Representatives from the National Nutrition Council (NNC) Region IV answered the call of Palawan Province to assist in providing nutrition interventions including identifying cases of Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM) among preschool children, pregnant and lactating women to Barangay Mangsee in the municipality of Balabac, which was hit by Typhoon Vinta and Agaton last December 2017.

ro4b 2018 wa mangsee responseNutrition Officer II (NO II) Francis Erik P. Bacena of NNC MIMAROPA and NO II Edward C. Paglinawan of NNC CALABARZON together with the Health Cluster of Palawan were deployed on 4-12 January 2018. The Health Cluster of Palawan was headed by Dr. Rebethia Alcala with the members composed of Dr. San Bonbon of Aborlan Medicare Hospital, Disease Surveillance Officer Ms. Lorna Loor, Sanitary Inspector Ms. Elvie Lao, Expanded Program Immunization Coordinator Mr. Meyrick Garces and Education Research Assistants Ms. Catherine Nuh, Mr. Harmain Sadican and Mr. Raoul Amador. 

With the aid of barangay volunteer Mr. Amir T. Musa, NO II Bacena and Paglinawan conducted Rapid Nutrition Assessment using the Mid-Upper Arm Circumference (MUAC) tape to easily identify SAM and MAM cases among preschoolers and pregnant and lactating women in Brgy. Mangsee. Based on the MUAC screening, out of 748 preschoolers screened, 624 (94.80%) are normal, 31 (4.71%) are MAM cases while 3 (0.45%) are SAM cases. For pregnant and lactating women, out of the 171 screened, one (0.54%) pregnant and 9 (5.26%) lactating mothers have MUACs measured below 21 cm. MUAC for pregnant and lactating below 21 cm is considered as nutritionally-at-risk and needed to be referred to a health station for consultation and provision of necessary intervention such as Micronutrient Powder (MNP), iron with folic acid supplements and be enrolled in Supplementary Feeding Program (SFP).

In addition, they also conducted nutrition counselling for pregnant and lactating mothers, observed the donations if there were breast milk substitutes and conducted Nutrition Initial Needs Assessment (NINA). Based on the NINA survey and observation in the barangay, it was revealed that the barangay did not receive donations of breastmilk substitutes.   However, the barangay needs to capacitate its nutrition and health workers on Infant and Young Child Feeding, Child Growth Standards (CGS) and management of SAM and MAM to ensure exclusive breastfeeding among lactating mothers with infants 0 to  six months. The training will also lead to adoption of  proper complementary feeding practices of mothers with children six months to two years old as well as to ensure accurate assessment of nutritional status of preschool children and to ensure rehabilitation of identified SAM and MAM preschoolers.

Prior to the assessment, the provincial government of Palawan assisted the municipality last December 26 – 29, 2017 by delivering relief goods, sending search and rescue team and medical team for treating the injured. It also deployed Rapid Damage Assessment and Needs Analysis (RDANA) team to identify the damages in the area as well as give observations and recommendations for rehabilitation. The Municipal government of Balabac also conducted relief operations last December 26, 2017 in several puroks of Barangay Mangsee. 

The Cluster approach refers to a grouping of various organizations and stakeholders working in an area of humanitarian response. It addresses a number of response gap areas at all times. These are nutrition, food and non- food interventions, water and sanitation, health, camp coordination and management, emergency shelter, protection, logistics, emergency telecommunications and early recovery. Cluster approach was adopted in the Philippines to ensure organized and effective response, strategic resource mobilization, clearly designated leads in each sector and provide support for existing government coordination structure and emergency response mechanisms.

Brgy. Mangsee is an island barangay composed of two islands on the southernmost part of Balabac, Palawan. Most of its inhabitants lived in the southern island while the northern island served as their reservoir of water. Communication was limited as only telecommunication lines from Malaysia were available causing high rates for communication. Main source of income of the residents is from fishing and trading of goods with Malaysia. The main source of  food comes from trade goods from Malaysia and fish and livestock such as goat and poultry. Majority of the residents do not practice fruits and vegetable gardening due to limited arable land in the island.

Brgy. Mangsee was hit by Typhoon Vinta in and Agaton in the last week of December 2017. The storms caused damage to property including income-producing equipment such as boats for transportation and trade and fishpen for gathering fish. Having their means of income destroyed, their access to food was disrupted which consequently gravely affected the health and nutritional status of vulnerable groups such as preschool children, pregnant and lactating mothers, elderly and persons with disabilities. The assessment made by NNC will be used by the provincial health and nutrition cluster in its rehabilitation and recovery plan especially by allocating and distributing Ready-to-use-Therapeutic Foods (RUTF) to identified SAM cases supervised by the Provincial Nutrition Office (PNO) and ensuring that MAM cases and identified nutritionally at-risk pregnant and lactating mothers will be enrolled in SFP of DSWD. Once the provincial clusters have consolidated their reports, the provincial government can send necessary support to rehabilitate the barangay. The NNC will continue to coordinate with the PNO for assistance. Through the support of the provincial government with the assistance of NNC, Brgy. Mangsee can soon recover from the effect of the typhoons.