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					                                             IBU4ACEH
                                    REPORT UPDATE
                    MEULABOH, ACEH BARAT DISTRICT
                                       December 9 – 22, 2005

GENERAL SUMMARY
It is almost a year after the tsunami. Program evaluation will be written as annual
report. Meanwhile, our activities went as usual. Mobile clinic schedule have been
routinely arranged and the play house building at Ujong Tanjong is finished.
Many people came to Meulaboh, mostly journalists from national as well as
international media. One of our doctors had his profile covered by a national
television network (Metro TV) for their Tsunami Aftermath: The Road to Recovery
program. Our child and adult psychosocial programs were also covered by the
same network.

HEALTH PROGRAM

Coverage Area
By this reporting period we have routine mobile clinic schedule to three CHCs in
the sub districts of Woyla Induk, Woyla Barat and Sungai Mas. We are now
assessing programs to run in these areas. In MCH, effective posyandu activities are
down to only four out of six. In collaboration with psychosocial team, we held
Healthy Friday on December 16 at the Play House in Beuregang IDP camp and
group discussion on reproductive health for female in Ujong Tanjong and
Beuregang. The overall coverage area is shown on Table 1.

Primary Health Care
   Static Clinics
Our static clinics are running on the regular schedule, Monday to Friday at 17.00 –
20.30 in all clinics plus Monday to Saturday at 08.30 – 12.00 in Keude Aron. There
were increased number of patients particularly in Lapang II and Keude Aron,
possibly related to the community meetings that we held on the last reporting
period.


                 MEDAN OFFICE                                  MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46                 JL. Gajahmada No. 79B
                 Medan — Indonesia                         Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844               Telp: +62 655 700 6264
                Fax: +62 61 787 0844
A 40-year old woman came to Keude Aron clinic with a pregnancy that grew faster
than normal, severe nausea and vomiting, and high blood pressure. We suspected
molar pregnancy and referred her to the district hospital for further examination
and treatment.

                          Table 1. Coverage area of health program
No   Sub district             Site                 Activity
 1                            Beuregang TLC        MCH*, Healthy Friday at Play House
     Kaway XVI
 2                            Keude Aron Camp      Static clinic, MCH
 3                            Ujong Tanjong TLC    Static clinic, MCH*
     Meurebo
 4                            Alue Penjareng TLC   MCH
 5   Johan Pahlawan           Lapang II Camp       Static clinic, MCH
 6   Woyla Induk              Kuala Bhee CHC       Mobile clinic
 7   Woyla Barat              Pasi Mali CHC        Mobile clinic
 8   Sungai Mas               Kajeung CHC          Mobile clinic
*No posyandu activities in Beuregang and Ujong Tanjong Block I-IV


   Mobile Clinics
The schedule for mobile clinic is Monday and Wednesday to Sungai Mas and
Tuesday and Saturday to Woyla Induk and Woyla Barat. The Head of CHC in all
targets asked our team to come three days a week, unfortunately we are unable to
do that at the moment since there is only one car available for mobile clinic.
All our mobile clinic targets are endemic areas for malaria, thus we planned an
eradication program in collaboration with the District Health Office and UNICEF.

   Healthy Friday
On December 16 we held Healthy Friday at the Play House in Beuregang IDP
camp. Thirty students aged 3-5 years old had their weight and height measured
and their general health status assessed. We also gave medication for their
ailments, mostly respiratory tract infections.

   Coverage
The coverage of primary curative health services includes static and mobile clinics
as well as Healthy Friday activities. The number of patients is higher than the last


                  MEDAN OFFICE                                MEULABOH OFFICE
          Taman Johor Indah Permai II No. A46                 JL. Gajahmada No. 79B
                  Medan — Indonesia                         Meulaboh 23617 — Indonesia
       Telp: +62 61 77 1054 77, +62 61 787 0844               Telp: +62 655 700 6264
                 Fax: +62 61 787 0844
reporting period (879 vs. 698) and the total number of patients treated from
January 1 to December 22, 2005 is 23,856 patients.

