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Connect Japanese Civil Society and Developing Countries

Zambia

Community Safe Motherhood Project

Everyday, more than 1,000 women die in pregnancy and childbirth, with most incidents taking place in developing countries where proper healthcare facilities are lacking. Many women simply cannot access them in time due to the large distances they must travel to get there. The Masaiti District of Copperbelt Province, Zambia, for example, has a population of 120,000 living in an area about three times the size of Tokyo, yet it is served by just one doctor and 12 midwives. Most women cannot walk the two or three hours needed to reach healthcare facilities and are forced to give birth at home without proper medical care. Many lose their lives in the process.

JOICFP works to improve maternal health based on UN Millennium Development Goal #5, which has two targets: a) to reduce the maternal mortality ratio by three quarters between 1990 and 2015, and b) to achieve universal access to reproductive health by 2015. While some progress has been made, with some countries in Asia and Northern Africa more than halving maternal mortality in the last ten years according to the World Health Organization, the risk in sub-Saharan Africa remains very high at 1 in 31 (compared to 1 in 4300 in the developed world). Most of these deaths are preventable if there is access to adequate reproductive health services, equipment, supplies and skilled healthcare workers.

Now what if pregnant women were able to move into a maternity waiting house located near a healthcare center while they are still able to make the journey, and then wait it out there until it is time to give birth? JOICFP saw that if this concept could be realized, more women would be able to give birth in a safe place and the risk of dying in childbirth would be reduced.

January 2011 saw the launch of the Community Safe Motherhood Project in Zambia, a JOICFP Partnership Program in cooperation with Planned Parenthood Association of Zambia (PPAZ), IPPF (International
Planned Parenthood Federation) member association and other local organizations. Since then, 140 community health volunteers from different villages have been selected and trained to become members of Safe Motherhood Action Group (SMAG). SMAG members disseminate information about pregnancy, childbirth and family planning, and work to change local awareness of maternal health, sensitize the community on the importance and benefits of seeking early antenatal care, and educate people on the benefits of birth preparedness and transferring to a healthcare centre in advance to seek skilled and specialized care once in labor and during delivery.

This initiative also saw the construction of the maternity waiting house JOICFP had envisioned – a place to stay in the period leading up to childbirth so that women have easy access to the healthcare they need. Expectant mothers arrive around two weeks prior to when they are due, and their husband/family member caring for them can also stay. Women unable to walk the distance or afford public transportation to get there are transported via tricycle. With the health center nearby, they can easily transfer once labor pains begin, and if any complications arise, the health center’s ambulance can be used to move them to a larger medical facility for immediate attention.

Construction of the maternity waiting house began in January 2011, with members of SMAG helping build its foundation. Architect Mikiko Endo, a Japanese expert in designing spaces for children and community development, provided technical support in planning and design work, incorporating suggestions from the local community. Two 40-foot shipping containers sent from Japan holding bicycles and relief clothing from JOICFP, in cooperation with 13 local Japanese municipalities, were recycled to construct the building. In addition to being environmentally friendly, this cut down on cost and time. The containers were laid side-by-side with a roof over the top and windows cut out. The building has eight small rooms with shared kitchen and toilet facilities.

The maternity waiting house was completed in June, with an official opening ceremony held on June 16, 2011 that was attended by 500 people. JOICFP and Endo organized a community participatory painting workshop to put the finishing touches on the building, with more than 120 SMAG members and people from the local community taking part. The names of one hundred individuals and organizations supporting the project were incorporated into the artwork on the building’s walls.

