Thursday, March 24, 2005

A spoonful of sugar

A spoonful of sugar

Posted 00:34am (Mla time) Mar 24, 2005
By Juan Mercado
Inquirer News Service

Editor's Note: Published on page A10 of the March 24, 2005 issue of the Philippine Daily Inquirer

"JUST a spoonful of sugar makes the medicine go down," Julie Andrews sang in "Mary Poppins," the 1964 Oscar-award winning movie, which was later turned into a Broadway musical.

A 2005 version of that tune haunts the country's sugar industry leaders: how to balance the Food Fortification Law's directive to lace staples with crucial nutrients, even as malnutrition ravages their workers' families within the "sugar belt."

Long before Republic Act 8976 came on the books, scientific data mounted on how widespread "hidden hunger" devastated the most vulnerable groups: children and pregnant or breast-feeding mothers.

The Sixth National Nutrition Survey, released last July, confirmed what previous studies revealed: 4 out of every 10 pre-schoolchildren lack Vitamin A, making them vulnerable to blindness and stripping away immunity to diseases. Stunted with crippled IQs, many go to premature graves.

Two out of every 10 pregnant and lactating women lack this vital micronutrient. Scrawny anemic women mother and nurse wizened infants who, in turn, will give birth to the next generation of dwarfed babies.

Here, "the rate of 172 maternal death rates per 100,000 is unacceptably high," says the United Nations study, titled "A Common View, A Common Journey." The comparative toll in Thailand is 36. It is 30 in Malaysia.

Experience shows that boosting micronutrients in staples -- from salt, flour, oil to soy sauce and sugar -- is the most cost-effective way of bringing these threats to heel.

The United States was "the first country that successfully used salt iodization in the 1920s." About 80 percent of instant noodles in Thailand today are fortified with iron, iodine and Vitamin A. China buttresses its soy sauce. Extensive tests confirmed that the rice variety IR681440 is Vitamin A-rich. It also packs four to five times more iron than other strains. But its commercial use may be three years away.

Fortifying salt here licked iodine deficiency. Yet, up to the late 1980s, 9 out of every 10 women in Mountain Province were inflicted with goiter. Use of iodized salt bolted from 31 percent to over 56 percent in less than five years.

Urine tests of pubic school kids document that "the Philippines has solved its iodine deficiency problem, although pockets of deficiency still exist."

Goiter is rarely seen now. How many kids were saved from becoming cretins or deaf mutes? No one can tell. The head count is only for the victims.

Reluctantly at first but with growing cooperation, flour millers and coconut cooking oil manufacturers are implementing the law. "Social responsibility is also good business," says a flour miller.

Members of the Coconut Oil Refiners Association are following the path blazed by San Pablo Oil, which fortified Minola since 1998. Three flour manufacturers market fortified flour commercially.

In Metro Manila and Cebu, the National Food Authority sells iron-fortified rice on a pilot basis. From the pork barrel, Deputy Speaker Raul del Mar set aside P1.49 million for an experimental project to distribute fortified "pan de sal" buns for students in 10 North Cebu elementary schools.

Will sugar see the example blazed by other industries as a "window of opportunity" for growth through service? Or will it forfeit the high ground by seeking exemptions?

The "sugar belt" sprawls loosely across Regions 6, 7 and 12 and some other pockets. Sugar workers and families make up a substantial portion of the population.

Ironically, it is here where nutritional shortfalls are most severe. In Negros Occidental for example, almost half the kids, from six months to five years of age, lack Vitamin A. Four out of 10 are anemic and underweight. Anemia is most prevalent in Iloilo (77 percent). Aklan follows closely.

Sugar is grown in Northern Cebu, mostly in Rep. Clavel Martinez's bailiwick. She wants to slice off the district into a miniscule province as her term ends. But over half (56 percent) of pregnant women lack iodine and almost 52 percent of children face Vitamin A shortfalls. They're also underweight.

That skewed pattern prevails in sugar areas in Tarlac, Negros Occidental, Sultan Kudarat, North Cotabato. It reinforces the stigma of exploited "sacadas" [seasonal workers] who work in sugar fields.

Impersonal statistics rarely capture the grisly poverty that savages lives of sugar workers. "They squeeze from most of us nothing beyond statistical assent," the late FAO regional representative Dioscoro Umali once said.

There are enough loopholes in the law to beat its purpose by foot-dragging. Who is accountable, the producer or repacker? What about the lack of Vitamin A sugar premix? Given the quedan system, will sugar destined for beverages be exempted? And so on. "More questions can be asked than a wise man can answer," Jose Rizal once said.

Persistent micronutrient shortfalls can shove death rate sharply up, the Nutrition Center's Dr. Florentino Solon warns. But it may be the "human face" on that toll that will be a crucial factor.

Perhaps, no one traced these features better than the late Claretian Nial O'Brien, who lived among sacadas. In his book "Island of Tears, Island of Hope," Father O'Brien, who chose to be buried in Negros, writes about what is at stake.

Here's just one searing incident: The sacada Nanding lays out the corpses of her two daughters, Margarita and Benilda, on top of a rough wooden box. "When I came nearer, I realized they were not really wearing dresses. It was crepe paper..."



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