ACCESSIBILITY

What is accessibility?

In the context of disablility,"accessibilty" refers to how easily, safely and independently an environment can be accessed by all people. It aims to create an environment free of barriers to to movement for everyone. For example, a person with disability who requeres a whellchair to move around cannot enter a building independently, freely and perhaps even safety if there are stairs at the entrance. If they have to be carried in this is not easy or independent, and may not be safe for them or their helpers.

An environment is said to be barrier free if every part of it is accessible, even for people with disability :

• Streets
• Public places
• Transportation
• Private buildings

A building is said to be accessible if everyone including people with disability can :

• Enter the building
• Move inside
• Use all the facilities
• Leave the building
  

Accessibility is a Human Right
A barrier free environment benefits everyone. It's a key factor in creating an inclusive society. But above this, accessibility has been declared a universal Human Right By the United Nations and this has been incorporeated into Indonesian law (UN resolution of 20th Desember 1993, art 19 of UN convention project and Indonesian law : no 4/1997 and no. 28/2002).

Why is accessibility improtant ?

• Better accessibility a significant part of the population that suffers from reduced mobility : according to the WHO, people with disability represent from 5% to 10% of the global population. If we add people "in situation of disability" (people with temporary disability, elderly pregnant women and children) this statistic reaches 50% of the whole population.
• Accessible places prevent accidents from happening.
  
• Incorporating accessibility into the original design of a building only the price slightly.
• But later modifications of the building are much more expensive.
• Taking accessibility into account in construction plans facilitates the practice of a sustainable development.

Obstacles or barriers in the environment become barriers for a person in achieving their rights.
What's up concerning accessibility?
Lauching of a 6 months Awareness Campaign "Access for all" June to december 2007 by the NGO HANDICAP INTERNATIONAL with the support of the Municipality of Banda Aceh (project financed by la chaine du bonheur, Swiss Solidarity).

For 6 months, public facilities of Banda Aceh are going to be audited in terms of accessibility. Following the audits, an accessibility map will be created showing accessible and non-accessible buildings as well as friendly areas. This map can be used as a guide by users of public facilities and policy makers. Accessibility awards will be offered to the most accessible buildings. There will be different categories of awards for : health facilities, commercial buildings, accommodations, schools, banks, markets and more.

Let's work for an accessible society for all
Sources : By Marjorie Unal, Inclusion Coordinator, Handicap International Banda Aceh, Health Massenger.

TAKE CARE OF YOURSELF

For people suffering from stress, "Psychological first AID" can be provided to relieve the tension and there are various ways to do that.
Different activities can help people to relax : singing, listening to music, going for a walk, taking time to talk with friends with whom feelings and experiences can be shared.

There relaxation techniques can be very useful and effective for people suffering from stress, anxiety and psychosomatic disorders :

• Breathing exercises
• Muscular relaxation
• Meditation

These exercises should be done in a quiet place where nothing or nobody can be a disturbance, wearing loose clothes and, twice a day, for at least ten minutes, preferrably before meals. It is also important to be concentrated when doing the exercice and not think about other things.

The regular practice of these exercises can really help to find peace of mind, tanquility and calm in various tituations and hence, improve physical health.

Breathing Exercises
Learn to breathe, slowly and deeply, with you abdomen. Putting your hand on it, you can feel it expand, when you breathing you can count when you breathe in and out. For example you can count u to three, for example, for each breathing. With further practice you can incrase the counting during each breathing to help you to breathe more deeply and slowly.

Be careful not to become sleepy or dizzy. Do not exaggerate or accelerate your breathing.

To help you concentration, you can focus your attention on the airflow in your nose.

Muscular Relaxation
This is a very good exercise when, due to stress, muscles are continuously contracted, and / or the patient has headache, backache, neck pain, joint pains and feels weak and tired.

For this exercise, lie down on your back, on a bed or a mat. Lay your arms on each side close to your body with the palms upwards. Observe your breathing as mentioned above.

Starting from your toes, relax each part of your body. First you consentrate your thoughts on your feed and thing deeply "my feed are relaxed, very relaxed" and try to feel the relaxation spreading in your feet. Then move up step by step to your ankles, legs, thinhs, abdomen chest, arms, hands, soulders, neck and head. For each part of your body you should think "my is relaxed, very relaxed" In each part of your body you should feel the relaxation and tranquility spreading.

At the end of the exercise, the whole body should be deeply relaxed, almost "lifeless". Experience the feeling or relaxation in you whole body for a few minutes.

At the end of the exercise do not get up suddenly. Slowly move slightly some part of your body and then get up slowly.

Meditation
Meditation is practiced seated with the back straight. Legs may be crossed in the lotus position for those who are flexible enough and feel comfortable like this.

The simplest practice of meditation is to attentively observe your breathing and focus your mind on the airflow in the nostrils or on the movements of your abdomen. You may start by counting each breathing by series of 10 and then, when the mind is well enough concentrated, you just keep focusing on the air you inhale and exhale.

Another technique is to choose an object, an idea or a word, a symbol of peace or aword of wisdom.

The most important is to keep the concentration on the object of your meditation. if you feel that your mind becomes distracted, comes back to your object. If you feel that other ideas come to your mind, do not follow them and let them go away peacefully, just keep focusing on your object.