Project Site

Fiwale, Masaiti District, Copperbelt Province, Zambia
Population of Masaiti District: 117,000, Fiwale: 15,000

Target Population

Female aged 15-49 (reproductive age) in the target area

Project objective

To increase facility-based deliveries to at least 50% and above by the end of 2013 in Fiwale, Masaiti District, Copperbelt Province towards the attainment of MDG 5* for reduction of maternal and neonatal morbidity and mortality.
(% of facility-based deliveries: 28% (average in rural areas in Zambia (DHS2007))

Co-implementing organization

Planned Parenthood Association of Zambia
(Link https://www.ppaz.org.zm/)

Project period

January 2011-December 2013

Supported by

Civil society including individuals, donations from the net proceeds of sale for Cath Kidston & UNIQLO

Output

Output 1: Quality of facility-based delivery service is improved
Output 2: Awareness and knowledge on the benefits of facility-based delivery and birth preparedness is improved
Output 3: Community Support system for safe motherhood is consolidated

Main activities
  • Train members of “Safe Motherhood Action Groups” (SMAGs)
  • Promote safe motherhood through IEC/BCC activities targeted to community people and conduct home visits to pregnant women and mothers with children under five by SMAG members.
  • Build a maternity house for pregnant women to wait their deliveries on the premises of Fiwale Rural Health Center in Masaiti District
  • Provide delivery kits and contraception to Fiwale Rural Health Center

Donation to Pregnant Women and Children Coming to Medical Checkups

Program in cooperation with Sogo & Seibu Co., Ltd.
In May 2009, a “trade-in service campaign” started in Seibu, Sogo, and Robinson’s department stores.

This was a new form of international cooperation has been created with the department stores and their customers participating together, where the customers, who brought trade-in items to the department stores, were given coupons to be used for shopping.

The campaign was received well with many favorable comments from customers, who brought their used shoes and clothes, such as “Children are the same everywhere in the world. I am glad if this item would be useful for children somewhere else,” or “This project is superb, thank you.” Articles collected from all outlets across the country were selected by Sogo & Seibu Co., Ltd. 170,000 items were donated to women and children in Masaiti district in Zambia in 2009.

Shoes are very important in Zambia to prevent parasitic infection and tetanus caused by injury. But cash income for self-sufficient farmers is only sixty dollars a year. They cannot afford to buy shoes and many children have to do with bare feet.

JOICFP arranged that shoes would be distributed on the day of medical checkups for pregnant women and infants. Hearing that they had got presents of shoes from Japanese children, many mothers and children gathered there. The donation from Japan became a good opportunity to increase the number of pregnant women receiving medical checkups.

Shoes were donated to children in Zambia along with a message on health promotion.

A pair of shoes served as a tool for health education to inform people in the waiting room of the importance of health and raise the awareness of health among pregnant women and mothers.

Helping HIV-Positive Women through “Goat Workshop”

Collaboration with a Japanese Creator (Architect)
Mikiko Endo, an architect, who had visited villages in Masaiti district in Zambia accompanied by JOICFP, invented “goat workshop,” a charity in which both Japanese children and adults can participate with enjoyment. This charity activity started in April, 2009.

Endo says, “I was moved by mothers raising their children with beautiful smiling faces under the sun and among greenery and at the same time, I learned that many of them were suffering from AIDS. I thought I wanted to do something for them. I really want them to keep smiling brightly and also I wish those who live in a city like us could get back a life full of smiles like them.”

In the workshop, Endo talked about Africa with photos, followed by 1.5 hours of art work, where participants make a figure of a goat from newspaper. The participation fee per person is 1,000 yen, 500 yen of which is donated to JOICFP’s “goat project” fund-raising pool. When 20 people participate, two goats, male and female each, are presented to an HIV-positive woman in Zambia through the project.By raising the goats, the woman and her family will be able to drink its milk and sell the baby goats to make a living.

As the workshop had 201 participants, a donation equivalent to 20.1 goats was collected.

The workshop was held also in concert with Boat Race Edogawa.

Goat Workshop
An art project invented by an architect, Mikiko Endo of Office Mikiko, and started in 2009, with the aim of supporting HIV-positive women in Africa. Out of a 1,000 yen participation fee, 500 yen is donated to JOICFP.

Indonesia

Earthquake Relief Program for Padang in Sumatra

Cooperation with UNIQLO(Fast Retailing Co., Ltd)
A powerful earthquake struck off the coast of Padang in western Sumatra in Indonesia on September 30, 2009 and caused serious damage to the city.

For women and new-born babies, who tend to be pushed to the back of the line for support among victims, JOICFP provided maternal and newborn health and family planning services.

