Improving the lives of disadvantaged children in Vietnam

Travelling impression with Save the Children Italy

 By Vu Thi Ngoc Tuyet

IMG_2172 Hoang Thi Lieu carefully arranged a food nutrition tray in the middle of a small hall room in front of about 20 ethnic minority mothers. Today, the local nutrition worker was teaching the mothers from Nam Kip Village how to cook proper nutrition food for their children. The session is a part of community’s communication session under Save the Children nutrition project in Van Chan District, Yen Bai Province. 

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It was lovely Spring morning as I accompanied two Italian colleagues from Save the Children Italy – Ms. Francesca Petrecca, the Head of Portfolio Management International Programs and Ms. Maria Luisa Altobelli ASIA and LAC Regional Portfolio Management – to visit projects that Save the Children in Vietnam is implementing in two mountainous provinces of Yen Bai and Lao Cai.

 We have been collaborating in term of institutional operations, however, this was my first time to coordinate our Italian colleagues visiting Vietnam country office. I felt a bit over-worried at beginning for the schedule was tight and the roads to our projects by this time of the year were so bad. But then, we were all caught up with our activities with excitement.

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 We started with a visit to Tran Yen District to see Save the Children’s work on disaster risk reduction for mostly H’Mong population in Hong Ca Commune. It was a long and challenging drive up to a high mountain to get to the school. I couldn’t imagine the difficulties the children have in walking to the school every day and what could happen to them if a landslide occurred. When we got to the school, the children had been ready to play an evacuation drill for us and our visitors. The children were very skilful in actions and with first aids assistance to each other. We were impressed to hear from the teachers that the children were also promoting disaster risk reduction activities in the community after they learned at schools.

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 As we went to Van Chan District to visit the child nutrition project site, our visitors had an opportunity to attend a child nutrition education session for mothers in a private home of a community leader. Here, under-2 year old children were measured by height and weight while mothers were trained on how to cook nourishing meals for their children with locally available foods. The exciting atmosphere of the education session, from introduction of ingredients, demonstration of cooking, practicing to eating the food, was interesting. This is a typical activity organized by community health workers and Women’s Union who has been trained by Save the Children in partnership with the Department of Health.

Our last step was in Lao Cai Province, where we have started the Child Sponsorship Programme. We visited Nam Lu Primary school in Muong Khuong, one of the poorest districts with 55,6% poverty rate. It is home to 6 ethnic minority groups (about 88% of total district population). Children, particularly the ethnic groups, face various challenges from hunger, poor nutrition, language barriers and limited resources for quality education.

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We had good talks with teachers, children and the school managers. It was really moving to see how difficult the poverty situation is. Teacher Then Thi Nhung said: “People are very poor, so they don’t consider education as important. Getting the children to the school is challenging, let alone asking parents to pay for anything. Many children go to school without textbooks and other school materials. The school facilities remain meagre. There is no clean water for the children to use.”

 Ms. Petrecca asserted Save the Children’s support at a meeting with Lao Cai’s authorities. As we are trying for better future, I see the hopes in smiling faces of the children.

 “I would like to go to school because I have fun, however, the school still doesn’t have electricity and water”, said a nine-year old girl Trinh.

Impression: Nutrition Improvement for Vietnamese Poor Community with Save the Children Japan

By Truong Thanh Van, Nutrition Project

One of the best experiences I have had with Save the Children is travelling to the project sites. I had a few occasions to accompany our colleagues from Save the Children Japan and its donors as Japan is the main sponsor for our nutrition project in the northern mountainous province of Yen Bai since 1990s and I am working for the project since early 2013.

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For me, meeting with the local people and having opportunities to talk about Save the Children’s work with my international colleagues and donors are both inspiring. In March, with three gentlemen from our donor organization Uokuni Food Services Co. Ltd., I went to Van Chan District to visit a poor family whom Save the Children in Vietnam has been supporting. As the local communities have been still struggling with food gaps and malnutrition, Save the Children developed a project to promote alternative improvement to children nutrition and to support local communities to create their own organic food through making use of natural resources.

