Tuesday, October 23, 2012

Special delivery: women give birth safely

Isabelle wants to deliver her fifth child at a health centre
© UNICEF Timor-Leste/2012/Andy Brown
Isabelle de Santos, 29, lives in Suku (village) Hatólia in Ermera district, Timor-Leste. Her husband is a coffee farmer. She already has four children aged six to 12-years old, and is four months pregnant with her fifth. “I’m hoping it will be a boy so he can help his father in the fields,” she says, laughing.

Suku Hatólia is part of a new initiative that encourages women to give birth at their nearest health centre. After a meeting with her local community, Isabelle signed up. “I don’t want to suffer or die giving birth,” she says. “Now, when I go into labour we can call the health centre and they will send the ambulance to collect me. I’m very happy to know they will come.”

The programme is run by local NGO Alola Foundation with support from UNICEF. There have already been some early successes. In the previous quarter, only nine women gave birth in the local health centre. This is now up to 20 and rising.

Early start

Part of the view from the mountainside above Suku Hatólia
© UNICEF Timor-Leste/2012/Andy Brown
I visited Suku Hatólia with my UNICEF colleagues Mi-Ann, Tony and Indra on the second day of our visit to Ermera district (see part one of this blog). As before, we spent several hours negotiating bumpy mountain roads, but this time the views were spectacular. We started in the early morning, driving along forested mountainsides where tall acacia trees rose out of the early morning mist, their pale trunks glowing orange in the low-angled light of the rising sun. We passed an old man leading a donkey along the road with sacks of coffee on its back, then crossed a river where a woman was washing clothes and laying them out to dry on the rocks.

Above Suku Hatólia, the view suddenly opened up and we stopped for a minute. Standing on the shoulder of the mountain, we could see a wide, deep valley ending in interlocking fingers of land with the expanse of sea beyond. The sky was clear and blue, except for a few clouds piling up behind the peak of the tallest mountain opposite. Along the valley floor, dried-out river beds like dusty scars on the landscape traced the route that the waters would later take to spill into the sea during the rainy season.

I was driving with UNICEF health specialist Aderito Docarmo, so I asked him about the programme. “The percentage of assisted births in this area is just 22 per cent,” he said. “We wanted to find a way to increase this.”

UNICEF started with advocacy, from the Ministry of Health down to village chief level. Once everyone was on board, Aderito and colleagues started meeting with local communities including pregnant women. “We asked them to list the reasons that they don’t go to the health centre to deliver,” he said. “Their reasons included lack of money, difficulties in transportation and lack of family support. Then we helped them to develop solutions to those problems. For example, if all the mothers in the village save $1 a month, they can use that money to help pregnant women when they need to go to the clinic.”

The team also helped the villagers determine which women needed extra help. “We get three coloured baskets and write all the pregnant women’s names on pieces of paper,” Aderito continued. “If the community agrees that ‘Maria’ can get to the clinic by herself, her name goes in the green basket. If they think ‘Johanna’ will need help, she goes in the red basket. Anyone that they’re not sure of goes in the yellow basket, and we follow up with them later.”

Midwife Ofelia (left) and head of the health centre and with their ambulance
© UNICEF Timor-Leste/2012/Andy Brown
Eventually we arrived at the health centre at Hatólia sub-district, built on a hillside looking out over the valley. Outside the clinic, one 36-year-old a pregnant woman with six children told us she was there for a pre-natal check-up. “I walked two hours from my village to get here,” she said. “I just want to make sure my pregnancy is good. I’ve also brought my youngest child for vaccination.”

At the maternity ward, we met senior midwife Ofelia Isabella Suarez, who had worked there since 2006. “Sometimes the women come and immediately deliver, other times they stay here for a few days,” she said. “We had two women with us last week. We cooked rice for them and their families brought them vegetables.”

Ofelia showed us round the health centre, which was spacious but fairly basic. “We can do normal deliveries here but we don’t have the equipment to deal with complications,” she continued. “Last month we had to send a woman to the hospital in Dili. We couldn’t get the baby out and she was suffering from hypertension. She delivered successfully in Dili and both mother and child survived.”

