On Nias Island, an Indonesian Red Cross initiative has mobilized and trained more than 800 new volunteers in just ten months.
When a community based first aid programme was launched on the Indonesian island of Nias in March 2007, there was little indication that it would go on to be a major Red Cross success story.
"At the beginning, there were no volunteers - so we had to start the programme completely from scratch," said Indonesian Red Cross Society (PMI) health officer Mariani Gulo, who worked with the International Federation of Red Cross and Red Crescent Societies to develop the programme.
Today, more than 800 community-based volunteers are teaching first aid in 39 villages across the island, reaching people in need in even the remotest communities.
It's a remarkable achievement for the PMI and the International Federation, given the remoteness of the island. Nias faced a number of challenges even before it was hit by the December 2004 tsunami and then devastated by the March 2005 earthquake that killed around 800 people and made tens of thousands homeless.
Thousands of families in remote villages were enduring daily health problems because they were unable to reach the island's hospital or local medical centre. This situation led PMI and the International Federation to launch a community based first aid programme in several areas, to empower local people to respond to daily emergencies where health professionals are absent or overworked.
To deliver the programme and ensure that it was sustainable, PMI and the International Federation began to recruit volunteers in Nias, including some who had been inactive because there had not been any suitable activities for them to participate in. Initially, only five volunteers were available, although this soon increased to 35.
PMI and the International Federation then ensured that all the volunteers were trained to national standards and understood the nature of the voluntary work they would be doing.
Rising to the challenge
Once the volunteers were trained up, community leaders were invited to select new potential first-aiders from each of the 39 villages targeted by the new programme.
The location of many of these villages proved a fresh challenge. In many cases, it took volunteers nearly four hours to reach settlements that were inaccessible even by motorcycle.
To avoid wasting time and energy, PMI and the International Federation decided that all volunteers must stay for three days in a targeted area to deliver modules for village volunteers and to arrange activities in the community.
This decision has been greeted with warmth and appreciation by the villagers, who have expressed their gratitude to the volunteers who have travelled so far and given up so much of their time.
Follow their schedule, not ours
Community based first aid volunteers must complete a minimum of 52 hours of training. However, as most villagers are farmers and local traders with community obligations, this tight schedule wouldn't work for them.
So a new approach was developed to suit the community. First, the training module was split into six parts and was delivered gradually. Each module consists of specific topics such as vector diseases like malaria and dengue fever; diarrhoeal diseases caused by poor hygiene conditions; nutrition and first aid. These, combined with disaster preparedness and disaster response topics, will encourage the formation of community based action teams and can then be used in emergency situations. The volunteers also received an induction on PMI and its work, and on the International Red Cross and Red Crescent Movement's Fundamental Principles.
"We follow the villagers' schedule as closely as we can, as long as we both agree," said Dr Eka Airlangga, the International Federation's health programme manager in Nias.
This flexibility allowed some first aid topics to be taught during community church services. Dr Airlangga added that the first aid trainers also used events important to the local culture, such as Maena (a community gathering with singing and dancing), to carry out training. Volunteers also organized a competition and provided a health message, which was then adapted into lyrics by village dance and singing groups.
To maintain the village volunteers' capacity, they are regularly involved in first aid trainings held for selected audiences including primary school students, teachers, and senior citizens.
From zero to hundreds
Then programme has achieved a great deal in the ten months since its launch.
"The good news is that the training the volunteers have received is at the same level as the PMI standard - and in some cases even higher," said Dr Jeyathesan Kulasingam, an International Federation health delegate with the Aceh tsunami operation.
The villagers are feeling the benefits most of all. When Nias was hit by a diarrhoea outbreak last summer, the villages supported by the community based first aid programme suffered less than others.
"In many cases, we can now save the money we used to spend travelling to the city hospital," said Faolozisokhi Zega, a volunteer coordinator from Lolo'ana'a lolomoyo village in Gunung Sitoli Utara sub district. More important, he added, the villagers can now respond quickly and effectively if a family member or neighbour falls ill or has an accident.