Save Our Child

Saturday, October 23, 2010

Universal blood tests hunt down the malaria parasite in Sabang district, Indonesia

Nurse Ibu Noua (left) takes a blood sample from a child at a school in the village of Aneuk Laot in the Indonesian district of Sabang. The blood-testing programme, supported by UNICEF, aims to eliminate malaria in the district by targeting the whole population – not just people showing symptoms.

By Edward Carwardine
SABANG, Indonesia, 13 July 2010 – Mohamed Safrina, 22, has never suffered from malaria, but he knows it’s a dangerous illness. However, the labourer from Sabang, an island district off the north-west coast of Indonesia, is terrified of needles and a little apprehensive of the gloved nurse kneeling beside him.
Mohamed shuts his eyes and turns his head away from the nurse and the needle. The children in the room watch with fascination as the drops of crimson blood gather on a glass slide.
A few minutes later, it’s over. His sample is recorded and safely stored for transport back to the laboratory, a few kilometres from this village of Aneuk Laot, which has been the focus of this special malaria elimination campaign.
The campaign is targeting everyone in some 14 villages – a population of 24,000 people. Routine malaria testing only covers those demonstrating symptoms of the disease, but the current exercise sets out to ensure that no potential carrier is missed.
“We want to identify the human reservoirs of malaria and stop them passing on the disease,” explains local health worker Ibu Nazaria. “If someone is carrying the parasite, and is bitten by a mosquito again, that mosquito can pass on malaria to someone else in the same family, or same community.”
Testing and treatment
Because not everyone with malaria immediately displays the symptoms, or may not come forward for medical help, the risk of transmission can be high – but hunting the malaria parasite means that infected patients can receive treatment quickly, helping to eliminate the disease.

Amir Faisal drops staining agent onto a slide as part of a UNICEF-supported blood-testing programme that aims to eliminate malaria in the Indonesian district of Sabang. Any positive cases will receive free treatment within 24 hours.

“Using bed nets and spraying against mosquitoes all bring the caseload down to a low point – but at that stage you have to focus on finding the parasite and wiping it out before it can be transmitted again,” says UNICEF Malaria Officer Bill Hawley, who leads the organization’s malaria programme in Indonesia.
“Sabang is the first district in Indonesia to take on this approach, with a clear focus on tracing the parasite through universal testing, and then treating carriers before the disease can be spread by another mosquito,” he notes. “Ultimately, this is going to make malaria a thing of the past.”
‘Everyone wants to be healthy’
In Aneuk Laot the whole community is involved in the testing campaign. The team of six testers comes from the district, and includes a village volunteer, Saiful Bahri. His role is instrumental in securing the confidence of his neighbours and explaining why blood testing saves lives.

Ibu Suparni (centre) holds her newborn son while surrounded by other family members under an anti-malaria bed net in her home in Batee Shak village, in Indonesia's Sabang district.

“Everyone wants to be healthy,” he says. “In the team, I collect information from the villagers as they are tested. I find out what they need – like bed nets – and pass on information to the authorities. When someone from the community is involved, things are more organized, easier to manage.”
Saiful adds: “I can also help by ensuring people get proper advice and that they understand what malaria is. People used to think you could catch malaria from fruit like papaya. That’s why giving accurate information to the community is the real strength – people need to know that if they have the malaria parasite they will get sick again and again if not treated.”
Community outreach
Saiful is not medically trained. He is normally a daily labourer, whose income is now supplemented by the 200,000 rupiahs (approximately $20) monthly stipend that is provided to malaria volunteers in the district. It’s a small cost, considering the value that these volunteers bring to the initiative – not least in providing a trusted source of reassurance for local people.

Community volunteer Saiful Bahri wears an awareness t-shirt while talking to villagers in Aneuk Laot, Sabang district, Indonesia. Local volunteers are essential to spreading information about health issues, in this case a malaria-testing initiative.

