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STORIES OF CHANGE: INFLUENCING HEALTH CARE SEEKING BEHAVIOR THROUGH NUTRITION-SENSITIVE PROGRAMMING

A young family from Pendolunan Marawi City fled to Malabang, Lanao del Sur when Marawi siege happened in 2017. This is the family of Sohairen Bangon. Sohairen is an 18 months old boy and 2nd child of Acmad Bangon and Juhaina Marohomsar. Their 1st son is also an under 5 years old boy. But life was difficult in Malabang, so they decided that Juhaina and her two children would better stay in Tuca, Madamba Lanao del Sur with her father. While Acmad will work as a tricycle driver in Malabang and sometimes he would visit his family in Tuca.

Juhaina, 22 years old, is a young mother who lacks guidance on how to take care of her children. Her son Sohairen was nutritionally screened by the Rural Health Unit (RHU) staffs and found out that this child has Severe Acute Malnutrition (SAM) earlier of year 2019. Prior to this screening, Sohairen was hospitalized due to Pneumonia. RHU Staff enrolled this child to treatment but became a defaulter. This is because Juhaina was non-compliant to the treatment of her son Sohairen. Whenever they were given Ready-to-Use Therapeutic Food (RUTF) supplies, she gives portion of it to her 1st child. So Sohairen was not receiving the required nutrients pack in the treatment. Their poverty situation all the more aggravated the situation affecting the whole family with the head of the family not having a sustainable job and income enough to provide their basic needs.

Through the project “REACH: Response to the Unmet Humanitarian Needs of the Most Vulnerable Conflict-Affected Populations in Mindanao”, Juhaina attended sessions on hygiene promotion, received hygiene kits and hyposol, and participated in nutrition education and psychosocial support. The REACH team organized a nutrition screening and nutrition education activity in Madamba last December 2019 in which Juhaina’s son, Sohairen, underwent nutrition screening and was still identified with SAM condition. To fully access the project’s health support, Juhaina supported her son on SAM nutrition management and treatment. In coordination with the Municipal Health Office, Sohairen was referred to RHU and started taking RUTF in December 18, 2019.

Since Juhaina’s family was found to be food insecure, she also accessed the project’s cash assistance for food amounting to Php4,320.00. The support enabled her to provide for her family’s food needs for a month, meeting each member’s required daily nutritional needs.

Sohairen’s condition was regularly monitored by the project team from the time he was enrolled in SAM treatment and finally in February 5, 2020, he transitioned to Ready-to-Use Supplemental Feeding (RUSF). “Tumaba na po ang anak ko (My son has gained weight),” Juhaina happily shared during one of the monitoring visits. This improvement was validated by the RHU Nurse saying, “Nag-improve na po ang weight ni Sohairen. Ngayon po itatransition na siya to RUSF (The weight of Sohairen has improved. He will now be transitioned to RUSF).”

This is just one of the stories of hope in saving children like Sohairen and his brother at the same time allowing the mother to eat well and be healthy in preparation for her 3rd baby delivery anytime soon, through the integrated humanitarian assistance provided by the REACH Project.

The Project “REACH” is funded by ECHO and implemented by the consortium Action Against Hunger, Oxfam, ACCORD, with CARE as lead. It aimed to address the unmet humanitarian needs of conflict-affected populations in Mindanao. The project provided support in Food Security and Nutrition, WASH, and access to health services (Primary health care, nutrition and psychosocial support).●

IT TAKES A VILLAGE

On May 23, 2017, conflict broke out in Marawi City between the Armed Forces of the Philippines and armed fighters from two ISIL-affiliated groups – Abu Sayyaf and the Maute. This led to a 5-month siege that destroyed most of the city’s central commercial district and forced 350,000 people to evacuate their homes. 5% of the evacuees stayed in evacuation centers while 95% choose to stay with relatives and friends in nearby communities.

