Sunday, March 15, 2015

Pantawid-gutom: Negotiating hunger in the Philippines

by Gideon Lasco, MD

TO TIDE OVER, through the sea of hunger from one island of satiety to another: such is the image conveyed by the term “pantawid-gutom”. For people who eat three meals a day, and meriendas in between, it may be a term that we rarely encounter in our everyday lives. But it means a lot for people who regularly experience what it feels to have an empty stomach.

What makes a good ‘pantawid-gutom’? The foremost and most obvious consideration is the ability to momentarily alleviate hunger. Second, it has to be easy to prepare and consume. Finally, it has to be affordable. After all, lack of funds is what keeps most people from buying better food in the first place.

Street foods are perhaps the most common form of pantawid-gutom. Doreen Fernandez surveyed Filipino street foods in the early 90's, dutifully chronicling some of their colourful names: Adidas for chicken feet, PAL for wings, Walkman for pigs’ ears. Over two decades later, these foods have been joined by pancit canton and other ‘instant’ foods such as candies and junk foods. High in oil, simple sugars, and artificial flavors, many of these foods have “empty calories” that do provide some energy, but without nutrients the body needs. Moreover, they have been implicated in the rise of non-communicable diseases like hypertension and heart disease as well as communicable ones like Hepatitis A and gastroenteritis. When people see what they eat as pantawid-gutom, they themselves recognise that these are not the ideal foods for their bodies, but given the circumstances, they would suffice.

Some also use certain drugs as pantawid-gutom. In my own research on the use of shabu (methamphetamine), I found that one of the drug’s desirable effects (for its users) is its potent ability to suppress hunger. This, and shabu’s other effects, such as giving alertness and allowing people to stay awake, makes it a particularly appealing choice for people who have to work all day and night, such as vendors and drivers, among many others. “Rugby” often used by street children, as well as the nicotine in cigarettes can have a similar effect. Much of the discourse around drugs has focused on how they are linked to addiction, peer pressure, and criminality, but often overlooked are the ways in which they are used by people to deal with their physiologic needs and everyday problems - such as hunger.

Who in our society commonly resort to pantawid-gutom? First, the urban poor, for whom access to food is as good as the money they could earn for the day - a “food insecurity” that we commonly express as “isang kahig, isang tuka” (one scratch, one bite). Children are not spared of this predicament, and the impact is particularly alarming: lack of healthy food leads to stunting and future health problems, as well as weak immune systems that contribute to more infant and child deaths.

Second, we have people who have to work for long hours without food. These include construction workers, laborers, street vendors, drivers, and many others. Often, these are people who belong to the informal sector, unprotected by labor laws. Their lack of funds and time to prepare for food impels them to eat just enough pantawid-gutom to stave off hunger until they get home.

Finally, we have overworked individuals - whether in the corporate world, in call centers, hospitals, schools, and various other institutions. They too, sometimes resort to pantawid-gutom to finish their tasks.

Drawing on the meanings of pantawid-gutom, the government named its conditional cash transfer scheme as “Pantawid Pamilyang Pilipino Program”, or ‘4Ps’. While there have been indications of positive results, its wider impact remains unclear. According to a recent SWS survey, 4.8 million Filipino families said they experienced hunger in the past month, representing 22% of our entire population.


THE WHOLE NOTION of pantawid-gutom speaks to us of the hunger that many Filipinos experience on a daily basis, and the tactics (“diskarte”) they deploy in order to get by (“makaraos”). Sadly, many of us have been desensitised to images of children sniffing rugby, or families on the streets partaking of pancit canton and whatever else they can find. Moreover, access to healthy foods among people working in different sectors, formal or informal, have oftentimes been overlooked.

The challenge for nutritionists and policymakers is to come up and promote food alternatives that are safer and healthier, but just as accessible and affordable. Admittedly, this is not an easy task, because for food to be “instant” and “cheap”, a lot of nutritional sacrifices have to be made. But we can start with foods that already there, like protein-rich taho (sweetened snack made of soy), boiled bananas, and kamote-cue. In addition, these efforts should go hand in hand with strengthening the agricultural sector to increase yield and lower food prices. Moreover, for people who resort to pantawid-gutom out of convenience, not out of necessity, education about the health risks of an unbalanced diet can go a long way.

As for those for whom there is little choice, we are called upon to show understanding, empathy, and solidarity. Many Filipinos rely on pantawid-gutom - unsafe and unhealthy foods and even drugs - to tide them over, even as the economic gulf grows wider, and the islands of satiety seem fewer and further apart. Rather than be judgmental or indifferent to their predicament, we should examine and act on the circumstances that have led to their chronic hunger in the first place.

Quezon City
February 26, 2015