IFE in Padang IFE in Padang Pariaman, West Pariaman, West
SumatraSumatra
2-9 October 2-9 October 2009 and 20-24 2009 and 20-24 October 2009October 2009
Natural Disaster: Natural Disaster: Earthquake 7,6 RSEarthquake 7,6 RS
The Natural Disaster: The Natural Disaster: EathquakeEathquake
Wednesday, 30Wednesday, 30thth September September 2009 at approximately 2009 at approximately 17:16:10 local time17:16:10 local time
Magnitude of 7,6 RS, Magnitude of 7,6 RS, epicenter was epicenter was 45 kilometres (28 mi) west-45 kilometres (28 mi) west-northwest of Padang, northwest of Padang, Sumatra Sumatra
Most affected areas: (a) Most affected areas: (a) Padang Pariaman, (b) Padang Pariaman, (b) Agam, (c) Padang, and (d) Agam, (c) Padang, and (d) PariamanPariaman
Government reports have Government reports have to date confirmed: (a) 1,115 to date confirmed: (a) 1,115 dead, (b) 1,214 severely dead, (b) 1,214 severely injured and (c) 1,688 injured and (c) 1,688 slightly injured slightly injured
AIMI’S AIMI’S Disaster Response Disaster Response Lactation Team:Lactation Team:First DeploymentFirst Deployment
2 – 9 October, 20092 – 9 October, 2009
ObjectivesObjectives
Rapid assessment and mapping of Rapid assessment and mapping of earthquake victims: (a) pregnant earthquake victims: (a) pregnant women, (b) breastfeeding mothers, women, (b) breastfeeding mothers, (c) babies and infants (under 2s)(c) babies and infants (under 2s)
Observation over the distribution of Observation over the distribution of infant formula and baby foodinfant formula and baby food
Early lactation support for pregnant Early lactation support for pregnant women and breastfeeding motherswomen and breastfeeding mothers
Day 1Day 1
Deployment on H + 2Deployment on H + 2 3 lactation counselors 3 lactation counselors
and 1 volunteerand 1 volunteer Establishing center of Establishing center of
activity at the city of activity at the city of PadangPadang
General conditions: General conditions: blackouts, emergency blackouts, emergency rescues, lack of fuel, rescues, lack of fuel, much chaosmuch chaos
Day 2Day 2
Reporting to the Reporting to the coordination for coordination for disaster relief center disaster relief center at the Governor’s at the Governor’s residenceresidence
Padang city, 1 post Padang city, 1 post natal mothernatal mother
Victims not in tents Victims not in tents staying with relativesstaying with relatives
Lack of drinking/clean Lack of drinking/clean waterwater
Mental & Mental & psychological psychological condition of condition of breastfeeding mothers breastfeeding mothers relatively goodrelatively good
Day 3Day 3
Location: Pariaman city Location: Pariaman city and the district of and the district of Pariaman (with several Pariaman (with several sub-districts)sub-districts)
30 mothers and under 2s30 mothers and under 2s Benefits of breastfeeding Benefits of breastfeeding
and risks of formula and risks of formula feedingfeeding
Mostly mothers lacking Mostly mothers lacking confidence on quality of confidence on quality of breast milk breast milk lack of lack of nutritious food, e.g. nutritious food, e.g. instant noodles instant noodles
Day 4Day 4
Location: sub-district Location: sub-district Sei Geringging, district Sei Geringging, district of Pariamanof Pariaman
Counseling and Counseling and screening for exclusively screening for exclusively breastfeeding mothersbreastfeeding mothers
20 pregnant women & 20 pregnant women & breastfeeding mothers breastfeeding mothers from 3 villagesfrom 3 villages
Generally trust health Generally trust health workers workers not not promoting breastfeeding promoting breastfeeding mothers lack mothers lack knowledge and supportknowledge and support
Day 5Day 5
Assisting the Assisting the Indonesian Society Indonesian Society of Pediatrics (IDAI) of Pediatrics (IDAI) for IYFE at M. for IYFE at M. Jamil Hospital Jamil Hospital health health professionalsprofessionals
More effective if More effective if carried out at H + carried out at H + 2 weeks2 weeks
Day 6Day 6 With IYFE IDAI team, With IYFE IDAI team,
socialization, counseling & socialization, counseling & screening for screening for breastfeeding mothersbreastfeeding mothers
Location: sub-districts of Location: sub-districts of Sungai Limau and TandikeSungai Limau and Tandike
25 breastfeeding mothers 25 breastfeeding mothers (5 <6 mos, 20 > 6 mos)(5 <6 mos, 20 > 6 mos)
Poor knowledge on Poor knowledge on exclusive breastfeeding exclusive breastfeeding and complementary and complementary feeding using local feeding using local indigenous ingredients*indigenous ingredients*
Role of midwife in Role of midwife in promotion of formula milk promotion of formula milk and processed baby foodand processed baby food
Day 7Day 7 Activities concentrated in Activities concentrated in
the sub-district of Sei the sub-district of Sei Geringging, district of Geringging, district of PariamanPariaman
10 pregnant women, 3 10 pregnant women, 3 breastfeeding < 6mos, 17 breastfeeding < 6mos, 17 breastfeeding > 6 mosbreastfeeding > 6 mos
Location already ‘visited’ by Location already ‘visited’ by an infant formula company an infant formula company midwife midwife
From 20 breastfeeding, only From 20 breastfeeding, only 5 exclusively 5 exclusively lack of lack of knowledge and support knowledge and support (midwife) (midwife)
