Going all out for every child: East Java's success in the Measles-Rubella campaign

By UNICEF Indonesia

East Java Governor Dr. Soekarwo (centre) helps one boy with his MR vaccine at an Islamic boarding school in Madura, East Java ©Office of the East Java Governor/2017

Surabaya: As Indonesia’s largest-ever immunisation campaign draws to a close, it is clear that its success is due to strong government leadership and committed partners working together.

The 2017 Measles and Rubella (MR) vaccination campaign aims to immunize 35 million children aged 9 months to 15 years old across Java Island, where half of Indonesia’s population lives. 

Led by the Government of Indonesia, with support from partners such as UNICEF, GAVI, the Indonesia Ulema Council (MUI) and others, planning for the two-month campaign began many months prior to the 1 August launch to ensure the ambitious targets were met. 

The campaign in East Java Province typifies this collaborative approach, as strong leadership by the provincial government has been instrumental in enabling the province to exceed the  benchmark set down by the central government of  95 per cent coverage. 

Community-based management of acute malnutrition: A new hope for children

By Blandina Rosalina Bait, Nutrition Officer

Disan Tallo with his mother, Yustina Tallo @UNICEF Indonesia/2017/Blandina Rosalina Bait

“If I had agreed to enrol Disan in the Community Based Management of Acute Malnutrition (CMAM) program earlier, he would have gotten healthy faster,” said Yustina Tallo, mother of 15-month-old Disan Tallo, in a small village in East Nusa Tenggara Province.

Yustina still feels guilty remembering how she rejected the diagnosis of ‘severe acute malnutrition’ by health workers at the puskesmas, or local community health centre, just a few months back. She found it difficult to believe them; though Disan was often sick with flu, diarrhoea and fever, she was confident he was, at root, just as healthy as his 8- and 5-year-old siblings. 

UNICEF is working with the Ministry of Health, local government authorities and Action Against Hunger to educate parents about the link between good nutrition and growth, and to bring counselling services from health centres directly to the homes of children in need. These initiatives form the core of the CMAM model.

In Disan’s case, Yustina was already 12 weeks pregnant when she found out she was carrying a child. He was born premature, weighting just 2.1kg at birth.

For the first six months, Disan was exclusively breastfed. Then Yustina began adding complementary foods like porridge and soft vegetables. But  Disan fell ill often, and trips to the puskesmas became nearly routine.

During these visits, health workers told Yustina that Disan was likely suffering from severe acute malnutrition, for which the foods he was eating were an insufficient remedy. 

Eventually, after two months, they persuaded her to enrol Disan in the CMAM programme. As a first step, Disan was given Ready-to-Use Therapeutic Food (RUTF), a peanut-based paste enriched with essential vitamins and minerals. However, shortly after starting the feeding programme, Disan fell sick. Yustina blamed the RUTF, and subsequently discontinued the programme. 

After a few weeks, health workers noticed Disan wasn’t gaining weight. In line with the CMAM mandate, health workers visited Yustina at home and coached her on the benefits of RUTF, explaining that Disan’s sickness was not related to the RUTF but was a symptom of another illness. 

After repeated visits from health workers and Action Against Hunger employees, Yustina agreed to see the programme through. Soon, Disan began gaining weight, which motivated his mother to bring him to the puskesmas for weekly visits. Today he has mounted a full recovery, and is a happy, healthy, energetic young boy.

“I cannot imagine the result if I had ignored treatment for Disan,” she says. For Yustina, the CMAM programme is a new hope for families with severe acute malnourished children.

“I can’t say enough about the health workers who never gave up trying to convince me to enrol Disan in the CMAM programme, and who did home visits to motivate me to feed him appropriately and provide continuous counselling,” she said.

With the grassroots health initiative now in full swing, more and more children like Disan will be reached with lifesaving nutrition support through the CMAM programme.

Ibu Federica is setting the tone for education in Tanah Papua

By Saskia Raishaputri Moestadjab

Ibu Federica sits in the greeting room at Santo Rafael © Saskia Raishaputri Moestadjab//UNICEF/2017

Timika: "I am aware of my role and duty. I am a teacher. Being aware of those obligations is what I share with my fellow teachers, that a teacher is coming to school not merely to teach. If it were like that, a junior high student could do the job." 

Ibu Federica Lope, from Santo Rafael primary school in Timika, Papua, is not your typical principal.

RapidPro: a secret weapon behind the Measles-Rubella campaign

By Cory Rogers, Communication Officer

Fatul and Akhsan show off Akhsan’s purple thumb at the village health post, indicating he’s has already received his MR vaccine  © Cory Rogers / UNICEF / 2017

Semarang: “Akhsan’s mother works at the garment factory during the day, I work nights,” says Fathul in Regunang, Central Java, a shady, rolling village in sight of Mt. Merbabu, a 3,145m volcano rising slowly from the hills. 

“It’s just me here today.”

He and 3-year-old son Akhsan are the lone father/child pair on the lawn of the village health post, but they are at ease; like the 30 mother/child pairs, they’ve come for Measles and Rubella (MR) vaccines -- two diseases that, while entirely preventable, can be deadly to children. 

“Did it hurt? Fathul asks Akhsan, who is busy watching throngs of toddlers in various stages of fear and relief, seemingly amused by the commotion. Akhsan shakes his head no. “He didn’t cry once! Fathul boasts. “Not once!”