MSF's Mother and Child Primary Health Project in Papua, Indonesia

MSF began working in southern Papua in March 2006, after a measles outbreak in the region. During the vaccination campaign alarming indicators were found especially for mother and child health.

Malaria, diarrhoea, respiratory infections among children and pregnancy complications are the main causes of morbidity and mortality.  The area is home to a semi-nomadic population, who live in the thick tropical forest that covers large swathes of Agats. The harsh existence they lead poses an additional health risk for pregnant women.

In partnership with the Ministry of Health, MSF launched a primary healthcare programme focusing on mother and child health to improve access to basic and emergency medical care for the isolated communities of Asmat district.  As of June 2008, MSF's mobile clinics have conducted 4478 consultations this year, using speedboats to access remote villages in the three sub districts of Akat, Agats and Sawa Erma. MSF also lobbied to establish a network of community health workers, which until then didn't exist in the villages.

The remoteness of the villages is a logistical challenge, which requires MSF to use speedboats to reach the population. MSF's mobile clinics cover three sub districts: Akat, Agats and Sawa Erma.

For cultural reasons the villagers rarely take the initiative to seek healthcare and tend to wait until too late. The problem is compounded by the fact that they are not familiar with western medicines. MSF strengthened its health promotion activities, which played a key role in changing attitudes and gaining the trust of the population.

In addition to providing primary health care to the communities, MSF organised training with government staff in the health centre (Puskesmas) on complicated deliveries, sterilization of medical equipment, blood screening and safe blood transfusion. MSF also rehabilitated the surgery room in Agats and donated surgical and obstetrical material.

In the local health posts based in the villages, midwives and community health workers also received training to help them recognise serious cases and take the necessary steps to refer patients.

A life saving emergency service has been set up. A radio system is in place to alert the health centre of emergencies and call for an ambulance boat to attend to the patient with the shortest possible delay.