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					Recent Emergencies: Impact on
 breast feeding – Tsunami and
Conflict Experience in Sri Lanka

              Dr.Vinya S. Ariyaratne
                Executive Director
    Sarvodaya Shramadana Movement Sri Lanka
Recent Emergencies: Impact on breast feeding
– Tsunami and Conflict Experience in Sri Lanka
• Introduction – Recent Emergencies in Sri
  Lanka
• Breast feeding – best practices and Sri
  Lankan context
• Tsunami
• Conflict
• Conclusions
Recent emergencies in Sri Lanka
• Natural Disasters
  –   Floods
  –   Cyclones
  –   Landslides
  –   Droughts
  –   Tsunami
• Human-induced
  – Armed Conflict
Sri Lankan context

• Need to analyze in the larger context of
  health and social development in Sri
  Lanka
• “pre-emergency” status of the population
Tsunami – December 2004
                      Displacement due to Tsunami
                                                 Tsunami Disaster, 26 December, 2004
             Last updated :16.00
             hrs                                                                                           As at : 21/02/2005
Province       District     Affecte   Displace        Displaced Persons        Death    Injured   Missin    Damaged Houses           No. of
                               d         d                                       s                  g                                Camps
                            Familie   Families     In       With     Total                                 Complet     Partially
                               s                 Welfar    Relativ                                           ely
                                                    e      es and
                                                 Center    Friends
                                                    s

             Jaffna          14,767     10,827     7,625    33,381    41,006    2,640    1,647      540       6,084        1,114      12 **
Northern     Killinochchi     2,297       407         0      1,603     1,603     560       670         0        246              -        0
             Mullaitivu       6,745      6,007    11,993    10,564    22,557    3,000    2,590      421       5,033         424          23

             Trincomale
             e               30,547     30,545    14,853    59,208    74,061    1,078    1,328        45      4,830        3,835         34
Eastern
             Batticaloa      63,717     12,494    22,002    35,047    57,049    2,975    2,375      346      13,530        5,839         36
             Ampara          58,729     38,866    24,179    75,322    99,501   10,436    6,581      161      18,889        8,641         55
             Hambantota      14,069      3,334     1,803    45,195    46,998    4,500      434     1,341      2,303        1,744         11
Southern     Matara          19,398      2,235     2,873     6,405     9,278    1,342    6,652      608       2,362        5,659         22
             Galle           24,583     23,278     2,633   119,301   121,934    4,248      313      564       7,032        7,680         27
             Kalutara         9,433      7,059     2,420    32,527    34,947     279       401        69      2,683        3,835         12
Western      Colombo          9,647      8,140     5,446    30,614    36,060      79        64        12      3,388        2,210         26
             Gampaha          6,827       308       876       573      1,449       6          3        5        278         414           2
North
Western      Puttlam            232         18       66                   66       4          1        3         23             72        2

           Total            260,991    143,518    96,769   449,740   546,509   31,147   23,059     4,115     66,681      41,467         262
Caring for Tsunami IDPs
“Waves of Compassion”
• Immediate response by
  the community
  first wave of compassion
• Local organizations and
  volunteers
  second wave of
  compassion
• External aid agencies
  third wave of compassion
Provision of Health Care for the Tsunami IDPs
• Swift response by
  government and non-
  governmental
  organizations
• Exemplary
  performance by
  MOHs managing
  health issues with
  completely destroyed
  infrastructure
Breast feeding status post-tsunami
• Media appeals for infant formula and bottles giving a
  wrong message to the public, donors as well as to the
  affected population.
   – ie. Women are no longer able to breast feed because they are
     “traumatized”.
• No national guidelines were in existence at the time of
  the Tsunami.
• 18 Days after the Tsunami, the Family Health Bureau
  (FHB) issued comprehensive Guidelines.
• January 2005 study covering 40 camps revealed most
  mothers continuing breast feeding with out any
  problems. Others who were giving formula feeding found
  difficulties.
Observations by stakeholders
• High rates of bottle/formula feeding in non-
  emergency times
• Inadequate policy implementation
• Few government and NGO staff trained in or
  knowledgeable about infant feeding during
  emergencies
• Unsolicited donations of formula/milk powder
• Unsuitable foods for complimentary feeding
  during emergency food distribution
Conflict-induced emergency
• Qualitatively different
  to a natural disaster
  induced emergency
• Pre-displacement
  health and social
  status
• During displacement
• Post-displacement –
  conditions in the IDP
  camps
A New Reality
Needs

 Shelter
 Water
 Sanitation &
  Hygiene
 Food and Nutrition
 Health
 Child Care           "

 Psycho-social
 Care of the
  Vulnerable Groups
Integrated Services




       •   Food – Communal cooking
       •   Nutrition Rehabilitation Programme
       •   Water Supply
       •   Sanitation
       •   Mobile Medical Service
       •   Mobile Library Service
Communal Cooking
Water Supply
Sanitation facilities
Mobile Library
Mobile Medical Unit
Observations on breast feeding/infant feeding

• Unsolicited (?) donations of infant formula
• Medical staff not fully knowledgeable on
  infant feeding in emergency setting
• World Breast Feeding Week – August –
  Training for the medical staff
  – Useful but with limitations
Conclusions and recommendations

• Need for capacity building in all sectors for
  effective IYCF during emergencies
• Complete ban of unsolicited donations of
  infant formula and feeding bottles
• Vigilance against promotion of infant
  formula
Thank You!

				
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posted:8/15/2012
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