1. IFE in Padang Pariaman, West Sumatra 2-9 October 2009 and 20-24 October 2009 Natural Disaster: Earthquake 7,6 RS

2. The Natural Disaster: Eathquake Wednesday, 30 th September 2009 at approximately 17:16:10 local time Wednesday, 30 th September 2009 at approximately 17:16:10 local time Magnitude of 7,6 RS, epicenter was 45 kilometres (28 mi) west-northwest of Padang, Sumatra Magnitude of 7,6 RS, epicenter was 45 kilometres (28 mi) west-northwest of Padang, Sumatra Most affected areas: (a) Padang Pariaman, (b) Agam, (c) Padang, and (d) Pariaman Most affected areas: (a) Padang Pariaman, (b) Agam, (c) Padang, and (d) Pariaman Government reports have to date confirmed: (a) 1,115 dead, (b) 1,214 severely injured and (c) 1,688 slightly injured Government reports have to date confirmed: (a) 1,115 dead, (b) 1,214 severely injured and (c) 1,688 slightly injured

4. AIMI’S Disaster Response Lactation Team: First Deployment 2 – 9 October, 2009

5. Objectives Rapid assessment and mapping of earthquake victims: (a) pregnant women, (b) breastfeeding mothers, (c) babies and infants (under 2s) Rapid assessment and mapping of earthquake victims: (a) pregnant women, (b) breastfeeding mothers, (c) babies and infants (under 2s) Observation over the distribution of infant formula and baby food Observation over the distribution of infant formula and baby food Early lactation support for pregnant women and breastfeeding mothers Early lactation support for pregnant women and breastfeeding mothers

7. Day 1 Deployment on H + 2 Deployment on H + 2 3 lactation counselors and 1 volunteer 3 lactation counselors and 1 volunteer Establishing center of activity at the city of Padang Establishing center of activity at the city of Padang General conditions: blackouts, emergency rescues, lack of fuel, much chaos General conditions: blackouts, emergency rescues, lack of fuel, much chaos

9. Day 2 Reporting to the coordination for disaster relief center at the Governor’s residence Reporting to the coordination for disaster relief center at the Governor’s residence Padang city, 1 post natal mother Padang city, 1 post natal mother Victims not in tents  staying with relatives Victims not in tents  staying with relatives Lack of drinking/clean water Lack of drinking/clean water Mental & psychological condition of breastfeeding mothers relatively good Mental & psychological condition of breastfeeding mothers relatively good

10. Day 3 Location: Pariaman city and the district of Pariaman (with several sub-districts) Location: Pariaman city and the district of Pariaman (with several sub-districts) 30 mothers and under 2s 30 mothers and under 2s Benefits of breastfeeding and risks of formula feeding Benefits of breastfeeding and risks of formula feeding Mostly mothers lacking confidence on quality of breast milk  lack of nutritious food, e.g. instant noodles Mostly mothers lacking confidence on quality of breast milk  lack of nutritious food, e.g. instant noodles

11. Day 4 Location: sub-district Sei Geringging, district of Pariaman Counseling and screening for exclusively breastfeeding mothers 20 pregnant women & breastfeeding mothers from 3 villages Generally trust health workers  not promoting breastfeeding  mothers lack knowledge and support

12. Day 5 Assisting the Indonesian Society of Pediatrics (IDAI) for IYFE at M. Jamil Hospital  health professionals Assisting the Indonesian Society of Pediatrics (IDAI) for IYFE at M. Jamil Hospital  health professionals More effective if carried out at H + 2 weeks More effective if carried out at H + 2 weeks

13. Day 6 With IYFE IDAI team, socialization, counseling & screening for breastfeeding mothers Location: sub-districts of Sungai Limau and Tandike 25 breastfeeding mothers (5 6 mos) Poor knowledge on exclusive breastfeeding and complementary feeding using local indigenous ingredients* Role of midwife in promotion of formula milk and processed baby food

14. Day 7 Activities concentrated in the sub-district of Sei Geringging, district of Pariaman Activities concentrated in the sub-district of Sei Geringging, district of Pariaman 10 pregnant women, 3 breastfeeding 6 mos 10 pregnant women, 3 breastfeeding 6 mos Location already ‘visited’ by an infant formula company  midwife Location already ‘visited’ by an infant formula company  midwife From 20 breastfeeding, only 5 exclusively  lack of knowledge and support (midwife) From 20 breastfeeding, only 5 exclusively  lack of knowledge and support (midwife)