Day 8Day 8
Distribution of Distribution of clothes, nursing clothes, nursing aprons, infant aprons, infant toiletries, towels, toiletries, towels, toys and bookstoys and books
Concentration of Concentration of activities: several activities: several villages in sub-villages in sub-district of Sungai district of Sungai Limau, district of Limau, district of PariamanPariaman
Return to JakartaReturn to Jakarta
RecommendationsRecommendations
Early deployment of lactation team very Early deployment of lactation team very important (H + 1 week), for:important (H + 1 week), for:
Accurate assessment and mapping of: (a) Accurate assessment and mapping of: (a) pregnant women, (b) breastfeeding pregnant women, (b) breastfeeding mothers, (c) babies and infants under 2smothers, (c) babies and infants under 2s
Observation on the distribution of infant Observation on the distribution of infant formula and commercial baby foodformula and commercial baby food
Dissemination of IFE guidelines Dissemination of IFE guidelines (Indonesian Ministry of Health) to local & (Indonesian Ministry of Health) to local & international relief agencies*international relief agencies*
Counseling & breastfeeding support to Counseling & breastfeeding support to pregnant women & breastfeeding motherspregnant women & breastfeeding mothers
AIMI’S AIMI’S Disaster Response Disaster Response Lactation Team:Lactation Team:
Second DeploymentSecond Deployment20 – 24 October, 200920 – 24 October, 2009
ObjectivesObjectives
Follow-up on First DeploymentFollow-up on First Deployment Counseling and socialization of the Counseling and socialization of the
benefits of breastfeeding, risks of benefits of breastfeeding, risks of formula feeding and proper formula feeding and proper complementary feedingcomplementary feeding
IFE training for volunteers and local IFE training for volunteers and local health workershealth workers
Day 1Day 1 Deployment on H + 3 Deployment on H + 3
weeksweeks 2 lactation counselor and 2 lactation counselor and
1 field coordinator 1 field coordinator volunteervolunteer
Location: Nagari VII Location: Nagari VII Koto, district of PariamanKoto, district of Pariaman
Meeting with religious Meeting with religious and community leadersand community leaders
Distribution of packages Distribution of packages for pregnant and for pregnant and breastfeeding women breastfeeding women feed the mother, and let feed the mother, and let the mother feed the childthe mother feed the child
Day 2Day 2
Various products Various products for distribution to for distribution to pregnant women & pregnant women & b/f mother not b/f mother not available in district available in district of Pariaman of Pariaman Padang cityPadang city
Preparation of Preparation of packages, packages, scheduling visits to scheduling visits to several villages several villages
Day 3Day 3 Socialization of Socialization of
breastfeeding and breastfeeding and proper complementary proper complementary feeding in 9 villages, feeding in 9 villages, sub-district VII Koto, sub-district VII Koto, district of Pariamandistrict of Pariaman
Screening and Screening and counseling partial-counseling partial-breastfeeding mothers breastfeeding mothers formula and/or early CFformula and/or early CF
Visiting local Health Visiting local Health Office of the district of Office of the district of PariamanPariaman
288 pregnant women & 288 pregnant women & breastfeeding mothers breastfeeding mothers 88 < 6mos, 200 > 6 mos88 < 6mos, 200 > 6 mos
Day 4Day 4
Increase mother’s Increase mother’s confidence to confidence to breastfeed, despite breastfeed, despite nutritional statusnutritional status
Explain increased risks Explain increased risks of formula feeding of formula feeding lack of clean water lack of clean water results in diarrhea results in diarrhea
Proper CF using local Proper CF using local indigenous ingredientsindigenous ingredients
Exclusive b/f = 30 Exclusive b/f = 30 mothers mothers midwives midwives ‘push’ formula feeding‘push’ formula feeding
Early CF at 2 monthsEarly CF at 2 months Formula donation since Formula donation since
week 1 directly from week 1 directly from formula companyformula company
Day 5Day 5
Finishing various Finishing various tasks assigned by tasks assigned by AIMIAIMI
Return to JakartaReturn to Jakarta
RecommendationsRecommendations
This Second Deployment highlights the This Second Deployment highlights the many benefits and nutritious advantages many benefits and nutritious advantages of breast milk, especially during disaster of breast milk, especially during disaster period period people tend to believe formula people tend to believe formula milk and commercial baby food as ‘more milk and commercial baby food as ‘more nutritious’nutritious’
Training on CF preparation using the Training on CF preparation using the many available local indigenous many available local indigenous ingredients ingredients people not aware that ‘local people not aware that ‘local foods’ are more nutritiousfoods’ are more nutritious
Third Deployment necessary for training of Third Deployment necessary for training of local volunteers and health workers on IFElocal volunteers and health workers on IFE
THANK YOU THANK YOU FOR YOUR ATTENTIONFOR YOUR ATTENTION