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A Perfect Future

© UNICEF Ukraine/2008/Jordi Oliver
Three children in Children Development Centre in Kosiv Hospital which is a part of UNICEF project in Ivano-Frankivsk (Ukraine)

Author: Paka Diaz
Photos: Jordi Oliver

Can a furnishings company contribute to improving the world?

With UNICEF, IKEA co-financed a child development project in one of the poorest of Ukraine’s regions, a place with high rates of infant mortality, a high prevalence of child trauma and injury due to a lack of parental care and high anaemia prevalence. Life for children used to be rough. Today, they’ve regained their hope.

The train from Kyiv to Ivano-Frankivsk, a region (oblast) centre in Western Ukraine, leaves peacefully. Fertile meadows yield to beautiful settlements and forested areas on the way to the mythic Carpathian Mountains. But we made our tour more out of necessity than mysticism. The average income level in that area is 30 per cent lower than it is in the rest of the country and the mother and child mortality rate was one of the highest in the whole country two years ago.

Europe’s second biggest nation experienced spectacular economic development in recent years. Nevertheless, high inflation, low salaries and high real estate prices, among other factors, are now converting it into a place in which it is difficult to live. The problem is even more complicated in rural areas, and we are on the way to the poorest of them. These were the main reasons that encouraged UNICEF to initiate a project for rural children’s development (from birth up to six years of age) in Ivano-Frankivsk with a special focus on parents’ education and integrated into the primary mother and child health care system. The project is co-financed by the Swedish multinational IKEA and their 1€ is a Fortune! campaign. The campaign launched at the end of 2005 after a pre-assessment of the state of children’s health in this area, a pre-assessment that generated very disturbing data. It was discovered, for example, that there were serious problems with anaemia and endocrine system dysfunctions among children up to age five. These problems were provoked mainly by a low breastfeeding rate and early introduction of inappropriate complementary feeding – for example, parents give their babies tea with sugar or even borscht (traditional sour red beet soup) beginning when the children are three months old. They do this not to hurt their children, but because they lack knowledge. In general, only six per cent of babies were exclusively breastfed by the age of six months, because their mothers thought that breastfeeding was insufficiently nourishing. In addition, parents pay insufficient attention to their small children, which results in high rates of trauma, injury and intoxication. Assessment also shows that parents’ knowledge and practice regarding childcare, feeding and development are far from adequate. Father participation in childcare was very low.


If we add to this that 1,000 kindergartens around the country were closed during the last five years and that 15 per cent of those that remain are not in operation due to lack of funds, it is not strange that one of UNICEF’s first tasks was to create, as a part of the project, Child Development Centres. The Centres operate at the mother and child health care facilities. More than 6,000 families with children benefit from them nowadays. The project resulted in many positive changes: the exclusive breastfeeding rate significantly increased and the Papa Schools established within the framework of the project were very successful in involving fathers in childcare and child development.

At the Ivano-Frankivsk Region Children’s Hospital, which recently received Baby-Friendly Hospital status, Liliya (34) is waiting for her child to get allergy treatment. Mother and child come once a week and she confirms that there have been very positive changes in the place during the last two years. “The way they treat children is incredible. My son spends his waiting time with a teacher who teaches him to play developmental games, sing songs and recite poems. He isn’t afraid to come here anymore, and he learns a lot,” she explains. 

This is only a small example of what UNICEF-trained health care workers are doing at the Child Development Centre. They help parents learn what they need to know so that they’re prepared to give birth to healthy children and then educate them in a friendly and informal manner about how to take care of them. They’re also encouraging parents to share their experience.

The work begins with making them conscious of the importance of breastfeeding and its benefits for babies, putting aside unsound opinions or superstitions. The six per cent exclusive breastfeeding rate lags far behind what it should be. This is the first step, but not the only one. In Soviet Ukraine, babies were taken from mothers right after birth. As a result, many newborns suffered from hospital infections, hypothermia and delayed initiation of breastfeeding. The presence of husbands or other relatives in the labour ward was prohibited. So men stood drunk outside while their spouses gave birth to children alone. In addition, there was a common understanding that a child ‘belonged’ to the mother during the first year of life.  That’s why fathers didn’t understand a lot about their babies’ lives. Men have regained permission to be present during childbirth and babies are now left with their mothers, but we now face a further challenge: involving men in the educational process and taking care of newborn children. That’s why the management of the Ivano-Frankivsk Region Children’s Hospital decided to learn the best European practices.

An excellent present. SHARE YOUR CHRISTMAS! A very superior mouth, a sweet bear or a pretty crocodile… 1€ from each soft toy sold during the IKEA Christmas campaign will be donated to Save the Children and UNICEF projects. Starting in 2003, the projects have accumulated more than 11 million euros. Some 294,269 toys were sold in 2007 in Spain – the fourth country in the IKEA Group’s world ranking. The sales target for 2008 was 340,000, and the money gained will be invested in improving the quality of life and access to education of children in the countries of Eastern Europe, Asia and Africa. The price of a toy is between 0.5 and 17.95 euros.

