Hope and Despair: The Save the Children Report on Child Death

The toll is staggering--28,000 children die each day in the developing world, and the large majority of these deaths are preventable. But the news is not all bad--even some desperately poor countries like Bangladesh have made tremendous strides in reducing the number of deaths by children under 5. This is the story told by Save The Children's annual report on death of children under 5.

The New York Times has a good report:

The rate at which young children perish has worsened most disastrously over the past 15 years in Iraq, hard hit by both sanctions and war, and in Botswana, Zimbabwe and Swaziland, devastated by AIDS, according to a report released yesterday by Save the Children. But researchers also found against-the-odds progress in some of the world’s poorest nations.

Bangladesh has profoundly improved the chances that a child would survive by promoting family planning, a strategy that has enabled women to have fewer children, space births and strengthen their own health and that of their babies.
Nepal, despite a decade-long Maoist insurgency, has halved the death rate of children under age 5. It has enlisted the help of 50,000 mothers, most of them illiterate, who have squeezed vitamin A drops into the mouths of every child, hauled laggards in for vaccinations and even diagnosed pneumonia and dispensed medicines to combat it.

And Malawi, with an extreme shortage of doctors and nurses, has made surprising gains by taking simple steps that require no professional skills, for example distributing nets that protect children from malarial mosquitoes.

Despite many hopeful stories, broad progress against infant and child mortality has flagged since international health agencies began a campaign to reduce deaths 25 years ago, the researchers concluded. By the end of the 1980’s, global rates of child mortality had fallen 20 percent, and the lives of 12 million children were saved.
“Much of the momentum behind the child survival revolution has now been lost, and gains achieved in the 1980s and early 1990s have slowed or reversed,” the report says. “Under-5 mortality declined by only 10 percent from the early 1990s to 2000.”

Among the 60 developing countries where 94 percent of the child deaths occurred, 20 have either made no progress or have regressed, while 24 have cut death rates of children under 5 by at least 20 percent.

So what works? An attention to the basics like basic health care, clean water, vaccinations, and family planning. And the countries that succeed do so because of political will, not wealth:

In countries that progressed, a focus on family planning was central to progress, the report said. In the five countries that made the greatest strides in reducing child deaths — Egypt, Indonesia, Bangladesh, Nepal and the Philippines — women’s use of contraceptives rose and fertility rates declined. In those countries, mothers were less likely to be physically depleted by having too many babies in too short a time. With fewer children, families were also able to invest more in the care of each child.

Political will was also an essential ingredient of success — and in Malawi, Tanzania, Nepal and Bangladesh was even more important than national wealth, the report found. Egypt, which has cut the death rate of children under age 5 by 68 percent since 1990, more than any other country, has shown a particular commitment to children’s health, said the researchers at Save the Children, a nonprofit group, and other experts.

“In words and deed, Egypt has put children more at the center of their social agenda than most other countries,” said Ruth Levine, author of “Millions Saved: Proven Successes in Global Health (Center for Global Development, 2004).

Egypt has carried out a comprehensive effort to improve the health of mothers and children. It invested in clean water and public health campaigns to teach the importance of hand-washing in disease prevention. It built roads that sped access to hospitals. It renovated dilapidated clinics. It made sure most mothers had midwives or other skilled workers to attend births. It strove to perfect immunization campaign strategies.

“There is a way to do a blanket of public health interventions that is very effective,” said Dr. Ayman El-Mohandes, a pediatrician and chairman of the Department of Prevention and Community Health at George Washington University’s School of Public Health, who served as a consultant on a United States-financed maternal and child health program in Egypt.

A final disturbing aspect of this report is the fact that Iraq suffered the worse increase in child deaths--deaths that occurred under our watch in Iraq:

Iraq experienced the most staggering rise in under-age-5 mortality — 150 percent over 15 years. Since the war began in 2003, deteriorating health services, rising inflation and electricity shortages have worsened living conditions, the report said. In 2005, about 122,000 Iraqi children died before their fifth birthdays.

So what is a Christian to make of all this? Again there is both hope and despair. There is despair that our indifference has allowed the death of 28,000 children a day. But there is hope from the examples of countries like Egypt and Bangladesh that tremendous progress can be made with sufficient will. The question that we need to ask ourselves (because it is a question that Jesus has warned us he will ask us someday) is what we have done to save these children.

Read the full report (pdf file) here.

Read The New York Times article here.