Health

Soap and Water Keep Children Healthier

 

hand-washing activity

Children at a Sri Lankan school learn the best way to wash their hands during a demonstration.

By Himangi Jayasundere, ChildFund Sri Lanka

“Soap and water, scrub, scrub, scrub,” hums Sashini as she washes her hands.

Like many of her friends, the 11-year-old did not bother too much with washing her hands properly before. Sometimes she and her friends would come home after playing outside or helping with paddy cultivation and wash their hands a little with water to get the mud and dust off. But now things have changed with a program organized by ChildFund Sri Lanka to promote proper hand washing, especially before meals.

Sashini was among 90 children age 6 to 14 who participated in the hand-washing program conducted at Mayurapada Kanishta Vidyalaya, a school in the Polonnaruwa district in north central Sri Lanka.

“We teach children about the importance of washing their hands, especially before meals,” says K.M. Chandralatha, a teacher. “But it happens within the classroom. This program was a practical experience in correct hand washing, and I think many of them got first-hand experience on the proper way to do it.”

Access to clean water is crucial for hand washing and other good hygienic practices.

The program commenced with an introduction to hand-washing day, followed by a practical demonstration by a science teacher, illustrating how harmful bacteria can be neutralized with the use of soap and water.

A midwife who works in public health taught the children good hand-washing techniques. “We talk regularly with parents on this subject, but we rarely get an opportunity to talk to children about the importance of hand washing,” says H.M. Chamali Piyaratne, the midwife. “It was a good experience, and I look forward to doing more sessions with children.”

Sashini adds that the program has helped many of her friends, who have in turn taught their younger siblings about proper hand-washing techniques.

“We were never taught to wash our hands like this before,” she says. “The experience of doing it with clear instructions has taught us how important it is.”

To further assist and promote hand washing and good hygiene among children, ChildFund Sri Lanka also provided two sinks to Sashini’s school.

 

Helping Families Build a Future Beyond HIV

By Christine Ennulat, with reporting by Joan Ng’ang’a, ChildFund Kenya

Halima greets Nadzua

Halima shakes the hand of Nadzua, one of the mothers she works with.

On any given day, Halima has her work cut out for her. As a community health volunteer in a rural area outside of Mombasa, she makes one or two home visits per day, checking in on families participating in ChildFund’s program to help children and families affected by HIV and AIDS in Kenya’s Coast and Nairobi provinces. Halima has 50 children on her list.

Launched in 2011 and run by ChildFund and several other partner organizations, the USAID-funded program takes a comprehensive approach to ensuring that these children and their caregivers have a safety net so they can build toward a more hopeful future. The program works to ensure that basic needs are met, including:

  • Health: Families have improved access to health care. Trained community health volunteers provide prevention education during home visits. Increased access to safe drinking water and improved hygiene and sanitation help protect children’s and families’ health.
  • Protection: When a caregiver dies, the children left behind are often vulnerable to abuse, exploitation and other risks. ChildFund works to protect children and help families stay together.
  • Psychosocial support: Through home visits, trained volunteers monitor families and educate them about stress management. Support groups for both children and caregivers help them cope with the stigma of HIV and AIDS and learn how to stay healthy.
  • Food and nutrition: Families receive nutritious food to supplement their diets and sustain their fragile health.
  • Education: Families receive help with school expenses, and schools are supported to become more child-friendly, with training for teachers. Schools also offer support groups, child rights clubs, financial literacy education and hygiene training.
  • Economic empowerment: Hundreds of savings and loan groups help thousands of adults grow their small businesses so they can support their families and overcome financial barriers that keep many HIV and AIDS patients from receiving care. Training and support for income-generating enterprises help families improve the circumstances.

Today, Halima’s first visit is with Nadzua, age 35, mother of 11; she is a second wife, married into a family who lost their mother to HIV. In her packed-dirt front yard, she greets Halima warmly, a sleepy toddler balanced on her hip. Her 2-year-old son, Mbega, is the only one of Nadzua’s children home this morning — the others are at school, and her husband is in town.