We entered a room and it was full of tatos (“fathers” in Ukrainian) with their babies. Surprisingly, and despite our arriving almost an hour late – thanks to the country’s roads – none of the babies were crying. The voices of their fathers, the men’s soft gestures and games, were keeping them entertained and smiling. A miracle? No, just applied knowledge. “It’s the fruit of the Papa School,” says Vasyl Khodan (24), the school’s director and a doctor who is preparing to become a father for the first time. He explains how the idea developed: “Sweden is a country with one of the lowest infant mortality rates in the world. They have Papa Schools, among other things, where the most experienced fathers teach novices. We contacted them and decided to borrow their approach. Sometimes it’s not a matter of having the best resources, but of having information. If you know simple hygiene requirements, you can save more lives than the most advanced and expensive technology.” Here are the lessons they learn: how to detect risk symptoms, how to feed a child correctly, how to perform a massage, how to use short words with babies and no diminutives so that they understand their fathers better and simple psychological methods with which to calm a child during moments of crisis.

A group of four ‘father-students’ assists at two hours’ a week worth of lessons over the course of a month and a half. They started in December 2007 and now are making recordings so that they can share information with other future fathers. The results are impressive. You should see a room full of smiling babies with their no less proud fathers. Nevertheless, they are taught not only to take care of children at this school. It’s important that men realize what pregnancy means for women. That’s why, during some lessons, a man puts on a big artificial belly and spends time wearing it. “They laugh at the beginning because it’s ridiculous. But little by little they start realizing what pregnant women feel like and that the moment comes when it is difficult for them even to unfasten their shoes,” explains Vasyl.

Petro (23), the father of Ruslan, a handsome blond boy of nine months, confirms: “It was very significant for me. I understood my wife better from the moment I put it on.” He is now a teacher of novices and says that it is important to understand the obligations that paternity implies: “Ukrainians must become more responsible,” he says. Volodymyr (25), a psychologist, with a daughter 10 months old, recommends these courses to all his friends: “I learned to take care of my baby in a way that’s much better than the way my father treated me. It’s great progress.” His wife, 25, also a psychologist, is very satisfied with his achievements: “I’m not afraid of leaving the girl with him, as he knows perfectly what to do. Sometimes he even teaches me. Now I look at the husbands of my friends and see that they only watch TV, and it’s a pity. They don’t realize what they’re depriving themselves of.”

Photo essay: A Perfect Future

© UNICEF Ukraine/2008/Jordi Oliver
Sofia is one of prematurely born children in Kosiv Hospital

The director of the Ivano-Frankivsk Region Children’s Hospital, Oxana Maniukh, 49, smiles when listening to fathers’ and mothers’ declarations and uses figures to illuminate the results of the UNICEF project: “We reduced children’s morbidity by 15 per cent, the exclusive breastfeeding rate increased by 10 per cent, anaemia in children fell by 69 per cent, postnatal complications decreased by 48 per cent and traumas and injuries in children fell by 58 per cent.” She adds, “People thank us very often, and that confirms that we’re doing the right thing.”

She accompanies us to lunch and while waiting for coffee I ask her about her salary as chief oblast paediatrician: barely 110 euros. An ordinary doctor earns between 50 and 80 euros. “We are not working for money, I suppose, but for the sake of ideas,” she says. The situation in the Health Centre in Lastivtsi village (40 km from the regional centre) is even worse. Mykhailo Goryn (28), the chief doctor, explains that they scarcely have the equipment to treat patients and they lack first aid and laboratory supplies. “The state doesn’t help. We placed our hopes in the Orange Revolution, but they deceived us.” With his existing salary, he cannot feed his family. “With my salary, I can’t. My mother, who is working abroad, sends me some money.” And all this is happening at a time when politicians are fighting for their own benefits and President Yuschenko is calling for new elections.” UNICEF delivers its projects in cooperation with governments, so it might be back to negotiate with a new one about fulfilling several programmes that can help to build a better future for Ukrainian children.

There is a welcome sign on the wall at the Kosiv Hospital, our last stop. This centre has a substantial department of intensive therapy for newborn children. We saw a baby wrapped in a red blanket in one of the rooms as we walked through. Her name was Sofia and she had been born prematurely. The doctors confirmed to us that we could make funny faces at her thanks to the equipment that had saved her life. It was a donation from the UNICEF Spanish Committee. A lot of people often ask if a small donation is enough or if the help really gets to those in need. I would like all of them to be able to touch this girl’s small hand and contemplate her calm gestures. She can confirm that all the help is worth it.

 

 
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