                                   Table 2. Disease proportion
                                                           Number of patients (%)
No   Disease
                                                    <5 years old             >5 years old
 1 ARTI                                              75 (8.5%)               201 (22.9%)
 2 Skin diseases                                     20 (2.3%)                 66 (7.5%)
 3 Diarrhea                                          15 (1.7%)                 17 (2.0%)
 4 Other                                             71 (8.1%)               414 (47.0%)
TOTAL                                                            879 (100%)

Maternal and Child Health
   Posyandu Activity
During this reporting period we conducted four posyandus. Posyandu activities in
Beuregang and Ujong Tanjong TLC Block I-IV were postponed. A community
meeting was held regarding this matter, and will be continued next week since it
has not reached a final decision. Posyandu results are shown on Tables 4 and 5.

    CHW
Topic for CHW training this month was “care for mother”. It was held in Keude
Aron IDP Camp, Ujong Tanjong block V-VIII TLC, and Alue Peunjareng TLC.
There were 10 out of 17 kaders attended. In Lapang II IDP Camp, we also gave
training in using NCHS standard for nutrition assessment.

                Table 3. Children attendance and results of Posyandu
Location/number of <5                Attendance             Malnutrition            Immunization
y.o. children                  Infant      < 3s   < 5s   Infant     <3s    < 5s
Keude Aron/85                     9         23     28      0         0      0                 4
Lapang II/127                    14         30     26      1         2      0                14
Alue Peunjareng I/47              5          9     11      0         3      0                 1
Ujong Tanjong 5-8/97              9          9      6      0         0      0                 7
TOTAL/259                        37         71     71      1         5      0                26
                                          179                       6                        26
Percentage                              69.11%                    2.3%                     10.04%

                 MEDAN OFFICE                                     MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46                    JL. Gajahmada No. 79B
                 Medan — Indonesia                            Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844                  Telp: +62 655 700 6264
                Fax: +62 61 787 0844
                   Table 4. Pregnant women attendance to Posyandu
Location                                         ANC              Iron supplement
Keude Aron                                         2                      1
Lapang II                                         11                     11
Alue Peunjareng I                                  0                      0
Ujong Tanjong 5-8                                 10                     10
TOTAL                                             23                     22

   Nutrition Assessment
We coordinated with UNICEF to give Unimix, a high calorie soy powder, for
nutrition supplement in every posyandu. The weight/height measurement was still
being calculated by the CHW because we wanted to give them full responsibility
on this matter.

Outcomes
We succeeded in retaining CHWs for posyandu in Keude Aron IDP Camp, while
in Beuregang they have not made a decision. All static and mobile clinic schedules
were fulfilled as scheduled. However, most of our patients with skin infection still
did not get proper treatment. Supplementary food at the posyandus not only given
to malnourished children because UNICEF distributed a new product for
supplementary food called Unimix to all children attended posyandu.

Constraints
 One of our mobile clinic target area only accessible by motorbike.
 We got many skin disease cases with very little medicine to treat them.
 We still cannot provide posyandu kit

Recommendation
 We recommend a motorbike and a more fuel efficient 4x4 vehicle
 We recommend budgeting for medicines supply, especially for skin infection
 We recommend budget for providing posyandu kits




                 MEDAN OFFICE                            MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46             JL. Gajahmada No. 79B
                 Medan — Indonesia                     Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844           Telp: +62 655 700 6264
                Fax: +62 61 787 0844
Coordination
  Health Coordination Meeting
  WHO is closing down all operation in Meulaboh by December 24, and UNICEF
  will take over their task to lead health coordination meeting.

   World Vision Indonesia
   There is still no news about our request for posyandu kit.

   Community meeting
   We held community meeting in Beureugang TLC and Keude Aron IDP camp
   regarding the role of the community member as CHW in posyandu.

   Catholic Relief Service (CRS)
   We send a request letter to CRS regarding health card for patients in static
   clinics.

Trainings and Courses
   TOT Kader Malaria Desa
   On December 19 – 21, 2005 one of our staff attended the TOT for Kader Malaria
   Desa in the Provincial Health Office in Banda Aceh held by UNICEF. The
   participants were health officers from 9 districts in Nanggroe Aceh Darussalam
   and 2 districts in Nias, North Sumatra, as well as some representatives of NGOs
   working in those districts. The goal is to train Kader Malaria at endemic
   villages related to the net distribution program from UNICEF.



