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Veejay Villafranca | Silent Emergency

Sunlight illuminate a part of a housing commune in Sitio Damayan in Vitas compound in Tondo, Manila. Spetember 12, 2011.

Silent Emergency
Battling severe malnutrition and maternal deaths in the Philippines.

The prolonged displacement due to the 2008 armed conflict in Central Mindanao caused a silent nutrition emergency to surface.  Since then, UNICEF with various partners such as Medecins Sans Frontieres from 2009 to 2010 and Save the Children in 2010 and 2011 implemented various approaches to address severe acute malnutrition (SAM). While these interventions were still largely seen as humanitarian in nature, there was a recognized need to align with global standards in management of SAM and at the same time document local experiences, challenges, and best practices towards the development of a national 

Community-based Management of Acute Malnutrition (CMAM) protocol.

By April 2011, 32,770 children under 5 years old were screened for acute malnutrition and given supplies of multi-micronutrient powders while 388 children were treated for SAM, doubling the number of children reached the year before in just four and a half months. Community mobilization activities were conducted in all target municipalities, and more than 1,100 mothers have been reached with nutrition education and IYCF counseling sessions by local NGO partners.  At its young stage, the CMAM program indicators were reaching very close to international standards. 

Implementation of CMAM since the first program cycle in 2009 has yielded significant challenges and experiences that aided in the gradual improvement of the quality of service delivery, means of coordination with partners, and the degree program objectives are achieved.

Training for service providers and agreements on roles and coordination mechanisms during the early phase of the project are crucial.  In all phases of implementation, the commitment and involvement of key government stakeholders at the regional, provincial and municipal levels must be sought.  

Community mobilization is seen as a means of addressing barriers to access; and sustained efforts to engage the beneficiaries must be made.

A health worker and coordinator in a nearby birthing and maternal health clinic talks to women about the importance of reproductive health and other information regarding the use of contraceptives. The Catholic church has been very vocal of their opposition of the passage of the Reproductive Health Bill in the Philippines which supposedly would help women most specially in the marginalized communities gain access to information regarding family planning.

Women who are living in isolated villages await for their check up alongside with their in a makeshift health center in the province of Maguindanao, considered to be one of the most impoverished municipalities in the southern Philippines.

Residents of Sitio Damayan and neighboring areas avail of the free contraceptives after consultation with health workers in a family planning and maternal health clinic in Tondo at the heart of Manila.

A patient undergoes a Bilateral Tubal Ligation (BTL) in Parang district hospital in the province of Sulu in Mindanao. The Long Acting Permanent Method (LAPM) strategy has been created and enforced by a group of international aid organizations under the Sustainable Health Improvements through Empowerment and Local Development (SHIELD) in partnership with local government health office with its goal of reducing maternal deaths due to complications during pregnancy. Sulu province has one of the highest rates of maternal mortality with an estimated 132 mothers dying in 2006.

A portrait of Magnolia Mendoza, a licensed midwife and volunteer for international aid group in the city of Cavite south of Manila. Ensuring women have access to modern contraceptives can help reduce maternal deaths that occur from complications in pregnancy and childbirth, and reduce unwanted pregnancies and unsafe abortions. Contraception can literally transform lives, empowering women to space their births or limit the number of children they have, avoiding health and economic burdens that can result from unwanted pregnancies.

Licensed birth attendants or more commonly known as midwives check on birth control devices on patients inside a lying-in clinic in the southern part of Greater Manila Area.

Ensuring women have access to modern contraceptives can help reduce maternal deaths that occur from complications in pregnancy and childbirth, and reduce unwanted pregnancies and unsafe abortions.

Different materials used for educating women about maternal healthcare are seen inside a rural health center in Jolo town in the island of Sulu.

Women from a non-profit group gather in a town center in Maguindanao province for consultation on livelihood programs, access to healthcare and also maternal health

Entertainers dressed as college students dance on top of a flaming bar in the former Coyote club in the Malate district in Manila. The women working here were mostly college dropouts trying to make ends meet either for their families in the city or back in their respective provinces. Migration to the city is still rampant as the promise of better paying jobs or access to opportunities abroad still lure those from marginalized sectors.

A newly wed couple participate in a mangrove planting ceremony after a mass wedding was held in the island of Palawan.

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