Asian Urban Information Center of Kobe


Asian Cities and Natrual Disaster Preparedness -
Increasing Capacities for Maternal and Child Health Care

On 11 June 2010, AUICK held a UNFPA Seminar on the activities of UNFPA and AUICK. Panelists included the First 2010 Workshop participants and representatives of Kobe City Government and UNFPA Asia and the Pacific Regional Office. Around 200 citizens of Kobe attended.


In his opening address to the Seminar Mr. Toshihiko Ono, Executive Director of AUICK, welcomed the citizens of Kobe, and outlined the role of AUICK to disseminate population data, information and best practices in service provision to urban areas in Asia, with the support of Kobe City Government and the United Nations Population Fund (UNFPA). He introduced the Facilitator of the Seminar, Ms. Kiyoko Ikegami, Director, UNFPA Tokyo Office, and Mr. Najib Assifi, Deputy Regional Director, UNFPA Asia and the Pacific Regional Office, and Representative, UNFPA Thailand Office, who spoke on the guiding principles of UNFPA and its activities in disaster prevention and management. 

The United Nations Population Fund operates through its headquarters in New York, five Regional and over 110 Country Offices, to support population, development and reproductive health programmes. Its guiding principles are the Programme of Action of the International Conference on Population and Development (ICPD) and the eight Millennium Development Goals (MDGs) formulated at the Millennium Summit in 2000. These shape UNFPA's vision as an international development agency to promote the right of every woman, man and child to enjoy a life of health and equal opportunity. It supports countries to use population data for policies and programmes to reduce poverty, and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/ AIDS, and every girl and woman is treated with dignity and respect. 

The ICPD Programme of Action, adopted by 179 countries in 1994, links population issues with development, as a twenty-year programme to be achieved by 2015, which emphasizes that without equal opportunities and rights, women cannot contribute to the development of a society. Its goals include: 

- universal access to reproductive health services by 2015, requiring UNFPA's work with governments to make reproductive health services including information, clinics and counseling, reach everyone; 
- universal primary education and closing the gender gap in education by 2015, as in some areas boys have more access to education than girls; 
- reducing maternal mortality by 75 per cent by 2015, as thousands of preventable deaths are caused annually by complications in pregnancy; 
- reducing infant mortality - many newborn babies die in developing countries; 
- increasing life expectancy, which is still low in many developing countries; and 
- reducing HIV infection rates, which are high in many Asia-Pacific countries. 

The 189 member states at the Millennium Summit in UNFPA SeminaUNFPA Seminar 2000 agreed to significantly help the world's poorest countries through eight interlinked Millennium Development Goals (MDGs), the results of a series of international conferences on children, population and development, human rights, women, social development, HIV and AIDS and financing for development. As guiding principles for UNFPA, their achievement will increase development in all countries. 

The UNFPA Asia and the Pacific Regional Office (APRO) addresses the technical needs of countries in the region to improve maternal health, family planning, gender rights and young people's sexual and reproductive health, and to reduce teenage pregnancies and the spread of HIV/AIDS and sexually transmitted infections (STI). It works with hundreds of universities and institutions to collect and analyze population data, and to advocate for its incorporation into development planning. For disaster situations, it procures and distributes commodities for reproductive health, including medicines, contraceptives and equipment, working with other UN agencies, national governments and NGOs. 

Following comments by Mr. Assifi, the city government and academic representatives of five AUICK Associate Cities (AACs) spoke on the issues their cities faced related to maternal and child health care in disaster settings, and the challenges of Kobe City were presented by Ms. Yukiko Tanaka, Manager, Community Health Promotion Division, Public Health Department, Public Health and Welfare Bureau, Kobe City Government. The Seminar audience then posed questions to the panel. 

Comments, Questions and Answers 

How is Japan supporting the achievement of the Millennium Development Goals (MDGs)? 