The women sit outside, facing each other, and begin. Before moving on to today’s subject — how Nadzua can gain skills to improve her family’s income — there’s a lot to talk about: the children’s health and immunizations, how things are going at school, how their improved hygiene practices are working out, whether the family is getting the nutrition they need, how Nadzua is doing in the literacy classes Halima encouraged her to take.

How You Can Help

These programs are possible thanks to a $3.5 million matching grant. To meet its terms, ChildFund must raise $321,000. Because of this arrangement, every dollar you donate will be matched by $4.35. Help now.

It’s all hard with 11 children to care for, but life has improved since Halima’s visits began. “I have gained a lot from Halima,” Nadzua says. “I am more educated, more informed on how to take care of my children and my household.”

And she’s especially proud of herself on this day: She just harvested and sold 10 bags of green lentils, which meant she could cover her oldest son’s high school fees.

Nadzua and son

Nadzua and her 2-year-old son, Mbega.

As Halima leaves a little later, she breathes a happy sigh: She loves her work. She loves seeing families thrive despite the devastation of HIV and AIDS. Because she knows exactly how hard it is.

Halima, a single mother of four, has taken in the three children left behind by her two sisters, whom she lost to AIDS. All three children are HIV-positive.

And, thanks to Halima and all she’s learned, all seven children are thriving.

On her way to her next appointment, Halima passes a school she visits nearly every week, educating parents about children’s needs, sanitation and more. “I’m proud to see that the parents in the village understand the importance of growth monitoring, and that they’re interested in their children’s school performance and attendance,” she says.

She’s also had a hand in one important improvement to the facility itself: Until recently, the toilets were dirty, spilling human waste outside — a biohazard. Halima contacted the local public health officer, who ordered the school administrator to either fix the latrines or close the school.

Halima’s next client, Mwau, is a widowed father of four, and he’s waiting. His wife died four years ago. “When one parent dies, it gets even more difficult to take care of the family,” he says. His children are a girl, 16, and three boys, 8, 12 and 14.

Mwau has participated in several of ChildFund’s workshops — on child rights, nutrition, health and economic empowerment. With other farmers, he’s a member of one of ChildFund’s village savings-and-loan groups. The men are also working together to find better markets for their wares. Thanks to what he’s learned and earned through the overall program, Mwau has been able to move his family from a rickety mud hut into a stone house.

Still, he worries about his children — especially his daughter.

Mwau of Kenya

Mwau points out his old home as he stands next to his sturdy, new stone house.

“My daughter was most affected when her mother died,” he says. When the 16-year-old began coming home late after school, he wanted to yell at her, but he didn’t — in the workshops and from his talks with Halima, he knew there were better ways to handle teenagers. But this was really a job for a mother … and his children’s mother was gone. So, at his request, Halima stepped in.

“I explained that while she may want to enjoy the company of friends, some will not have good intentions toward her,” Halima remembers. “There are risks such as rape, and the consequences can be unwanted pregnancies and dropping out of school.”

And HIV.

Halima also encouraged the girl to help out at home — her family needs her. They all need each other.

It’s moments like this that keep her moving forward. “My drive is that people in the community listen to me,” she says. “I have a deep desire to see them grow and lead better lives.”

 

Healthy Habits Spreading Through a Community

By Sagita Adesywi, ChildFund Indonesia

In this blog post, we meet Nuren, a woman who worked for REACH, a project in Indonesia run by ChildFund and UNICEF that promoted health care of pregnant women and young children to help lower the infant mortality rate. REACH ended in December 2013, but the health-care training continues to make a big difference in these communities.

Indonesia

Nuren (left) spends time with a health cadre, his young son and the head of Moesin village (center).

Nuren works in East Nusa Tenggara, training community health volunteers (known as cadres) and families about keeping infants and young children healthy and safe. Beginning in 2011, she traveled to homes and clinics in remote villages, where women traditionally have given birth without access to prenatal care or emergency assistance when it’s needed.

