NUTRITION AND RELATED SERVICES PROVIDED TO THE REPUBLIC OF THE PHILLIPINES BY VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVEXSITY UNDER CONTIZACT AID/ASIA, C-1136 Final Report Contract AID~ASIA,C-1136 September, 1979 Prepared by : R. W. Engel, Ph.D. Chief of Party A J. C. Arnold, Ph.D. Campus Coordinator Table of Contents Sect ion Page A A summary of the events which identify the role of VPI~in nutrition in the Philippines ......... 1 Attachment - Section A ............... 5 B A listing of working papers and planning documents developed by or under the direction of the VPI Chief of Party and their relationships to the evolution of the Philippine Nutrition Program ........... 7 C A summary of TDY consultant services provided by VPI, in addition to the in-residence advisor, and their impact on food and nutrition policy and the evolution of nutrition policies and programs ..... 30 Attachment - Section C ............... 44 D A brief history of the evolution of the Nutrition Program in the Philippines - A perspective from the office of the VPI Chief of Party ......... 46 E A summary of evaluations as to VPI's effectiveness in carrying out its role in the Philippine Nutrition Program ...................... 64 Attachments A-L- SectionE ............. 68 Attachments A-S - Section B ............. 123 'Although the University now is titled Virginia Polytechnic Institute and State University, reference to the University is abbreviated as shown. Section A A Summary of the Events Which Identify the Role of VPI in Nutrition in the Philippines Summary Statement: Through short-term consultancies, training of Filipino counterparts and professional guidance to USAID Food for Peace and Public Health officials over a period of nearly a decade, VPI had gained considerable experience to qualify for the provision of technical services in support of a Philippine nutrition program. In particular, R. W. Engel, first as head of the Department of Biochemistry and Nutrition and later as Associate Dean of Research in Agriculture and Life Sciences, had maintained a continuing interest and developed firm and productive working relationships with counterparts in Philippine agencies concerned with food and nutrition from 1959 to 1967. 1. In 1959 the Interdepartmental Committee on Nutrition for National Development (ICNND), an inter-agency body of the U.S. Government from USAID, STATE, USDA, HEW, and DOD, invited R. W. Engel, Head, Department of Bio- chemistry and Nutrition, VPI, to participate in a review and follow-up of a nutrition survey which had been conducted in the Philippines in 1957 with ICNND support through the USAID mission in Manila. Engel had served as consultant to the ICNND in the development of its program of providing technical expertise and equipment to assist developing countries in defining their malnutrition problems. He had also served in the Philippines in W. W. I1 as Food and Nutrition Officer and had developed some background and understanding of the Philippine culture and its food and nutrition situation. Further, his department at VPI had pioneered, through support from the Williams and Waterman Fund, Research Corporation, N.Y.C., village-level nutritional rehabilitation of children and mother-education in nutrition in the Republic of Haiti. During the 2-month tour in the Philippines in 1959 it was learned that the Philippines, through its Food and Nutrition Research Center, was using the equipment and the trained personnel (gained from the 1957 survey experience) effectively in continuing food and nutrition surveys and had developed plans for completing in a decade, surveys in nine major regions of the country (1959-68). Much of the 1959 tour by Engel was devoted to consultations with De. Conrado R. Pascual, Director of the Food and Nutrition Research Institute, in developing a machinery or infra-structure through which the nutrition survey data could be disseminated and through which local government units could operate in developing interventions for dealing with the food and nutrition problems evident from the analysis of the survey data. 2. In 1962 Engel was invited to serve as a delegate from VPI to the First Far East Symposium on Nutrition sponsored by ICNND, in cooperation with USAID mission in South Vietnam, and to proceed on a brief visit in Manila for further follow-up on nutrition activities in progress as related to the nutrition surveys assistance and consultancies provided earlier. On this visit Engel learned that the National Coordinating Council on Foods and Nutrition (NCCFN) had been organized in 1960 by the Food and Nutrition Research Center (later Institute) as the mechanism for dissemi- nating nutrition information, particularly survey results, and for planning local nutrition programs or interventions through regional, provincial, municipal or city and village (Barangay) coordinating councils. This plan had been partially completed during Engel's 1959 tour as a possible mechanism for coordination of nutrition activities. 