The following piece appeared in Essentially MIDIRS news, Vol 5, no 1, pg 24
Pregnant women who survived Typhoon Haiyan, which struck the Philippines on 8 November last year, are still at risk following destruction of health care facilities and the displacement of an estimated 4.4 million people (UNFPA 2013). The United Nations Population Fund estimates that 230,000 pregnant and 156,000 lactating women have been affected by the typhoon in a country that sees 865 births every day, of which 129 face life-threatening complications (UNFPA 2013). So whilst the Philippines may not still be hitting the headlines, the vital relief effort continues.
UNICEF and the World Health Organization (WHO) have united to stress the need to promote and protect exclusive breastfeeding in order to minimise the onset of infections in babies (UNICEF 2013). They estimate that prior to the typhoon, nine out of ten babies under the age of six months old were breastfed to some degree and about a third were exclusively breastfed. Both organisations underlined the need to support the transition to exclusive breastfeeding and discouraged the distribution of formula. Dr Julie Hall, a WHO representative in the Philippines stated: “The uncontrolled distribution and use of infant formula in emergency situations like this — where there are serious water and sanitation challenges and other disease risks — is extremely dangerous. Supporting breastfeeding is one of the most important things we can do to protect babies in areas of the Philippines hit by the typhoon”.
The organisations both stressed that health workers should explore every other option — such as supporting mothers who are not breastfeeding to reinitiate exclusive breastfeeding, finding a wet nurse or using breast milk from a milk bank — before resorting to formula feeding. Community leaders have been asked to report any donations that could undermine breastfeeding.
Other ways of fighting disease and infection include the Philippine government’s campaign to vaccinate all children in affected areas under five years of age against measles and polio. Children will also receive a supply of vitamin A supplements, which — like breastfeeding — should boost immunity and reduce the incidence of infections.
A spokesperson for the United Nations Population Fund based in the Philippines estimated that 60% of women in the Philippines gave birth in health care facilities prior to the typhoon (IRIN 2013), but with damage to facilities in affected areas varying from 50-90% (OCHA 2013), coupled with displacement on a large scale (including midwives), this figure is expected to drop radically. Not only are increasing numbers of women left to give birth in unsanitary conditions without experienced or medically trained help, but in the chaos it is difficult for women to obtain adequate antenatal care that may identify problems before they become critical. This leaves pregnant women particularly vulnerable in these situations and often results in a rise in poor outcomes. For example, pregnant women in evacuation centres rely on food rations and donations and may be unable to obtain adequate nutrients for their unborn child, increasing the rates of infant morbidity and mortality (IRIN 2013). The shock and trauma of being caught up in a disaster may also lead to an increase in the number of preterm births, which also decreases the baby’s chances of survival, particularly where insufficient care is available (IRIN 2013). It is therefore vital that the relief effort continues.
How to help
To find out more about the problems facing pregnant women in the Philippines, or to make a donation, go to the UNFPA website: www.unfpa.org
For those interested in volunteering in areas affected by armed conflict, epidemics or natural disasters, go to the Médecins Sans Frontières website: www.msf.org
IRIN (2013). Maternal healthcare struggles for survival after Typhoon Haiyan. http://tinyurl.com/o92xno2 [Accessed 2 January 2014].
UNFPA (2013). Philippines Typhoon Haiyan. http://www.unfpa.org/public/home/donate [Accessed 2 January 2014].
UNICEF (2013). Breastfeeding is life-saving for babies in Philippines typhoon emergency http://tinyurl.com/qgsgw3r [Accessed 2 January 2014].
UN Office for the Coordination of Humanitarian Affairs (OCHA) (2013). MIRA: multi-cluster/sector initial rapid assessment Philippines Typhoon Haiyan, November 2013 http://tinyurl.com/pk97ymx [Accessed 2 January 2014].