PSYCHOSOCIAL PROGRAM

Coverage Area
  Beuregang TLC, Kaway XVI Sub-district
  Ujong Tanjong TLC, Meureubo Sub-district

Activities
The new play house building at Ujong Tanjong had made it possible for us to
divide the children in two classes based on their age. We coordinated with the
                 MEDAN OFFICE                         MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46          JL. Gajahmada No. 79B
                 Medan — Indonesia                  Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844        Telp: +62 655 700 6264
                Fax: +62 61 787 0844
health team to conduct Healthy Friday at Beuregang Play House and group
discussion on reproductive health for female teenagers and adults in Ujong
Tanjong and Beuregang. The rate of participation in all psychosocial activities is
shown on Table 5, 6, and 7 for Child, Teenagers, and Adults program, respectively.

                               Table 5. Play House Participation
     Location                     Age                          Sessions                  Average of
                          3–6          7 – 12                 November                   attendance
                        years old     years old               (2 weeks)                    /session
 Beureugang                35            47          - play & learn: 8               - play & learn: 23
                                                     - children group                - children group
                                                       counseling: 7                   counseling: 22
 Ujong Tanjong              14             27                   6 times                       10

                        Table 6. Teenager Counseling Participation
 Location        Age (years old)                Sex                  Method                 Average of
                13 – 18   19 - 24/          Male Female        Individual Group             attendance
                         married
 Ujong            46         -                   6      40            1            46            6
 Tanjong
 Beureuga          45             -          11         34                         42            4
 ng

                          Table 7. Adult Counseling Participation
     Location                    Age                          Sex                     Method
                         25 – 45    45 years           Male         Female     Individual  Group
                          years      and up
 Ujong Tanjong             34           4                2            36            13           45
 Beureugang                36           3                1            38            13           35

    Play & Learn
We are still doing various activities such as drawing, coloring, and writing as well
as some games to stimulate the development of cognitive and psychomotor ability
of the children. We gave presents for three student-of-the-weeks as usual, as a
reward for those who accomplished good grades and showed nice behavior. With


                 MEDAN OFFICE                                         MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46                          JL. Gajahmada No. 79B
                 Medan — Indonesia                                  Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844                        Telp: +62 655 700 6264
                Fax: +62 61 787 0844
the new play house, it is easier to set up rules such as taking a bath before
attending sessions and open shoes/sandals when entering the classroom.

   Children Group Counseling
We had another scientific session with plants and animals. We grew green beans in
transparent bottles to study their growth and open the body of a fish to study its
anatomy. Cognitive thinking is also raised by giving them arithmetic problems to
solve. The children showed high enthusiasm and good cooperative ability among
the groups.

   Teenage Sharing and Counseling
The main focus of all activities for teenagers is to help them to know themselves
cognitively as well as emotionally. We integrate this in the group discussions and
English learning activities.
A 16-year old girl left the barrack due to a quarrel with the relatives she lived with.
She cried as she was saying goodbye, and fortunately decided to come back a few
days later and reside at the barrack. She admitted that the presence of IBU4ACEH
team is one of the reasons that brought her back.

    Adult Counseling
Almost all participants feel more comfortable in individual counseling. Thus group
activities were only done in Qur’an reading and a new program of reproductive
health discussion.
Most of the problems were loss of children. Some still believe that their children
are still alive somewhere. Others believe otherwise, and want to forget about the
lost child. A woman tried to have another child in order to forget about her lost
daughter. In general they wanted to keep themselves busy so that their mind
would not be occupied by the grief.

    On-Air Counseling
The on-air counseling activities during this reporting period were shown on Table
8. Topics were chosen in light of the existing phenomenon that we identified in the
community.