Most health cadres come from non-medical backgrounds, so they received regular support and monitoring during the project’s duration. Nuren’s routine visits helped to remind the volunteers how to provide basic health services, and she checked the amount of medical supplies to make sure health posts were fully stocked. Some visits took hours to accomplish.

“When we had two new cadres in Sotual, we went there for a monitoring visit,” Nuren recalls. “We left the city at dawn to reach Nuapin village. We then walked for three hours through the forest from Nuapin village to finally reach Sotual. The return trip was more difficult, because it was uphill. We took a shortcut, and I almost fell off a cliff on the way back.

“The wife of the health cadre gave us pineapples, but unfortunately, none of us carried a knife. We walked all the way up the hill to our car before we saw an old man with a big dagger to help us cut and eat the pineapples. We weren’t even wondering if the dagger was clean or not, we were just so thirsty from the long walk!”

Upon reaching Nuapin, the group stopped by a health center. “The health worker asked where we came from. He was surprised when we told him that we had just visited our health cadres in Sotual, since they had never gone there before,” Nuren says. “With basic medical supplies in such a remote area and limited access, the health cadres are able to provide basic health care for young children. Seeing this is really rewarding for me.”

In 2011, the REACH project covered 40 villages and 14 health centers. By January 2013, it had expanded to 49 villages and 15 health centers, with more than 200 trained health cadres. Since the project ended, Nuren has continued her work with ChildFund in the eastern program areas.

Fatukoto, Indonesia

During a monitoring visit in Fatukoto, Nuren (second from right) visits a young mother who is practicing sei, a local tradition. This room has been better ventilated.

One of the biggest challenges in the project area is the traditional activity called Sei, in which firewood is burned underneath a platform and mattress that a mother and her newborn lie on in a room with very limited ventilation, sometimes as long as a month. It is believed that this practice will make them strong and healthy, but in fact, it contributes to many respiratory problems. Another challenge is that the community’s water source is far away.

Nuren says that although the region continues to face some hardships, “I see the changes happening in the community. People now have a reasonable access to health services. This really helps in obtaining basic health care in critical situations, especially for young children who suffer fevers or stomach aches, as malaria and diarrhea are common in the area.

“I have seen the community is really enthusiastic about the health services they have in their neighborhood. Even though they know the health cadres are trained specifically to help young children, people now choose to go to the health cadres instead of the traditional healer when they are sick,” she adds. “People are also more aware of health issues. They learned not only to be aware of the common symptoms of diseases, but also how to prevent contracting them with healthy living habits.”

Tobacco Has Victims Who Never Smoke

By Meg Carter, ChildFund Sponsorship Communication Specialist

Are you a smoker? Maybe you’ve quit, or have you never taken a puff? Perhaps, like many of us, you fall somewhere in between.

I have a lifetime count of less than 100 cigarettes, but I’m not protected: One in ten tobacco-related deaths involves a never-smoker. And of those deaths, one in four is a child — because there is no safe level of second-hand smoke.

Tomorrow, May 31, is World No Tobacco Day, a time to contemplate these grim facts and consider what we can do to make a difference.

cigarette

Photograph by Tomasz Sienicki – Wikimedia Commons

In my early 20s, working in Saint-Louis, Senegal, I occasionally smoked, even though I hated cigarettes. Smoke filled that sleepy town’s only nightclub, and on Saturday nights, my Gauloises burnt down to my fingertips. Smoking was my cover charge for entertainment.

Several years ago, when I lived in Guinea, I watched children buy single cigarettes at the same shacks where they purchased food: hard-boiled eggs, bread cut to order, powdered milk packets, tea leaves by the gram, hard candy by the piece, tomato paste by the tablespoonful and Maggi stock cubes. Errand boys ran groceries for Mom and cigarettes for Dad, making shopping a gateway activity.

Nearly half of the world’s children regularly breathe second-hand smoke in public places, and two in five have at least one smoking parent. Among Cambodian, Thai, Senegalese, Filipino and Vietnamese, three in five children live in smoking homes, while in Belarus, Indonesia and Timor-Leste, it’s four in five. Southeast Asians suffer disproportionately from second-hand smoke.