15. Day 8 Distribution of clothes, nursing aprons, infant toiletries, towels, toys and books Concentration of activities: several villages in sub-district of Sungai Limau, district of Pariaman Return to Jakarta

16. Recommendations Early deployment of lactation team very important (H + 1 week), for: Early deployment of lactation team very important (H + 1 week), for: Accurate assessment and mapping of: (a) pregnant women, (b) breastfeeding mothers, (c) babies and infants under 2s Accurate assessment and mapping of: (a) pregnant women, (b) breastfeeding mothers, (c) babies and infants under 2s Observation on the distribution of infant formula and commercial baby food Observation on the distribution of infant formula and commercial baby food Dissemination of IFE guidelines (Indonesian Ministry of Health) to local & international relief agencies* Dissemination of IFE guidelines (Indonesian Ministry of Health) to local & international relief agencies* Counseling & breastfeeding support to pregnant women & breastfeeding mothers Counseling & breastfeeding support to pregnant women & breastfeeding mothers

17. AIMI’S Disaster Response Lactation Team: Second Deployment 20 – 24 October, 2009

18. Objectives Follow-up on First Deployment Follow-up on First Deployment Counseling and socialization of the benefits of breastfeeding, risks of formula feeding and proper complementary feeding Counseling and socialization of the benefits of breastfeeding, risks of formula feeding and proper complementary feeding IFE training for volunteers and local health workers IFE training for volunteers and local health workers

19. Day 1 Deployment on H + 3 weeks Deployment on H + 3 weeks 2 lactation counselor and 1 field coordinator volunteer 2 lactation counselor and 1 field coordinator volunteer Location: Nagari VII Koto, district of Pariaman Location: Nagari VII Koto, district of Pariaman Meeting with religious and community leaders Meeting with religious and community leaders Distribution of packages for pregnant and breastfeeding women  feed the mother, and let the mother feed the child Distribution of packages for pregnant and breastfeeding women  feed the mother, and let the mother feed the child

20. Day 2 Various products for distribution to pregnant women & b/f mother not available in district of Pariaman  Padang city Preparation of packages, scheduling visits to several villages

21. Day 3 Socialization of breastfeeding and proper complementary feeding in 9 villages, sub- district VII Koto, district of Pariaman Socialization of breastfeeding and proper complementary feeding in 9 villages, sub- district VII Koto, district of Pariaman Screening and counseling partial-breastfeeding mothers  formula and/or early CF Screening and counseling partial-breastfeeding mothers  formula and/or early CF Visiting local Health Office of the district of Pariaman Visiting local Health Office of the district of Pariaman 288 pregnant women & breastfeeding mothers  88 6 mos 288 pregnant women & breastfeeding mothers  88 6 mos

22. Day 4 Increase mother’s confidence to breastfeed, despite nutritional status Explain increased risks of formula feeding  lack of clean water results in diarrhea Proper CF using local indigenous ingredients Exclusive b/f = 30 mothers  midwives ‘push’ formula feeding Early CF at 2 months Formula donation since week 1 directly from formula company

23. Day 5 Finishing various tasks assigned by AIMI Finishing various tasks assigned by AIMI Return to Jakarta Return to Jakarta

24. Recommendations This Second Deployment highlights the many benefits and nutritious advantages of breast milk, especially during disaster period  people tend to believe formula milk and commercial baby food as ‘more nutritious’ This Second Deployment highlights the many benefits and nutritious advantages of breast milk, especially during disaster period  people tend to believe formula milk and commercial baby food as ‘more nutritious’ Training on CF preparation using the many available local indigenous ingredients  people not aware that ‘local foods’ are more nutritious Training on CF preparation using the many available local indigenous ingredients  people not aware that ‘local foods’ are more nutritious Third Deployment necessary for training of local volunteers and health workers on IFE Third Deployment necessary for training of local volunteers and health workers on IFE

25. THANK YOU FOR YOUR ATTENTION