Kedungsana people join hands to save mothers

Kedungsana people join hands to save mothers

Sari P. Setiogi, The Jakarta Post, Cirebon, West Java

One mother dies out of every 299 live births in Cirebon, the
second highest maternal mortality in West Java province, after
Bogor.

Considering that some 20 years ago, the mortality rate was one
for every 235 births, Cirebon is hardly making any progress to
save the lives of mothers.

By now, the rate should have dropped by 50 percent," said
Inang Wahyudi of the Cirebon branch of the Maternal and Neonatal
Health office (MNH), a non government organization that aims to
reduce deaths during childbirth.

Inang said that since the 1980s, the maternal mortality rate
should have dropped from 425 to 212 deaths for every 100,000
births. Now it was still 334 deaths for every 100,000 births.

However in Kedungsana, a small village in Cirebon, progress is
underway.

Kedungsana is one of several villages in the area that have
embraced the Suami Siaga and Warga Siaga programs, Inang said.

Supported by the government and the United States Agency for
International Development (USAID), SIAGA encourages communities
to participate in helping mothers deliver babies safely.

SIAGA stands for Siap Antar Jaga, meaning "ready to deliver
and take care of (mother)".

While Warga SIAGA encourages communities to develop a support
system designed around helping pregnant women. The system may
cover transportation to hospitals, savings and blood donors.

SIAGA is the result of MNH's efforts to raise awareness about
birth preparedness and possible complications through village
institutions.

The program began in 1998 in Indonesia and is available mainly
in West Java and Banten but also in South Sulawesi, South
Sumatra, Lampung, South Kalimantan and West Nusa Tenggara.

In Indonesia, MNH focuses on the important role of midwives.

At Kedungsana, the SIAGA program was first introduced in Dec.
2002, said village chief M. Surjaya.

The village has one midwife and two traditional witch doctors
who often help in child births.

Kedungsana lies about 30 minutes by car from the heart of
Cirebon. Just over 3,000 people live here, and two-thirds of its
population have only an elementary school education or less.

Surjaya said he was surprised to see how positive response
was.

"Today we always have one or two cars ready to rush pregnant
women to the hospital in case of a complications," he said. "The
cars belong to our residents and they lend them to us at night."

A list of 75 blood donors hangs on the wall of his office,
said Surjaya: "if a hemorrhage happens, we'll ask the donors to
donate their blood."

He said that most donors on the list were already regular
donors at the Indonesian Red Cross (PMI).

Hemorrhage, obstructed labor, eclampsia (pregnancy induced
hypertension), and unsafe abortions account for nearly two-thirds
of maternal deaths, according to the United Nations Population
Fund (UNFPA).

It said that some 15 percent of all pregnancies led to
complications which, if left untreated, could be fatal.

In Kedungsana, regular check-ups by the midwives have helped
reduced cases of complications. Saeroh, a volunteer who helps
contact midwives, said that complications occurred most often
with women over 35-years-old, or those who had more than four
children.

"We will refer them to either the Gunung Jati Hospital or the
Arjawinangun Hospital, or the Puskesmas (community health center)
Plumbon, which is open 24 hours," she said.

Part of the SIAGA program is to encourage parents to open a
savings account in case the mother needs hospital treatment.

"A family who is expecting a new member usually opens a
savings account with us. They pay about Rp 1,000 per day,
depending on how much they can afford," she said.

"If the pregnant mother needs hospital treatment, we'll make
use of the savings. If not, we'll return the money."

As Kedungsana has only one midwife, Saeroh said that others
from nearby villages could be reached in case of an emergency.

Thanks to the SIAGA program, maternal mortality rates are
coming down in villages like Kedungsana. However elsewhere in
Indonesia, the rates remain high.

According to MNH data, the nation's average maternal mortality
rate is 390 for every 100,000 births. The rate ranks among the
poorest in Asia.