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Phung Thi Quy, a mother of six, took us to visit her small farm that she built based on the techniques she has learnt from Save the Children’s trainings. She uses red worm to feed livestock and worm compost to fertilize the soil. The technique allows the farmers to save money on chemical and livestock foods. Besides, by making use of natural resources, families could also create their own food and improve the nutrition for them. “We have had more food for our daily meals from our own farm. Our neighbours have started to come and learn from what I am applying”, Quy said.

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I had never imagined how red worm compost would be useful and helpful for farming before joining Save the Children. So do my foreign visitors, I guessed. In 2013 Quy won the “Best Nutrition Garden” Award at a community competition organized by Save the Children.

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Another trip to Van Chan that I will never forget was when our nutrition team and a colleague from Save the Children Japan, Taketa Mayuko visited the district to conduct a natural food research with the participation of children. It was a heavy rainy day of August which turned all the mountain roads into muddy and slippery trails. Our car couldn’t move so we had to walk about two kilometers to get to Nam Toc village where Save the Children is  implementing the project. The village is home to Dao ethnic minority people. The children we met were very shy to answer questions so we decided to group them for activities from which they could address their knowledge about nutrition and food. To our surprise, the children could present food groups in their amazing drawings. Some of them took us to the local woods to show us the food resources they could use by the end of the days. We got everything we need for our research as the children provide us such a great information and experience.

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My Japanese colleague was so excited. She couldn’t be happier when she dressed in Dao costumes and danced frenetically at a lunch invited by a local.

A story of a male midwife

By Nguyen Quynh Mai , Alive & Thrive Vietnam

Sweaty forehead, Vy Van Ot, was holding breast feeding counseling cards and enthusiastically talking to local mothers in the narrow space of a Thai stilt house. Ot, 33 years old from Thai minority group, is one of nine village health workers in the commune.  All nine health workers in the commune are men.

On a rainy day last month, I followed the Alive & Thrive project team to Dun village, Bat Mot commune, Thuong Xuan district, Thanh Hoa province. We crossed over 65km of winding mountain roads, which made me feel a little queasy. Bat Mot commune appeared in front of my eyes with small villages, hidden behind terraced rice fields and hills. A Laos-Vietnam frontier commune, Bat Mot has 3,679 citizens, mainly ethnic Thai people, living primarily on rice and corn cultivation and afforestation. On average, 50% of households are poor and one of 3 children under 2 years of age is stunted.

Vy Van Ot is playing with his nephew, Vy Quoc Khanh, 6 months, 8kg, thanks to exclusively breastfeeding.

Vy Van Ot is playing with his nephew, Vy Quoc Khanh, 6 months, 8kg, thanks to exclusively breastfeeding.

“I have been working as village health worker for 10 years. My main job is to communicate and support health centers in health related activities such as immunization, plague prevention and family planning. In addition, I also work as a midwife in my village as well as in the neighborhood as health centers are often far away from villages many women are still giving birth at home.” Ot said.

A male midwife – we were surprised as typically men are not known to perform child delivery services in villages. “If I conduct a delivery for a woman in the village, we need prior approval from her husband“, said Ot. In February 2013, his village was chosen as one of three villages to implement the infant and young child feeding support group model as part of the ”Improving the Nutrition Status of Children 0-24 months in Thuong Xuan District, Thanh Hoa Province, Vietnam” project funded by Irish Aid. As a village health worker, Mr. Ot, participated in training on breastfeeding and complementary feeding. Following eight days of training, he returned to his village, and along with other staff organized group meetings for pregnant mothers and families with young children about the benefits of breast milk, exclusive breast feeding in the first 6 months and appropriate complementary feeding. The talks were sometime officially organized in the house of the village chief, sometimes casually in the field.