Sources : Health Massenger, http://www.activefitnessworld.com/articles/yoga/yoga_workout.php

IMPORTANT TREATMENT DURING PREGNANCY

According to a July survey (ASHO), There were, in july 2005, 28 pregnant women in Banda Aceh, 54 in Aceh Besar, 52 in Bireun, 100 Aceh Pidie, 119 in Aceh Utara, 15 in Aceh Barat, and 7 in Nagan Raya : 375 women needing to know the basics for a good treatment during pregnancy.

Goot To Remember

• Women with risk conditions need to be cared in a health facility which is staffed and equipped to provide essential obstetrical and neonatal services, including surgery.
• Do not delay anymore! Have you health routinely checked-up starting labor, and during puerperal period by the doctor, nurse or midwife, in the nearest health center or hospital!

What are ante-natal basic cares?
Improved nutrition and address anemia

• Promote good and balanced diet iron and folic acid for all
• Provide target protein-energy supplementation as appropriate
• Identify and treat sever and moderate anemia.

Prevention and treatment of infections in pregnant women

• Identify and treat STIs, especially syphilis, gonorrheal and non-gonorheal urethritis, always aware of possible trnsmission of HIV/AIDS.
• Institute prevention of malaria in endemic areas.
• Ensure tetanus, toxoid immunization coverage of all pregnant women

Get eady to delivery

• Enable women to choose a skilled midwifes/doctors and to ensure clean materials for delivery.
• Encourage mothers, fathers, and families to prepare for potential complications during delivery.
• Address transport difficulties wiht use of community paticipatory metheods

Health promotion for community

• Educate women/communities about the danger signs for the mother during pregnancy and delivery.

Warning!
what are the risks situations during pregnancy?

• Very young (less than 20 years) or over 40 years old women.
• Very frequent period of pregnancies (less than 2 years).
• Woman with medical problem (such as very short in height or malnourish woman)
• Woman who had more than four previous pregnancies.
• Woman who had experienced difficulties during previous deliveries.
• Woman who had caesarean section in the past.
• Woman who had baby born dead or miscarriage in the past.
• Woman who had premature or very small baby in the past
• Woman who is pregnant twins babies
• Woman who is bleeding abnormally
• Woman with high blood pressure
• Woman with abdomen size over than normal.

Sources : Health massenger, WHO, Special Issue On Mental Health.

HYGIENE PROTECTS YOU AGAINST DISEASES

Good hygiene is the first step towards good health, in the health centre, the house and for people. In hard working or living situations it is important to fit to simple hygiene principles and to remind the patient about it.

What is good hygiene? to have good hygiene means to keep yourself, your house, your garden, your village, and your work environment clean to prevent infection. An infection is a desease caused by bacteria or virus, which can be extremely harmful to people, especially the weak one: children, pregnant women, sick persons and elders.

Why prevention is so important ?

• Not all infectious diseases can be traated and some of them are fatal
• Prevention is less expensive than treatment.

What is an infectious disease?
Infectious diseases are the result of an attack of the body by a bacterium, a virus, a superior parasite or a fungus. The symptoms of an infeciton depend on the balance between of an infection depend on the balanace between the demaga done by the germ and the immune defences of the body and the localization of the infection.

Glossary
Virus : Very small and simple orgnisms which cannot live without the help of the body the infected. The live and reproduce themselves within the body cells and meanwhile they can be infecting them. Them are not necessarily harmful.
Bacteria : Bigger then a virus but still not a complete cell. Bacteria can live without the help of an external organism, on the skin, in the digestive tract or the vagina. They are not necessarily harmful for people. High temperature kills bacteria.
Germ : Small animal, peresnt in the air but only visible with the help of a microscope. It can transmit infection to the human body.
Superior Parasites : Organisms with one (Plasmodium Falciparum) or many cells (worms). They cannot live without the help of a host.
Fungus : Kind of vegetal organism that needs exchange of food with another body. Funguses only generate pain and infaction when body's immunity is destroyed.

Health Education
As a health worker you also have to give health educaion to your patients. These are some of the advices that you can give them:

Personal Hygiene

• Wash your body with soap every day
• Keep your fingernalis short and clean
• Brush your teeth twice a day
• Wear shoes when you are outside
• Wash your hands with soap before and after cooking, eating, drinking, using latrines, etc.
• Wash small wounds with boiled water, protect them with a clean and dry cloth, and go to the pustus as soon as possible.

Washing

• Wash your clothes, mats and blankets regularly.
• Hang or spread blankets in the sun after washing.

In the house

• Use the latrines; do not pass stool or urine on the ground or in the river.
• Teach your children to use latrines early
• Do not let anmals come into the house
• Do not spit on the floor
• Clean the house often (floors, walls, furniture).

Cleanliness in eating and drinking

• Boil the water during 10 minutes before drinking.
• Keep boiled water inside clean and covered containers
• Do not let filies and other insects land or crawl on food
• Protect food by keeping it covered.
• Before eating fruits or vegetables, wash it with clean water.
• Only eat meat that is well cooked. Do not eat food that it still or smells bad. It may be poisonous. If it is necessary, re-cooked again the food or makes it warm before eating it.

Sanitation

• Do not let the children drink water directly from the tap or the well
• Put the garbage into a deep hole far away form the houses
• Burn all the garbage that can be burnt
• Build latrines far away from the houses, from the river and from where the people bathe or get drinking water.
• Avoid stagnant water

Sources : WHO, Healt Massenger.