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Building Back Better - Ensuring a healthy start for children in Andaman & Nicobar Islands

© UNICEF/India/Bagla/2005
At village Sawai, UNICEF medical specialist Dr. Mahesh Srinivas examines 10-day-old Joseph who weighs 2.25 kg. Auxiliary Nurse and Midwife Mrs. Susana Alexander and the local Aaganwadi worker Mrs. Uincy are also present.

By Priyanka Khanna

Car Nicobar, Andaman & Nicobar Islands, 28 December 2005: Enmay’s 10-day-old baby Joseph is weak, and at 2.25 kg he is also underweight. Suzanna, a government health worker, and Unicy, a child care worker, inform Enmay and her husband that little Joseph also shows signs of dehydration.

Trained by UNICEF, the two are part of a UNICEF-supported system for strengthening home-based care and provide special care for under-nourished newborns in the tsunami hit Andaman and Nicobar Islands.  Suzanna and Unicy ask Enmay a series of questions in order to determine what other health problems Joseph may have.
For an island with a population of 20,000, baby Joseph is a precious addition

They conclude that Enmay has not been breastfeeding Joseph correctly, and offer her advice, promising to check on him again in five days.  Enmay, who has already suffered from a previous miscarriage, is glad to learn how to recognize symptoms of disease early. “God has heard our prayers. I need all the advice I can get to take care of him,” Enmay said.

Joseph is Enmay’s first baby, born after the tsunami hit Car Nicobar Island in December last year. For an island with a population of 20,000, Joseph is a precious addition. 

“Close to 50 per cent of newborn deaths in India occur during the first seven days of birth. Many young lives are lost because parents fail to notice warning signs, and sick children are not taken to health facilities on time, and because many mothers do not have sufficient knowledge on the protective value of breastfeeding,” said Dr. Mahesh Srinivas, a paediatrician working with UNICEF.

© UNICEF/India/Bagla/2005
Baby Joseph being weighed

“UNICEF’s Integrated Management of Neonatal and Childhood Illnesses (IMNCI) approach deals with neonatal and childhood illness holistically, allowing health workers to address a wide range of issues simultaneously,” he said.

The IMNCI programme is already underway in five districts of five states in mainland India. Set up with the government after the tsunami, Nicobar is the first district where the programme is fully implemented in the Andaman & Nicobar Islands.
Huge bodies of water left behind by receding tsunami waters have made the traditional  hunting too dangerous and livestock rearing is yet to resume.

The reason for Joseph’s low birth weight is not difficult to find: the tsunami changed Enmay’s eating habits. Huge bodies of water left behind by receding tsunami waters have made the traditional wild boar hunting too dangerous. Livestock rearing is yet to resume. Coconuts used to be an integral part of local diets, but the once-swaying palms are dead or dying in the stagnant saline water. For most of the year, the island’s inhabitants relied on rations of rice and vegetables that came by sea from Port Blair once a week.

The Andaman and Nicobar Administration is providing extra rations for pregnant and lactating mothers, and nutritional supplements for children are also a high priority. “These concerted efforts have played a key role in ensuring that the feared second wave of deaths from diseases never happened,” said Dr. Srinivas.

 

 

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