Mothers and caregivers of Dun village participate in a regular meeting of Infant and Young Child feeding support group in Bat Mot commune, Thuong Xuan district, Thanh Hoa province

Mothers and caregivers of Dun village participate in a regular meeting of Infant and Young Child feeding support group in Bat Mot commune, Thuong Xuan district, Thanh Hoa province

“I was unaware of this information before. My wife and I fed our children with chewed rice, as is tradition of this village. After participating in this project, undergoing trainings and receiving documents about infant feeding, I have applied the knowledge for my nieces and nephews at home”, he said enthusiastically. His youngest nephew, Vy Quoc Khanh (6 months), was exclusively breastfed for the first 6 months. Khanh now weighs 8 kilos, only 2 kilos less than his sister who is 2 years old.

“Given the positive experience in my own family, I always ask mothers to breastfeed their children immediately after delivery, and carefully instruct them not to give their babies anything to eat or drink other than breast milk during the first 6 months and to continue to breast feed up to 24 months. I believe these meetings are very useful. Mothers now understand how to feed their children and are changing age-old habits”, said Ot.

Many mothers in the village who worried that these recommendations will make their babies die of starvation, have now become pioneers in exclusive breastfeeding.

“He advised us to work in the fields as normal, and comeback after 3 or 4 hours to breastfeed our babies. His niece and nephew grew up healthy, having been exclusively breast fed since birth. I can see the changes in the development of my child, I trusted Mr. Ot and applied the advice”, Ms. Vy Thi Xuan, mother of a 4 month-old boy.

Prior to December 2013, exclusive breast feeding upto six months in Dun village was practically non-existent. By December 2013, four of six babies of 6 months old were successfully breastfed during the first 6 months. In addition, the perception of mothers and caretakers about infant feeding has improved. Children are no longer fed too soon with chewed rice. The Thai house of Dun village has become a place for mothers to meet and share their infant and young child feeding practices every month.

 

The Forgotten Emergency: In Vietnam, Child Protection Systems Strengthening and Disaster Preparedness Offers Lessons for Other Countries in Child-Informed and Prioritized Planning

David Brickey Bloomer

Asia Regional Child Protection Advisor

In an emergency context, shelter and infrastructure tend to garner a lot of focus from local authorities—as well it should in many cases, as shelter is a basic right—and it was no surprise in Vietnam, experiencing two typhoons before the world’s attention turned to the Philippines in the aftermath of Typhoon Haiyan, that local authorities talked extensively about their struggles to meet all of the shelter and other infrastructure, such as school repairs, needs and demands.  It did not take a lot of prodding on my part, however, for local authorities to talk about their disaster risk reduction and response planning as well as their efforts to strengthen systems which responded to the needs of women and children, which was a good effort to build foundations under a burgeoning system.

Pre-school children happy to be back in their revamped centre

Pre-school children happy to be back in their revamped centre

In several affected areas, Commune and People’s Committee members spoke enthusiastically about their disaster risk and evacuation planning and how this planning revolved first around the priorities of women and children.  We note the good practice of including Women’s Union representatives in disaster preparedness planning.  In Hung Trach commune an area of frequent flooding and where over 70% of the homes had roof damage due to high winds, the Women’s Union representative recounted how women and children were their first consideration.  “We organized boats to evacuate women and children first and the disaster group works with individual households on disaster preparedness,” she commented proudly.  A community member echoed this sentiment:  “We wrapped up the children’s school books and stationery items and some of their clothing and made sure it was in a place where it wouldn’t be damaged by water.”  It’s not often that I hear parents prioritizing their children’s school books and although it may seem a rather small matter, in actuality it is often the loss of these items that can make the difference in a child rejoining school in the aftermath of a disaster as families are typically burdened with the loss of income and livelihoods and find it difficult to replace these items.  Save the Children did provide back to school kits for many children from the most marginalized households, but the good efforts of communities and local authorities to prioritize children’s needs—and to take into account children’s concerns—are highlighted as excellent examples of child informed disaster preparedness planning.

