Sunday, October 4, 2009

UP-PGH Disaster Relief Operation and Breastfeeding Mission in Cainta

First, there was a call for breastmilk donations. Reports of infants experiencing diarrhea due to formula feeding (either badly-prepared formula or non-sterile water and feeding bottles) have started to alarm authorities. UP-PGH (spearheaded by Dr. Mianne Silvestre and Dr. Jessa Zareno), in coordination/cooperation with Arugaan (Nanay Innes Fernandez, Lita Nery and Velvet Roxas) and the Medela Clinic (which donated the feeding cups) rallied breastfeeding supporters to get the word out.

Facebook, Twitter and Plurk as well as text messaging all proved very useful tools in getting mommies from all over Manila to donate milk. People offered to be drop-off points, others offered to pick-up the frozen milk and bring them to PGH for pasteurization. The response was just overwhelming. We had three chestfuls of frozen breastmilk that day, leaving behind two freezerfuls at PGH.

Meanwhile, of course, relief goods also poured in PGH and medical paraphernalia as well as drugs were set aside for the medical mission. Four buses of volunteers were brought to Cainta last October 02 (at Kabisig Elementary School and Ynares Covered Court), some to distribute relief goods, some for the medical mission (nurses to perform vital signs and preliminary interview, doctors to conduct diagnosis, pharmacists to distribute prescriptions, and pharmacy counselors to discuss correct administration of drugs), and the lactation support group to distribute breastmilk and provide breastfeeding counseling and support.

One complaint about the whole thing is the fact that the call time for volunteers was 6-6:30 AM but we ended up still waiting for more volunteers at 8 AM. Of course, the breastmilk went ahead of the buses and I should have gone with it and not joined the volunteers assembly. So I generally missed the entire thing at Kabisig.

Kabisig Elementary School was the evacuation center for the people in Cainta who were really affected by Ondoy. They were the ones living near the floodway, whose homes were washed away. I am not entirely sure why the medical mission did not set up there and it seems, settlers there were not advised that they were to go to Ynares Covered Court for medical check-ups. Of course, when we told them about that, they all complained that they didn't have any means to go there... and it is some 1.5 kilometers away, an easy walking distance (if you don't mind the heat) if you're not sick, old or half-starving like they were.

From what I gathered though, breastmilk WAS dispensed to infants who needed it, and those with infants were gathered to be encouraged to breastfeed more and give formula less. They were given information (such as proper positioning and latching), strategies (switch nursing among themselves to help boost milk supply, relactate or encourage an infant to suckle), and some goodies (mommy and infant clothes from PGH, Prolacta breastfeeding kits, literature, etc). Velvet Roxas came with two wet nurses (with their babies) which helped a lot in getting the information across. Jenny Medina of LATCH conducted interviews and counseling with the moms there. Dr. Jessa Zareno was interviewed by some TV station. Nanay Innes also gave a short talk with the mothers to encourage them to breastfeed, then later on went to ANC to be interviewed on breastfeeding and its role in volunteerism and heroism after Ondoy.

Anyway, as all volunteers coming from PGH were dropped off at Ynares, we got a van to bring us to Kabisig. But since we arrived there late, we didn't have anything to do except maybe wait for the next feeding (after three hours or so). I suggested that we bring part of the milk to Ynares and we all ended up going there. They did leave milk behind for the infants staying at Kabisig but couldn't leave more because there's no refrigerator to store the milk in.

Being a covered court, the second venue was really conducive for the medical mission. They made space for us in the chapel which we shared with nuns dispensing relief goods. The pharmacists and doctors all included instructions that those with infants have to pass by us before submitting their records and leaving (the documentation, written on yellow pad, will be submitted to the local government for reference by other medical missions and for follow-up). But since filling prescriptions took time, we later ended up cajoling those in line to drop by first in the chapel.

Some obliged us. Some immediately left after realizing we're not dispensing relief goods. Some didn't want to leave their positions in line.

