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Disparities in Diabetes: Applying intersectionality to understand diabetes

  • CARE Philippines
  • Blog, Gender, Gender, Healthy Mothers & Children, Other Topic, Uncategorized

Written by: Juin Ancha (CARE Philippines)

November 14 — World Diabetes Day. Various health organizations and groups all over the country urge the Filipino community to take active measures to prevent this life-threatening illness. However, simple lifestyle and dietary changes may not be enough to comprehensively address diabetes, especially within the context of vulnerable populations. Pervasive gender norms and roles are also factors that influence the health and well-being outcomes of Filipino women and men. As we commemorate World Diabetes Day, we encourage the public to use an intersectional lens to understand diabetes.

Diabetes at a glance

Diabetes is a worldwide epidemic, and the Philippines is not exempt. According to the International Diabetes Federation, of the 64 million adults in the country, 4 million have diabetes. However, even with these high numbers, there could be more undocumented cases, specifically in low-income, rural, and armed-conflict-affected areas. Lack of health facilities in far-flung communities, lack of access to diabetes information, and lack of access to basic services continue to be major factors that prevent people, including the elderly, children, women, and men, from seeking timely health check-ups and routine monitoring. Socioeconomic constraints do not help either, and only contribute to a general reluctance among poor families to seek medical intervention.

Early detection of diabetes is hard when you are poor and internally displaced. In Lanao del Sur, many people did not know that they were diabetic until they saw CARE Philippines NCD-LOVE. NCD-LOVE was a three-year pilot project designed to introduce innovative approaches to address health issues, specifically non-communicable diseases, diabetes included. From providing technical assistance and capacity buildings to partner government stakeholders, augmenting NCD service delivery in project sites, and ensuring its sustainability through transition plans, the NCD-LOVE indeed provided strong advocacy on health and well-being. In 2023 alone, the project reached 15 municipalities in Lanao del Sur and served 7,031 patients, of which 67% were women.

Using intersectionality as lens to understanding diabetes

Lived experiences of diabetes can be best understood through an intersectional lens that considers the social identities of ordinary Filipinos. Due to deep-seated culture and gender norms, various gender biases have affected not only our behavior towards health but also our understanding of health. According to the World Health Organization, the majority of studies on NCD, diabetes included, have been undertaken on men, and women have been less diagnosed at early stages. As a result, even health interventions have placed women at the periphery of diabetes attention.

“No words could express how CARE helped us and made us happy, especially here in our community,” – shared Alma (not her real name), 58 years old, a woman with diabetes from Boganga Transitory site. That is why the NCD-LOVE project purposefully targeted not only low-income households in conflict-afflicted areas but, more importantly, women.

“We deeply appreciate the invaluable support from CARE and Abbott, which has been instrumental in propelling this NCD-LOVE program forward. Our steadfast commitment to prioritizing health and well-being remains resolute. As we look ahead, our focus remains steadfast on ensuring the sustainability of our NCD-LOVE program, guaranteeing that the progress achieved endures for the long term,” stated IPHO II.

Unlocking one of the key solutions, applying intersectionality in analyzing diabetes, opens discussions beyond the medical model of this life-threatening, non-communicable disease.

The NCD-LOVE project was funded by Abbott and the Abbott Fund.

Bangsamoro women and youth: emerging leaders from the ground up

  • CARE Philippines
  • Gender, Latest News & Stories, Press Release, Uncategorized

Photo: A young Bangsamoro woman participates in one of the series of gender-sensitive conflict and resilience analysis and capacity-building sessions among women and youth civil society organisations, gender and peace advocates hailing from Basilan, Sulu, and Tawi Tawi (BaSulTa).

Witten by: Juin Ancha and Winonna Fernando (CARE Philippines)

SULU, PHILIPPINES Since the establishment of the Bangsamoro Autonomous Region of Muslim Mindanao (BARMM) in 2019, there has been increased attention to the differentiated impacts of decades-long conflict on Bangsamoro women and girls. However, for most, justice, healing, and reconciliation remain elusive. As we commemorate the 11th anniversary of the International Day of the Girl, women and youth-led CSOs in Sulu are retelling their history to every Moro woman and girl, one story at a time.

“The youth of today are fortunate to not witness the suffering and pain of conflict and war in Sulu following the declaration of Martial Law in the 1970s… But now, I have learned about the impact of historical injustices on communities and how the presence of conflict and war over the past 50 years has contributed to the province’s present condition.” – Woman youth leader whose name was withheld.

