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Sixteen months have gone by since Yayasan Balita Sehat (YBS) opened
its doors to the malnourished children of Cipete and Cilandak. The original
idea to boost the nutritional intake of children under five years old,
has expanded into a far larger community based Sadly, some of our original expatriate volunteers have left us for overseas postings elsewhere, but all our original national staff have remained with us, forming a tightly knit group of loyal members involved in every aspect of running the Yayasan's activities:
Information on Yayasan Balita SehatSeventy children now have access to our early learning centre at YBS. Classes are divided into age related groups from two and half years to five years of age. It is not just children on the malnourished list who attend the preschool. Also encouraged to enrol, are those children who live nearby and who are from very modest backgrounds. The kaders (local community helpers) attached to YBS, know the local population very well and maintain strong links with community leaders. They therefore know which families have children eligible to join the YBS pre school. In an effort to start bringing money into the Yayasan, parents have started to pay a small fee of Rp 4000 (approx 33p) per term for their child. For those parents who cannot afford it, the fee would be waived, but so far, this has not been necessary. The money raised in this way will be used to buy essential educational equipment such as paper, crayons, pencils etc. Two pre school teachers employed by YBS, are helped by two volunteers. They are responsible for organising a schedule of topics, which are taught on a monthly basis. For example, one month the topic could be the family, the next month transport etc. Simple health lessons are taught: for example how and why to brush their teeth. Painting, gluing and jigsaws are all popular activities. After a snack and a glass of milk, it is playtime outside where the children have access to swings and a slide. The final activity might be a singing/musical session or storytelling session. A tape recorder has been a valuable asset together with tamborines and other musical instruments. The younger children have a less structured teaching session: mostly learning through supervised play and song. We have many toys and they enjoy being able to play with other children knowing that their mothers are nearby. They are also given a nutritious snack and a glass of milk after their activities have finished. Thanks to our SponsorsNone of the Yayasan's functions could have been started without our sponsors, and we greatly appreciate the support that our main sponsors Standard Chartered Bank have provided these last 16 months. However, the support also given by our other sponsors (which provide us with a third of the total running costs), is equally important and is just as equally appreciated. New Preschool opening in May 2002
The manager of the local mosque has agreed to let us use the mosque premises on some mornings. It is new and very light so a perfect place for children to play. A small house has also been rented, and this will serve as a base for the school. It not only allows the school to continue after 12 noon when the mosque will be used for prayers, but also allows the teaching of health, nutrition and hygiene classes for mothers. Eventually, the aim is to train up local kaders and mothers who would continue to run the preschool; the teachers moving onto a different area and starting the same process all over again. The mosque of course being free and a central part of the community is perfect for this kind of activity. We are very excited about this new venture. Feeding Program105 children are now on the YBS feeding programme and are being fed three times a week with a nutritious meal. They continue to be weighed once a month and their heights measured every 3 months. A professional nutritionist has now joined us on a volunteer basis and she is currently assessing the statistics we produce each month. There has been an improvement in some children's weights at YBS. Twelve of those who were originally on the red line i.e. were seriously below weight for their age, as defined by the WHO, have now reached their age expected weights i.e. are on the green line. A great success. Others have not been so fortunate, and these children we have taken aside and have undergone medical tests, only to find that they were suffering from TB or some other upper respiratory tract disease. Our volunteer doctor at YBS has liaised with the local puskesmas and all these children are now being treated with the appropriate drugs and their weights are slowly improving. Many children lost weight in the aftermath of the terrible floods we had in Jakarta in January and February of 2002. The incidence of illness rose and hence weights dropped. However, they seem to be stabilising again now. Statistics for April 2002The statistics for April 2002 show that of 109 children weighed, just
27 remain on the red line or below (very underweight), 40 are in the yellow
