Tuesday 25 September 2018

Indonesia’s Famed Spice Islands Aim to Have ‘No Child Left Behind’ in MR Campaign

By Tomi Soetjipto

With a confidence of an army cadet, four-year old Jupe Rusmani stomped into a small-dilapidated room full of health workers armed with injection needles. Her poise surprised everyone, including Jupe’s Mother, Nor Rusmani, who stood outside smiling.
Armendo Fransesco received the Measles & Rubella vaccine
©Fauzan Yo/UNICEF Indonesia/2018

“What a brave little girl you are,” said one of the nurses before she injected life-saving Measles and Rubella (MR) vaccines on Jupe’s upper left arm.  Within seconds Jupe walked out the room and shook her head furiously when asked by her ‘aunties’ neighbours whether she felt pain from the injection. 

Buoyed by Jupe’s confidence, other kids followed her steps, including eight-year old Gloria Titahena who didn’t flinch her eyes when the injection needle rested on her bony upper arm. With a timid smile, Gloria then posed for a photograph while holding a sign in local language that says, “I’m brave, I just had a rubella vaccination ”. Another kid, five-year old Armendo Fransesco, a cheerful boy with shoulder-length curly hair, held up another sign that says, “Want to be healthy? Have a Rubella vaccination”
Mothers in Waimahu Passo, city of Ambon, took their children to receive Measles & Rubella vaccine
©Fauzan Yo/UNICEF Indonesia/2018 

It’s been an eventful day for the children of Waimahu Passo in  Ambon, capital of the Moluccas province.  On this recent September day, around 23 kids have been registered to receive MR vaccines, as part of a nationwide second phase campaign to immunize 31.9 million children. The first phase was done in the main island of Java in 2017, targeting around 35 million children. Lying at the eastern part of Indonesia, Ambon is part of the famed Moluccas islands, once a sought-after colonial destination due to their spices.

As of early September, around 50 per cent of children aged above nine months to below 15 years in Ambon city, or around 50 thousand have been vaccinated against MR. The port city is targeting around 114 thousand children whilst the provincial target stands at around 546 thousand.
Rosa Penturi is doing puppet shows and singing to relieve children's tension during the Measles & Rubella vaccine activity
©Fauzan Yo/UNICEF Indonesia/2018 

Waimahu Passo is not your usual neighborhood. The community of makeshift houses was built out of a dark chapter in Ambon’s history when it was engulfed in communal violence in 1999. All of the 300 residents living in this crammed zone lost their homes and belongings when mayhem gripped Ambon.

19 years on, the displaced community has made Waimaho Passo their home, with many finding jobs in the informal sector as vegetable sellers or motorcycle taxis.

Local NGO, Yayasan Pelangi Maluku, has been at the forefront of efforts to include marginalized children into the MR campaign.
 
“At first we informed community leaders about the government’s plan, then we visited the communities a couple of times, informing them about the danger of MR. So far it’s been a great,” said Rosa Penturi, Head of Yayasan Pelangi Maluku, her left hand is covered with a sock puppet.  Rosa has been giving puppet performances and sing-a-long sessions to ease children’s tension.

BUILDING TRUST WITH COMMUNITIES

Seated next to Rosa is the chief of Passo Puskesmas, Dr Eka. M. Susanti and she is a staunch supporter of “no child is left behind”. To achieve this goal, health officials have been working together with community workers, she said.

“It helps up building the trust with the communities…. this community doesn’t necessarily have the time to bring their kids to Puskesmas…we have to be pro-active in visiting them” said Dr Susanti, adding that they had held several immunization sessions in the same neighbourhood before.
Head of Passo Community Health Centre dr. (Med.) Eka M Susanti was with children, who received Measles & Rubella vaccine
©Fauzan Yo/UNICEF Indonesia/2018 

Moving inward to Ambon city center, to the densely populated area of Gang Buntu in Honipopu, a group of marginalized children gathered one afternoon to share their MR vaccination experiences. One of them was 13-year old Mutiara Palappesi, a grade eight student who received MR vaccination at her school, Alhilal Junior High School.

Mutia’s mother used to be a street sweeper before staying home to look after her 5-month old sister. Her father is now the sole breadwinner, working as a street sweeper and rubbish collector, bringing home cardboards that he can sell to junkmen.  During a conversation with Mutia, it was clear to see that she was well informed about MR. Though she may not know the technical terms, she was quite well versed in outlining the symptoms of MR.

But a sign of innocence was quite apparent when asked about her future goal, “ I want to become a PNS  (a civil servant)… I like seeing PNS people, because they are always on the move and they wear nice uniform.”

Mutia spends her evenings scraping extra income for the family.  Every evening she sells five newspapers in the main street of Ambon; for every sale, she gets a cut of 1000 Rupiah (USD 0.067 in September 2018).

Back in Waimassu Passo, all of the interviewed children were upbeat about their future. Jupe wants to become a doctor; Gloria sees herself as a policewoman and Armendo hopes to become a teacher.

Their road may be long and complicated, but the MR immunization is the first step in realizing their goals.
Brave Armendo Fransesco after receiving Measles & Rubella vaccine
©Fauzan Yo/UNICEF Indonesia/2018