By age 15, many boys in developing countries have become smokers, but years can pass before their health deteriorates. Tobacco smoke contains 4,000 chemicals, including 50 carcinogens and another 200 lesser toxins. In Timor-Leste, fully half of all boys between ages 13 and 15 smoke. Among Belarusians, it’s one in three. But boys aren’t the only ones at risk; substantially more Brazilian girls than boys smoke.

Brazilian boy

Brazil produces the world’s second-most amount of tobacco, which supplants food crops. You can help.

Mothers who smoke often deliver babies prematurely or with lower birth weights, and exposure to second-hand smoke causes one in four sudden infant deaths.

Globally, tobacco consumption is on the rise, and so are its opportunity costs. Tobacco’s direct costs to Thailand could fund the country’s energy services. In Mexico, treatment of tobacco-related illness accounts for one in 10 health care dollars.

According to the World Health Organization, tobacco kills up to half its users. Every six seconds, tobacco takes a life. Every minute of every day, two die in high-income nations, and eight more die in developing countries.

ChildFund works in the world’s second, third and fourth largest tobacco-producing countries: Brazil, India and the United States. Indonesia also ranks in the top ten and, during the past decade, Mozambique, Zambia and Cambodia have experienced the greatest increases in tobacco production. In low-income countries, tobacco contributes to deforestation and supplants food crops. And it’s inefficient; agricultural land yields up to 15 times tobacco’s weight in edibles, which contributes to high rates of malnutrition.

Tobacco plants, like coca and opium, also are biohazards. Children often work in the fields, topping and harvesting green tobacco leaves covered with dew and raindrops. In the heat, that coating of water dissolves nicotine from the leaves. The nicotine solution can cross the skin barrier and pass into the bloodstream, causing acute poisoning. A day’s worth of absorbed nicotine is equivalent to smoking anywhere from 12 to 50 cigarettes.

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The Enormous Toll of Vector-Borne Diseases

By Meg Carter, ChildFund Sponsorship Communication Specialist 

One in a series this week for World Health Day (April 7)  

One bright morning, I was administering the English language section of a four-hour exam in a high school in Saint-Louis, Senegal. About halfway through the test, which divides high school graduates who go on to university from those who return to their villages to farm, I felt dizzy and feverish. 

malaria in Senegal

A malaria clinic in Senegal.

By noon, I was walking slowly across a quarter-mile-long cantilever bridge, clinging to the handrail. The bridge connects the island portion of the town to the mainland, where I lived. It felt as if a vise was crushing my head; I could barely see. 

Reaching the mainland, I sat down on a pile of rocks on the bank of the Senegal River, shaking uncontrollably in the intense sunlight. Eventually, a cool hand grazed my forehead. I heard a sharp intake of breath, then a familiar voice saying, in French, “malaria.” 

I stared at the child in front of me, unable to move or speak. 

“Miss Meg, it’s me, Amadou N’Diaye. I’m taking you home now.” 

He ran back to the street and flagged down a taxi. Together, Amadou and the driver lifted me inside. When we arrived at our apartment block, Amadou ran first to my Peace Corps colleagues, who carried me up the stairs and into bed. Then he found my French friend. “Bring your medicines, quick,” he told Christian. 

Christian’s cocktails of anti-malarial and tetracycline drugs worked. Three days later, I came out from under my mosquito net, no longer wanting to die. 

I’d slept under that net for nearly two years. And I’d taken tonic water daily for its quinine benefit, lit a mosquito coil in my bedroom each evening at sunset, and swallowed my weekly pills. But despite these precautions, on restless nights when I bumped up against my net, mosquitos feasted on my arms and legs. Anti-malarial drugs don’t entirely destroy plasmodium parasites, which carry malaria; they merely keep them under control. In those days, the West African breeds were increasingly drug-resistant. 