area (moderately underweight) and Of the 27 children who remain on the red line or below, 10 have been diagnosed as having TB, 5 are new children and the remaining 12 children are undergoing tests to see if they have an underlying medical condition. Their mothers will be interviewed individually by the YBS doctor to see if there is any specific reason why the child is not growing. If there is no noticeable chronic underlying medical condition, a visit will be paid to their homes to see whether their living conditions are contributing to their lack of growth. Underweight children and StuntingIf the children's weights are plotted against their age, as is done across the world, many of the children are still below their target weight and are considered to be underweight. Conversely, when looking at results comparing the children's' weight against height, most of them fall into an acceptable category and hence are not considered to be wasted (very thin). This is because they have stunted growth or are short for their age. The use of weight for age chart alone therefore can be misleading as it is confounded by low stature. The mechanisms involved in the development of low stature are not well understood, but it is believed that deficiencies in micronutrients (vitamins and minerals) from an early age play a role. Correcting certain micronutrient deficiencies e.g. vitamin A and iron are possible with supplementation, fortification of foods and change of diet. However as stunting is possibly caused by a multitude of factors, protocols for correcting this condition are not available. Simply, if a child is underweight and it's because they are wasted alone, correcting the diet helps to increase weight gain. If on the other hand they are underweight because they are stunted alone, it is difficult for the child to catch up growth. YBS is currently involved in discussions with the World Food Programme and Helen Keller International on the topic of stunted growth and the possiblility of starting a micronutrient programme. Nutritional Aims
Health EducationWe continue to test the local salt for iodine, using kits donated by UNICEF, and have found a wide variety of results. We have identified brands of salt on sale in our local warungs that contain the required amounts of iodine and our mothers are being encouraged to use them in their cooking. Lack of iodine in the diet of course produces a variety of medical symptoms, the best known being goiter, cretinism and low IQ. Children and their siblings, continue to be de-wormed at regular 6 monthly intervals and this also helps to increase their weights. At every feeding session they are taught that they have to wash their hands with soap before touching any food, and we have found that this tiny adjustment to personal hygiene has also played a huge part in reducing diarrhea and sickness amongst the children. Health and HygieneLessons continue on a weekly basis and are taken by our doctors. A variety of topics including basic nutrition, infant feeding, prevention of dengue fever, immunisations and the treatment of common medical complaints are covered. Cooking LessonsTwice monthly cooking lessons for mothers of children attending YBS
have started. Kaders, with help from the nutritionist, teach methods of
cooking foods that will provide the most nourishment for their families.
Only local cooking implements and food used by Recently, our teachers, kaders and administrator all took part in a 2-day first aid course donated by SOS International. They were taught CPR and first aid treatment for burns, fevers, drownings and many other topics besides. It was hugely successful and now our kaders can go on to teach mother basic first aid treatment. Help for Flood VictimsDuring the terrible floods earlier this year, many of our families suffered enormously. Families found that their houses, in common with many of the Jakartan population, were flooded up to the ceiling and cooking for their children was impossible. Whilst the worst phase of the floods was in progress, YBS kaders took it in turns to cook food twice a day, every day, in the kampungs. Luckily, within a week or so, in the areas of Cipete and Cilandak, the floodwater soon receded to manageable levels. But in the aftermath, many mothers and children suffered from eye infections, flu like symptoms, skin infections and diarrhoea, which our doctors were able to treat. A Child's Tale: Farida AmeliaAmelia started coming to pre school at Yayasan Balita Sehat on 5 May 2001, having just celebrated her third birthday. Her teacher Fauna has written the following report: “Amelia was very nervous of other mothers and children when she first started school and stayed with her mother all the time. She did not want to join in and play with the other children and found it difficult to share toys. Now, one year later, Amelia is 4 years old. She is much more independent, likes talking and is very friendly towards everyone. She loves playing with the teachers and other children and especially likes drawing. One of her pictures is shown here.” Income Generating Skills: Bags made from non recyclable materialsAmerican artist, Anne Wizer recently held an exhibition of her work that included, amongst other things, bags made out of used Caprisonne containers. This idea has now been expanded upon to provide income for a scavenger community and mothers of malnourished children at YBS. Scavengers and school children, collect the used containers (the scavengers being paid for their work) which are then washed and sent to Yayasan Balita Sehat. Here, our mothers handmake each bag individually using sewing skills they have already learnt during classes at YBS. They are paid per bag. They are also taught simple business skills which we hope will encourage them to set up their own business in the future. This is the beginning of a new venture providing an income generating scheme for both scavengers and mothers from poor backgrounds who wish to improve their childrens' health and wellbeing. Sewing classesThis sector of the Yayasan has grown substantially over the last year. Mothers of children who attend YBS were initially offered the opportunity of learning how to sew and learning how to use use a sewing machine. Eight sewing machines and an overlocker were purchased and classes began. It became clear very quickly, that it would take several weeks, if not months, before an acceptable standard of sewing was