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