New tsunami concern: A baby boom in Aceh's refugee camps

New tsunami concern: A baby boom in Aceh's refugee camps

Chris Brummit, Associated Press, Banda Aceh, Aceh

With the birth of her first child just one month away, Wadiana
Wahab worries about the world her baby will enter.

She mainly eats rice and instant noodles and has no money for
a crib, diapers or baby clothes. And while she expects to deliver
at a hospital, she will likely return to the sweltering tent she
calls home, where the stench of human waste hangs in the air.

"I never imagined it would be like this," said Wahab, 23, at a
makeshift camp for about 5,000 refugees in Banda Aceh, the
capital of Indonesia's tsunami-hit Aceh province. "It's already
eight months and we have bought nothing for the baby."

With the threat of epidemics abating and most injured
survivors treated, one of the most pressing medical needs now
emerging across tsunami-hit countries is also one of the most
basic: ensuring pregnant women stay healthy - and deliver safely.

Indonesia, the country most devastated by the Dec. 26
earthquake and killer waves, is girding for a flood of newborns
in Aceh's squalid refugee camps and ruined villages. Some experts
say that birth rates among tsunami survivors may rise next year,
as bereaved parents who lost children in the disaster try to
rebuild their families.

Pregnant women comprise about 25,000, or 6 percent, of some
400,000 refugees in Aceh's camps, the United Nations says. Every
month, some 800 babies are expected to be born in the province,
on the northern tip of Sumatra island.

The figures are similar in Sri Lanka, an island nation off the
coast of India, where as many as 5,000 will be delivered in the
next few months, the United Nations says.

"What can we say to them? They want someone to continue the
family line," said Sri Setiyati, a midwife in Banda Aceh. "It is
their right to have children. We can only advise them to wait."

Despite a massive international relief effort, Aceh's
devastated public health system is ill-equipped to handle the
births. Though a few hospitals have reopened, smaller clinics
remain shuttered. Once abundant, midwives are now scarce, many of
them having died when the sea surged.

"The (pregnant) women here are in a bad shape," said Henia
Dakkak, a Palestinian public health specialist with the U.N.
Population Fund in Banda Aceh. "If we don't start to do something
in a few weeks, then we are endangering people's lives."

Health workers say most pregnant women in Aceh are not eating
enough protein, meaning they may have underweight babies or may
become anemic and bleed to death during labor.

Indonesian and U.N. authorities say a shortage of
contraceptives means that many women in the camps will have
unwanted pregnancies.

Still, things have improved since the disaster's immediate
aftermath when many women gave birth without any medical
supervision, often in unsanitary conditions in refugee camps.

Midwives flown into Aceh from Jakarta now routinely call on
Wadiana and the 40 other pregnant women in her camp. A car is on
call to take them to a health clinic, if needed. And a freshly
painted maternity unit has just reopened in the city's public
hospital, parts of which remain covered in thick mud washed in by
waves.

In Sri Lanka, most refugee camps have access to a doctor. U.N.
officials have provided hospitals with 300 emergency reproductive
health kits, which include equipment to perform caesarean
sections and blood transfusions and treat miscarriages.

For Wadiana, it's not just about health care, though. She said
it pains her to think about being unable to prepare for the new
member of her family.

"Before the tsunami, we were getting excited and readying the
house for the birth," she said. "Now all I can do is sit here."

Indonesia's family planning agency has been swamped by
requests for condoms and other forms of birth control, agency
official Tri Tjahjadi said. The office has about 16,000
contraceptives - but needs 80,000, he said earlier this week.

Workers from U.N. and other agencies have rushed to respond,
distributing thousands of tons of contraceptives to clinics and
health workers in camps, though they've been hampered by damaged
roads and poor coordination.

There were concerns that Islamic leaders in this predominantly
Muslim region might resist the distribution of contraceptives,
sometimes believed to encourage pre-marital or extramarital sex.

But U.N. officials say there have been no complaints in Aceh,
where awareness of birth control is high. An estimated 60 percent
of couples had used contraceptives before, officials say.

Zamzami and Baruna, a couple who live in a camp attached to a
mosque on the outskirts of Banda Aceh, last week had their
seventh child, named Rizki after the Indonesian word for
"fortune."

"We have gone back to having nothing. Everything we owned was
destroyed. Maybe Rizki will bring us good luck," Zamzami said,
pointing to the tiny baby being breast-fed by her mother.