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Photo: Ana Santos/IRIN
|Poverty and conflict have aggravated the health risks of children|
MANILA, 5 August 2009 (IRIN) – Children born in the conflict-affected Autonomous Region of Muslim Mindanao face a greater risk of death and disease than elsewhere in the country, say health specialists.
Comprising five provinces, the region has witnessed an upsurge in fighting between government forces and the separatist Moro Islamic Liberation Front (MILF), which has been fighting for an ancestral homeland on Mindanao for decades.
Hundreds of thousands are now displaced on the southern island, many of whom are staying in government evacuation centres.
According to the Philippine Information Agency, the government information arm, the region has the highest under-five mortality rate in the country.
For every 1,000 babies born in Mindanao each year, about 34 die before reaching their first birthday while another 50 die before their fifth birthday.
According to the National Demographic Health Survey conducted by the Department of Health (DoH), the national average is 29 deaths before age one per 1,000 live births, and 40 before age five.
According to a study by the Guttmacher Institute, an NGO that researches reproductive health, an estimated 52,000 babies in the Philippines died before their first birthday in 2008, 30,000 of them within a month of being born.
Poverty and displacement
Marisa Ricardo, a health and nutrition specialist for the UN Children’s Fund (UNICEF) in Manila, says: “With poverty incidence as high as 81 percent, many families cannot afford access to basic health services,” noting other contributory factors, such as insufficient funding and inadequate human resources.
Tonto and Nasset Bato (not their real names), residents of an IDP shelter in the town of Datu Piang, lost their four-month-old daughter Zaida to pneumonia and severe dehydration last June.
“She had fever and diarrhoea for a few days, but we had no money to buy medicine. When we went to a doctor, it was already too late,” Nasset said.
Displaced children are further exposed to risk because of exposure to harsh living conditions in overcrowded evacuation centres, say local health authorities.
“In cramped evacuation centres with insufficient water and sanitation systems, children under five are vulnerable to diseases like diarrhoea, respiratory illnesses, and skin diseases like scabies because there is not enough water to bathe,” Julie Villadolid, emergency programme coordinator for the DoH, said.
|Photo: Ana Santos/IRIN|
|Access to healthcare for new mothers can prove problematic in conflict-affected Mindanao|
Leading causes of death
Of the 226 deaths recorded due to illness in Mindanao from August 2008 to July 2009, 80 were children younger than five, a DoH report stated.
“The leading cause of death is diarrhoea [followed by respiratory infections]; 57 percent of deaths due to diarrhoea were children below five years of age,” Villadolid explained.
The prolonged period of conflict and ensuing displacement has also heightened the need to monitor malnutrition.
“Malnutrition has not affected more than 15 percent of population, so it is not yet an alarming rate. However, the nutritional value of the food that the children are eating, mostly from food donations, is not very good,” she said.
But not all infant deaths in conflict zones and remote municipalities are reported.
A recent bombing in Cotabato and two other Mindanao provinces led to travel restrictions, further limiting access.
Elizabeth Samama, provincial health officer at the Datu Piang Regional Health Centre, says her clinic has been unable to operate fully because of a lack of electricity for the past five months.
“We have had to suspend our 24-hour operation. Only the bigger hospitals and clinics that have a generator can operate in the evenings, but these are much farther away.”
Clinic records show that, in Datu Piang, seven children younger than one have died since the conflict restarted in August 2008.
However, Samama admits this number may be under-reported, “since there are many cases that don’t reach the health centre because of distance, the Muslim preference for traditional healing methods, as well as the Muslim ritual of burial within 24 hours”.
Curbing infant mortality is one of the Millennium Development Goals the Philippines is committed to achieving before 2015.
“Currently, our IMR [infant mortality rate] is 29 per 1,000 live births; the goal is to lower this to 27 deaths per live births by 2015. We are on track,” said Mario Villaverde, Under-Secretary of Health.
“As part of our commitment to meet this MDG, the DoH has allotted an estimated US$17 million for the continuous immunization and issuance of vitamin supplements for children belonging to the impoverished sector, including [Mindanao],” Villaverde said.