THE ASIAN VOICE

A silent crisis in our midst: Philippine Daily Inquirer columnist

Filipino children play in shanties along a polluted river in Las Pinas city, south Manila, Philippines on Sept 5.
Filipino children play in shanties along a polluted river in Las Pinas city, south Manila, Philippines on Sept 5.PHOTO: EPA

Data from the Philippine Statistics Authority’s Food Security Information System tell us that 3.8 million, or 33.5 per cent of all Filipino children up to five years old, are biologically stunted, or substantially shorter than the median height for their age.

Most of us probably don’t realise it, but a silent crisis of potentially disastrous proportions is creeping up on us. 

No, I’m not referring to the roughly 2,000 and still growing number of casualties in the ongoing war on drugs, although that should worry us, too. 

I’m talking of something affecting far more people—that is, a full one-third of all Filipino children aged 0-5 years—who are already permanently impaired for life due to stunting traced to hunger and undernutrition.

Data from the Philippine Statistics Authority’s Food Security Information System tell us that 3.8 million, or 33.5 percent of all Filipino children up to five years old, are biologically stunted, or substantially shorter than the median height for their age (for the statistically-inclined, the technical threshold is two standard deviations below). 

An additional 7.1 per cent, or nearly a million, are “wasted,” meaning acutely undernourished such that body weight is substantially (again, two standard deviations) below median weight for their height—and this is actually worse than what it was in the 1990s. 

While wasting can still be corrected, the damage from stunting is lifelong. 

The relative number of individuals afflicted by both stunting and wasting already well exceeds what would comprise a public health crisis, in the technical definition of the word.

What makes the problem even more insidious is that it will only be in 20-30 years that the full impacts of this crisis would be felt. 

Just like environmental degradation, it’s something that will hit back at us farther in the future than most of us care to plan for or worry about. 

But it will hit us just the same, and we had best pay attention and act accordingly if we are to at least arrest the crisis and reduce its long-term damage on our country.

Perhaps contributing to the complacency, we’ve been hearing about how the Philippines is entering a “demographic sweet spot,” referring to how working-age (hence presumably productive) people will dominate our population within the next two to three decades. 

In marked contrast, the outlook for most countries in the world, including many of our Asian neighbours who have had much lower rates of fertility and population growth, is a dominant elderly population well exceeding those of working age. 

Imagine a bar graph around a vertical axis, showing our population age profile with youngest at the bottom and oldest at the top, with number of males graphed on the left and number of females on the right. 

Our own graph looks like a pyramid now, widest at the base denoting our youngest children, and narrowest at the top denoting the oldest among us. 

By 2050, our graph is projected to look like a rounded dome, while for most countries it would take on the shape of an inverted pyramid, overburdened by large elderly and dependent populations, with a much narrower younger population base to support them. 

It’s often said that our unique population age profile by 2050 will be a distinct advantage for us.

But having working-age people dominate our population profile will not guarantee economic dynamism and prosperity in itself. 

The so-called demographic sweet spot can just as well be a demographic time bomb for us, if much of that coming generation of working-age Filipinos will be ill-equipped for productive employment due to ill health, inferior education, and lower mental capacity. 

That is precisely what is already in store for our stunted young children of today, who make up an unduly large segment of their generation. 

They have been irreversibly impaired from reaching their potentials due to inadequate brain development from poor nutrition within their first 1,000 days in life.

In a review commissioned by the World Food Program on the Philippines’ food security and nutrition situation, an expert team from Brain Trust Inc. warns of a “lost generation” of children for whom stunting is having adverse short-, medium- and long-term effects. 

Among the short-term effects identified by child development experts are higher mortality from infections and diarrhea. 

In the medium term, these children will manifest cognitive and behavioural deficiencies that affect learning ability and social adjustment. In the long term, they will face a significantly greater risk of poor health, lower stamina and poor cognition, leading to lower productivity and ultimately lower wages and incomes. 

The study cites a World Bank estimate that puts the loss from undernutrition at 10 per cent of lifetime earnings, and about 2-3 per cent of gross domestic product (equivalent to around P400 billion). 

These numbers could well make it the biggest public health crisis in the country today, according to the study team, albeit a quiet and hardly visible one.

Last year, the Philippines missed the Millennium Development Goal (MDG) of halving child malnutrition. 

Stunting among 0-5-year-olds actually rose by 3.2 percentage points between 2013 and 2015. 

We have since signed up to the Sustainable Development Goals (SDGs), the sequel to the MDGs, where SDG-2 is achievement of zero hunger by 2030. 

That would mean also bringing down stunting and wasting close to, if not at zero, by then, from the current aggregate of 40 per cent.

An impossible dream? Not if we put the right attention and resources to curbing hunger now, and recognise the crisis for what it is. 

And as I have constantly written here, we need to make food, especially our food staple rice, more affordable to our people than it is now, particularly for mothers and children. 

Rice price, after all, is the single biggest culprit behind hunger in the Philippines today.