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In the far-flung villages of eastern Indonesia, two bamboo poles and a traditional sarong can help save a woman and her baby’s life.

At 2 pm on July 13th 2012, Isabela Belita, 42, started going into labour in the remote village of Blopur Bola on Flores Island, Nusa Tenggara Timur province (NTT). Isabela was pregnant with twins, and her husband Pardianus began to panic when one of the babies’ umbilical cords started to emerge.

From left to right: Midwife Maria Marieta, Traditional Birth Attendant (TBA or dukun) Monika Mele, and Mother Isabela Belita with her two month-old twins. The midwife at this AIPMNH-supported puskesmas works closely with dukuns through the TBA-Midwife Partnership program to make sure women like Isabela give birth in a health facility with a skilled birth attendant.

This condition, known as umbilical cord prolapse, endangers the life of the fetus because oxygen and blood supplies to the fetus may be diminished or cut off. Prompt delivery of the baby is crucial.

Fortunately, Blopur Bola falls within the “alert village network,” known as desa siaga, of nearby Wolonwalu village, one of 305 desa siagas supported by the Australia Indonesia Partnership for Maternal and Neonatal Health (AIPMNH). Through the Desa Siaga program, AIPMNH supports communities to build finance, family planning, transportation and blood donor networks that ensure women give birth safely at health facilities versus at home with an unskilled birth attendant.

Once Pardianus informed the local traditional birth attendant, or dukun, the desa siaga network was mobilized. The dukun, Monika Mene, contacted the Village Midwife, who then contacted the Midwife Coordinator at the nearest health centre, Puskesmas Bola.

“In the past I might have handled this myself, but I’ve made an agreement with the midwife that all pregnant women must be brought to skilled health staff at the puskesmas,” said Monika.

Knowing Puskesmas Bola’s ambulance would take at least an hour just to reach Wolonwalu, the dukun and four members of the desa siaga transportation network quickly looped a traditional sarong around two bamboo poles to create a stretcher.

Blopur Bola is so remote that it cannot even be reached by car, and the team carried Isabela for nearly an hour down steep paths and rocky hills to Wolonwalu.

The desa siaga transportation network demonstrates how they carried Isabela from her remote village to Wolonwalu, where she was picked up by the puskesmas ambulance and taken to the District Hospital, where AIPMNH-trained doctors performed a caesarean section and delivered her two twin boys, Julius Moagate and Julius Moalerong.

According to Maria Marieta, the Midwife Coordinator at Puskesmas Bola, the mother’s situation was critical.  ”We decided to refer Isabela to the District Hospital in the capital, Maumere, because of the various high risk factors surrounding her pregnancy” Maria said.

“Her last two children were breech, and being pregnant with twins at 42 and having umbilical cord prolapse, we needed to get her to the hospital immediately,” she explained. 

At 4pm, Isabela received a caesarean section conducted by doctors and midwives trained through AIPMNH’s Sister Hospital Program. The twins, although weighing only 1.4 kg and 1.2 kg, were delivered safely. Isabela received the service free of charge through the national Jampersal health insurance program, which guarantees all women in Indonesia free delivery in a puskesmas or hospital.

”Pardianus and I are so indebted to Monika, the midwives and the hospital for making sure that three lives were saved that day,” Isabela said.

Isabela’s journey from a high-risk pregnancy in a remote village to safe delivery in a hospital shows how AIPMNH works at all points along the referral system. From creating ready teams in rural villages to establishing more responsive puskesmas to training on emergency and obstetric care at hospitals – the program ensures that women from even the most modest backgrounds have access to the services and facilities they and their babies deserve.

AIPMNH is managed by Coffey on behalf of the Australian Government

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