Although BARMM has been admired for its efforts for better women’s representation, and has progressed in pushing for laws and initiatives promoting the Bangsamoro’s right to know, right to justice, right to reparation, and the guarantee of non-recurrence through Transitional Justice and Reconciliation, along with other normalization initiatives, the Bangsamoro youth, particularly women and girls, in the isolated segments of Basilan, Sulu, and Tawi-Tawi remain sidelined and without means to access basic services, comprehensive education, and violence prevention programs that can facilitate and sustain their meaningful participation and leadership in formal or informal spaces and letting their voices be heard.

Life amid constant displacements

Sulu is ranked second-third to lowest in the 2019 Provincial Human Development Index by the Philippine Statistics Authority. Decades of evolving conflict have resulted in a vicious cycle of poverty, systemic exclusion, and sociocultural marginalization and discrimination affecting vulnerable populations including youth, women, and children. Surviving in these situations comes in many forms. To some youth it means resorting to other forms of self-preservation such as involvement in crime and illegal activities, violent extremism, and other negative coping mechanisms. But for some women and youth-led CSOs, surviving also means thriving. Despite constant displacements, many women and youth-led CSOs believe that harnessing collective power, claiming space and amplifying influence, and becoming positive agents of change can promote recognition, reconciliation, and healing.

“Justice has not been served to benefit all the abused, displaced and dispossessed. As women youth leaders, we want to be deeply involved in claiming our rights and ensuring that injustices do not happen again.” – Woman youth leader in Sulu whose name was withheld

Engaging young women and girls is key

Apart from conflict, deep-seated cultural norms and beliefs about what women and girls should be and how women and girls should behave have shaped the lives of young Moro people for generations. These norms drive many girls out of school, to forced marriages, and expose them to gender-based violence. However, recent developments have served as proof that reshaping cultural norms and engaging women and girls is key to achieving peace, reconciliation and healing.

CARE Philippines sees gender equality, synergy and complementation in humanitarian-development-peace nexus spaces, as key to ending poverty and social injustices.

In February 2023, CARE Philippines launched the “Civil Society Women and Youth Promoting Culture of Peace in Mindanao” (BRIDGE) Project, funded by the European Commission, aimed at reducing the drivers of conflict through strengthening women and youth CSOs, and working with various peacebuilding actors in Mindanao – complementing its existing humanitarian and disaster preparedness programming in the island.

In partnership with Nisa Ul Haqq fi-Bangsamoro (Nisa) – a women’s rights organization, small-scale women and youth-led CSOs hailing from Basilan, Sulu, and Tawi-Tawi are capacitated and linked with relevant BARMM ministries and commissions with initiatives on peacebuilding and Transitional Justice and Reconciliation. Women and youth-led CSOs from Sulu are committed to increasing their involvement in community memory projects, narrative documentation activities, and rights awareness and information drives that will facilitate communities’ access to services ultimately aimed at addressing drivers that perpetuate conflict in the communities.

Peacebuilding by women, with women

Anything is possible. Miriam Coronel-Ferrer, the first woman to sign a major peace agreement in the world and led the peace negotiations with the Moro Islamic Liberation Front (MILF), and human rights lawyer Raissa Jajurie, co-founder of Nisa and current minister of the Ministry of Social Services and Development of BARMM became an inspiration to many Bangsamoro youth and girls to pursue peacebuilding initiatives using nonviolent collective power.

For many women and youth-led CSOs, retelling their history would mean constantly defying cultural norms and beliefs that have curtailed women and girls’ rights. Through BRIDGE, they are positive to pursue peacebuilding initiatives involving more women youth and girls in the process. True enough, when youth and girls are recognized as equal citizens towards peacebuilding, meaningful participation arises.

As we observe and celebrate the International Day of the Girl, may we continue to seek and maximize avenues that amplify her-stories that promote genuine representation of youth, young women, and girls and ensure that no one is left behind.

Farming, sewing, and saving

  • Mary Therese Norbe
  • Blog, Featured Stories, Gender, Latest News & Stories

Dark clouds hovered when Lolita, 53, arrived at her house on a gloomy December morning. She had just finished her daily trek of the muddy trail to and from their vegetable farm in Brgy. Malabanan, Balete, Batangas. It had been raining for a few days, so she and her son, who works with her on the farm, constantly checked how their crops were faring with the weather. They learned to be meticulous in monitoring their crops, especially the vegetables, because of their experience with the Mt. Taal volcanic ash eruption earlier that year.

The string beans they planted were already in their first month of growth when it happened. The leaves turned yellow and were laden with small holes.

“We immediately applied fertilizer to help the crops withstand the effects. It did help them from withering and grew to produce string beans that were shorter and thinner”, shared Lolita. Their few kilos of harvest only paid for a part of the expenses they made for that cropping.