Now imagine what it’s like for children without bed nets or medication who are bitten every night of every rainy season by hundreds of mosquitos. 

mosquito bed net

A Gambian girl’s bed net helps protect her from malaria.

This year, World Health Day is turning its focus toward vector-borne infections; its motto is “small bite, big threat.” Epidemiologists refer to insects and snails as the vectors for parasites and viruses they transmit to our bloodstreams. 

Malaria is the world’s most prevalent vector-borne infection, but dengue fever, a mosquito-borne virus, is the fastest growing. In the countries where ChildFund serves, other parasitic diseases such as Chagas, from kissing bugs, and trypanosomiasis, from tsetse flies, threaten children’s health. Viral illnesses, including chikungunya (mosquitos), schistosomiasis (freshwater snails), and the hemorrhagic fevers — Yellow Fever (mosquitos), Rift Valley Fever (mosquitos) and Crimean-Congo Fever (ticks) — are less widespread but still deadly.

Urbanization, deforestation and damaging agricultural practices all contribute to the spread of malaria. Deforestation and urbanization also led to resurgences of Yellow Fever and the sudden emergence of dengue and chikungunya. 

Mosquitos breed in stagnant water, hiding in tall grass during the day and tracking their human targets nightly by the carbon dioxide we exhale. Although we can’t yet eradicate malaria, giving families access to medicated bed nets is a step in the right direction.

Uphill Climb to Provide Health Care to Rural Indian Families

By Saroj Pattnaik, ChildFund India

One in a series this week for World Health Day (April 7) 

Saraswathi

Saraswathi and her baby at a parenting workshop in southern India.

On a hot afternoon in southern India, the atmosphere inside the small community center  was unbearably sultry. But for a group of women, the heat was not terribly bothersome, as they were in the middle of an informative and eye-opening session on child care and parenting skills. 

Led by Beula Ruth of the Kalaiselvi Karunalaya Social Welfare Society, one of ChildFund’s local partner organizations in the state of Tamil Nadu, the workshop was aimed at educating pregnant and lactating mothers about prenatal and postnatal care. 

“I had no idea about exclusive breastfeeding. I didn’t know that a child needs only breast milk for six long months,” says Saraswathi, a first-time mother of a 5-month-old baby. “This is something that I am hearing for the very first time.” 

Beula agrees and adds, “Every time, we come across some women who don’t have the basic knowledge on child care. This is why we continuously conduct such awareness sessions in our project area.” 

There has been substantial improvement to government health services in India, but a majority of people living in rural areas still don’t have access to health care.  And that’s where ChildFund comes into the picture, by working with the government and local partners to bring public health services to underserved communities.  

Here are some of the stark facts about the lives of rural Indians:

  • 66 percent of the rural population in India lacks access to preventive medicines
  • 31 percent of the rural population has to travel more than  18 miles for medical treatment
  • 10 percent of all babies die before their first birthday
  • 56 of every 1,000 Indian children will die before they turn 5
  • Only 35 percent of all Indians have access to improved sanitation facilities
  • Just 3.9 percent of India’s 2011 GDP was spent on public health

(Sources:  National Rural Health Mission, Government of India; WHO; Indiafacts.in) 

health camp in India

A doctor sees patients during a health camp organized by Pride India in the district of Raigad.

As part of our Early Childhood Development program, ChildFund and its partners in India conduct training sessions for mothers, discussing good nutrition (both for themselves during pregnancy and for their children under the age of 5), developmental benchmarks and preventive health care, among other issues.  

Last year, there were more than 9,000 training sessions across India, with more than 180,000 parents and other caregivers participating. As a result, more than 86 percent of births  occurred in hospitals or other health institutions, and more than 68,000 children have been fully immunized. 

“We make sure that all the communities have the access to government health facilities and if they don’t we bring those services to their doorsteps,” Beula says. “Our ECD workers and volunteers continuously monitor the health of children, pregnant women and new mothers and refer them to nearby hospitals whenever necessary.”   

