38-year-old Divina de la Cruz in Pandacan, Manila, are already having difficulty coming up with P100 for the family’s entire expenses each day. If she were to feed her five children according to the FNRI menu, Divina would have to have at least P110 for her daily food budget alone, and that would be just for the kids.De la Cruz already counts herself lucky if husband Carlos makes P150 hawking shampoo on the streets. For them and other poor families, basic necessities, such as adequate food, have become luxuries, their choices reduced to whether to use three cups of water to cook the instant noodles, or six cups to feed more.

Only coffee for breakfast

    The De la Cruzes can afford to eat only twice a day This excludes their shared breakfast of a peso worth of coffee. The situation has driven one of the sons, 12 year-old Cesar, to scavenge for junk he can sell for about PlO, which he then uses to buy instant pancit canton (noodle) for his family. Social workers had already tried sending Cesar to Boys’ Town in Marikina City but he ran away and went back home.

The Macaurogs are not faring any better.

    Lina’s two daughters who are with her – Jamella, 16, and Janina, 13 – say that in the past, they would wake up at 6 a.m. to help with household chores. Now they deliberately get up just in time for an early lunch, the better to save on meal expenses. Since they have no money for food to keep them going while they are in school, which begins at noon and ends at 7 p.m., they drink a lot of water.They have to see to it that it is not cold, though, since they both have ulcers.Yet even if they had a little bit more money, families like those of the Macaurogs and De la Cruzes might still not be able to follow the PNRI guidelines simply because the food being sold in nearby sari-sari stores are often canned or instant and short on nutrients. If families want fresh produce, they would have to fork over more pesos for a ride to the markets.

Fortified food

    Acknowledging the popularity of quick-cooking or prepared food, especially among the poor, government nutritionists have been wracking their brains to develop nutritious and fortified instant food. Some of the results of their work have been shared with small manufacturers, who are now produce iodine-rich drinking water, rice crispy bars, and canton noodles with squash.The government has a three-pronged strategy of supplementation, nutrition education, and food fortification to curb incidence of malnutrition, particularly deficiencies in vitamin A, iron and iodine. The health department says food fortification is the most cost-effective and sustainable strategy to address micronutrient malnutrition. This is why the government has the “Sangkap Pinoy Seal” program, which grants a seal of certification to processed-food manufacturers who fortify their products with nutrients.There is also a law which mandates the fortification of all salt with iodine, and another which stipulates the fortification of rice from the National Food Authority with iron, sugar and edible oil with vitamin A, and wheat flour with vitamin A and iron. But it has come to a point where families can no longer even buy these fortified foods.Some feeding stations across Metro Manila have reported a rise in the number of daily “clients.” Meant only as a temporary means of staving off hunger the plain rice porridge offered by these stations have become the breakfast, lunch, and dinner of many impoverished folk who come day after day.

To each his own

    Just recently, newspapers and television ran stories about people who had resorted to eating food scrounged from garbage heaps. As Divina de la Cruz says: “Kanyakanyang diskarte na lang para makakain. At kapag walang makain, matulog na lang. (To each his own way of finding ways to eat. And if there’s really no food, you can just go straight to sleep).”The asthmatic mother has one more sacrifice to make: In just a few months, Desiree, the youngest child, wiil go and live with her grandmother in San Jose, Nueva Ecija. De la Cruz sounds calm talking about what she believes has to be done, even if it means sending her 7-year-old away. She has been counseled that it is for the best, especially for her “so that my troubles here will be eased a bit.” Desiree is still with her and her resolve may not be as strong once her little girl goes to the province.In Culiat, Lina’s cheeks are streaked with tears as she recounts her last visit to her youngest daughter. “I want to take her home so we can all be together again,” she says. But she knows that may not happen anytime soon. So long as she and her husband are unable to earn enough to feed their entire family, they will have to live apart.

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