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Supported by Benefiz and American Overseas Medical Aid Association (AOMAA)
IBU4ACEH Meulaboh Office
Update – November 2006
Compiled and submitted by Annisa Rahmalia
OVERVIEW
Update – November 2006
Compiled and submitted by Annisa Rahmalia
OVERVIEW
We started activities in the second week of November. This is the last month of our agreement project of Health and Psychosocial service with Action Medeor from Germany. An incident happened during Idul Fitri holidays that interferes our program. There was massive flood at Cekok Marek barracks, and the IDPs must be relocated again (after being moved to the location in July from Keude Aron camp) to two locations, Peunaga Paya and Blang Beurandang. Apparently the flood happened because Cekok Marek was a swamp at the riverbanks and the river always rises when it rains. The relocation has not yet begun but activities were hindered because the waist-deep flood on the road made it impossible for any vehicle to get into the area.
PROGRESS OF ACTIVITIES
Health Program
Primary Health Service. Total number of cases treated this period is 1189 (last period 918), and total number of cases treated from December 2005 to November 2006 is 17,658, or 88.3% of the targeted 20,000 cases. The highest prevalence of illness was respiratory tract infections (27%) followed by skin diseases (12%).
* Static Clinic
Clinics opened five days a week at the MCU located in Ujong Tanjong Block 1. In Lapang II barracks the IDPs provide a vacant barrack for primary health service, because the MCU can no longer be used due to the loss of generator set last period. However, at the last week the barrack is not vacant anymore and we have to stop service until we get a new place. At Cekok Marek we had to cancel trip several times due to the flood. Total number of cases this period is 913 of 38 clinic operations (average number of consultation/day/clinic is 24).
* Mobile Clinic
After a long process and discussion with the head of Kajeung CHC in Sungai Mas sub district we managed to encourage them to hold two trips of outreach clinic service to two villages. It conincided with mother and child health service (posyandu) held by CHC staff under assistance from Medan Peduli, a local NGO. In Woyla Barat we went on four trips to different villages. Total number of cases at mobile clinics is 276 of 6 visits (average number of consultations/visit is 46).
Maternal and Child Health. The project of posyandu assistance at five IDP camps surrounding Meulaboh continues, while posyandu revitalization project at Woyla Induk sub district has finished last month. We believe that the integrated service for pregnant women and under five-year old children is a pointer of health status in community village basis.
* Posyandu assistance at IDP camps
Posyandu held at five IDP camps in three sub districts in Aceh Barat. Attendance of under five-year old children is 175 (last period 168) or 49.2% (last period 43.9%) of 356 children in the population. This was far below the expected target of 80%. There were 41 (23.4%) children gained weight (last period 44/26.2%), while the expected target was 60%. We found 40 (11.2% of total population) children with malnutrition, and reported the case to local CHC for further treatment. Attendance of pregnant women is 6. The number of kaders involved at Posyandus in all five locations is 29. Thirteen (44.8%) of them attended weekly kader training about posyandu reporting.
IEC Sessions. As a means of campaign we did regular on-air talk show every Friday morning at a local radio station. Topics raised this period were kidney stone, leprosy, and abscess.
Donation. During warehouse restocking we found unused drugs, some of them were donated during the emergency phase and was indispensable. We will donate several items to the hospital or our CHC partner, while the antibiotic injections will go to DHO to be redistributed.
Psychosocial Program
This period we started child, teenage, and adult programs at three sites in Woyla Induk sub district (Cot Lagan, Padang Jawa, and Blang Mee villages). There will also additional program of early childhood education, and we conducted workshop at the three sites regarding the importance of stimulating development and socialization in children under 5 years old. Accordingly, the program activities at our two previous sites (Beureugang and Ujong Tanjong barracks, Meulaboh) must be reduced because we did not have additional personnel.
Child Programs. The goals of activities are to improve children’s ability in the aspects of cognition, creativity, fine and rough motor, emotion, discipline, independency and introduced social gender role.
