Illuminating the Arts-Policy Nexus 

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From the Spring Issue "Beyond Bondaries"

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Fahad Ingkiang, age 2, was diagnosed with severe acute malnutrition by volunteer doctors on the Philippine island of Mindanao.

By Veejay Villafranca

MINDANAO, Philippines—The Badjao people have inhabited this island since at least the 16th century. Traveling in their hand-built boats, they scattered as far as Malaysia and northern Borneo. They remain the largest Muslim group in the largely Catholic nation of the Philippines. For 10 years, I have covered brutal conflicts on this beautiful island, and since I began photographing here, I have hoped that one day Mindanao will once again live up to its name, the Promised Land.

Members of a Philippine marine landing team prepare for deployment in the wake of the beheading of 15 marines in southwestern Mindanao. The security and economic stability of Mindanao always deteriorates following armed clashes between government forces and guerrillas fighting for Mindanao's independence.

The casualties among the island’s Moro rebels, who have been fighting for independence for more than four decades, as well as government troops and civilians, have been mounting at an alarming pace.

Beginning in 2000, breakaway groups, which allied themselves with such
notorious terror organizations as the Jemaah Islamiyah and al-Qaida, launched a series of kidnap-for-ransom attacks, setting off a decade of bloody battles with government forces.

Apart from armed conflict, central Mindanao has been plagued with massive flooding from torrential rains—the product of fast changing weather conditions, further complicating the ability of mothers to receive health care in restive regions.

Fighting between the government and the Moro rebels has created harsh conditions, leading to epidemics and hunger among the Badjao. More than 20,000 children suffer from severe acute malnutrition with complications including chronic cough, pneumonia, and diarrhea. When a child fails to express emotions, such as crying or laughing, it is a clear indicator of acute malnutrition. Their bodies become weak as their organs cease to function properly. At this point, if not addressed immediately, malnutrition is fatal. In Datu Odin Sinsuat on Mindanao, mothers hold their stunted children while waiting in line for their checkup in a small makeshift facility. Those in critical condition are brought to the pediatric ward, which has a small area for those suffering from acute malnutrition.

Volunteers leave the rural health center of Datu Odin Sinsuat to follow-up on patients who failed to attend check-ups.

In 2009, with over half a million people displaced, the United Nations Children’s Fund (UNICEF) along with Save the Children and Medicins Sans Frontiers initiated the Community-based Management of Acute Malnutrition to address the alarming number of children dying due to complications brought about by acute malnutrition. The program, proven effective in four West African countries (Burkina Faso, Mali, Mauritania, and Niger) includes proper nutritional feeding and patient management. Paul Andrew Zambrano, nutrition officer for the Health and Nutrition Division of UNICEF Philippines says Maguindanao is the perfect place to implement such a program since moderate to severe malnutrition afflicts a startling 9.8 percent of children.

Lack of income and food security overlaid with rampant violence and corruption contribute to malnutrition in the province, which is thought to be the highest in the Philippines and one of the highest in Asia.

Today, the program has rescued more than 60,000 children, most of whom would have died of malnutrition caused by violence of the Moro insurgency. “In times of emergency, there’s displacement, then there’s an initial problem in water and sanitation,” says Zambrano. “If the displacement is prolonged, then you have a possible outbreak of diseases. And the malnutrition problem is triggered by that situation. It makes children more prone to diseases and stunts physical and intellectual growth for a lifetime.”

Many women, some on whom have been displaced, injured, or blinded due to armed clashes, have difficults attending health check-ups.

In October 2012, the Philippine government and the Moro Islamic Liberation Front signed a peace accord that will hopefully pave the way for a lasting peace in Mindanao. So far, the violence has decreased, but peace agreements have been signed and broken in the past. Right now, it’s still the everyday, unsung efforts of the relief workers that are keeping so many children alive.

Since war broke out in 2008 on Mindanao, a renewed national and local effort has focused on upgrading facilities and providing accessible health services to pregnant women and mothers as well as measuring and evaluating babies—a first step in monitoring nutrition.

Volunteer health workers, leaving a remote rural unit, make rounds to even the most isolated areas of Mindanao, giving continuous health care to children suffering from severe malnutrition.

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Veejay Villafranca, a Manila-based photographer, began his career on the news magazine Philippines Graphic and has exhibited across Europe and Asia.