Wonderfully enough, a lot of those with infants/babies were breastfeeding or mixed feeding so it was just really a matter of encouraging the mixed-feeders to drop the formula. Some of those with babies 8 months and older who reported that they were breastfeeding exclusively were given rewards in the form of shirts. "Spoil the breastfeeding mom!" after all :)

Since we had some thawed milk that we had to distribute or throw away, we resorted to going up and down the line and giving away milk, even to toddlers. PGH-NICU could have probably given away all the breastmilk but doing so would have defeated the purpose of the mission: to get mothers to breastfeed. See, that would just make it a milk doleout, healthier than formula maybe, but a doleout just the same. But the thawed milk, we gave away, of course, out of consideration to the mommies who painstakingly pumped and donated them. We didn't even consume everything in one chest, but they agreed that since that chest has been opened several times already, the milk there will be used in PGH-NICU and given away to the children in PGH's pediatrics ward. The milk in the two other chests remained frozen so they were returned to the freezers.

Others who want to organize their own breastfeeding missions can probably coordinate with PGH and get access to their milk resource. But the goal must always be to give the breastmilk to infants on formula, while encouraging breastfeeding mothers to continue doing so.

The misson ended around 2 PM and we immediately headed home for fear of Pepeng, which thankfully did not cause further devastation.

And now, in pictures:

breastmilk being loaded into the van at PGH

breastmilk awaiting recipients at Kabisig

newly-arrived LCS volunteers at Kabisig with nothing to do

volunteer doctors at Ynares Covered Court

view of the line/crowd waiting for prescriptions

stage served as the pharmacy

doctor at work

Velvet teaching a mother of twins the football hold (not this pic),
the cross cradle hold (this pic) and that nursing twins is possible

one of the babies getting breastmilk

some of the volunteers and PGH staff

One of the doctors with us was so moved by the experience that she even attempted to play wet nurse. Unfortunately, the baby was already so full from her own mother's milk. It was really amazing that so many from that area were breastfeeding :)

Oh, they also gave breastfeeding moms Vitamin A :)

My only real interview was of a Mom with a one year old who only breastfed for two weeks. She was not interested in relactating (and given the time frame and situation, it would require a lot of support and work on her part for that to happen) but I hope I was able to correct her notions of empacho (because she was not feeding her baby at night, and feeding her only twice a day) and encourage her to offer more solids so that the baby's formula requirement will be reduced. It was especially important since they don't have clean water yet and she had to ask me for a liter of mineral water to make her baby's formula. And I couldn't give her breastmilk that time because they were still in Kabisig then.

One other wonderful thing, I think, is that the LCS volunteers loved feeding the babies so much that they're asking the PGH-NICU doctors if they can volunteer regularly at the NICU. This is very important because these are single, medical students who are now in a position to be the breastfeeding advocate doctors of the future.


UNICEF is organizing breastfeeding support missions in the many evacuation centers. Those may not prove as easy as this one (because we need not go through muck and mire to get to the displaced) and chances are, we will not be appreciated by half of the people if we're not bringing goodies as well... but still, the breastfeeding campaign has to be done and the babies have to be saved yet again.


Love thy own... and I not only love LATCH but I am ever proud of my breastfeeding circle. Not only did many of our people donated milk and rallied their friends to also donate, but we also offered to be drop-off points or to pick-up milk. We even got our friends to do the same, relying on friendships and contacts to really facilitate the milk donation. We appealed to Facebook friends and used up our load in text brigades. Amelia Alba even prepared 500 packs of noodles to be given away to breastfeeding moms (told you, spoil the breastfeeding mom!). And now, we're responding to UNICEF's call for volunteers again.


Just to explain further (because even I am still learning this paradigm shift), breastfeeding missions do not hope to dispense breastmilk as if they're formula to be fed to babies. Breastfeeding missions are about getting mothers to breastfeed, breastfeed more and breastfeed again. What we want is for them to have the information and suppport to sustain their own infants after we've gone.

Breastmilk donations are given to really premature babies, babies whose mothers cannot nurse them just yet, babies in emergency situations, sick babies and orphaned babies. But they are only given for a short period of time, when they're critical, but means for sustaining the babies is the goal. That's where breastfeeding, a mother's commitment, a community's support and the help of shelters, LGUs, concerned citizens, etc. come in.


Jenny said...

great post mec! thanks for sharing your experience :)

Unknown said...

wonderful post, mec! i can't wait to join you guys the next time!

howie said...

Big hugs and congrats to LATCH Moms for this effort. I really think middle class breastfeeding Moms should make this a habit -- going to communities flooded out or not, to spoil the Moms who are breastfeeding. I'm sure many breastfeeding Moms are just waiting for a chance to share their joy in an organized and predictable way.
Another idea is to tie up with a TV show where spot visits and gift bags for those using a product are shown on TV, but this time, the product is their own MILK! (Ipat using Howie's google account)