Like Beula, Anita Ghalekar in Chochinde Kond — a remote village in Maharashtra State’s Raigad district — is a busy woman. Even after her retirement from ChildFund’s local partner Pride India, she is committed to maintaining access to health services for local families.     

health care in home

Anita Ghalekar monitors a boy’s growth in his home in the Raigad district.

Besides overseeing ChildFund’s home-based ECD intervention activities in her region, Anita leads 15 health camps, which provide workshops and care in individual villages. 

“We make sure that all the villages in and around our program area are covered under our programs designed to ensure basic health care of the people, especially children, new mothers and adolescent girls,” says Virendra Kulkarni, manager of Pride India. 

“And we implement these programs in such a way that the communities take ownership of them,” he adds. “For example, when we conduct health camps, villagers provide us accommodation, beds and other logistic support required. And this has helped us reach out to a wider population and implement our program successfully.”  

Dr. Vijay Kumar Singh, who led a health camp in Uttar Pradesh recently, says, “ChildFund is doing a great work. They are reaching out to people in those places where the government health service has not yet reached.”

Breaking a Dangerous Tradition in Indonesia

By Sagita Adesywi, ChildFund Indonesia

Yuliana, a mother of five, lives in far eastern Indonesia in a simple house made with bamboo, tree bark and other wood.

mother and daughter in Indonesia

Yuliana and her daughter at a rumah bulat, or roundhouse, where women in their village stay with their newborn babies for at least a month.

Like many others in her community, Yuliana’s family has a wooden rumah bulat or “roundhouse” that serves as a kitchen and a storage place for harvested crops. The outbuilding has a door but no windows, and the walls and ceiling are black from smoke.

Aside from these uses, the rumah bulat is also a birthing room. According to local tradition, mothers and their newborns need to be “baked” to become strong and healthy. Mother and child lie on a wooden platform with a fire burning underneath it — often for a month or more.

Yuliana did this for all five of her children, but now she discourages other mothers from doing the same. “It was so hot, I felt like dying, but we didn’t dare to say no to our village elders,” Yuliana recalls. “It was such a miserable time. My children fell ill easily when they were younger, coughing all the time. As I now know the harmful impacts, I want people here to stop doing this.”

health care volunteer weighing a child

Yuliana, a local health-care volunteer, weighs a child at her home.

Today, Yuliana is a volunteer with a health project in the village called REACH. ChildFund and UNICEF work in partnership with community-based organizations, training health volunteers to raise awareness about proper health care for expectant mothers and young children.

The rumah bulat practice contributes to a significant number of young children suffering from chronic respiratory diseases and malnutrition. “It is not easy to change people’s views, since traditional norms are held in high esteem in the community,” Yuliana notes. “From the training, I understand it is not just about what a bad experience it is, but most importantly how badly it impacts the health of the mother and the baby. I want people here to understand this too.”

As part of her efforts, Yuliana helps the local midwife facilitate counseling sessions at the village health post. She carries a first-aid kit and keeps information about basic health care with her at all times.

“I am very happy to have Yuliana as a health volunteer,” says Adel, another community member. “She visits pregnant mothers regularly and discourages the rumah bulat practices.” It’s difficult to break old habits, though.

“I still underwent this practice for my niece when she gave birth,” Adel says. “I know it is wrong, but I was terrified of going against the village elders here. Yuliana has been telling us we shouldn’t keep doing this, but we’ve been told we will be cursed and that if we don’t follow the practices we will go crazy.”

new mother in Indonesia

Adel (right) was afraid to go against the rumah bulat tradition with her niece, a new mother, but they are performing the ritual in a healthier way.

However, Adel did make some adjustments to the norm. Her niece was confined to a rumah bulat with a bamboo wall that allowed more ventilation than the customary solid wood wall, and Yuliana checked on mother and baby.

Indonesia’s government supports the abolition of this practice, having introduced a new fine of US$30 if a woman gives birth at home instead of at a health center. This is a hefty fine in Yuliana’s province, where the average income is US$17 a month. The government’s regulations and the sharing of health information among mothers are helping to reduce the harmful custom.

