Recent Emergencies: Impact on breast feeding – Tsunami and

Conflict Experience in Sri Lanka

Dr.Vinya S. AriyaratneExecutive Director

Sarvodaya Shramadana Movement Sri Lanka

Recent Emergencies: Impact on breast feeding – Tsunami and Conflict Experience in Sri Lanka

• Introduction – Recent Emergencies in Sri Lanka

• Breast feeding – best practices and Sri Lankan context

• Tsunami

• Conflict

• Conclusions

Recent emergencies in Sri Lanka

• Natural Disasters– Floods– Cyclones– Landslides– Droughts– Tsunami

• Human-induced– Armed Conflict

Sri Lankan context

• Need to analyze in the larger context of health and social development in Sri Lanka

• “pre-emergency” status of the population

Tsunami – December 2004

Tsunami Disaster, 26 December, 2004

 Last updated :16.00 hrs               As at : 21/02/2005  

Province District Affected

Families

Displaced

Families

Displaced Persons Deaths

Injured Missing

Damaged Houses No. of Camps

In Welfar

e Center

s

With Relatives and Friends

Total Completely

Partially

Northern

Jaffna 14,767 10,827 7,625 33,381 41,006 2,640 1,647 540 6,084 1,114 12 **

Killinochchi 2,297 407 0 1,603 1,603 560 670 0 246 - 0

Mullaitivu 6,745 6,007 11,993 10,564 22,557 3,000 2,590 421 5,033 424 23

Eastern Trincomalee 30,547 30,545 14,853 59,208 74,061 1,078 1,328 45 4,830 3,835 34

Batticaloa 63,717 12,494 22,002 35,047 57,049 2,975 2,375 346 13,530 5,839 36

Ampara 58,729 38,866 24,179 75,322 99,501 10,436 6,581 161 18,889 8,641 55

Southern

Hambantota 14,069 3,334 1,803 45,195 46,998 4,500 434 1,341 2,303 1,744 11

Matara 19,398 2,235 2,873 6,405 9,278 1,342 6,652 608 2,362 5,659 22

Galle 24,583 23,278 2,633 119,301 121,934 4,248 313 564 7,032 7,680 27

Western

Kalutara 9,433 7,059 2,420 32,527 34,947 279 401 69 2,683 3,835 12

Colombo 9,647 8,140 5,446 30,614 36,060 79 64 12 3,388 2,210 26

Gampaha 6,827 308 876 573 1,449 6 3 5 278 414 2

North Western Puttlam 232 18 66   66 4 1 3 23 72 2

Total 260,991 143,518 96,769 449,740 546,509 31,147 23,059 4,115 66,681 41,467 262

Displacement due to Tsunami

Caring for Tsunami IDPs“Waves of Compassion”

• Immediate response by the community first wave of compassion

• Local organizations and volunteers second wave of compassion

• External aid agencies third wave of compassion

Provision of Health Care for the Tsunami IDPs

• Swift response by government and non-governmental organizations

• Exemplary performance by MOHs managing health issues with completely destroyed infrastructure

Breast feeding status post-tsunami

• Media appeals for infant formula and bottles giving a wrong message to the public, donors as well as to the affected population.– ie. Women are no longer able to breast feed because they are

“traumatized”.• No national guidelines were in existence at the time of

the Tsunami.• 18 Days after the Tsunami, the Family Health Bureau

(FHB) issued comprehensive Guidelines.• January 2005 study covering 40 camps revealed most

mothers continuing breast feeding with out any problems. Others who were giving formula feeding found difficulties.

Observations by stakeholders

• High rates of bottle/formula feeding in non-emergency times

• Inadequate policy implementation• Few government and NGO staff trained in or

knowledgeable about infant feeding during emergencies

• Unsolicited donations of formula/milk powder• Unsuitable foods for complimentary feeding

during emergency food distribution

Conflict-induced emergency

• Qualitatively different to a natural disaster induced emergency

• Pre-displacement health and social status

• During displacement• Post-displacement –

conditions in the IDP camps

A New Reality

"

Shelter Water Sanitation &

Hygiene Food and Nutrition Health Child Care Psycho-social Care of the

Vulnerable Groups

Needs

Integrated Services

• Food – Communal cooking• Nutrition Rehabilitation Programme• Water Supply• Sanitation• Mobile Medical Service• Mobile Library Service

Communal Cooking

Water Supply

Sanitation facilities

Mobile Library

Mobile Medical Unit

Observations on breast feeding/infant feeding

• Unsolicited (?) donations of infant formula

• Medical staff not fully knowledgeable on infant feeding in emergency setting

• World Breast Feeding Week – August – Training for the medical staff– Useful but with limitations

Conclusions and recommendations

• Need for capacity building in all sectors for effective IYCF during emergencies

• Complete ban of unsolicited donations of infant formula and feeding bottles

• Vigilance against promotion of infant formula

Thank You!