With one of the great People’s Committees of central Vietnam that prioritizes the needs of children

With one of the great People’s Committees of central Vietnam that prioritizes the needs of children

 Most of the local authorities that we met thought that psychosocial distress issues among children were not overt as a result of the twin typhoons and subsequent flooding.  One rationale for this came from our meetings with teachers all acknowledging that as teachers they were provided with some basic “psychological” and counseling skills as part of their teacher training.  It certainly helped that schools were able to reopen rather quickly after the emergency, thereby, providing a safe and structured environment for children.  But teachers, and school administrators, were quick to point out that their psychosocial first aid skills were fairly basic and that they could benefit from and wanted to learn more about assisting children with their well being needs.  Many schools are already beginning to integrate and mainstream components of disaster risk reduction into their curriculums, in health and physical education, for example, and, as one teacher pointed out, “psychosocial support training would help us understand the practice of providing support more extensively and we could even use those skills to raise awareness on protection issues with the larger community—with parents and caregivers.” 

 This coincides well with our discussions with Bo Trach district Social Affairs officials (DOLISA) on our first day in the field.  They specifically mentioned “bringing back a counterpart system” by which districts worked more closely with local level officials and that capacity building support for local committees and officials would be welcomed and would strengthen the overall child protection system.  Like in many other countries, Vietnam’s child protection systems are challenged in a humanitarian context to meet various demands, yet there are visible signs that with its focus on mainstreaming protection initiatives in other aspects of disaster risk reduction and preparedness planning and a strong emphasis on prioritizing women and children that the continued growth and effectiveness of child protection systems in the country is bright.

 

Why do ethnic minority women like to delivery at home?

By Nguyen Thi Cam, Health Programme Officer

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A lot of ethnic minority pregnant women especially in the mountainous regions of Vietnam have opted for home delivery.  In fact, given the hygienic and disadvantaged conditions, it causes a lot of dangers for the health of both mothers and babies.

There are many cases of serious infection and complication during the labour which have resulted maternal and newborn death. However the number of women goes for this option of delivery doesn’t drop.

There are many reasons for it.

Firstly it is their culture. Many ethnic minority groups still assume that pregnancy and the delivery are within of their personal and family’s issues.  If a mother has a sign of complication during her labour, then she will seek for the support by her husband, her mother or other family members rather than a health worker or a midwife.

Secondly, it is difficult to have access to the health centre with proper facilities to provide treatment and care for mothers and newborns. Under Vietnamese government policy, a clinic is available for every commune; however, this clinic is located in the very centre while most of ethnic minority people live in remote village from which it takes them hours on mostly bumpy and slippery roads to get to the centre. Many people when asked to concern about the fees as well.

Finally, due to living isolated and remote, the ethnic minority mothers have little opportunity to have access to information and education, let alone the skilled midwives or health workers. Save the Children have been working to address the problems and to propose solutions for safety of mothers and babies.  

 (1) Improving the accessibility, availability as well as quality of health care service in remote and mountainous areas, including the provision of training courses on Behavior Change Communication not only for commune health staff, village health workers but also the leaders of villages and women unions;

(2) Strengthening and encouraging communication campaigns on maternal and newborn health for community people, particularly activities on home visits or community meetings;

(3) Establishing good and supportive environment for staffs who are working in the grassroots health system: good salary/stipend, regularly supportive supervision trips.

 

CHANGES FOR BETTER FUTURE

By Phan Thi Thu Huong

We visited 6 schools in Tien Yen and Ba Che districts, Quang Ninh Province where the project “Closing Educational Disparities for Disadvantaged Children in Vietnam through Increasing Access to Quality Basic Education” funded by IKEA Foundation is being implemented.

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It was raining and chilly but, to my surprise, almost all children attended their classes . Normally, the February is the holiday month which means that many parents let their children stay at home as that was the relaxing time after Tet. The atmosphere in the classes was the most impressive scene. Raising little hands were seen every time the teachers asked for student’s opinions. The exciting voices were heard from groups to groups during their discussion activities. The confident manner was expressed during the sharing of the students.

