CARE International Indonesia

Despite the highest malaria rates in the country, the people of East Nusa Tenggara fight back

By Melanie Brooks

East Nusa Tenggara, 18/4/2007 --

Two days after giving birth to her second child, Maria Modesta Kolo contracted malaria. Weakened from a difficult pregnancy, it took her more than a month to recover; in the meantime, she couldn’t breastfeed, couldn’t care for her newborn.

“It was very hard to be away from my baby,” she said. “But I am healthy now and my baby is healthy. I know that malaria is very dangerous for pregnant women. And now I know how to protect myself and my children.”

Around her, a group of pregnant women nod their heads. They are attending a session of CARE’s Centre of Mother’s Education program in West Timor, which works with pregnant women to teach them how to prevent malaria and improve their health and nutrition during pregnancy and breastfeeding.

“If a woman gets malaria while she is pregnant, she could miscarry, have bleeding, anaemia, or the baby will be born with a low birth weight,” said Imelda Manurung, CARE’s Health and Nutrition Technical Specialist in East Nusa Tenggara. “Babies with a low birth weight can easily become malnourished or develop other health problems, which can mean that their physical growth will be small, intelligence will be less, and have possible mental problems.

“There is also a risk that the mother and baby could die.”
East Nusa Tenggara is a hyper-endemic area – malaria is present year-round, with the highest prevalence rates in the country. More than 40 per cent of the population is infected each year. With education and preventative measures, that number can go down, especially for pregnant women.

As part of the Centre of Mothers’ Education program, pregnant women in each village meet with CARE health cadres seven days a month to discuss how to keep their environment free of mosquito breeding areas like standing water, the use of bed nets, and how to be healthy in the home through proper nutrition, food preparation and personal hygiene.

In today’s session, the women are learning to use what little food they have available to cook a nutritious, balanced meal for themselves and their families. Good nutrition is essential for pregnant women, and it has the added bonus of helping people recover more quickly if they do get malaria.

CARE health cadres and pregnant women prepare a nutritious meal as part of CARE’s Centre of Mothers’ Education program.

Maria Modesta Kolo is one of hundreds of pregnant women across East Nusa Tenggara learning how to protect herself and her family from malaria

In today’s session, the women are learning to use what little food they have available to cook a nutritious, balanced meal for themselves and their families. Good nutrition is essential for pregnant women, and it has the added bonus of helping people recover more quickly if they do get malaria.

But in East Nusa Tenggara, one of the poorest provinces in Indonesia, grinding poverty makes the malaria situation worse. Many families already know the importance of a balanced diet, but they don’t have enough money to buy the food they need. Nearly every family in Mrs. Kolo’s village uses a bed net, but the nets are old and full of holes. New bed nets cost nearly 50,000Rp ($5US), well beyond the means of most families here.
CARE is working to help vulnerable people in villages like Mrs. Kolo’s fight the impact of poverty and the threat of malaria at the same time. In 36 villages, CARE’s MIAT project (Mitigation of Malaria for the Most-Affected Groups on Timor Island), funded by EC, trains health cadres to teach people how to protect themselves from malaria, supports Village Malaria Posts for early screening and treatment, provides antenatal care and education for pregnant and breastfeeding women and their children, and works with local governments and aid agencies to develop effective, lasting policies to fight malaria.

CARE is also distributing free, insecticide-treated nets to 15,000 children under five and 4,500 pregnant or lactating women, and helping people make malaria-fighting practices part of their daily lives through the use of inexpensive local solutions such as traditional mosquito repellant and removal of mosquito breeding areas.

“It is hard to keep the mosquitoes out of our homes,” said Mrs. Kolo, pointing at the large gaps between the slats of her bamboo hut. “But now I use a mosquito net and mosquito repellent. So even if mosquitoes do get in, we are protected.”

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Projects related to this feature story
	MIAT - Mitigation of Malaria for the Most Affected Groups on Timor Island

Sectors related to this feature story
	Health and Nutrition

Emergencies related to this feature story
	Assistance to East Timorese refugees in West Timor - 1999

Related documents or links
	Towards a better life