December 24, 2006 : After the wave: IMNCI in Tamil Nadu
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December 24, 2006 : After the wave: IMNCI in Tamil Nadu

By Bronwyn Curran

**incorporates updated ICO inputs received Thursday November 8- Joan Howe

SAMANTANPETTAI VILLAGE, Nagapatinam District, Tamil Nadu, India: Twenty-nine year old Lakshmi lost her thatch-and-mud home when the tsunami roared into her traditional Tamil fishing village of Samanthanpettai, killing 148 people and leaving 380 families homeless. Southern coastal villages in states like Tamil Nadu were the worst-hit in India, where more than 12,400 people died, three quarters of them women and children.

With her husband, five children and five stepchildren, Lakshmi now live in the row of new concrete homes built for Samanthanpettai’s homeless survivors on government land behind the old seafront village.

All of Lakshmi’s family, one of 10 Dalit “untouchable” low-caste families of Samanthanpettai in Nagapattinam district of Tamil Nadu, survived. Twenty months after the tsunami, she gave birth to the 10th addition to the family: daughter Mahadnee.

Every week during her pregnancy Lakshmi was visited by local health workers trained under UNICEF’s Integrated Maternal Neonatal and Childhood Illnesses program (IMNCI). The program, introduced by UNICEF in its post-tsunami health intervention, trains frontline community health workers and midwives in delivering antenatal and neonatal care in the home, ensuring remote villagers receive proper care for their newborns.

UNICEF-trained health workers supplied Lakshmi with folic acid and iron tablets during her pregnancy.

She gave birth in a state-run hospital in Nagapattinam’s main town – one of the hospitals to benefit from

In 2006, UNICEF supplied 4,275 health facilities in Tamil Nadu with emergency obstetric and newborn care supplies.

Now the health workers visit Lakshmi visit every week to check on the health of baby Mahadnee, share hygiene tips, and encourage her to exclusively breast-feed for at least six months. The tips have made an impact.

“I will breast-feed my new baby for 12 months,” vows Lakshmi.

IMNCI equips village-based workers and auxiliary nurses and midwives in assessing sick infants, providing the first-level of treatment when doctors aren’t available, and referring the child to the nearest health facility if it displays clinical signs of danger.

The workers are trained especially to detect signs of diarrhea, acute respiratory illnesses, malnutrition, anaemia, and malaria – the five top killers of children under 5.

IMNCI was first introduced to tsunami survivors on India’s remote Andaman and Nicobar islands, 1,400 kilometres across the Indian Ocean. Child malnutrition on the islands has already declined from 48.5 percent in 2005 to 33.6 percent in 2006.

Low birth-weight and malnutrition contribute to nearly 50 percent of deaths among under-5s. In India in 2003, neonatal deaths accounted for nearly two-thirds of all infant deaths.

“Almost 50 percent of newborn deaths occur in the first week of life,” said Dr Marzio Babille, Chief of Health for UNICEF India.

In Tamil Nadu, UNICEF is placing extra IMNCI-trained volunteers in early child development centres known as Anganwadis.

“The volunteers use the afternoons to visit pregnant and lactating mothers,” said Barbara Atherly, UNICEF Tsunami Recovery Program Officer for Tamil Nadu.

“They visit the homes of children who come to the Anganwadi centres.”

With UNFPA and the Tamil Nadu government, UNICEF is also providing mobile emergency obstetric and newborn care units to Nagapattinam and two other tsunami-hit districts.

India’s government is working hard to bring down its high infant mortality rate of 58 per 1,000 live births and maternal mortality rate of 407 per 100,000, said UNICEF’s Dr Babille.

“IMNCI will go a long way in helping to achieve that,” he said.

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