These small changes were made by huge efforts from Save the Children’s staff, local authorities, education managers, teachers and students themselves. When the project started in 2011, there were not enough words to show the difficulties of the students and the teachers. Teachers and students could not communicate effectively as students only used their mother tongue while teachers only spoke Vietnamese.  Teachers also did not know how to make the lessons more interesting and understandable for their children. As the result, the attendance rate and the performance of students were very low. Keeping the students to stay at school was a big challenge, let alone helping learn well.

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Thanks to the support of IKEA Foundation, Save the Children has organized series of training to help teachers on how to work with ethnic minority children and how to use interactive teaching methods to engage the active participation of more children.  In addition, teachers were also guided to approach the new “Cluster Teacher Professional Coaching Model” which focused on analyzing the learning activities of the children so that teachers can adjust their teaching methods to suit their children’s ability and needs.

The crystal laughter of the students went out of the classroom as a cheerful goodbye to us which warm our hearts in the cold winter. A mental note was written in our mind that we would try harder for the better development of this young generation.

Nearly 12,000 babies in Vietnam die each year during childbirth or within the first day

Nearly 12,000 babies in Vietnam die each year during childbirth or within the first day each year, Save the Children says in a new report released today. The report, Ending Newborn Deaths, revealed that globally 2.2 million children die during childbirth or within a first day of life, half of which could be prevented if the mother and baby had free healthcare and a skilled midwife.

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Southeast Asia region is home to six of 75 high-burden countries in terms of child and maternal mortality, including Cambodia, Laos, Indonesia, Myanmar, Philippines and Vietnam. Within this regional group, Vietnam leads the way on maternal and child health, with the lowest number of children dying with during childbirth or within the first day.

Vietnam also has a high percentage of skilled attendants at birth (91.9%) in the region, compared to Laos at 37%; and a high government expenditure on health per capita (US$93.39) that is above the WHO recommendation of minimum US$60 per capita, compared to countries like Myanmar that invests a mere US$3.61 per capita.

“The first moments of a child’s life are the most dangerous, yet too many mothers do not have access to any skilled help during labour,” said Gunnar Andersen, Country Director for Save the Children in Vietnam. “Vietnam has made substantial progress in maternal and child health, but we should not rest on our laurels. Instead, we should continue our work to achieve even better health services so no child dies from preventable causes.”

In a bid to save millions of newborn lives, Save the Children has called on world leaders to commit in 2014 to a blueprint for change – The five point newborn promise – which focuses on training and equipping enough skilled health workers to make sure that no baby is born without proper help, and removing fees for all pregnancy and birth services.

Save the Children is calling on world leaders, philanthropists and the private sector to meet and commit to the Five Point Newborn Promise in 2014:

  • Issue a defining and accountable declaration to end all preventable newborn mortality, saving 2 million newborn lives a year and stopping the 1.2 million stillbirths during labour
  • Ensure that by 2025 every birth is attended by trained and equipped health workers who can deliver essential newborn health interventions
  • Increase expenditure on health to at least the WHO minimum of US$60 per person
  • To pay for the training, equipping and support of health worker remove user fees for all maternal, newborn and child health services, including emergency obstetric care
  • The private sector, including pharmaceutical companies, should help address unmet needs by developing innovative solutions and increasing availability for the poorest to new and existing products for maternal, newborn and child health.
  • For Vietnamese version, please go to the link: Press Release – Vietnamese

Scaling up financial education programme for young people

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Save the Children in coordination with the Education and Training Department of Hai Phong City has launched a financial education project for children from 10 secondary schools in Hai Phong last week.

The project is a part of the organization’s financial education programme titled “Smart Start for Students” since 2009 which aims to provide high school students with personal financial management and basically financial service management skills. The programme started in two schools in HCM City in 2009 and is currently implemented in 182 high schools across the city.