reached if these women were to sell products they made. Several local and expatriate teachers worked tirelessly to help bring standards of sewing up to a good level and they succeeded. There are now 15 mothers, divided up into two groups, a fast track group, and a slower group. Both groups thoroughly enjoy designing and making all kinds of different articles, which for the moment, they keep for themselves, but eventually, will sell. Cushion covers, napkins and tablemats, aprons, aqua bottle covers, tissue box holders, girls' dresses, baby blankets and mobiles. At the British Womens Association Xmas bazaar in December 2001, we sold 75 hand made mobiles for babies and all profits from this stall were returned to the mothers. We are aiming to have a similar stall, selling a greater range of products, at this years Xmas bazaar. Spotlight on Asih - our Office Manager
The most experience I have gained by working in Yayasan Balita Sehat is how to interact with people from different nationalities and backgrounds, both expatriates and local people, so I can practice my English intensively. I have also learnt how to operate and manage the office, makes sure the programs run well and am responsible for the staff. It is totally different from my last job. It is very challenging! The other reason that I like working at YBS is the flexible working hours, (so that I am still able to do my hobbies such as gardening and taking care of my favourite pets which are birds and fishes) and I also have the freedom to re decorate the office. I would not be able to do my job well without all of the committee's kind help, passion and understanding. I very much appreciate it. Thank you so much for this precious opportunity and everything.” History of YBS & Kemang Well Baby ClinicIn March 1997 the original well baby clinic was set up from a house in Kemang. The idea was to provide a support system for English speaking mothers, (be they expatriate or Indonesian) on their discharge from hospital having just given birth. Many women found that they just did not have the backup they needed to cope with a new baby. They wanted a place where they could get professional advice and meet other mothers with similar aged children. So the Kemang Baby Clinic was founded. Nowadays, the Well Baby clinic is still being held, but instead
of being based from a house, it is at YBS. One morning a week, volunteer
nurses and midwives see mothers individually and speak to them on a variety
of topics such as breastfeeding, weaning, and immunisations. Their babies
are weighed and measured and records are kept, both written and charted,
of their baby's progress. If there are areas of concern, Prior to YBS opening, mothers were asked for a donation when they attended each clinic, and these donations were collected and used to start up a feeding programme at Cilandak puskesmas. Hence our long association with that puskesmas and its kaders. A nurse from the Kemang Baby clinic would go and monitor weighing of Indonesian babies each month and work closely with the Doctor in charge. Kaders would be given food, paid for by the Kemang Baby clinic, and they would in turn, cook each day for the underweight children. Family planning days were sponsored and through other fund raising events, various pieces of equipment were bought for the maternity wing of the puskesmas : an obstetric bed, cots and beds for the post natal ward, fans, sterilizers for the labour room, needles and syringes an so on. Eventually, it was decided that a more permanent building was needed if larger numbers of malnourished children and their mothers were to be helped, and so the idea of setting up Yayasan Balita Sehat started. We still ask for donations from the mothers, and these are put towards the running costs of the Yayasan. Currently we have volunteer nurses and midwives from the UK, Australia and New Zealand, and ante natal classes are also offered as well as the weekly baby clinic. Gado Gado Ala Bule: a cookery book with a difference
For more information, contactYayasan Balita Sehat
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project
with education skills for both women and children being of
As
the early learning centre at YBS Cipete has been so successful, we have
decided to open another small pre school in Kabagusan, in the Pasar Minggu
area. Two more teachers have been trained up at YBS and in May they will
open the new school. This new pre school will work on the same principles
as our existing one in YBS Cipete but will be more community based. 72
children between the ages of 3.5 and 6 years are on the waiting list to
join. The new school is situated right in the centre of the kampung, making
it easy for mothers to bring children to school.
13
in the green area i.e. have reached their appropriate weight for age. When
the Yayasan started in January 2001, nearly all of 75 original children
The
main aim of the feeding programme at YBS is to teach both mothers and children
what a good balanced meal consists of. Hence affordable but nutritious
meals are prepared so that the mothers are able to replicate these at home.
What we can, and have, achieved by growth monitoring of these children
(weights and heights) is:
mothers in the Kampungs will be used during demonstrations and we will
be encouraging mothers who have successfully improved the weights of their
children, to share their experiences with other mothers.
“My
name is Asih Puji Rahayu, and my friends call me Asih. I was born in Purwokokerto,
Central Java on 25th March 1974. I graduated form Saint Mary Secretarial
Training Centre in South Jakarta in 1995. When I first came to Yayasan
Balita Sehat in January 2001, I worked as an Administrator. I love taking
care of the Yayasan because I agree with its main aims.