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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.

Managing a Community-Based Coconut Nursery: The Padillos of Calape, Bohol

  • Mary Therese Norbe
  • Featured Stories, Latest News & Stories, Other Topic, Stories of Change

“I’ve learned how to manage a nursery which farmers can establish in their own farms. The training also encouraged us to be smart on how we plant coconuts as well as other crops to avoid losses due to changes in weather conditions”, said Lorna Padillos, 47, a farmer from Barangay Lucob, Calape, Bohol.

She is the manager of the community coconut nursery which is located in a patch of land near their family’s farmhouse. She and her husband, Silvestre, take turns ensuring that the nursery is well taken care of and secured from being damaged by farm animals.

One hundred coconut farmers who are partners in the implementation of the RISE Coco (Recovery Intervention for SEverely Affected Coconut Farming Communities of Bohol by ST Odette) project in Barangay Lucob presently use the nursery to propagate seed nuts and prepare seedlings for planting in their respective farms. Lorna shared that the nursery became a learning venue for them to apply good coconut farming practices such as choosing the best variety of seed nuts to propagate, using organic compost or vermicast as fertilizer, and deciding the appropriate time of the year to plant based on climate conditions that they learned from the series of training conducted through the project. They were also trained on how to manage their finances and how to save for emergencies such as typhoon Odette which took almost everything they own.

“We used to live comfortably before the typhoon. We had a house, a coconut, and a rice farm. We also raised poultry and livestock and tended a vegetable garden for food”, she said.

The typhoon left only one room of their house for them to live in for a while. They lost the coconuts, rice, farm animals, and vegetables to the harsh winds and heavy rains. The experience left the couple devastated and didn’t know how to provide for their family’s daily needs.

They received financial and material assistance from the government which only lasted for a couple of months. They had to rely on one of their children who was already working to provide them with money for repairing their house and to have something to eat daily. To start farming, they borrowed money from lenders to buy farm inputs like seeds and fertilizers. However, they found it difficult to source coconut seedlings because all of Bohol was heavily affected by the typhoon.

When the RISE Coco project staff conducted a consultation in their barangay in August 2022, their family was selected as one of the beneficiaries in their community and were oriented about the project. They accepted to be part of the project because of their interest in recovering their coconut farm. She and her husband underwent training on financial literacy and sustainable good agriculture including climate-resilient coconut farming.

With the establishment of the nursery, Lorna became its manager. This was during the long dry season and propagating seed nuts was a challenge because of the intense heat. She and her husband, along with other farmers took turns in watering the seed nuts every day to prevent them from withering. Their hard work paid off. By October 2023, they were able to propagate almost 3,9678 seed nuts and seedlings. Out of these, they have replanted 2,849 coconuts in various beneficiary farms.  

As a manager, she has the challenging task of encouraging her fellow coconut farmers to be responsible for their seed nuts and seedlings in the nursery. She sees it as a sustainable source of seedlings and income for the members. Many farms in the province are still struggling to find a good source of copra-quality seedlings. Community-based nurseries that are well-managed like theirs could earn from selling their seedlings.

“We rehabilitate our farms and we will no longer worry about where to get seedlings when we need them”, she added. 

The RISE Coco project aims to address the critical needs of typhoon Odette-affected coconut farmers for livelihood support, primarily the alternative sources of income while rehabilitating their damaged coconut trees in 2 years. It is implemented by CARE in partnership with the CebuBohol Relief and Rehabilitation Center and supported by Cargill.

Gendered Implications Of COVID 19 Executive Summary

  • CARE Philippines
  • Impact Reports, Other Topic, Reports & Publications

CARE’s analysis shows that COVID-19 outbreaks in development or humanitarian contexts could disproportionately affect women and girls in a number of ways, including adverse effects on their education, food security and nutrition, health, livelihoods, and protection. Even after the COVID outbreak has been contained, women and girls may continue to suffer from ill-effects for years to come.

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