The Code and Emergencies

• The Code is still in force in emergencies.

• The Code does not prohibit the use of BMS during emergencies, only the way in which they are procured, packaged and distributed.

Supplies of BMS should be targeted to infants (Violation Article 6.6, 1994 Resolution)

- INGOs & local NGOs provided formula to all mothers - especially in ‘child boxes’.

- Govt Relief Committee distributed ‘child’s kits’ to Municipalities - distributed according to economic need (>27,000 according to their website 27/9/06)

- Post-conflict an INGO gave Municipalities ‘Village kits’ containing formula (25 boxes x 24 cans) & baby food (80 units)

Donated (free) supplies of BMS should not be part of the health care system (1994 Resolution)

LEBANON, 2006

Around Sour: Baby milk formula and diapers were provided for 1,500 babies [given as ‘baby kits’ including formula & bottles to hospitals, Municipalities & directly to IDPs]

Saïda: Hygiene and cooking kits, blankets, bed sheets, and baby milk formula were distributed to around 20,000 displaced people.

Jezzine: The donations included blankets, mattresses, enough baby milk formula for 2,000 babies,

Labels should be ‘in an appropriate language’ & ‘easily readable & understandable’

(Violation Article 9.2)

- INGOs & local NGOs distributed formula to mothers that were in a foreign language

- Foreign governments donated formula to the Lebanese government (HRC) that were not in Arabic.

There should be no text that idealises the use of BMS or claims it is as good as breastmilk

(Violation Article 9.2)

Important Notice states:

‘It contains all vitamins and minerals known to be essential for the healthy development of the infant and is based on the same formula as mother's milk’

Additionally it does not advise that it should only be used on the advice of a health worker

Complementary food

(potential violation of Article 9.3).

E.g. Local NGO gave Fabimilk 2 (a follow-on milk) to mother while an IDP

- her child was only 2 ½ months old

Mothers provided with the wrong type of formula for their child’s age.

Mother who ‘tried’ her sample tin of formula.

Code Article 7.7 – Health workers should not give samples of infant formula (‘sample’ means ‘single or small quanitities of a product provided without cost)

Violations include things that ARE NOT DONE!

Seemingly none of the following were done by an INGO or local NGO:

(i) distribution of BMS linked to training on safe preparation, home follow-up & regular weight monitoring (Violation Article 6.5)

(ii) systems/programmes to protect, promote & support breastfeeding (Violation 1994.)

(iii) Continued supplies of BMS for infant (Violation Article 6.7)

Examples of Code violations in emergencies - INDONESIA

Companies:

- In Java post earthquake donations had been received by the Provincial Health Office directly from the manufacturer (Violation Article 5.2)

Foreign Governments:

- Java - foreign government donated cartons of formula in a foreign language (Article 9.2)

NGO’s: Bantul - an INGO distributed boxes including formula to local health cadres

(Violation article WHA 47.5 (1994)

Pundong - boxes of food supplies including infant formula were distributed to families even with no children (as part of general ration) (Violation article 6.6)

- Jedis - infant formula was distributed as incentive/reward for partaking in measles & tetanus campaign (Violation 6.2)

The Code and YOU!

• Training on the Code:

- ‘Making Sense of the Code’ Training material – ICDC

- Week course on the Code – ICDC