“These volunteers are vital,” says team member Pak Hasballah, “especially for social mobilization, knowing where to find people, to identify who has been missed by the testers. And we have to reach everyone, as this is what builds confidence amongst the community.”
This team alone has tested 11,000 people in the last month, finding just nine positive cases. But Pak would like to see the initiative running on a regular basis.
“There are at least six malaria-endemic villages in the district that should be screened every three months,” he says. “We need to be more proactive if we are to stop malaria here.”
Malaria elimination is possible
The testing programme is showing results. Prior to 2005, there were an estimated 80 malaria cases for every 1,000 people in Sabang. After massive investments by organizations such as UNICEF, Care International and the Global Fund to Fight AIDS, Tuberculosis and Malaria – amongst others – that figure fell to 10 per 1,000 in 2009.
This year, the caseload has dropped even further to just 2 per 1,000. At this point, the shift in focus towards malaria elimination is of paramount importance.
Dr. Maria Meldi, a local government health official, is confident that elimination is possible.
“We organize public awareness campaigns about malaria every quarter, which result in a noticeable increase in the number of people coming to be tested,” she explains. “We have a programme of distributing bed nets for pregnant women and children, and we have plans next for malaria education in schools.”
The mass testing campaign is a model that could be introduced to other districts in the province. The Sabang initiative is being supported by UNICEF in the hope that its success – and the lessons learned from the experience – will encourage other areas to adopt the same approach, led by local government bodies.

Special Olympics Indonesia and UNICEF promote social inclusion

Juliwati Japi listens to her trainer during preparations for the National Special Olympics Games in Indonesia.

By Regi Wirawan
JAKARTA, Indonesia, 14 June 2010 – The sun was just rising over a Jakarta sports stadium one recent morning when Juliwati Japi, 16, arrived for her regular training session, organized by Special Olympics Indonesia.
Juli, as she is known, has almost never skipped her Saturday training routine. But she was especially excited to arrive on the day she would be meeting Marcos Diaz, a world-champion ultra-distance swimmer from the Dominican Republic. He was scheduled to visit the training session to meet and talk with the young athletes of Special Olympics Indonesia.
Juli joined the programme in 2004 and, like all of the athletes here, is a child with intellectual disabilities. She was born with Down’s Syndrome, a condition in which extra genetic material causes delays in the way a child develops both mentally and physically.
Despite the challenges of her disability, Juli has participated in many international sports events – including the 2007 Special Olympics World Summer Games in Shanghai, China, where she placed fourth in athletics.

‘Keep on training’

When Mr. Diaz arrived at the training session, a big smile crossed Juli’s face – it was clear that she is a huge admirer – and he told the children how he used to suffer from a chronic asthma in his early years but has overcome it since he became a swimmer.

Ultra-distance swimming champion Marcos Diaz (centre-right) with Special Olympics Indonesia athletes during a recent visit to a training session for the national games.

“I encourage you to keep on training, because sports help you to make you strong and confident,” he said.
Mr. Diaz, who is also a trainer for Special Olympics children in his country, added: “There are many children out there don’t have the opportunity to develop their potential. You are lucky to be with the Special Olympics, who can help provide that opportunity.”
Importance of inclusion
Special Olympics Indonesia is a non-governmental organization accredited by Special Olympics International, which targets almost 200 million people with intellectual disabilities through sport activities worldwide. Indonesia became the 79th member of the Special Olympics in 1989 and now organizes a National Special Olympics Games every four years, normally one year ahead of the global games.
The next National Special Olympic Games are slated to be held in Jakarta from 26 through 30 June.
This year, UNICEF Indonesia has partnered with Special Olympics Indonesia to help promote the importance of inclusion for children, regardless of their circumstances. Social and economic exclusion are major barriers to development for millions of Indonesian children in areas such as education, health and protection.
‘Role models to us all’
“Disparities in Indonesia are a critical challenge that we need to address if Indonesia is to move closer to achieving the Millennium Development Goals – and if we are to ensure that every child benefits from the incredible economic progress that the country has enjoyed in recent years,” said UNICEF Representative in Indonesia Angela Kearney.
“Special Olympics Indonesia is demonstrating in a very tangible way just how much Indonesian children can achieve when provided with equality of opportunity, free of stigma or exclusion,” she noted. “These young athletes themselves are role models to us all.”
Juli has also been inspired by her own new role model, Mr. Diaz, the champion swimmer. She has been training hard for the upcoming National Special Olympics Games, where she will compete in running and swimming.
Given her determination to excel, Mr. Diaz might be forgiven for worrying about the potential competition.