* Play and Learn (for 4-6 year olds)
Beureugang and Ujong Tanjong Barracks, Meulaboh
This period we had 7 sessions at both locations. Average daily children attendance was 12 out of 49 in Beureugang and 9 out of 43 in Ujong Tanjong. Children learned to write the numbers 1 to 5, and the letters A, B, C, D, and E. Other than writing exercise, we played with clay to enhance fine motor ability as well as stimulate creativity. Cards matching game is used to enhance cognition. To teach concentration we asked children to throw rings to a spike. We also made a play with dolls, where children can improve their linguistic ability while role-playing. To develop sense of social gender role, we let the children pick their own toys. Most girls picked dolls and played mother and most boys picked stuffed animal. Gross motor ability is enhanced through sport games such as badminton, ball, and playing hula-hoop. In emotional aspect, we used pictures to visualize various emotional expressions. Aggressive behavior towards classmates still happened every now and then, but we note that children had some sort of guilt and unease afterwards. We then encouraged them to apologize. More than half of the children now able to do tasks without asking for help. But all children can make their own decisions in doing activities and are confident enough to lead prayers as well as sing in front of the class. We still keep the rules of coming on time, take a shower, no eating in the class, and pray before starting lessons, and more children are getting accustomed to it.
Cot Lagan, Blang Mee, and Padang Jawa villages, Woyla sub district
We only had one session of Play and Learn at Cot Lagan and Padang Jawa. Number of participants was 18 and 21, respectively. In Blang Mee we had two sessions and the average of attendants was 25 of 34. We explained the rules, schedules, and learning material to the parents. On the first meeting with children, after introducing everyone’s names we did some physical
* Children Group Counseling (for 6-12 year olds)
Beureugang and Ujong Tanjong barracks, Meulaboh
There were 7 sessions in Beureugang and 7 in Ujong Tanjong this period. Average daily children attendance was 16 out of 60 in Beureugang and 38 out of 93 in Ujong Tanjong. We note that some of the children who could not complete simple math equation last period gained much improvement after paying attention to our explanation. For those who still performed poorly, we note that they had difficulty to concentrate. To enhance their concentration ability, we played with rings and spikes. Children must throw rings to a spike located three meters away. Another exercise in concentration was combined with the activity to improve listening and reading comprehension as well as Bahasa Indonesia. Children must pick a book and read the story, then tell it in front of the class with their own words using Bahasa Indonesia. Around one third of the children use good Bahasa Indonesia while the others mixed it with Acehnese. The listeners must listen carefully because there are questions regarding the story told afterwards. Most of the children performed well in this activity. Another listening exercise is by dictating some sentences that should be written by the children. In English class, more than half of the children able to memorize the names of body parts in English.
Regarding Idul Fitri celebration, we emphasize on the topic of forgiving and emotional expressions related to that. Verbal aggression still happens more often than physical aggression, and we always remind the children and encourage them to apologize, particularly when they showed that they regret it.
Discipline training by applying rules has not changed, and more children seemed to get accustomed to the rules. We also note that the self-confidence of most of the children are quite good, because they are brave enough to step in front of the class to tell a story, sing, or lead prayers. Independency in doing tasks is always encouraged, by not helping them but asking them to try by themselves in all activities.
Cot Lagan, Blang Mee, and Padang Jawa villages, Woyla sub district
We held one session at Cot Lagan and Padang Jawa villages, with 12 and 42 participants, respectively. At Blang Mee we held two sessions, the average number of participants is 38 of 73. Most of the children can understand Bahasa Indonesia, but could not speak it. However, we managed to explain the Play House rules and taught them prayers to start and finish a session. To know their creativity and fine motor ability, we did some drawing and they did it well. To know their ability in reading we asked them to read a few sentences one by one. Children in 4th ato 6th grade were able to read well, 5 children in 3rd grade and most of the children in 1st and 2nd grade could not read well.
Teenage Programs. Goals of activities in teenage sharing and counseling are to improve cognitive (math, language, common sense, and memory) abilities, problem solving in everyday life, and in caregiver project giving them opportunity to contribute their psychosocial ability within the community.
Beureugang and Ujong Tanjong barracks, Meulaboh
The number of teenagers ever participated in any of our activities are 86 in Beureugang and 69 in Block 1 and 4 Ujong Tanjong, but average daily attendance was only 8 and 7, respectively. This is probably due to clique issue; they seemed to be reluctant to welcome teenagers outside their clique to join our activities.
Activity results in November:
* English Class
- We used the picture of a house and asked teenagers to mention as many English words as they can that are related to a house. We also played word puzzle using the words related to emotion. Then we had mime session where teenagers must make gestures indicating several emotions and the audience must guess the emotion.