“I was really scared of the rumah bulat practice. I chose to stay at my uncle’s house in town so that I could give birth at the health center,” says Dorsila, who, inspired by Yuliana, has also become a community health volunteer.

Community Members Band Together to Improve Childbirth Practices

By Sagita Adesywi, ChildFund Indonesia

In Indonesia’s low-income communities, the expenses related to childbirth lead to difficult decisions. Mulyana, a trained health-care volunteer (locally known as cadres) in Pakan Sari, had a miscarriage when she was three months pregnant.

“The treatment at the hospital cost me about US$400,” she recalls. “We have enough money for food, but we couldn’t afford to pay the hospital. Thank the Lord, I received an allowance from the government and have a childbirth savings account as well. Otherwise, I don’t know how I would be able to pay.”

Indonesian health cadre

Mulyana, one of the health cadres, has dealt with the costs associated with having children herself.

Many women in Mulyana’s region go to traditional birth attendants instead of the hospital, which is often better prepared if a mother or baby encounters complications during birth. Improper medical treatments have contributed to the high number of deaths of mothers and babies. Indonesia’s maternal mortality rate, 228 deaths per 100,000 births, is among the highest in Southeast Asia; its infant mortality rate is 28 deaths per 1,000 live births.

Traditional birth attendants charge much less than a hospital, but that advantage sometimes comes at the expense of current medical knowledge, properly maintained equipment and even good hygiene.

To reduce the number of maternal and infant mortalities, a government program called Desa Siaga (Alert Village) has been rolled out by the Indonesian Ministry of Health targeting rural and poor regions.

Indonesian health cadre

Yayah, another health cadre.

Desa Siaga programs aim to encourage self-reliant communities that actively address their own health challenges, such as maternal and infant mortality. Through this initiative, the government provides a childbirth allowance that pays all expenses incurred at a state hospital. Women must first go to their health post for prenatal appointments to receive the allowance.

In Pakan Sari, community members started a forum to discuss needs and healthy practices surrounding childbirth and pregnancy. Everyone in the community — husbands, neighbors, community leaders, midwives and health cadres — has a role to play in promoting birth preparedness. This participatory approach is aimed at raising awareness that pregnancy should not be a private concern affecting women only.

Supporting this initiative, ChildFund works with its local partner organization, Warga Upadaya, strengthening the health cadres’ capacity to assist midwives in the community. Health cadres attended training on monitoring of pregnant mothers, breast feeding, nutrition for children from birth to age 5, household economy management and community organization.

Each pregnant woman’s health status and due date is recorded, as well as who will assist with transportation or give blood if it’s needed. The record also shows the family’s financial resources, aside from the government allowance.

“We have endorsed the rollout of the Desa Siaga program in our neighborhood for the last year,” says Sigit Murjati, a community leader. “We have developed a community savings system to prepare for the costs of childbirth.”

These financial contributions are used to offset the costs of transportation and medical care during and after childbirth.

Indonesian health official

Sri Dwi Lestari, an official at the local health department (left), attends the launch of Desa Siaga.

When a state hospital is full, and the mother is then referred to a private hospital, the savings play a critical role since the government pays only for a stay at a state facility.

With the community preparedness system in place and health cadres all trained, Pakan Sari can better meet the needs of mothers and newborns. At the launch of the Desa Siaga program on May 15, 99 health cadres from 22 health centers came to Pakan Sari, as well as the sub-district head.

“This launching of Desa Siaga by the sub-district head is recognition from the government to the health cadres and the entire community,” says Sri Dwi Lestari, a community leader who works for the local health department. “This makes the community feel that they own the program, since the health cadres are all community volunteers. If the community doesn’t feel like they own the program, the program would not run so well.”

50 Days: Keeping Women and Girls Healthy

 By Kate Andrews, ChildFund Staff Writer

For 50 days, ChildFund is joining with numerous organizations to demonstrate support for government policies and programs that will allow women and girls to be healthy, empowered, and safe — no matter where they live. Improving the Health of Women and Girls is this week’s theme.

