Improve Health for Mothers and Babies in Myanmar

The distribution of baby kits to IDPs inside Karen state, Myanmar has brought great benefits to families and communities as women learn more about caring for their children and for themselves. Despite the ceasefire community workers continue to encounter obstacles as they move around between the villages and often reaching medical assistance can take days. It will take many years for proper, functioning health systems and infrastructure to be developed and in the meantime community-led health initiatives, like the baby kit project, are essential for minimizing the impact of the poor and under-resourced health programming of the central government.
Educating individual communities is certainly proving one way to counter these problems. We have seen how the distribution of the baby kits strengthens the capacity of people at district and township level as well as benefiting the women and babies. More and more women are becoming empowered as they improve their understanding of the issues relating to pregnancy and care for their babies. For example, some women said that before they attended these sessions, they never knew that the first milk is good for the newborn babies. They always used to throw away the first milk, and then they did not feed their child sometimes.

In the coming months, the project will continue to distribute a further 600 baby kits to displaced communities along with nutritional support and training.
The nutrition aspect of the programme provides women with 1kg of beans every month from their 3rd month of pregnancy. Women feel the immediate benefit of this because there is a good deal of ignorance in about nutrition. Few mothers are aware that some foods affect the growth of the baby.
One mother of 29 years old, living in Hpa-An district in Karen state has 2 children. She received the baby kit package with health message for the youngest one. She said that by joining the nutrition awareness raising session she found out that there are certain foods that are good for pregnant women, foods that she used to believe were not good for pregnant women to eat such as eggs and some wild vegetables. There is the mistaken belief in the community that eggs can make the baby fat and it will be difficult for them to deliver the baby. She also learnt that there are certain kinds of wild or farmed vegetables that you must avoid during your pregnancy because it will make your baby sick or weak. She said “I am very happy that I joined the awareness raising session and I can share this information with other women so that it will help other babies. There are still stereotypes in our community, which will need constant health awareness raising to reduce this kind of wrong thinking.“

As donors prioritise development projects inside Myanmar RIJ continues to support those communities that are being neglected.

‘This project report is a submission to GlobalGiving’s 2017 Fail Forward Contest, where organizations are asked to share a story of when they tried something new that didn’t go as planned and how they learned from it. Enjoy!’

Unlike many other of the entries for the GlobalGiving Fail Forward contest, RIJ's story is slightly different. Rather than a failure of results, we have learned from our failure to achieve full commitment to our core values.

For every challenge we have encountered over the past 38 years, we have learnt how to better evaluate projects to ensure that the three core principles of community, empowerment and sustainability are met in all projects. This is due to the lessons we have learnt through failure to achieve a lasting impact across all projects.

We strive to ensure that projects better reflect our core values that have been upheld firmly since RIJ was founded.

We now know that all RIJ funds do not merely provide quick, temporary aid, but they go well beyond that, providing refugees with the means to improve their lives and community for the long term. Our funds empower refugees and their community, providing hope and opportunity to help build a brighter and better future for them and their families.

Two examples can be found in projects we support on the Thai-Burma border. As a result of years of persecution and violence committed in their home country, many refugees have been living in camps on the border for 20 years or more. One of the primary projects that RIJ has had a close partnership with for many years has been the provision of baby health kits to mothers living in refugee camps and those living within Karen State in Burma.Through decades of neglect, the government health system now ranks among the worst in the world and rates of maternal and newborn child mortality are some of the worst in the world.

This project initially addressed this issue, by providing kits containing baby and laundry soap, nappies and sarongs. This ensured that mothers and their new-born children’s basic hygiene needs were met within these camps. However, the results were not far-reaching and lacked sustainability. It was felt that more attention should be placed on ensuring sustainable solutions for maternal health issues within this region. The first step was the inclusion of a health message in the kit, providing guidance on looking after the baby as well as the mother. For most of these women, before this, they had received little to no antenatal education about pregnancy, birth and caring for a newborn, so the leaflet had a big impact on the long-term health of mothers and babies. Then in 2014, RIJ funding included a 14-day women’s health training workshop. By establishing training workshops alongside the existing project, RIJ ensured sustainability and continuity as women were given the skills and resources to empower themselves and their community, understanding how to care for themselves ante and post-natally, as well as look after their newborn baby.

Naw Ma Hei Paw, a young mother who was involved in this project, said “When I delivered my baby, I got a baby kit. It was very valuable for me. The kit fulfilled my needs and really helped my family. I was so happy that a tear came out when I saw it. In the past, I have never cleaned my babies with soap, I cleaned them with fruit. This is the first time I can clean my baby with soap and I can see she is happy and healthy. I hope the project will continue to help other mothers and babies”.

The other example is an addiction programme in camps along the Thai-Burma border for refugees with drug and alcohol addiction. Originally the clients underwent a course of treatment that achieved good results at first but people found there were few opportunities beyond the treatment. The programme now includes community worker training and many former clients have become community workers. They have an important role in the community and feel they are contributing to the common good and providing a positive role model for others.

One client said: “The things that has kept me from slipping back, is my determination to be a valuable part of the community, and the promises I made to my family. For the future I want to avoid all the bad things that could make me fall back into abuse.”

Through these challenges, RIJ has emerged as a stronger organisation that is having more impact both through direct and indirect beneficiaries within refugee communities around the world. Where we saw shortcomings in the support provided, we learnt to strengthen our support to ensure sustainable and durable solutions. This has taken us forward to make a more lasting impact in the distribution of funds.