3. In 1964 the ICNND served as the agency through which PL480 Title I1 Foods (Food for Peace commodities) could be tested as to their usefulness in child feeding programs. VPI was invited by ICNND to provide the services of Engel as an investigator in a project planned for the Philippines. Engel was to extend technical advisory services 2-4 weeks annually to assist the Philippines in testing the usefulness and acceptability of soy grits, a newly available Food for Peace commodity in elementary school lunch programs. Through this project VPI developed considerable exchange relationships with Philippine scientists in the Food and Nutrition Research Institute and some Philippine universities with biochemistry and nutrition programs. As a result, VPI began training Filipinos at the masters and doctorate level in food, nutrition, and biochemistry. These research activities brought Engel to the Philippines once a year (1964-66) and provided opportunity for review of other nutrition activities, particularly those relating to nutrition sur- veys and nutrition program implementation following such surveys. During these visits Engel also provided briefings for the USAID Food for Peace and Health offices and for the Mission Director as requested. ' During these TDY tours, Engel also learned that UNICEF had been invited by the Philippines to assist with the implementation of an Applied Nutrition Program through the Bureau of Public Schools, Department of Education. The program was to develop expertise, through school systems, for implementing activities,at community level, in food production, nutrition education, nutritional rehabilitation and other interventions to solve nutrition problems. 4. In 1964 Engel also participated, by invitation from ICNND,in the Second Far East Symposium on Nutrition in Taipei, Taiwan. At this symposium the Philippines reported in detail the organization of the National Coor- dinating Council on Foods and Nutrition and how it was facilitating the im- plementation of the Applied Nutrition Program and serving as the organization for planning and coordinating nutrition activities at all levels. 5. In February,l967, the Third Far East Symposium on Nutrition was held in Manila. VPI participated with Dr. K. W. King of the Department of Biochemistry and Nutrition, who was invited to describe the Mothercraft Nutrition Center program in Haiti, mentioned above. Engel served as a U.S. delegate to this symposium and also served on a Nutrition Reconnaissance Team for the Philippines. The team was organized by ICNND and the USAID/ Washington Office of Nutrition in order to explore, for the Office of War on Hunger, the interest of Philippine public officials in developing a nutrition program with assistance from USAID. There was particular interest in the Office of War on Hunger in developing nutritionally-oriented usages for PL480 Title I1 food blends which had been developed through participation l~nimportant development emerged from a chance meeting with Mission Director Wesley Haraldson, in June,1966 which is described in some detail in Attachment A, Section A. of the U.S. food industry and made available as food donations in foreign aid programs. The nutrition reconnaissance team was composed of Dr. A. E. Schaefer and Dr. J. M. May, ICNND, Dr. T. B. Dublin, HB/TCR/AID/W, Mr. Layton E. Allen, Consultant to AID, Dr. D. B. Hand, Cornell University, and Dr. R. W. Engel, VPI. During and following the above mentioned symposium the team held dis- cussions with the Secretaries of the Departments of Health, Education and Agriculture and with the USAID mission to assess interest and feasibility for an AID-supported nutrition program. The team concluded that such interest existed in both the government of the Philippines and the AID mission. At the Third Far East Symposium on Nutrition, Dr. Paulino J. Garcia, Secretary of Health, had identified the high mortality rate among children aged 1-4 years as a specific and urgent signal for the implementation of more extensive nutrition efforts directed toward the most vulnerable persons, namely, infants, pre-school children and women in the reproductive process. Secretary Garcia lauded the on-going Applied Nutrition Program as particularly useful for school-age children but felt more vigorous efforts would be needed to reach pre-schoolers more extensively and more effectively. The favorable report of the reconnaissance team was concurrently endorsed by the Secretary of Health in a letter to the USAID mission director in Manila requesting that a technical consultant be made available for planning a program. This letter of invitation further contained a policy directive to the effect that such a program should concentrate on alleviation of malnutri- tion in the pre-school child and infant. 6. In response to a request from the Office on War on Hunger, VPI sub- mitted a project proposal to provide consultant services between August and December, 1967, to assist the Philippines Department of Health in planning a program aimed at pre-schoolers, infants, and pregnant or lactating mothers. Engel resided in the Philippines from 2 August to 8 December, 1967 and en- gaged in nutrition program planning with USAID mission and Filipino counter- parts.