                 MEDAN OFFICE                           MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46            JL. Gajahmada No. 79B
                 Medan — Indonesia                    Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844          Telp: +62 655 700 6264
                Fax: +62 61 787 0844
                             Table 8. On-air counseling activities
       Radio                                                                            No. of short
No                      Time and date                 Topic of discussion
       station                                                                        messages/calls
                      Sunday, Dec 11             How we are affected by our          11 messages
 1
                      20.30 – 22.00              friends                             3 calls
      Dalka FM
                      Sunday, Dec 18             Being single                        12 messages
 2
                      20.30 – 22.00
                      Friday, Dec 9              Pre-marital relationship            5 calls
 3
                      20.00 – 21.00
       FAS FM
                      Friday, Dec 16             Pre-marital relationship            7 calls
 4
                      20.00 – 21.00              (continued)                         6 messages

Outcomes
At the play house the physical abilities of most students were improving. Some
students are able to write their own names. They also started to get used to using
the words of manner. In children group counseling, scientific sessions and
arithmetic problem solving stimulated various degrees of cognitive thinking ability
among students. In teenager group counseling, the diary project helped them to
feel special about themselves and became more confident. The English learning
activities encouraged them to be eager in learning new things and different culture.
However, they are still need a lot of help in identifying future orientations. In adult
counseling sessions participants are gaining more trust in our counselor and
became easier to talk. Relating made them able to see the problems more clearly
and figure out a way to solve them.

Constraints
 The increasing number of children attending classes have increased children :
  teacher ratio
 Another agency in Ujong Tanjong is giving away food and money to the
  children, and some parents tried to make their children to go there instead of
  our play house.
 We have not yet figure out the appropriate approach for male teenagers.

Recommendation
 We recommend recruiting new teacher or breaking down classes.

                 MEDAN OFFICE                                       MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46                        JL. Gajahmada No. 79B
                 Medan — Indonesia                                Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844                      Telp: +62 655 700 6264
                Fax: +62 61 787 0844
 We recommend defining more strict rules for psychosocial activities to avoid
  destructive programs
 We plan to add more variety in the activities in addition to English class, such as
  outbound games, art therapy, and social skill enhancement activities to embrace
  male teenagers

Coordination
   Pesejuk Hatee and ICMC
To commemorate a year after tsunami, we coordinated with Pesejuk Hatee and
ICMC to conduct preaching sessions with mass praying at Beuregang which will
be held on December 28, 2005.

   Psychosocial Inspiring Banners
In coordination with other agencies, we produced banners with inspiring
sentences to be posted in the streets of Meulaboh. The collaborating agencies are
UNDP, CWS, District Health Office, Pesejuk Hatee, and ICMC.




                 MEDAN OFFICE                          MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46           JL. Gajahmada No. 79B
                 Medan — Indonesia                   Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844         Telp: +62 655 700 6264
                Fax: +62 61 787 0844
ABOUT IBU4ACEH

It has been almost a year since IBU4ACEH began its service for the tsunami- and
conflict-affected people in Aceh Barat. Because of the hard work and the initiatives
taken by the IBU4ACEH team, we gain more understanding on the overall
situation, the geographic topography and the real need of the IDPs as well as
affected people. We will develop new programs based on our annual activity
evaluation.

OFFICIAL CONTACT NUMBERS

Country Coordinator                              Project Manager
Dr. Ridwan Gustiana                              M.Fauzi
+62 812 211 9358                                 +62 813 1660 3488
junkjack@yahoo.com                               ojiexie@gmail.com

Program Director                                 Medical Director
Destrian Setiawan                                Dr. Hendra Gusti Lambe
+62 812 824 8674                                 +62 812 213 4356
baut12@gmail.com                                 hendragl_md@yahoo.co.id

Finance Manager                                  Psychosocial Director
Riki Gustiansyah                                 Fitriana Wuri Herarti, M.Psi, Psych.
+62 812 224 2582                                 +62 815 612 0228
ricky_gust@yahoo.com                             fitriherarti@yahoo.com

                                                 Livelihood Director
                                                 Robertus Paulus Gawe. ST
                                                 +62 813 1606 3735
                                                 roberto_sheva@yahoo.com




                 MEDAN OFFICE                             MEULABOH OFFICE
         Taman Johor Indah Permai II No. A46              JL. Gajahmada No. 79B
                 Medan — Indonesia                      Meulaboh 23617 — Indonesia
      Telp: +62 61 77 1054 77, +62 61 787 0844            Telp: +62 655 700 6264
                Fax: +62 61 787 0844

				
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