WUNRN
05 May 2009
|
In the
belief it will make the child smarter, some mothers dig a hole in the ground
and bury the baby’s umbilical cord with books |
DILI, 15 April 2009 (IRIN) - Infant and
maternal mortality rates in Timor-Leste are being adversely affected by harmful
traditions and practices, according to experts. But fighting them is a
sensitive issue.
Nadine
Hoekman, country director and programme manager for Health Alliance International
(HAI), a
Washington-based NGO working with the Health Ministry, told IRIN it was
difficult to quantify the problem.
“There
are no stats available regarding mortality or morbidity specifically related to
these practices,” she said, adding that even accurate information on exactly
how many mothers and newborns are dying is difficult to ascertain since the
deaths often go unreported.
“It
happens quite a lot that when a mother gives birth, they stay by a fire for
three months,” said Macu Guterres, the coordinator of the National
Breastfeeding Association for the Alola
Foundation, an NGO that supports women and children in Timor-Leste.
“They
make a small bed beside the fire and sleep there while the fire burns 24 hours
a day,” she said, explaining that the heat from the fire is believed to help
dispel “dirty” blood from the body after birth.
Rather than operating
under the assumption that anything traditional is bad, and modern is good, we
have chosen to look at how non-harmful traditional practices can be supported |
“This
can affect the baby’s health as well as the mum. The baby can develop asthma or
may find it hard to breathe because of the smoke. It happens a lot in Oecussi,”
she said, referring to the Timorese enclave deep inside Indonesian territory.
According
to figures published by the UN Children’s Fund (UNICEF), the infant mortality
rate in Timor-Leste in 2007 was 77 per 1,000 live births, which is “relatively
high” for the region.
Timor-Leste
has one of the fastest-growing populations in the world, with women having an
average of 6.5 children each, according to the UN World Population
Prospects.
Several
NGOs are working to raise awareness of the potential danger of such customs for
mothers and babies, but this is not easy given that the adult literacy rate is
just over 50 percent (UN Human Development Index).
Traditional birth
attendants
Traditional
birth attendants (`dukuns’), using traditional medicines and sometimes harmful
practices, are common, especially in rural areas. The Alola Foundation
estimates that only 10 percent of women in Timor-Leste give birth with the
assistance of a skilled birth attendant.
According
to HAI, harmful practices by `dukuns’ include encouraging the mother to push
before she is ready, and placing rice or other substances in the birth canal to
“lure the baby out”.
“Sometimes
this choice [of birth attendant] is related to a stronger belief in the skill
and practices of a traditional birth attendant in the community as compared to
a trained health person,” Hoekman said.
|
A map of Timor-Leste and
surrounding countries |
Another
common belief is that colostrum, the nutrient-rich milk mothers produce in the
late stages of pregnancy and immediately after birth, is bad for the baby.
“They
believe using water and honey instead of colostrum will wash the baby’s stomach
and intestines and remove dirty blood,” Alola Foundation’s Guterres said,
adding that the Foundation has 436 volunteers in nine districts working in
“mother support groups”.
Rogerio
Pedro Sam, an obstetrician and gynaecologist at the Mother of Perpetual Help Pharmacy
and Clinic in Bidau (part of Dili), said another harmful custom was the taking
of a really hot bath, and drinking really hot water, after delivery. “Sometimes
they burn their skin,” he said, explaining that the hot water is believed to
flush out “dirty” blood after childbirth.
Sam
said harmful practices were most prevalent in rural areas, where 70 percent of
the country’s one million people live.
“Behaviour
change is a long process. We try for a multi-pronged approach in our work -
using different strategies to address issues, keeping messages simple and
consistent, but delivering them in a variety of ways,” HAI’s Hoekman said.
“Rather
than operating under the assumption that anything traditional is bad, and
modern is good, we have chosen to look at how non-harmful traditional practices
can be supported.”
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