Recent Tsunami Survivors in West Java Still Lack Reproductive Health Care, Team Finds

CIAMIS, West Java, Indonesia — Survivors of last month’s tsunami here still lack access to basic needs and health care, and many have to rely on the generosity of communities near their temporary shelters, a team of specialists reports.

Usirah, 28, is three months pregnant with her third child. She has not changed her clothes for three days. Her belongings were swept away by the powerful wave that levelled the inn in Karapyak beach, where she worked as domestic servant before the disaster.

“Everything is difficult,” she said. “I don’t have access to water for bathing. I haven’t had care and I don’t think I would do that because the health workers who came here were all men.”

Usirah and 25-year-old Komiah, four months pregnant with her third child, live with 46 other women in a tent camp in Bagolo village, not far from where the inn used to be. Around 68 male survivors set up makeshift tents in front of local community houses.

“Many people go to houses in the neighbourhood to bathe,” said Wiwin Winarni, a member of a reproductive health assessment team sent by UNFPA, the United Nations Population Fund. “Those who use latrines in the camps have to stand in a long line waiting for their turn.”

The 17 July tsunami, triggered by a 7.2 magnitude earthquake, affected West Java, Central Java and Yogyakarta provinces along the southern coast of Java island. Among the worse hit areas are Tasikmalaya district and the resort town of Pangandaran in Ciamis district, both in West Java. Unofficially, about 623 people died, 176 were declared missing and 7,600 were rendered homeless in these two districts.

When disaster strikes, women and girls are among the most vulnerable because their reproductive health-related needs are often left unmet. Difficulties in getting water and sanitary napkins may lead to health problems, while the lack of pregnancy care, especially for those with complications, can expose both mothers and newborns to life-threatening conditions. Complications occur in around 15 per cent of pregnancies in normal situations, but may be more frequent in an emergency situation due to stress, trauma and hard living conditions.

While most local health facilities were functioning immediately after the tsunami, there were urgent shortages in maternal health supplies and equipment. Nani, a midwife at a community health centre in Pangandaran, was busy tending the wounded and assisting three women in labour when the UNFPA team arrived. “We don’t have enough medical supplies and blankets to keep the newly born babies warm,” she told a team member.

Another midwife, Elin, who visited all the temporary shelters in Ciamis, said, “I lost my equipment so I could not provide optimal assistance to displaced women in labour.” Items to maintain personal hygiene for women, girls and newborns are badly needed, she added.

“It’s good news that health workers and facilities in the stricken-areas could immediately resume their work, but they have limited supplies and need support to optimally serve those who were displaced and the community in general,” said Dr. Zahidul Huque, UNFPA Representative in Indonesia.

The needs assessment in Ciamis and Tasikmalaya districts found that local midwives serving displaced women needed life-saving maternal care supplies immediately. UNFPA has shipped 50 midwifery kits, enough for the next three months, and will soon send more supplies to ensure personal hygiene among tsunami survivors.

UNFPA has also offered to help provincial and district health offices collect data related to mothers and newborns. “Data on beneficiaries, health providers and their capacities would be useful in determining priority assistance to address the immediate needs,” said assessment team member, Dr. Tommy Sulaksono.

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UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.

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William A. Ryan
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