The host communities where the evacuees stayed were caught unprepared with the massive influx of people. Food, health, water, sanitation and other basic services for the displaced population were severely compromised. Action Against Hunger personnel were on the ground two days after the conflict started to assess the situation and determine the urgent humaniarian needs of the affected population. Emergency Response projects in Food & Nutrition, Water, Sanitation & Hygiene (WASH), Food Security and Livelihoods, and Shelter started on June 1, 2017 and continues to this day.

These are the voices of the people who endured the Siege of Marawi through resilience and determination.

 

The village of Paling in Piagapo, Lanao del Sur was among one of the communities where hundreds of people displaced due to the Marawi Conflict sought refuge. Being one of the poorest in the municipality, its local government headed by Barangay Chairman Dimalumping Matanog was caught unprepared to address the problems that came with hosting the displaced families. “They needed help and it is in our culture as Maranaos to come together as a village to help them in their time of need,” Chairman Matanog said.

However, their distance from the town center hindered the delivery of relief goods when they were badly needed. Evacuees who chose to stay with their relatives than in the evacuation centers felt left out from receiving aid. They soon became weak with hunger and sick with diarrhea.

“Our water here was contaminated and we already had problems with diarrhea amongst the residents, even before the arrival of the bakwits (evacuees). The nearest health center is 2 KM from

here,” he said.

Action Against Hunger Team assessed the situation and found out that the swell in population exacerbated a fragile sanitation infrastructure: the well where the community sourced its water needed to be rehabilitated; only a few households had their own toilets, and if they did, these were open pit latrines that could possibly contaminate the groundwater. The lack of toilets meant that a lot of people defecated in the open – a practice that would easily spread diseases.

With funding from the European Union Civil Protection and Humanitarian Aid (ECHO), Action Against Hunger launched a Water, Sanitation and Hygiene (WASH) project to address the concerns of the host community and the evacuees.

Action Against Hunger WASH Engineers launched the project by rehabilitating the community’s exposed water source and covering it

to stop contamination. The engineers trained the barangay officials proper maintenance of the water source to ensure the availability of clean water for the residents.

Paling is a rural barangay composed of sitios that are far from the village center with consultation with the barangay officials, the engineers identified 3 areas where a 2-door toilet facility with a water tap stand and its own water reservoir would be built. Having these WASH facilities in several areas would make access more convenient for the community.

As their counterpart in the project, the barangay officials organized a group from the residents and the evacuees to provide labor. Guided by Action Against Hunger WASH Engineers, the laborers finished construction on March 6, 2018.

One WASH facility was built near the village’s mosque. “The worshippers would use the water from the tap stands for their

ablution,” Chairman Matanog Said “We also have events here in the barangay and many people who attend could now use the toilets. Families whose house are nearby that don’t have toilets could now use what we built. Even transients who passed by our roads could use the toilet or drink from our tap stand.”

An important component of the project was promoting good hygiene and sanitation practices in the community. “There is this concept of Positive Deviance that aims for behavioral changes within the community,“ WASH Project head Samera Monib explains “We do this by identifying and recruiting individuals – mothers, fathers or any members of the community who has expressed understanding and commitment to change the WASH situation in their respective communities – and have them pass on their good practices to other families. They were actively participating in their community activities and were recommended by the Barangay Leaders and the Rural Health Unit. We call them Community Health Promoters and give them training on WASH participatory approach on hygiene promotion.”

Junaidah Matanog, one of the twelve Community Health Promoters, was encouraged to volunteer because she saw how some of the children in the village became vulnerable to skin diseases, diarrhea and even dengue due to poor hygiene. “We try to promote these to our neighbors but in casual conversations only so that it doesn’t come as offensive to them. Most of the volunteers are young mothers so it gets awkward for us to lecture older people,” she said.

She and her fellow health promoters taught the children to make proper hygiene a habit. They coached the children on the proper way to wash their hands, brush their teeth, and cut their fingernails. They also instructed them to bathe regularly. In addition, the promoters also spearheaded clean-up drives involving the whole community to prevent mosquito production that could spread bacteria. ●