At a time when many NGOS are withdrawing support from the region, your generous donations are even more vital to ensure that women and their babies in camps in Myanmar can get a good and safe start in life.

Increasingly more and more donors have been withdrawing from the area along the Thai/Myanmar border, but the essential healthcare support, like these baby kits is still needed. While we understand the needs of those within other states of Myanmar, we know that refugees living on the Thai border and in IDP camps near the border still face challenges of normal living in camps with inadequate supplies. Although there is an official ceasefire in place, there is still a lot of violence and the military have many bases in villages, as well as large numbers of landmines that need to be cleared, before people can feel it’s safe enough to return home.

Children born in camps and settlements with poor provisions such as safe water supplies and inadequate toilets are most likely to die within the first five years of life. In Karen state, where these camps are based, the rate of maternal and neonatal mortality is one of the highest in the world and these baby kits provide essential support to give both mother and baby a better chance at surviving.

Through decades of neglect, the government health system now ranks among the worst in the world. Community based projects like this are essential to address the dire situation and the rates of maternal and newborn child health. It is likely to be years, if not decades, before a fully functioning health system is in place.

The baby kits provided in this project make a huge difference to people’s lives – not only through improved support at birth, but also in the longer term as mothers learn how to nurse their babies and teach others along the way. Providing mothers with basic nutrition and training community workers extends the benefits into the wider community and reaches more and more people each year. Women learn that certain foods can counteract the benefit of other foods and learn that certain wild vegetables can actually be harmful to them and their children. This is a benefit that goes beyond the immediate purpose of the project. The psycho-social aspect of this project is also valuable as it makes mothers feel cared for and alleviates the loneliness of giving birth in strange surroundings.

One mother said, “I am so happy that I can share this information with other mothers. We need such health awareness training to reduce this kind of wrong thinking.”

With your kind support, RIJ can continue raising global funds for local projects like this. Through RIJ, you can support sustainableprojects that work at a local level in communities to empower refugees to build a brighter and better future. Thank you.

Recently people have a little more freedom to move around in Karen State, Myanmar, but there are still problems such as the danger of land mines and indiscriminate attacks by soldiers. Medical facilities continue to be limited and it will take years for proper functioning health systems to be re-established. We can only imagine the anxiety that new mothers face if they have to give birth without the assistance of a birth attendant or doctor.

The baby kits funded by RIJ, while providing important support, also feel like a gift that can make people feel quite special. This promotes a ‘feel-good’ factor that encourages the mothers to listen to the health information provided in the health message that teaches them how to care for their baby and themselves. In turn, this must impact the baby because it gives the mother better peace of mind before giving birth.

The kits contain simple things that many of us take for granted: soap, washing detergent, nail clippers and baby wraps. We can learn from this too – sometimes our lives are too complicated!

Provision of the kits is far more effective than providing cash support because it makes the mothers feel special, it makes them feel someone cares and the information provided through the health message ensures the mothers continue to care for their children, themselves and the rest of the family.

Purchasing the kits locally further empowers the community workers as well as providing business to the local traders. This, in turn, avoids extra transportation costs.

The people distributing the kits gain the confidence of the community because they are bringing support and assistance. Through this they can learn more of other issues and challenges facing the community and understand how to provide further support to the displaced communities.

"It really helped the family who got the kits to keep the whole family clean and healthy and reduced the burden of the family needs."

"KWO staff members at different levels are able to manage more work in the community through the experience they learned by implementing this project activity and increased their skills in management and negotiation within the community."

We appreciate your valuable support that enables us at RIJ to continue our work that creates opportunities for people to live as normal life as possible despite the challenges they face.

Your generous support has ensured women living in camps in Myanmar have received baby kits with essential health and hygiene items to give their newborns a good start in life.

One of the mothers who received the kit said:
"While we are displaced we don't have enough clothes or food or shelter. We have to move from here to there. In this time we received a gift so it made us feel so happy. Even if we received only a piece of cloth and a bar of soap, I feel so happy and I feel like somebody cares for me and is willing to help me, even to go through all the obstacles to get to me. So I felt very encouraged."

It is important to just feel that someone cares. Giving birth is an exciting but traumatic experience at the best of times. These women are living in camps in very tough conditions in the jungle, in small houses made of bamboo with leaf roofing. For those who find themselves without any support, it is even more worrying.

The provision of baby kits to new mothers goes beyond just caring. The health leaflet that accompanies the distribution of the kits provides guidance on looking after the baby as well as the mother. For most of these women, they will have received little to no antenatal education about pregnancy, birth and caring for a newborn, starkly compared to the overabundance of information and educational courses available to mothers in more developed countries.

The distribution of the baby kits is clearly improving the health of babies and their mothers. For example, one mother we met explained how she had learnt about the different cycles of breast milk production which removed a huge amount of anxiety when feeding her baby. Another mother had never used soap for her babies before, instead cleaning her previous babies with fruit.

The program’s reach is more than direct support to the mother and her baby and having positive effects on the wider family. In the words of one camp leader;
"Because we are able to distribute Baby Kits our whole community benefits. Even if some mothers only received a few items, the whole family feels better."

With your kind support, RIJ can continue raising global funds for local projects like this. Through RIJ, you can support sustainableprojects that work at a local level in communities to empower refugees to build a brighter and better future. Thank you.