* Creative session
- There is much excitement regarding our most recent activity: stitching. Apparently most of the female teenagers and even female adults enjoy it. Other than creativity, this activity also developed fine motor ability, concentration, patience, and diligence to finish one stitchwork.
- We introduced ribbon stitching in Block 4 Ujong Tanjong barrack. It is much more difficult and needs a lot of effort. But we keep motivating them to try.
* Cooking sessions
- In Block 4 Ujong Tanjong, there were many small kids coming during cooking session and they created a chaos, which annoyed the teenagers, when they wanted to try the donuts.
Blang Mee and Padang Jawa villages, Woyla sub district
Due to flood, we could not come to Cot Lagan village on the day scheduled for teenager activity. Therefore this period we only got the chance to start teenagers program in Blang Mee and Padang Jawa villages.
In Blang Mee, there were 11 participants. We introduced our staff and programs, and discussed the activities they desired to do with us. At the second session we made friendship band and half of them could proceed without further instructions. We had one session at Padang Jawa. We introduced our programs and asked about their every
day activities.
Adult Programs. The goals set for adult counseling are to make efficient use of peer helpers in managing women group activities and facilitate women group counseling to expand their knowledge and skills.
Ujong Tanjong and Cekok Marek barracks, Meulaboh
Due to the flood at Cekok Marek, we held no routine activity. At times when we can get into the area, the women asked about the start of activities and we decided to postpone every activity until they got settled in the new place. The only activities continued were peer helper training and several home visits to maintain good relationship.
Activity results in November:
* Creativity
* Focus Group Discussions (FGD)
- Topics raised at FGDs in Ujong Tanjong barracks were ‘Schedule of Routine Activity,’ ‘Psychological problems during pregnancy,’ and ‘Raising Children,’ which was a repetition requested by the women because they find it very useful.
* Peer Helper
- At Cekok Marek we had one session of peer helper training and we introduced the training subjects.
- We observed that the peer helpers at Ujong Tanjong did what they can to increase participation of women in their block.
Blang Mee and Padang Jawa villages, Woyla Induk sub district
We only had one session at each village and we use it to introduce our activities. Only a small number of women speak Bahasa Indonesia in both villages, and the others have poor ability in understanding Bahasa.
We could not come to Cot Lagan village due to the flood on the scheduled day.
On-air Counseling. We only had one session of on-air counseling at Dalka FM, and three at the other radio station. This is because in Dalka FM the time is used for campaign of local election.
The topics raised on the counseling were Depression in Teenagers, The Bonds of Friendship, Developing Social Skills in Teenagers, and Selecting Best Friends.
Psychological Assistance for Victims of Woman and Child Abuse. We participated in a meeting with UNICEF, DHO, and several NGOs to discuss referral system for woman and child abuse. As a follow up from the meeting we will provide psychological assistance to identified victims of woman or child abuse.
LOGISTICS
SUPPORT
In November we refurbished the wooden Play House at Beureugang.
For operational purposes we use two cars, one Toyota Kijang from Benefiz and another rental car Isuzu Panther Touring. We have no 4wd cars, but the high tires of Isuzu Panther make it possible to go to Woyla on most days (except when the muddy flood is too high). The
We moved to a new office, separated from the guesthouse. With a proper warehouse at the new office, we can arrange all stocks more neatly.
CONSTRAINTS
* Health Program
- Unavailabilty of definite location for clinic at Lapang II and Cekok Marek decreased service. It also created confusion among the community whether or not we open service.
* Psychosocial Program
- Our limited ability in Acehnese and the poor ability of people in Woyla to understand Bahasa Indonesia had been a major constraint in conducting activities. We will have intensive Acehnese learning and also teach them to speak Bahasa.
* Logistics Support
- We have three MCUs (mobile clinic units) idle and abandoned in a poor condition, because their relocation to the new barracks are hindered by unavailability of crane to lift them.
- We have a lot of expired drugs at the warehouse, because there is no certain policy regarding the disposal of expired drugs from the DHO.
RECOMMENDATIONS
* Health Program
- Providing suitable location for clinic service
- Additional human resource in Posyandu assistance program in order to increase community participation
- Human resource and fund to work on outreach health promotion
* Psychosocial Program
- Build a proper place for activity (a Play House) at Block 1 Ujong Tanjong