“How far along are you?” a midwife asks a pregnant woman, making a hand gesture over her stomach.
Without saying anything, the expectant mother puts up one hand.
“Five months,” repeats the aid worker, holding up her own hand in unison.
The woman nods.
“And your age? How old are you?”
The woman flashes both hands three times.
“30?” the midwife repeats, imitating the young woman’s hand actions.
The woman nods.
Simple and straightforward, these questions among others provide the basic information required to assess the reproductive health needs of women following an emergency or in this particular case, in a humanitarian situation.
The expectant mother, named Montas, is one of 315 Rohingya refugees stationed in a temporary shelter in the north Sumatran province of Aceh. Having spent months at sea, the young woman was rescued by local fishermen off the coast of Aceh near the city of Lhoksumawe in May after the captain abandoned the boat she was travelling on.
Wiping away her tears as a midwife and a humanitarian worker ask her about her health in the corner of a crowded room – where other women are resting and young children run around – Montas explains primarily through hand gestures that she is alone and this is her first child.
Despite the language barrier, obtaining this data is vital to make sure that the health needs of pregnant women are not neglected.
Montas is part of the group of 996 ethnic Rohingya Muslims and 795 Bangladeshis escaping poverty, according to data from UNHCR, who ended up in Indonesia after a failed attempt to reach Malaysia or Australia in search of a better life.
When the boats filled with hundreds of Bangladeshi and Rohingya migrants were first spotted off the coast of Aceh in May, local fishermen were unable to ignore the pleas from the men, women and children aboard the stranded boats at sea, rescuing them before towing them to safety.
On 20 May, the Government of Indonesia agreed to provide temporary shelter to the refugees for one year.
UNFPA Indonesia sent a team to visit four of the six camps housing the refugees in Aceh in June to conduct reproductive health and sexual-gender based violence assessments before determining what steps needed to be taken next.
The mission also provided the opportunity for humanitarian workers from the agency to distribute pregnancy and hygiene kits – basic essentials required during the early stages of an emergency – to women and children in need.
“Dignity kits are important to hand out to women to make sure that they at least have access to basic necessities such as clean underwear, clothes, soap and sanitary pads,” explains Leny Jakaria, a Humanitarian Focal Point Officer with UNFPA Indonesia, who joined the mission to Aceh.
“During a humanitarian situation like this one, we also need to pay attention to the care management. Women and children should be separated from the men to ensure they are in a safe and protective environment. At one of the camps more than half of the people there were children and we saw that there were a few policewomen working at that particular camp, which was a good sign.”
A Helping Hand
Walking through one of the temporary shelters housing Rohingya and Bangladeshi migrants in Kuala Cangkoi, on the northern coast of Aceh, there are young kids running around and taking turns riding a toy car, a group of teenage boys huddle around two others playing a game of chess and some women are washing their children in an outdoor open-air shower facility.
“Assalamualaikum,” refugees say as they pass visitors to the camp.
While they may not be able to communicate fluently with the Acehnese locals, they use the Muslim greeting that roughly translates to “peace be with you” to say hello.
Some of the youngest refugees at a temporary shelter in Aceh. These young girls were part of a group of 996 ethnic Rohingya refugees who ended up in Indonesia after a failed attempt to reach Malaysia or Australia in search of a better life. © UNFPA Indonesia/Sandra Siagian
Since the migrants arrived in May, a team of local midwives in Aceh have visited the camps to help ensure pregnant women – one of the most vulnerable groups during an emergency situation – are provided with the necessary health services that they require. This includes antenatal care for pregnant women and also post-partum care for new mothers and their infants.
“Our priority is to make sure the pregnant women and new mothers are given the right care and receive the necessary check-ups,” explained Indra Supradewi, Chief of the Educational Department from the Central Board of the Indonesian Midwives Association (IBI), who was part of the UNFPA team to visit the refugee camps.
“We met nine pregnant women on this mission, ranging from the ages of 15 to 30 and they were all at different stages. Some were just a few months while one young girl was already at eight months,” she said, adding that there was a referral system in place for any of the expectant mothers to deliver their baby in a puskesmas (public health centre) or hospital.
In Aceh, there are 15,000 registered midwives with IBI. Ahead of Indra’s visit, local midwives at four of the six refugee camps located primarily along the northeast coast of Aceh had already met most of the pregnant women, to not only provide support and health services, but also to help empower them.
“Along with offering counselling services for the women, we have tried to provide them with activities to engage in, such as sewing,” explained Syafrina, a local midwife who has been visiting the temporary shelter in the city of Langsa, where there are three pregnant women.
“We want to open a public kitchen for the women to use so that they can cook food for themselves. We want to empower them and provide spaces for the children and also with specific women-friendly spaces at these camps.”