'Letter to a friend' campaign promotes healthy pregnancies in Indonesia

By Ahmad Pathoni
TIDORE, Indonesia, 22 July 2010 – Nafisa, 30, lost two of her four children before they turned one year old. They had fever and she took them to the local community health centre. “They could not be saved,” she says. “I was very sad.”

VIDEO: 8 July 2010 - UNICEF correspondent Nina Martinek reports on the 'Letter to a friend' initiative that promotes healthy pregnancies in Indonesia.

Nafisa is pregnant again, but this time she has every reason to believe that her baby will be born healthy, because she recently received a written invitation to attend an antenatal clinic in Tidore.
She can’t read, so she took the note to a neighbor who could. It came just in time. A check-up by village midwife Siti Fara revealed that Nafisa had an extremely low red blood cell count – an indication of severe anemia, which could lead to potentially fatal complications during pregnancy.
“So they gave me pills for my blood and asked me to eat a lot of vegetables and fish,” says Nafisa.
‘Respected and honoured’
Ms. Fara and two other health workers are behind a new UNICEF-supported campaign to send formal invitations to pregnant women asking them to come in for ante-natal check-ups. They developed the idea for the ‘Letter to a friend’ campaign at a UNICEF-sponsored workshop in 2008.

Midwife Siti Sara monitors Nafsia's pregnancy at a community health centre in Tidore, eastern Indonesia, where UNICEF is promoting innovative ways to lower child mortality and improve maternal health.

The programme is having a significant impact in Tidore, a small island town in the far flung eastern Indonesian archipelago that suffers from a lack of skilled midwives.
“In our society, people feel respected and honoured when they are invited through a letter,” says the head of the Tidore Kepulauan Health Office, Dr. Harun Konaras, “so it’s an innovative way to encourage women to have pregnancy check-ups.”
Inequalities in maternal health
Almost 20,000 women die from every year in Indonesia from complications relating to pregnancy, the rate is amongst the highest in Asia.

After receiving a formal invitation from UNICEF, Nafsia has an antenatal check-up at a community public health centre in Tidore, Indonesia.

And while the latest data show that more than 70 per cent of deliveries in Indonesia are attended by skilled medical practitioners, it also reveals the deep inequalities between provinces. Jakarta has 97 per cent coverage compared to just 33 per cent in the Maluku islands, where Tidore is located.
Tidore Kepulauan’s district officer for maternal and newborn health, Sukma Albanjar, says past reliance on traditional birth attendants, or ‘dukuns’, was also complicating efforts to improve maternal health in remote areas. UNICEF is helping to address that issue.
Under a new local partnership between traditional birth attendants and midwives, dukuns no longer assist delivery directly. Instead, they refer their patients to skilled midwives or doctors. Dukuns also help deliver the ‘Letter to a friend.’
“Through the partnership, deliveries assisted by skilled health workers have reached nearly 100 per cent,” says Ms. Fara, “and so far in my village no mother has died during childbirth.”
Averting needless tragedy
Ms. Albanjar notes that Nafisa’s case highlights how effective a simple idea can be. Without the invitation campaign, she says, “it would be very difficult to reach women like her because there’s a shortage of health workers.”

Fahria Mustafa 29, and her daughter Aisha Gurabati village, located in the Maluku islands of Indonesia, where UNICEF's 'Letter to a friend' initiative promotes maternal and young child health.

Meanwhile, Nafisa remains optimistic that her fifth pregnancy will not end in needless tragedy as two others have done.
“I was proud and happy to receive the letter,” she recalls, smiling broadly. “I hope my baby is healthy.”

