Recent Emergencies: Impact on breast feeding – Tsunami and
Conflict Experience in Sri Lanka
Dr.Vinya S. AriyaratneExecutive Director
Sarvodaya Shramadana Movement Sri Lanka
Recent Emergencies: Impact on breast feeding – Tsunami and Conflict Experience in Sri Lanka
• Introduction – Recent Emergencies in Sri Lanka
• Breast feeding – best practices and Sri Lankan context
• Tsunami
• Conflict
• Conclusions
Recent emergencies in Sri Lanka
• Natural Disasters– Floods– Cyclones– Landslides– Droughts– Tsunami
• Human-induced– Armed Conflict
Sri Lankan context
• Need to analyze in the larger context of health and social development in Sri Lanka
• “pre-emergency” status of the population
Tsunami – December 2004
Tsunami Disaster, 26 December, 2004
Last updated :16.00 hrs As at : 21/02/2005
Province District Affected
Families
Displaced
Families
Displaced Persons Deaths
Injured Missing
Damaged Houses No. of Camps
In Welfar
e Center
s
With Relatives and Friends
Total Completely
Partially
Northern
Jaffna 14,767 10,827 7,625 33,381 41,006 2,640 1,647 540 6,084 1,114 12 **
Killinochchi 2,297 407 0 1,603 1,603 560 670 0 246 - 0
Mullaitivu 6,745 6,007 11,993 10,564 22,557 3,000 2,590 421 5,033 424 23
Eastern Trincomalee 30,547 30,545 14,853 59,208 74,061 1,078 1,328 45 4,830 3,835 34
Batticaloa 63,717 12,494 22,002 35,047 57,049 2,975 2,375 346 13,530 5,839 36
Ampara 58,729 38,866 24,179 75,322 99,501 10,436 6,581 161 18,889 8,641 55
Southern
Hambantota 14,069 3,334 1,803 45,195 46,998 4,500 434 1,341 2,303 1,744 11
Matara 19,398 2,235 2,873 6,405 9,278 1,342 6,652 608 2,362 5,659 22
Galle 24,583 23,278 2,633 119,301 121,934 4,248 313 564 7,032 7,680 27
Western
Kalutara 9,433 7,059 2,420 32,527 34,947 279 401 69 2,683 3,835 12
Colombo 9,647 8,140 5,446 30,614 36,060 79 64 12 3,388 2,210 26
Gampaha 6,827 308 876 573 1,449 6 3 5 278 414 2
North Western Puttlam 232 18 66 66 4 1 3 23 72 2
Total 260,991 143,518 96,769 449,740 546,509 31,147 23,059 4,115 66,681 41,467 262
Displacement due to Tsunami
Caring for Tsunami IDPs“Waves of Compassion”
• Immediate response by the community first wave of compassion
• Local organizations and volunteers second wave of compassion
• External aid agencies third wave of compassion
Provision of Health Care for the Tsunami IDPs
• Swift response by government and non-governmental organizations
• Exemplary performance by MOHs managing health issues with completely destroyed infrastructure
Breast feeding status post-tsunami
• Media appeals for infant formula and bottles giving a wrong message to the public, donors as well as to the affected population.– ie. Women are no longer able to breast feed because they are
“traumatized”.• No national guidelines were in existence at the time of
the Tsunami.• 18 Days after the Tsunami, the Family Health Bureau
(FHB) issued comprehensive Guidelines.• January 2005 study covering 40 camps revealed most
mothers continuing breast feeding with out any problems. Others who were giving formula feeding found difficulties.
Observations by stakeholders
• High rates of bottle/formula feeding in non-emergency times
• Inadequate policy implementation• Few government and NGO staff trained in or
knowledgeable about infant feeding during emergencies
• Unsolicited donations of formula/milk powder• Unsuitable foods for complimentary feeding
during emergency food distribution
Conflict-induced emergency
• Qualitatively different to a natural disaster induced emergency
• Pre-displacement health and social status
• During displacement• Post-displacement –
conditions in the IDP camps
A New Reality
"
Shelter Water Sanitation &
Hygiene Food and Nutrition Health Child Care Psycho-social Care of the
Vulnerable Groups
Needs
Integrated Services
• Food – Communal cooking• Nutrition Rehabilitation Programme• Water Supply• Sanitation• Mobile Medical Service• Mobile Library Service
Communal Cooking
Water Supply
Sanitation facilities
Mobile Library
Mobile Medical Unit
Observations on breast feeding/infant feeding
• Unsolicited (?) donations of infant formula
• Medical staff not fully knowledgeable on infant feeding in emergency setting
• World Breast Feeding Week – August – Training for the medical staff– Useful but with limitations
Conclusions and recommendations
• Need for capacity building in all sectors for effective IYCF during emergencies
• Complete ban of unsolicited donations of infant formula and feeding bottles
• Vigilance against promotion of infant formula
Thank You!
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