Lolita has been farming for the past thirty years. She shared that the challenges have become more difficult in recent years. The biggest hurdle was the unpredictable weather which greatly affected their planting schedule and their crops’ resilience to the intense heat in the dry season and the heavy rains in the wet season. Added to this was how traders controlled the market: which crops to produce and the price of these crops.

These are the seeds of pigeon peas locally known as kadyos which Lolita stored for planting. | Photo: M. Norbe/CARE

“We used to plant different varieties of vegetables. We had no choice but to stick to only those the market demands”, shared Lolita.

With most farmers doing the same, the supply increases every harvest. This leads to a decrease in the buying price for their crops.

When she attended one of the sustainable agriculture trainings organized by CARE and the Southern Tagalog People’s Response Center – STPRC, Inc., she learned that food producers like her should be innovative in navigating the tricky waters of the market and ensuring that their farm production will be sustained for future generations.

Her son, Reymark, 27, is already working on their farm, and Lolita wanted him and his family to continue reaping the benefits of farming. These training were part of the aGAP (Asenso sa Good Agriculture Package), a project supported by the Metrobank Foundation that assists marginalized farming households whose livelihoods have been doubly affected by the COVID-19 pandemic, and the intermittent Taal Volcano eruptions since January 2020.

After the training, she decided to integrate natural ways of farming by making oriental herbal nutrients (OHN), fish amino acids (FAA) and fermented plant juice (FPJ) and applying these as fertilizers and enhancers to their crops. Her first harvest after this was a success. The string beans yielded more than their usual harvest. The fruits were also longer and firmer. She also noticed that the soil turned darker, and the flowering vegetables kept blooming and bearing fruits every week.

Lolita (left) and another farmer participant peeled garlic to make oriental herbal nutrients (OHN) used to boost plant growth. | Photo: STPRC

She also decreased their production of ampalaya (bitter gourd), which sells at a high price but requires intense labor and is very sensitive to changes in weather and soil conditions and recurrent volcanic ash eruptions. Instead, she focused their vegetable production on crops that were easy to grow and required less amount of capital. She continued storing seeds that were open-pollinated varieties like string beans, okra, pigeon pea and winged beans, so she didn’t need to buy these from traders.

“We are near Taal, and we had to find ways like these to survive the effects of its eruption on our crops and livelihood,” she said.

Hence, Lolita also doesn’t depend on farming as her family’s sole source of income. After doing her farm chores, she sewed school uniforms that retailers of ready-to-wear clothes would buy from her for 130 pesos (2.6 USD) per dozen. She usually finishes two dozen per day. She also works on other farms as a weeder and harvester.

Above photo: Lolita spends most of her time in her porch where she sews school uniforms after her tending to their vegetable farm. |
M. Norbe/CARE

Right photo: Part of income from selling this fresh harvest of string beans will be put in the tin savings bank. | STPRC

“It felt so good to have some cash to use in times of difficulty. I didn’t have to borrow from anyone”, she added.

This story is part of the aGAP (Asenso sa Good Agriculture Package) sa Batangas implemented by CARE and its partner, Southern Tagalog People’s Response Center – STPRC, Inc. in three barangays in the Municipality of Balete in Batangas province. The Metrobank Foundation supports this project.

Women in Leadership and Community Rebuilding: A Photo Story

Cherry prepares the ingredients for her barbeque marinade. To make ends meet, she sells grilled meats each afternoon in her neighborhood of Barangay Poblacion, Araceli, Palawan.

Story and Photos by Shirin Bandari

Cherry Cuberos, 50, is a leader of a livelihood group for women in Purok 2, Barangay Poblacion, Araceli, Dumaran Island, Palawan. The remote village suffered immensely when Typhoon Odette (Rai) devastated homes, roads, and public infrastructures in December 2021. Close to a year after the storm, the European Union Humanitarian Aid together with  ACCORD Philippines provided crucial support through shelter repair, and cash assistance, and intervened in a project designed to engage and encourage participation and leadership among women.

Cherry is a working mother of four. She takes on multiple jobs to be able to feed her family. Her town suffered immensely when Typhoon Odette (Rai) made landfall in December 2021.
The European Union Humanitarian Aid, CARE, and ACCORD provided cash assistance and livelihood programs to those affected by Typhoon Odette (Rai). Through this, the Women’s Association in Barangay Poblacion, Araceli set up a compact general store to provide for the needs of the community at affordable prices.

Women and girls who survive disasters face overwhelming risks and immediate consequences such as displacement, trauma, sexual violence and exploitation, health services disruption, and financial instability, which can lead to devastating short- and long-term effects. 