Tens of thousands of Indonesians forced to flee homes after deadly quake

UNICEF deploys humanitarian staff to quake-zone to support Government emergency relief efforts

JAKARTA, 1 October 2009 – UNICEF Indonesia is deploying emergency staff to the province of West Sumatra to assess the immediate health, water, sanitation, education and critical protection needs of children who survived yesterday’s deadly earthquake. According to initial estimates, a 7.6 Richter-scale earthquake killed at least 500 people on 30 September. The death toll is expected to rise sharply. Tens of thousands of people have been forced to leave their homes in the coastal provincial capital of Padang and surrounding highlands. One third of those affected are estimated to be children.
“The needs of thousands of children are vast and urgent. They must have access to clean water, shelter, and get help in overcoming the aftermath of the earthquake,” said Angela Kearney, UNICEF Country Representative in Indonesia.
“Children who survived the quake are at extreme risk of illnesses, including diarrhoeal diseases, acute respiratory infections and outbreaks of vaccine-preventable diseases such as measles, and polio. The risk of tetanus is very high due to injuries and open wounds,” she said.
UNICEF is ready to support the Indonesian government tackle immediate needs such as ensuring the availability of clean water, sanitation facilities and hygiene kits, providing protective services and safe places for children, and by providing emergency early childhood care kits, school tents, school-in-a-box and recreational kits which help get children back to school quickly and build a sense of normalcy.
UNICEF has been present in Indonesia almost continuously since 1948. In cooperation with the government and local non-government organizations, UNICEF has assisted children with the difficult challenge of adjusting to a radically altered life after emergencies. This includes the world’s biggest humanitarian assistance effort for the 2004 Indian Ocean tsunami, which killed more than 130,000 people in Aceh, Indonesia, the northernmost tip of Sumatra island.
About UNICEF
UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.

UNICEF ready to meet urgent needs of children affected by Indonesia quake

Health, water, sanitation, education and protection are main priorities

JAKARTA, INDONESIA, 2 October 2009 – UNICEF emergency personnel are on the ground in the Indonesian province of West Sumatra to ensure that the urgent needs of children are met in the aftermath of Wednesday’s earthquake – up to one-third of those affected are believed to be children.
“Every one of those children is acutely vulnerable to potential disease, lack of shelter, disruption to education, and the traumatic effects of living through such an experience,” said UNICEF Country Representative in Indonesia, Angela Kearney.
UNICEF is working with the Indonesian government and other UN agencies to provide assistance for up to 50,000 families – including making available water pumps, water storage equipment, 40,000 jerry cans and 40,000 hygiene kits, the provision of protective services and safe places for children, supplying 250 school tents, schools-in-a-box, and recreational kits which help children re-establish a sense of normalcy. These initial supplies are expected to reach the quake zone in the next 24 hours.
“Children are always the most affected by emergencies, and it is critical that they have access to clean water, and are protected from the threat of diarrhoeal diseases, acute respiratory infections and outbreaks of vaccine-preventable diseases such as measles, polio and tetanus,” said Ms. Kearney. “At the same time, we must ensure that other services such as education are re-started as soon as possible, to help children regain a sense of normalcy in the aftermath of this tragedy.”
According to initial government estimates, Wednesday’s earthquake, which measured 7.6 on the Richter-scale, left nearly 500 people dead and forced tens of thousands of people to leave their homes in the coastal provincial capital of Padang and surrounding highlands. Access to the affected area is limited due to the availability of only a single airstrip.
UNICEF has been present in Indonesia almost continuously since 1948. In cooperation with the government and local non-government organizations, UNICEF has assisted children with the difficult challenge of adjusting to a radically altered life after emergencies. This includes the world’s biggest humanitarian assistance for the 2004 Indian Ocean tsunami, which killed more than 130,000 people in Indonesia's Aceh, the northernmost tip of Sumatra island.
About UNICEF
UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.