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Amid a gold rush, infant health improves

Indonesia, August 8, 2012

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  <span class="field-credit">
    Lindsay Hamsik/Mercy Corps  </span>
    Midwives like Rina Ardina, 24, are partnering with Mercy Corps to increase exclusive breastfeeding. Rina practices first initiation, which is when the midwife lays a newborn infant on a mother’s breast in the first hour of birth. This practice encourages long-term breastfeeding. Photo: Lindsay Hamsik/Mercy Corps
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  <span class="field-credit">
    Lindsay Hamsik/Mercy Corps  </span>
    Lele village resident Yati Nacikit is one of thousands who flock to work the mines in Buru every day. Yati is the mother of six children. She works for two to three days in the mine before returning home to care for her children. “I don’t sleep more than two or three hours a day. I just work,” she said. She continues to mine despite the recent conflict that occurred here. Photo: Lindsay Hamsik/Mercy Corps
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  <span class="field-credit">
    Mercy Corps  </span>
    Since a local man discovered gold on Botok Mountain, people have poured in from all over Indonesia and local people have slowly abandoned their farms and fishing boats to mine. Each colored tarp pictured on the mountainside represents an informal mine. These unregulated mines are subject to cave-ins, trapping miners inside. Photo: Mercy Corps

Late last year, a man on the tiny Indonesian island of Buru discovered gold in the mountains. In just months, the population exploded by half, to an estimated 140,000 people, as Indonesians from Kalimantan, Sulawesi, Sumatra, Java and elsewhere in the archipelago poured in with the hopes of striking it rich.

Even the rice farmers and fishermen of Buru slowly abandoned their livelihoods to travel en masse to the mountainside, where impoverished day laborers employ toxic mercury to separate gold from ordinary rock.

When I visited Buru recently, it was harvest season for rice, Buru’s agricultural staple. But most rice paddies nowadays sit idle and untended, and once-verdant fields are now brown with disuse.

“The men say they have new paddy fields on a mountainside,” said Kasi Ani, whose husband is away mining.

Kasi Ani, a 25-year-old midwife and mother, is helping Mercy Corps run mother support groups in Waetina, a small village in Central Buru. Mother support groups, which have been operating in Buru with funding from UNICEF, are designed to encourage exclusive breastfeeding and proper prenatal care. Programs like this are critical in Buru, a place where infant mortality as a result of malnutrition remains high.

But gold fever runs high, too, even among the program’s volunteers and participants. Buru exported approximately $14 million worth of gold in the first three months of this year, according to one report. When I asked a woman in one village how many men there worked in the informal mine, she replied, “All of them.” And mothers are often right alongside them.

Addressing health risks

Hayati, a 44-year-old mother and volunteer motivator for the program in Lele village, is still breastfeeding her year-old infant, but only when she is not digging for gold. “I work until I can no longer stand,” she said.

Hayati isn’t the only mother working in the mine. Fifteen others in this community who are still breastfeeding their babies work there. Some take their children with them. Like Hayati, many women have stopped breastfeeding exclusively, and now substitute with formula and porridge.

Early initiation of breastfeeding is when a newborn is rested on a mother’s breast within an hour after birth. According to studies cited by the World Health Organization, early initiation of breastfeeding can reduce neonatal mortality by 22 percent. The practice also encourages long-term exclusive breastfeeding, which promotes health and wellbeing for infants as well as mothers.

But in 2010, only 2.8 percent of Buru women practiced early initiation of breastfeeding; 2 percent were breastfeeding exclusively. And the rush to mine gold certainly hasn’t helped efforts to keep children healthier. Risks from mining run the gamut of risks, from armed conflict to accidents to mercury poisoning.

A week before I arrived, Buru made national news when seven miners were reported killed in a clash on Botok Mountain, the island’s largest informal gold mining site. Locals suspect the death toll was closer to 100.

There is simply little regard for human health. In artisanal gold mines like the one on Botok Mountain, mercury is used to separate small pieces of gold from rock. Informal gold mining is the “second worst form of mercury pollution after the burning of fossil fuels,” according to a 2009 Associated Press article. Mercury ravages the nervous system of people exposed to it, and pollutes waterways and fish.

Regulations of other safety hazards are also nonexistent. Though we were unable to travel to the mine, the mothers we interviewed shared with us the terrible conditions there. There are no bathrooms. Makeshift mines are dug one next to the other. They frequently collapse, trapping miners inside. Locals we interviewed said as many as 1,000 people have died in these accidents.

“Sometimes they can’t find the dead,” Mercy Corps field facilitator Yayu Erlyna said, “and they just continue mining.”

Signs of healthier children

Community health leaders say that during this explosion in mining, women’s health practices have actually improved. Their assertions are backed by Mercy Corps surveys.

In 2011, the first year of Mercy Corps’ program on the island, the rate of both early initiation and exclusive breastfeeding nearly tripled, to 8 percent and 5.5 percent, respectively. The first quarter of 2012 demonstrated an even greater improvement – early breastfeeding followed 72 percent of all live births, and 15.5 percent of all women were exclusively breastfeeding for six months after the birth or more.

Midwives and community health workers also reported increased attendance at posyandus, monthly community health clinics where mothers can weigh their babies and access nutritional and prenatal advice from local midwives. Mothers are more informed about monitoring infant illnesses like diarrhea, respiratory infections and malaria. They know where to take their children when they are sick and how to access care when they need it most.

Even these improvements, however, are under threat. According to the head of the Buru District Health Office, disease outbreaks are becoming more prevalent. “We’re seeing rising cases of malaria, diarrhea, scabies and HIV and other STDs,” he said. “In the last few years, dengue has been almost non-existent in Buru, but since February we have had eight reports of the disease.”

Despite the obstacles, Mercy Corps plans to train 275 volunteer health care workers in early disease detection by year’s end. Armed with information about how to treat malaria, pneumonia and diarrhea, these health care workers will fan out to 10 villages, including Waetina, where Kasi-Ani lives — and where malaria is a serious problem.

“It’s step by step,” the midwife said. “We have to teach better health practices over time. Here it began with the benefits of first initiation and breastfeeding. Now, we need to focus on the early warning signs for when our children get sick, especially now that disease is on the rise.”