Working with Fast Retailing, JOICFP provided pregnant women and newborn in devastated areas in Padang with life necessities such as tents, mats, blankets, and lamps as well as emergency kits consisting of clothes for babies, hygiene products, and sanitary goods. We also set up health posts (facilities for emergency healthcare) in afflicted areas, provided basic healthcare services together with prenatal/postnatal medical checkups, and opened mobile clinics offering medicine and hygiene products.

A clinic destroyed by the earthquake

(Left)The clinic for obstetrics and gynecology for IPPF Indonesia (Indonesian Planned Parenthood Association) Padang Branch, has been repaired by support from the Fast Retailing.
(Right)A baby born in an evacuation shelter with hardly any equipment

Outcomes
As maternity centers were repaired, safe childbirth has become possible.
Medical services and trauma counseling at the same time improved recovery of victims.
By understanding the characteristics of the area and offering services based on community participation, JOICFP could nurture the attitude among the community that they themselves were implementing this project.

Maternal and newborn health support program in Lombok

Cooperation with Yakult Honsha Co., Ltd.

JOICFP has supported maternal and newborn health in cooperation with Yakult Honsha since 2006 for Lombok, an island in West Nusa Tenggara Province, Indonesia.
The five-year support program was started as a part of projects to commemorate the company’s 70th anniversary of its foundation.
The support site is Jerowaru sub district in East Lombok, wheree the level of maternal and newborn health was very low even for Indonesia. Aid from the Indonesian government did not sufficiently reach villagers and many people suffered malnutrition and undernourishment. Facing many problems in healthcare for pregnant women and infants, environmental hygiene, and infectious diseases, the residents were hoping for international aid.

Children at a day-care center express their gratitude, “Thank you, Yakult!”

Over a period of five years, JOICFP and Yakult Honsha rebuilt health posts in 31 places (13 places in 2009), improving the rate of prenatal checkups from 15-20% to 97%. The number of children with serious malnutrition decreased and the infant mortality rate dropped to zero.
In 2009, the 4th year of the program, activities designed for malnourished children and pregnant women were implemented with the view of increasing their access to medical facilities and improving their health, such as micro credit activities and nutrition improvement programs, as well as literacy education for adults and young children.

Afghanistan
“School backpacks go overseas” in cooperation with Kuraray Co., Ltd.

In cooperation with Kuraray Co., Ltd, and the Japan Luggage Association, JOICFP has conducted campaigns, “School backpacks go overseas (organized by Kuraray)” and “Donation of backpacks of memory (organized by JOICFP)” to send backpacks, which were used by Japanese children, to school children in Afghanistan.

In 2009, a total of 13,449 backpacks (including brand new ones) were sent: 11,910 to Afghanistan and 1,539 made of pigskin to Mongolia.

Number of backpacks Partner country’s organization Time
6,240 United Medical Center for Afghans (UMCA) May
2,820 United Medical Center for Afghans (UMCA) June
1,539 Mongolian Family Welfare Association (MFWA) June
1,650 United Medical Center for Afghans (UMCA) December
960 United Medical Center for Afghans (UMCA) March

Besides individuals, including elementary school children and junior high school students, backpacks were donated from by a wide variety of groups such as Rotary Club, Lions Club, Social Welfare Council, the PTA (Parent-Teacher Association), and companies. The campaigns were also covered by many national newspapers.

Supporting women in Afghanistan, where the maternal mortality rate is the second highest in the world

Cooperation with Shinnyo-en and Bank of Tokyo-Mitsubishi UFJ
Supported by the Religious Corporation Shinnyo-en and Bank of Tokyo-Mitsubishi UFJ, JOICFP, in partnership with United Medical Center for Afghans (UMCA),provided local people in Afghanistan with basic health services, including MCH for the purpose of reducing maternal and infant mortality rates.

In 2009, in order to improve matern and newborn health the following three activities were held for about 206,500 people living in three districts in Nangarhar Province:

  1. Provide healthcare service by local clinic staff and communitynurture healthcare workers;
  2. Offer health education through prevention of parasites; and
  3. prevention of parasites; and

(Left) Prenatal checkup
(Right) Training workshop in health education for school teachers

Program