Senegalese mother and daughters

Sadio and her twins, Awa and Adama.

Visiting the doctor is usually a mild inconvenience in the United States. It may entail a drive across town and a sit in a waiting room filled with people coughing and sneezing. But in Senegal, which has only 822 doctors serving a population of more than 12 million, seeking medical attention is a major undertaking.

For some families, it’s too much. Sadio is the mother of 2-year-old twin girls in the village of Pakala, which is often flooded during the rainy season. This makes it difficult to travel 6 kilometers (more than 3 miles) to the nearest health post staffed by nurses. Awa and Adama suffer from respiratory problems, and Adama is especially sickly, having come down with a debilitating cold that required a doctor’s care — a 30-mile journey from home to a hospital. 

Senegal health hut

A health hut in a Senegalese village.

Sadio and her husband Moussa, a farmer, have experienced loss before; their first child, Matar, died in 2007 at 13 months from diarrhea and a respiratory infection. But today their village has a health hut, which is staffed by a matron, community health workers and birth attendants. They can help patients with basic needs, but more complicated illnesses and ailments still call for a trip to the health post 3 miles away or 30 miles to the hospital.

Sadio reports that her diet improved during her pregnancy with the twins after receiving advice at the health hut, but her girls still face challenges from the respiratory infection; also, they were born underweight.

Senegal mother and children

Sadio, the twins and their 4-year-old brother, Assane.

The health of women and girls is important to ChildFund, as we work with local partners to provide access to health care in isolated villages as well as underserved urban areas in developing nations. In Senegal, ChildFund is leading the implementation of a $40 million grant from USAID to establish community health care services for children and families in great need.

Over five years, we plan to establish 2,151 health huts and 1,717 outreach sites throughout the country, along with a sustainable national community health policy working in partnership with USAID and other key community development organizations. By the end of the project, we expect to have helped more than 9 million Senegalese people in 72 districts.

A Frightening Brush With Malaria

By Silvia Ximenes, ChildFund Timor-Leste

Cristina Moniz was busy as usual one morning three years ago, getting her children up for school and preparing breakfast for them and her husband, Joaquim Lopez, a police officer in the Timor-Leste district of Covalima. She passed by her 7-year-old son Deonizio’s room, and to her surprise, he was still in bed asleep.

Approaching his bed, Cristina discovered that Deonizio had a fever.

mother and sons

Cristina and Deonizio (with his youngest brother) spend time at their home in the Covalima district.

“I felt not well at all, got headaches and vomited all the time,” Deonizio recalls today. “With all those conditions, it prevented me from going out; I couldn’t go to school or play around with my friends.”

It turned out that Deonizio had malaria, one of the deadliest diseases in the developing world, especially for children. He and Cristina first went to the village health post, Salele Community Health Center, which referred Deonizio to the hospital, where he had a blood test analyzed.

Cristina was shocked that her son had malaria, but the health center’s staff advised her to give Deonizio anti-malarial medication on time and keep the home clean and mosquito-free. This isn’t an easy task for Cristina, who now has five children and many duties. But insecticide-treated bed nets that arrived from ChildFund in 2011 have helped.

“Before getting the bed nets, there were many mosquitoes around the house,” Cristina says. “We are happy because there are no more mosquitoes, no more sickness.  Now, my family and I can sleep safely away from mosquitoes. No more malaria in our family. Deonizio can go to school any time,” she notes.

boy and baby on bed

Deonizio and his baby brother are protected by a mosquito net.

“I feel sure that mosquito will no longer bite me when I sleep under the bed net,” adds Deonizio, who is 10 now. “I’ll be freely doing my daily activities as usual, going to school, playing with friends.”

Having recognized World Malaria Day recently, we’ve learned about how many children are at risk of contracting this preventable disease in developing countries like Timor-Leste. Malaria kills 200,000 children worldwide each year, and many more become sick. However, the gift of a medicated mosquito net can mean good health, education and fulfilled potential for children in need like Deonizio and his brothers.

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