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Orpa Tondabitu and her newborn. Orpa is a village health volunteer and mother of five

Orpa Tondabitu breastfeeds her fifth child, a three day old healthy baby boy, as she describes the story of his birth. Like many other women in her small farming community in Sumba Timur, one of Indonesia’s poorest districts, Orpa gave birth to her previous four children at home. But since the province of Nusa Tenggara Timur (NTT) began implementing its “Mother and Child Health Revolution” or Revolusi KIA in 2009, more and more women are beginning to give birth in health centers – a move that can save theirs and their    babies’ lives.

Orpa, 36, lives in a two-room bamboo house in the village of Lewa. The road to her house from the district capital, Waingapu, is full of potholes and hair-raising twists and turns on gravelly mountain roads. Houses here can be miles apart - electricity, running water and mobile phone reception are sporadic at best.

Getting to a health clinic to give birth is no small feat, but it’s a crucial choice, and women like Orpa are helping to change mindsets in a patriarchal society that often lets ill-informed husbands or in-laws decide whether a woman should give birth at home with an untrained traditional birth attendant (TBA), or at a clinic better equipped to handle any potential complications.
According to Orpa, she learned her lesson last time.

“I had complications with my fourth pregnancy,” Orpa explained.  “I began to hemorrhage during the birth, and I was really scared that I wouldn’t survive.”

Fortunately, both she and her baby made it, but it encouraged her to develop a birth plan when she found out she was pregnant again. This time, she made sure that transportation by motorbike would be available when the time came so that she could make it to the closest clinic to give birth.
Here, volunteers like Orpa weigh babies and provide health education on topics like nutrition, danger signs during pregnancy and immunization – as well as encourage women to deliver at health clinics.

Team of village health volunteers trained by AIPMNH. Thousands of these volunteers have been trained through AIPMNH’s Community Engagement program throughout Nusa Tenggara Timur province (NTT)

“As a kader, I have to set a good example,” Orpa said. “How could I give birth at home if I’m telling other women they should go to a health clinic?”

The benefits of going to a clinic may seem obvious, but the tradition of giving birth at home with a TBA runs deep. The reluctance to go to a clinic is further compounded by some clinics’ poor reputation of impersonal service and limited equipment.  That’s why in villages like Lewa, the Australia Indonesia Partnership for Maternal and Neonatal Health (AIPMNH) is working directly with the community to renovate birthing facilities while training health workers and volunteers at the same time.

Throughout NTT, midwives, doctors and nurses are being trained in emergency care so that they can better handle complications on their own without having to refer patients on to a city hospital. In places like Sumba Timur, where geographical conditions can cause major delays in treatment, having trained staff relatively close by is critical to helping women like Orpa have safer births. 

In fact, the clinic in Lewa where Orpa delivered her baby boy is now handling eight times as many births since AIPMNH support began three years ago.  “The clinics are cleaner and safer now than they were before,” Orpa said. “Women at the posyandu now tell me that they’ll go to a clinic instead of giving birth at home – the word is out.”

AIPMNH is managed by Coffey on behalf of the Australian Government

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