THEME

Maternal and Child Health Care in Natural Disasters

BACKGROUND

Between 1995 and 2005, over 2.5 billion people were affected by natural disasters. In 2006, three-quarters of more than 21,000 deaths from natural disasters were in Asia. The continent is the area most hit by the disasters, creating a huge need for emergency assistance.

Dr. Thoraya Ahmed Obaid, Executive Director of the United Nations Population Fund (UNFPA), stated in 2005 that “The lives of up to 7 million women, children and newborns can be saved each year if proven and cost-effective interventions are expanded to reach those in need. We are committed to working together to scale up action to achieve Millennium Development Goals [MDGs] 4 and 5 to dramatically reduce child and maternal mortality by 2015. This is a major effort, and no one agency can do it alone. Commitment and partnership are essential.”

UNFPA believes that in relief efforts during natural disasters, the support to women and youth must be an urgent priority and not a secondary concern. This constitutes a critical investment in the rehabilitation of families, communities and societies and greatly speeds recovery and reconstruction. As such, in times of disaster, it is necessary to ensure safe childbirth and reestablish maternal health services where they have been devastated - to provide basic services including water, sanitation, food, health and protection, and also psychosocial support to survivors of natural disasters.

In the early morning of 17 January 1995, the city of Kobe (1.52 million inhabitants) and its surrounding urban areas were devastated by the Hanshin Awaji Great Earthquake. It killed 6,434 people, including 4,571 residents of the city, and destroyed 249,180 houses. In addition to the normal relief efforts by police, the Self Defense Force, doctors, rescue and health care workers were dispatched from the Central Government, prefectural governments and other local authorities to Kobe, and many volunteers rushed to the city from all over Japan and from abroad. The city had the task of organizing the volunteers into such activities as delivery of relief supplies, assistance at the shelters, preparation of hot meals, and nursing care. The number of volunteers involved over the 13 months after the earthquake is estimated at about 1.4 million in total. Organizing the volunteers as well as managing the official relief and reconstruction gave the city administration valuable experience. After the earthquake, the Kobe City Government reviewed the lessons learned and established a department for general crisis management. This gives the city greater capacities in the future to manage natural disasters and maintain a city with security and peace. It also gives the city valuable experience that it can share with others.

With this in mind, AUICK held its second 2007 workshop with the theme of ‘Maternal and Child Health Care in Natural Disasters’ from Monday 27 August to Friday 7 September 2007, in Kobe, Japan. The workshop was funded by UNFPA.

AIM

The aim of this workshop was to facilitate the presentation of the knowledge and the experience of representatives from Kobe City to relevant officials from AUICK Associate Cities (AACs). Recognizing that many of the AACs themselves have experienced natural disasters and have learned useful lessons from that, the workshop was also designed to provide AAC officials with the opportunity to learn from one another as well as from the experience of Kobe. The exchange and sharing of knowledge and experience were conducted in the form of presentations, case studies, site visits, and discussions on current situations and challenges which each city faces. Each participant developed a concrete action plan regarding maternal and child health care service in emergency situations during natural disasters, to be carried out upon his/her return to his/her city.

PARTICIPANTS

The workshop was designed for top or middle-level city officials who had authority to plan and implement policies and actions directed at maternal and child health care or crisis management from 9 AUICK Associate Cities: Chittagong (Bangladesh), Weihai (China), Chennai (India), Surabaya (Indonesia), Kuantan (Malaysia), Faisalabad (Pakistan), Olongapo (Philippines), Khon Kaen (Thailand), and Danang (Vietnam).

Countries are listed in alphabetical order.

PERIOD

From Monday, 27 August – Friday, 7 September 2007

SCHEDULE/PROGRAM

REVIEW

As with all AUICK workshops, the participants of the Second 2007 Workshop were asked to give their comments on all of the components of the workshop.  This provides AUICK with the necessary information to further improve its workshop strategy.

As a whole, the Second 2007 Workshop was praised for the way it gave participants opportunities to interact with one another, as well as with the city of Kobe, regarding provision and experience of maternal and child health care, especially during natural disasters.

As Kobe City had experienced such a major natural disaster in the 1995 Hanshin-Awaji Earthquake, the task of providing health care at that time was presented through various site visits and lecture presentations.

Particularly praised by participants, was the visit to Hyogo Prefectural Kobe Children’s Hospital, and its “very good coverage and fantastic explanation” of the complexities concerning newborn children’s health, and the necessary responses that a children’s hospital should make.

Also praised were the innovative MCH equipment and nursing strategies, which were explained at the Kobe City Nursing School by Dr. Masayo Takada’s presentation “Maternal and Child Health Care – Lessons learnt from the Great Earthquake”.

The open discussion at which workshop participants and invited experts exchanged views with citizens of Kobe, UNFPA Deputy Executive Director Dr. Mari Simonen and AUICK International Advisory Committee members, was described as “very beneficial”, in that it was a forum for direct interaction with citizens who are the recipients of MCH provision, as well as the chance to hear the views and guiding principles of UNFPA.

The formulation of Action Plans for MCH services in natural disasters was described by participants as a good chance to listen to various cities’ plans, to “widen the horizon and help us to implement or adopt good things from every city and incorporate them in one’s own action plan to improve it.” This was due to the policy of participants presenting their action plans at each stage of development, to facilitate further guidance and improvement.

Overall, the workshop was praised as giving all its participants “ample time to air one’s views, opinions and suggestions”.  Moreover every participant took the suggestions “very well and in a positive way”.  Even participants from areas where natural disasters are not a regular occurrence saw the workshop as giving “a lot of insight about disaster management” and as a means to ”adjust” both health care provision and natural disaster preparedness upon returning home.

Recommendations included more of a focus on the one-on-one institutional relationship with each of the nine AUICK Associate Cities, as opposed to the workshop-participant relationship, in order to “ensure the longer term goals of AUICK are met”, in terms of urban service improvement projects’ implementation in the AACs.

The pre-workshop preparation and assistance from AUICK and its invited experts were appreciatively remarked upon, and comments and recommendations will serve to achieve both improvement of future AUICK workshops and the realization of their goals.