UNFPA is most appreciative that Japan is among its top five donor countries, enabling its effective work in many countries. The fifth MDG, universal access to reproductive health and a reduction by three quarters in the maternal 15 AUICK Newsletter No.December 2010 55 mortality ratio, is more difficult than others to achieve, in part due the inaccessibility to pregnant mothers of clinics in remote areas which lack adequate roads or transportation, and the social issue of families preferring home deliveries where there is no medical assistance in the case of complications. Preventing maternal deaths caused by complications during delivery is not only the duty of health ministries, but also other sectors such as those in charge of transportation and road networks. Countries have plans to improve maternal health care, based on evidence and data, but resources must be directed to where they are needed. All countries and agencies in development work must address such pertinent issues together, through a more coordinated approach of donors and intergovernmental sector support. 

Japan has made significant progress to achieve the fourth and fifth MDGs; to reduce child mortality and improve maternal health care. The Japan International Cooperation Agency (JICA) is involved in international support to maternal and child health care, and Kobe can share its experience with other countries. Such organizations as SAARC (South Asian Association for Regional Cooperation) also strengthen political commitment to achieve development goals. Much is achieved, but much more needs to be achieved, through the promotion of bilateral and intergovernmental support. 

Does the promotion of equal rights for women and children include opportunities for their participation in policy making? 

UNFPA promotes involvement of women and youth in the formulation of programmes and policies to address maternal and child health. The most effective policies start with assessment and feedback, and effective programme design requires the views of target beneficiaries, such as those of young persons for strategies to improve adolescent sexual and reproductive health. 

Is there any duplication among United Nations agencies in their provision of maternal and child health care support? 

Three main agencies provide health care assistance: the World Health Organization (WHO) helps governments in setting national and global standards for heath care and conducts activities for global pandemic prevention (such as in the cases of SARS and Bird 'Flu), the United Nations Children's Fund (UNICEF) primarily works in child health and survival, and UNFPA focuses on reproductive health and related areas targeting women and girls. Here, UNFPA and UNICEF work is close but not duplicated, as they plan and work together in country teams. Disaster contingency planning is developed to involve all agencies and define their roles through the "cluster" approach, minimizing duplication. 

What is the status of post-disaster psychological care to women in the AUICK Associate Cities (AACs)? 

This varies among cities. Psychological support provision to disaster victims by medical workers, volunteers and NGOs was increased in Chittagong (Bangladesh) and Chennai (India), following the 1991 cyclone and the 2004 Sumatra Earthquake Tsunami, respectively, and in Danang (Vietnam), many local organizations provide support. Less psychological support is provided in Olongapo (Philippines), and Weihai (China), where local welfare volunteer communities will receive training on psychological support as a result of this Seminar. 

Have the lessons learned from Chittagong's natural disasters increased local capacities for disaster management? 

In 1991, there was no information or advance warning of a cyclone which killed over 130,000 people. Flood waters rose by 10-15 feet and submerged homes, where many women were trapped, unable to climb or swim, wearing heavy saris and lacking shelter protection. Since then, the development of extensive community training on disaster preparedness (especially to mothers and children on health care measures), and advance storm warning systems through the media and local volunteers (enabling people to seek shelter while their properties are protected), mean that a cyclone of a similar intensity in 2007 caused the significantly lower loss of life of 4,000 people. 

In conclusion to the Seminar, Dr. Hirofumi Ando, President of AUICK, summarized the key points it had raised.

There is strong recognition that natural disasters will continue to occur when they are unexpected, and their frequency will increase with the effects of global warming. In Japan alone, typhoons in 2009 were more numerous and occurred later in the year than usual. Natural disasters cannot be predicted, so we need to be prepared for all types, from typhoons and floods, to earthquakes and fires. The aftermath of the Kobe earthquake showed that the local community is the first source of assistance after a disaster occurs, before local or national government help arrives. So, to be effective, disaster preparedness should be based on networks of community participation. 

Since the AUICK Second 2007 Workshop on Maternal and Child Health Care in Natural Disasters, there has been significant development in the preparedness of the six cities represented at the Seminar, both physically (through shelter provision), organizationally (through disaster information and training provision), and in the supply of commodities, supported by UNFPA. Post-disaster management is also critically important, especially health care for mothers and children, on which we need to learn and disseminate more in the future, so that effective programs can be developed.
Panelists of the AUICK UNFPA Seminar

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