Village meeting

Pregnant women and new mothers at the community meeting
© UNICEF Timor-Leste/2012/Andy Brown
After another journey over treacherous packed-earth roads, we arrived at Suku Hatólia. Most of the houses were traditionally built out of bamboo and wood with thatched roofs. Children played on a swing and in the few patches of shade. Most of the villagers were already assembled in the town hall, including pregnant women, mothers and volunteers.

The community meeting began with one of the volunteers, 26-year-old Paul Soares, reading the outcome of the previous meeting, where they talked about problems and solutions related to women giving birth. Paul and the other volunteers were chosen by the community. They are responsible for monitoring pregnant women, taking them to the clinic when they’re ready to deliver, and helping care for children left at home. At the end of the meeting, Paul and another volunteer were each given a mobile with $15 credit so that they could call the clinic when mothers had to be brought to the health centre.

“Isabelle is my mother’s goddaughter,” Paul told us afterwards. “I want to help her and other pregnant women in the village. When Isabelle is ready to deliver, I will take her to the health centre. If there’s an emergency, I can call the health worker on this mobile.”

Paul (left) and another volunteer examine the mobile phones
© UNICEF Timor-Leste/2012/Andy Brown
Another volunteer, 40-year-old Ceasar Noronha, came from nearby Suku Aculausarae to address the community meeting. “My brother’s wife was pregnant during the Indonesian occupation,” he said, speaking passionately. “She could not deliver so the child died inside her. Then she died too. I don’t ever want to witness a repeat of that experience. So when this programme started, I wanted to take part. Now all the women in my family give birth at the health centre with support from health workers. They have all delivered successfully.”

The maternal health programme is still in the pilot phase and covers just a few villages and UNICEF is looking for additional funding to scale it up. “This is a good example of our equity approach,” Aderito said as we left. “Before, only the women who lived close to the clinic could go. Now all the women can, including those in remote areas.”
A boy plays on a swing at Suku Hatólia.
© UNICEF Timor-Leste/2012/Andy Brown

3 comments:

  1. Most of the People are knows Where is Everest Base Camp Trek is a top destination in the world because those trekkers are planning to hike if they
    have enough for fitness and healthy and also enough budget first try 10 Days Everest Base Camp, Everest Base Camp trek 12 days, Everest Base Camp Trek 13 days,
    Everest Base Camp Trek 14 days. these trip are depended budget and physical fitness. Because There are many route and most challenging path and passes above 5400 meters as chola, Renjola and kong mala.
    Everest Base Camp Trek cost is not any type of designation trekkers choices. if you have just hired a guide and self-paying rest of the thing that
    would cheaper but take full board packages then cost does higher. Everest Trekking Routes Organized as flexible time and custom Everest Base Camp Trek
    Itinerary
    for Everest Base Camp Trek Route. Because tour organizer has been over 20 years experience in this industry. only Kathmandu to Lukla
    and Lukla to Kathmandu domestic flight ticket is expensive and rest of thing are compared to another trekking route as cheap Everest base Camp Trek.
    These days most of Asian Country search on Internet as EBC Trekking that country are Thailand, Singapore, Malaysia, honking, Indonesia, and China.

    ReplyDelete
  2. Everest Base Camp Trek is one of those journeys that

    create your vacation dreams return true. Hiking on the legendary foothills just under the mighty Mount

    Everest 8848m with exciting views of the master peaks will solely be found within the Everest Region. This

    celebrated trek is thought worldwide for its trailblazing routes & the landscapes speak to your senses. On

    this trip you furthermore Mera peak out at the celebrated Kala Patthar (5,600m/18,373ft) read purpose for a

    few grand direct views of the very best mountain in the world. Everest Base CampTrek additionally includes different

    celebrated eight thousand peaks like Mt mountain peak (8,516m /27,940ft), Makalu (8,485m /27,838 ft) Cho-Oyu

    (8,201m /26,906ft). The culture of this specific space is of nice notebook stuff & interacting with the

    native of us puts a lot of zest into your venturesome journey as you walk through the Khumbu region of the

    Asian country. This legendary path could be a psychological thriller for top & wild hikers World Health

