In a region with one of the highest rates of maternal mortality in the world, one organisation is working with the community to provide not only safe and healthy maternity services to low-income women; they are working to improve living standards throughout the community for women and children alike.
First founded in 1995, Bumi Sehat Foundation International is a non-profit organisation run by midwife Ibn Robin Lim, a midwife who first had a vision of providing health services to women and children in Bali that would not only reduce the rates of morbidity and mortality, but also to increase standards of living through education and community programmes.
Bumi Sehat functions primarily as a birth centre where some 600 women come to birth each year, but the foundation also conducts community education and outreach programmes and family health services, as well as a village recycling programme and a youth centre.
The Bumi Sehat Foundation is staffed by a team of midwives, doctors, nurses, teachers, students and volunteers from Indonesia and around the world; and runs two community health centres in Indonesia - one in Ubud, Bali and one in Aceh.
The centrepiece of the work done at Bumi Sehat - maternity care - has a strong focus on evidence-based care and natural, gentle birth. Most of the births at the centres are water births - where the mother gives birth underwater – a practice that is known for being particularly gentle and supportive to both mother and baby, reducing the need for analgesia and other interventions in the birth process.
Maternal and infant mortality rates in Indonesia are among the highest in South East Asia, with studies showing that many of these deaths being due to complications caused by malnutrition. Bumi Sehat’s mission is to ensure the continuity of health and wellness in the community by providing a comprehensive nutritional education programme with an aim of reducing the rates of mortality.
The foundation also works to reduce the rate of caesarean deliveries of babies as a way of improving quality of life for impoverished families - caesarean section surgery is not only costly, the required recovery time for the mother, which in some cases is up to six weeks, can significantly impact on a family’s well being.
In addition to ante-natal care, labour and birth support, Bumi Sehat also provides post partum care and breastfeeding education services. The main focus of the centre is to put mothers and families at the centre of birthing, so that their labours are supported naturally and safely.
Ante-natal classes are held at the centre, where women and their partners are taught about pregnancy, childbirth, breastfeeding and parenting. Yoga teachers guide the pregnant women in gentle stretching exercises that help to increase flexibility and mind-body awareness in preparation for birth as well as improving circulation. Reiki practitioners and classes are also available for women to get treatments both ante- and post-natally.
The majority of clients at Bumi Sehat give birth naturally without interventions, thus reducing risks to both mothers and babies while empowering women to birth with dignity and control.
The midwives and nursing staff at Bumi Sehat place a strong emphasis on encouraging delayed cutting of the umbilical cord and early skin-to-skin contact between mother and baby, which has been shown to improve maternal bonding, reduce the incidence of respiratory distress in newborns, reduce maternal haemorrhage post partum and increases success of breastfeeding initiation.
The midwives also make good use of alternative therapies such as herbal medicine and homeopathic remedies where indicated as a preference over western pharmaceutical medicines. The double benefits of this are fewer side-effects and lower costs, while still maintaining safety and efficacy.
New mothers are sent home from the centre armed with information about breastfeeding, maternal nutrition, natural fertility management, infant hygiene, health and safety. Mothers are also welcome to return to the centre at any time to receive help with breastfeeding or neonatal health issues.
There is also a bi-weekly acupuncture clinic open to the community for fertility treatments. Acupuncture has been shown to be successful in treating infertility in couples, though nutrition advice also plays a part.
The centre goes even further than simply providing top-notch maternity care for women, Bumi Sehat also trains student midwives in safe, natural midwifery practices, and works to place and support local midwives in other areas.
Just as pregnancy and birth is just one facet of a whole community, Bumi Sehat reflects this through its community outreach programmes, which focus on improving many aspects of life for locals.
A branch of Bumi Sehat has been established to function as a youth centre which offers a wide range of services, activities and education to Balinese teenagers. Classes offered include sexual education, computers and internet, and English language.
The English classes are particularly successful, and are taught at four levels, with the lower levels being taught by graduates of the higher levels. According to the centre, this not only works to improve the English of the student-teachers, it also fosters the development of leadership skills. Given that tourism is one of the major sources of income for young Balinese, proficiency in English is a great boon to youth seeking employment.
At the other end of the community spectrum, Bumi Sehat provides programmes for the elderly which include walking and exercise groups, yoga classes, Reiki and support groups as well as health check-ups with the community doctor.
A strong emphasis is also placed on the environment, with a recycling programme which includes education and information about recycling as well as the dangers of the common local practice of burning rubbish, as well as offering a rubbish and recycling collection throughout the village. Recyclable plastic, paper and tin are recycled in partnership with a local health food store and the local Rotary Club.
The work done at Bumi Sehat is an inspiring example of how integrated community outreach can achieve amazing results throughout every aspect of a community, through raising awareness of health and safety issues, offering support, education and health services, within the community, by the community and for the community.
http://www.bumisehatbali.org/