Cherry works part-time at the General Store run by women. She assists in the inventory of stocks and balances the daily sales ledger. The island’s remote location makes it difficult for supplies to reach the area. The newly opened General Store comes as a welcome relief to the community.

“When Typhoon Odette came, it was hard to move on from what happened to my home and family. My livelihood and earnings were affected. But through the help of the European Union Humanitarian Aid and ACCORD, we are very thankful that our Women’s Association was able to set up a General Store that sells groceries at affordable prices.” Cherry adds. “This General Store is part of the livelihood program which has become an invaluable addition to the community, the women who work with us are able to get enough for their daily expenses. It also provides groceries on loan for women in our area who are struggling to feed or put their children through school.” Cherry Cuberos explains.
“Some women in our association are single mothers and are unable to support their families. At the same time, others make rice cakes or have opened small carinderias. We allow them to take goods on loan from the General Store, in case they are short on supplies. They repay us once the food is sold. This way we support other small businesses to grow and see a return on investment”

Through Cherry’s devotion to her women’s association and volunteerism, she is able to provide for her family and serve as an inspiration, by encouraging others to band together to rebuild what was lost and be contributing members of their community. 

A mother with her infant visits the local barangay health center where Cherry has volunteered her time for the past 20 years.
Cherry meets with the Women’s Association at the Barangay Hall to discuss new ideas on ways to improve their livelihood. She encourages others to join them so more can benefit from the program “They just need to trust us to have a good relationship. We are here to help them and the community.”
Cherry monitors an infant’s temperature. She has proven to be a devoted member of the Araceli community.
Essential health services were abruptly put on hold when Typhoon Odette hit the shores of Araceli. Today, Cherry is able to assist the local nurses and doctors to tend to local patients.

Tuberculosis remains a pressing issue in the islands of Palawan. Cherry has been trained to test swab samples of patients so they may know their current health status.

“It is my dream that my children can finish their studies. I invite others to keep our barangay clean. I hope that I can continue to help the people in my community.” 

150 million more women than men were hungry in 2021 – CARE analysis finds

  • CARE Philippines
  • Blog, Featured Stories, Food & Nutrition, Gender, Gender, Latest News & Stories, Press Release

An analysis by humanitarian organisation CARE highlights, for the first time, a global link between gender inequality and food insecurity. Analysing data from 2021, the report shows that across 109 countries, as gender inequality goes up, food security goes down.

Christine Campeau, CARE’s Global Advocacy Director – Food Systems, said, “Between 2018 and 2021, the number of hungry women versus hungry men grew 8.4 times, with a staggering 150 million more women than men hungry in 2021. And the implications of the escalation of conflict in Ukraine will make the situation even worse for women, who play a crucial role across food systems and in feeding their families and communities. Gender equality is highly connected to food and nutrition security at a local, national, and global level. To put it simply, the more gender inequality there is in a country, the hungrier and more malnourished people are.”

Of the four major global datasets on gender, including the World Bank’s Gender Data Portal, the only sex disaggregated food indicators reinforce women’s role solely for their importance in reproduction: measuring anemia in women of childbearing age and counting stunting for children.
Most food security datasets are strangely silent on gender. And, despite women being responsible for 90% of preparing and buying food, they are eating last and least.

Even when both men and women are technically food insecure, women often bear bigger burdens. For example, in Somalia, while men report eating smaller meals, women report skipping meals altogether.

Aisha, who lives in a village in eastern Somalia said, “I don’t remember how old I really am, the drought has affected me mentally and physically so much that I can’t remember. Most days we don’t get anything to eat, other days we eat one meal.”

In the World Bank Gender Data Portal on food and women, the only sex disaggregated food data is related to the number of women who believe, or do not believe, that a husband is justified in beating his wife when she burns the food.

Ms Campeau said, “As women keep feeding the world, we must give them the right space in our data collection methods and analysis to make the gaps they encounter visible and work with women themselves to find solutions to those gaps. Global datasets should be publishing sex disaggregated data on food—whether the focus is on gender or on food. It is time to update our global understanding of food security and gender inequality, and, local actors, including women’s organisations in crisis-affected communities, need to get the flexible funding and support desperately needed to protect women and girls from hunger-associated gender-based-violence and protection risks.”

About CARE: Founded in 1945, CARE is a leading humanitarian organisation fighting global poverty. CARE has more than seven decades of experience helping people prepare for disasters, providing lifesaving assistance when a crisis hits, and helping communities recover after the emergency has passed. CARE places special focus on women and children, who are often disproportionately affected by disasters. To learn more, visit www.care-international.org  

For media enquiries contact:

Suzy Sainovski
Senior Humanitarian Communications Coordinator, CARE International
Email: suzy.sainovski@care.org
Skype: suzy.sainovski

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