The Hai Phong project launching was conducted together with a training course for 20 teachers from the 10 schools. The two-days training provided information about monetary policy, business management and investment, need-and-want management, savings and personal budgeting and the methodology to teach the subject for the teachers.

 

“We highly appreciate valuable support by Save the Children. The financial education is useful and helpful because it provides young people with financial knowledge and skills, with which they should recognize the importance of financial resource, respect their parent efforts and learn how to manage their personal finance. It is not only helpful now, but also helpful when they enter to the university where they begin to live independently. Currently, the education sector not only focuses on theoretic knowledge but also emphasizes on life skills for the children. Therefore, we will make a full commitment to implementing the project”, said the Director of the Education and Training Department, Mr. Vu Van Tra, at the launching event.

In January, the financial programme will start for university students in Can Tho City. The programme will focuses on free-training courses for students. Completed certificates will also be granted for full participants.

 

Save the Children provides training on medical teaching system for top obstetricians and pedestrians

2014-01-08 11 05 56Save the Children provided a week-long training on medical teaching system – SCORPIO- for 15 top obstetricians and pedestrians from Yen Bai, Dac Lac and Ca Mau provinces.

The SCORPIO (Structured, Clinical, Objective Referenced, Problem-based, Integrated and Organized) is a model of on-the-job training that involves in a series of lecture-demonstrations wherein the trainers and trainees can interact the same time. The method is not yet to be used in the medical schools in Vietnam.

The 15 doctors are expected to pass on their acquirement from the training to other 300 doctors, nurses and midwives at districts and communal levels in attempts to improve the maternal and newborn care services in poor areas of the three provinces.

“This is a useful methodology that would help us, and other health workers from remote and rural areas have an opportunity to improve our skill in providing clinical treatments for mothers and infants,” said the Director of Ca Mau Reproductive Centre, N.N Hoang.

The week-long training is a part of Save the Children maternal and newborn care programme which focused on:

  • Increasing access to and availability of key services for maternal and newborn health at all levels
  • Increasing in quality of essential and emergency maternal and newborn care at all levels of health services
  • Improving knowledge, skills and home care practices for new mothers
  • Strengthening management, social support, and enabling environment for maternal and newborn survival

The programme titled “Household to Hospital Continuum of Maternal and Newborn Care in Vietnam” started in Khanh Hoa and Da Nang in 2008. After three years of implementation, the programme proved a great impact. The mother death rate and newborn death rate were reduced remarkably in the two provinces.  Between 2011 and 2012, Save the Children expanded the programme in Thai Nguyen, Thua Thien Hue and Vinh Long provinces.

Currently, the programme is scaling up nation-wide.

Over 2000 poor women have access to Save the Children’s micro finance programme

Save the Children has supported more than 2000 poor women in Can Tho City to increase their incomes through a microfinance programme since 2010.

Strong economic growth in Vietnam has brought about an increasing number of economic opportunities that traditionally were unavailable. However, many disadvantaged women entrepreneurs failed to survive the market leading to limited growth and low bargaining power in the marketplace.

In partnership with the Can Tho City’s Women Union, Save the Children provides small loans for rural women farmers to help them expand their production, invest in new farming and set up service business to generate incomes.

It also provides trainings on agricultural and farming productions, service business operation and budgeting management so to help the poor women adapt new livelihoods practices.

The ultimate objective is to build sustainable livelihoods for poor households in the province from which the children are provided with opportunities to have access to education and reasonable conditions to grow healthily.

“Save the Children’s microfinance programme has gained fundamental achievement. Through the progamme, the local poor women have had opportunities to have access to financial service and training to improve their production and business capacity. Most of borrowers have increased their incomes and improved their livelihoods quality”, says the President of Can Tho Women Union, Phan Thi Hong Nhung at a reviewing workshop held in Can Tho last week.

“The programme has made a remarkable contribution to the provincial poverty reduction objective in the past few years’.

Save the Children has had over 10 years of experience in assisting poor households to develop sustainable micro enterprises in Mekong River delta, northern mountainous and central regions in Vietnam.

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