Mother's milk: reducing child mortality after natural disasters

2016 Killam laureate aims to empower breastfeeding women in disaster relief camps

Yolanda Poffenroth - 03 October 2016

Not many people would readily travel to a natural disaster relief camp where hundreds or thousands of families are living in cramped conditions, but that's exactly where Shela Hirani will do her PhD research.

Ready to fly out the moment a disaster strikes, the Faculty of Nursing graduate student is set to carry out her research in an incredibly demanding-and possibly dangerous-setting. Hirani is eager to jump into her research, which focuses on facilitators and barriers related to breastfeeding practices among displaced mothers living in disaster relief camps.

Less than a year after arriving in Edmonton from her native Pakistan, Hirani has turned her goal of reducing the number of child deaths and illnesses in disaster relief camps into a $150,000 Vanier scholarship, as well as an Izaak Walton Killam Memorial Scholarship.

Growing up in a disaster-prone country, Hirani is no stranger to being displaced and forced to live in a relief camp. In fact, it was her first-hand experience as a health-care professional that shaped her chosen career and research path.

In the aftermath of a natural disaster, relief camps are one of the most vulnerable settings for mothers with young children. In a setting with little privacy, an absence of nurses or other people who can help them with breastfeeding, and free distribution of formula, women are much more likely to discontinue breastfeeding.

"Infant and child deaths are high in Pakistan, and disasters and discontinuation of breastfeeding can result in increased death rates," says Hirani, who is an internationally board certified lactation consultant with more than a decade of experience in maternal and child health. "Supporting and protecting breastfeeding practices of women is an essential intervention to reduce the number of child deaths and illnesses during emergency response."

Women often feel uncomfortable talking about breastfeeding, but it's a vital aspect of parenting and an essential source of nutrition for infants, explains Hirani.

"Breastfeeding is crucial for both physical growth and brain development. Breast milk provides the ideal nutrition and also contains antibodies that help young children fight off viruses and bacteria. It also can lower the risk of asthma, allergies, ear infections, respiratory illnesses and bouts of diarrhea."

When breastfeeding women are displaced from their homes to a disaster relief camp, many turn to using formula donated by well-meaning individuals and companies-a change that can be harmful to children in this situation.

"To use formula, the powder has to be mixed with water and put into a bottle," says Hirani. "In disaster relief camps we don't have handwashing facilities. We may not have time before and after the feeding to sterilize the bottles. We may not have access to a secure source of water."

Without access to safe water and the ability to sterilize bottles, children in these disaster relief camps often develop dysentery, a contributing factor to the increased rates of child mortality seen during disaster relief.

Hit the ground running

Hirani plans to conduct her research in Pakistan. When she arrives, she'll travel directly to a disaster relief camp. Once there, she'll work with numerous stakeholders, including breastfeeding mothers, health-care workers and relief agencies.

"By observation I hope to determine why mothers may or may not be breastfeeding their infants," she says. "Is it because there's formula? Is it because there's no privacy? Are their support systems not available? And what about the intent of the relief agencies and health-care workers-what's their understanding of distributing formula?"

Hirani's end goal is to empower breastfeeding women.

"Currently, they can't communicate their needs and are in a very vulnerable situation. Many times women are being exploited and can't fight for their rights, or even ask the relief stakeholders to provide privacy."

By giving this vulnerable population a voice, Hirani's research will help relief workers and health-care professionals develop context-specific supportive interventions, improve breastfeeding practices in relief camps and decrease deaths of young children.

Hirani is hopeful that her research can make a real change-not only in Pakistan, but globally.

It's not an issue that only low-income countries face, she explains. When the Fort McMurray wildfire displaced more than 80,000 residents, many breastfeeding women faced the same issues in Alberta that their counterparts do in Pakistan. Any displaced woman and child is vulnerable, whether they are internally displaced like those from Fort McMurray, or moving to another country as a refugee like those fleeing Syria.

For Hirani, receiving the Vanier scholarship is both a great honour and a responsibility. "This is the kind of scholarship that recognizes an individual's research potential, leadership capacity and academic excellence," she says. "I want to live up to-and exceed-these expectations."