    Organization want the tread the methods wherever legends walked before on their thanks to conquering

    mountain peak, some did some didn’t however the Everest Base Camp Trek path keeps those legends alive for

    many trekkers World Health Organization head to the present region. The trip begins with a stirring mountain

    flight to Lukla, one among the world’s highest mountains; & as shortly as you set down at that altitude, the

    remainder is history. Your hike takes you to the favored village city of Namche, referred to as the ‘gateway

    to the Khumbu’’ & from there on you rehearse quiet monasteries with the acknowledge Sherpa of us World

    Health Organization inhabit this region & their culture is price noting. On the way, we have a tendency to

    visit the Sagarmatha parkland, home to some rare fauna & flora, this additionally wherever we have a

    tendency to adapt for a few time. We head deep into the Khumbu hiking into the forest of shrub, birch trees

    & pine, with colorful villages wherever we have a tendency to square measure sincerely welcome by the Sherpa

    community. we have a tendency to square measure pleasantly stunned to return across a hospital-based mostly

    in Khunde and health post at Pheriche that shows this region not solely cares for the locals however also

    are able to look out of trekkers World Health Organization have altitude issues. Doctors square measure

    invariably at the post for aid treatment. The Everest Base

    Camp Trek
    is arduous however varied teahouses square measure found on the paths providing smart grubbed

    to shelter from the generally harsh climate. Our trek culminates at base camp so we have a tendency to

    create a path for Namche as we have a tendency to hike back to Lukla to rendezvous for our flight to

    Katmandu. we have a tendency to add an additional contingency day for inclement weather which will delay

    flights. It’s recommended to be pretty acceptable to undertake this journey; you only want some smart hiking

    exercise before doing this trip. And Nepal Base Camp Treks can do the remainder to allow you AN action-

    packed odyssey of a period.

    ReplyDelete
  3. Annapurna Base Camp Trek is one in every one of the big ranges that expand from Vara-Shikar (Annapurna Fang) towards Manaslu and Lamjung range that is roughly 60-70 kilometer of lateral distance. which has one peak over eight,000 meters, 13 peaks over seven,000 meters, and sixteen additional over half dozen,000 meters. The landscape of the region provides breathtaking sceneries. the first morning views of the mountains square measure majestic. The sunrise views from on the trail of the trek square measure breathtaking. The treks mix such a large amount of totally different landscapes and convey you, therefore, getting ready to the bottom of seven,000 and 8,000-meter peaks.Annapurna Base Camp trekking designed by Nepal Base Camp Treks is one in every of the foremost loved trekking destinations. throughout the trek except witnessing made cultural diversity, you'll additionally withstand remote farms still as villages occupied by Gurung ethnic tribes WHO square measure popularly celebrated everywhere the planet for his or her bravery. you'll be able to expertise the culture, previous traditions, and spiritual values of grunge individuals. To begin ten days Annapurna Base Camp, we are going to drive to Nayapul from Pokhara and walk right along the trail and keep on trekking downhill following a watercourse to Birethanti. Also, we are going to climb to Jhinu danda wherever we will get pleasure from tumbling within the natural spring. On the thanks to Dovan, we are going to be rewarded by the outstanding views of Mt. Machhapuchhre, Annapurna South, and Huinchuli. Plus, we are going to pass Chomrong, an oversized Gurung village. we are going to additionally pass the tree-plant full of bamboo and bush trees beside the Modi watercourse and reach Donovan. Then we are going to walk for six hours to urge to Annapurna Base Camp lies at the elevation of four,095m via Machhapuchhre base camp that fantastically assaults the northern aspect of the very giant Mt. Machhapuchhre. Walking for around four hours we are going to reach Annapurna Base Camp that enthralls the North American nation with the putting views of the world’s tenth highest Annapurna I ( eight,091 m), Mt. Machhapuchhre Annapurna South, Huinchuli and additional. Trekking Guide Team offers a wonderful probability to travel for Annapurna Base Camp that is one in every of the foremost picturesque and exciting set within the heart of the nice Mt. Annapurna. we are going to cause you to feel the nice distinction if you choose to travel with North American nation since our good staffs and hospitable porters will certainly cause you to trek safe, comfy and unforgettable.

    ReplyDelete