Child Survival Revolution

views updated

Child survival revolution

Every year in the developing countries of the world, some 14 million children under the age of five die of common infectious diseases. Most of these children could be saved by simple, inexpensive, preventative medicine. Many public health officials argue that it is as immoral and unethical to allow children to die of easily preventable diseases as it would be to allow them to starve to death or to be murdered. In 1986, the United Nations announced a worldwide campaign to prevent unnecessary child deaths. Called the "child survival revolution," this campaign is based on four principles, designated by the acronym GOBI.

"G" stands for growth monitoring. A healthy child is considered a growing child. Underweight children are much more susceptible to infectious diseases, retardation, and other medical problems than children who are better nourished. Regular growth monitoring is the first step in health maintenance.

"O" stands for oral rehydration therapy (ORT). About one-third of all deaths under five years of age are caused by diarrheal diseases. A simple solution of salts, glucose, or rice powder and boiled water given orally is almost miraculously effective in preventing death from dehydration shock in these diseases. The cost of treatment is only a few cents per child. The British medical journal Lancet, called ORT "the most important medical advance of the century."

"B" stands for breast-feeding. Babies who are breast-fed receive natural immunity to diseases from antibodies in their mothers' milk, but infant formula companies have been persuading mothers in many developing countries that bottle-feeding is more modern and healthful than breast-feeding. Unfortunately, these mothers usually do not have access to clean water to combine with the formula and they cannot afford enough expensive synthetic formula to nourish their babies adequately. Consequently, the mortality among bottle-fed babies is much higher than among breast-fed babies in developing countries.

"I" is for universal immunization against the six largest, preventable, communicable diseases of the world: measles, tetanus, tuberculosis, polio, diphtheria, and whooping cough. In 1975, less than 10% of the developing world's children had been immunized. By 1990, this number had risen to over 50%. Although the goal of full immunization for all children has not yet been reached, many lives are being saved every year. In some countries, yellow fever, typhoid, meningitis, cholera , and other diseases also urgently need attention.

Burkina Faso provides an excellent example of how a successful immunization campaign can be carried out. Although this West African nation is one of the poorest in the world (annual gross national product per capita of only $140), and its roads, health care clinics, communication, and educational facilities are either nonexistent or woefully inadequate, a highly successful "vaccination commando" operation was undertaken in 1985. In a single three-week period, one million children were immunized against three major diseases (measles, yellow fever, and meningitis) with only a single injection. This represents 60% of all children under age 14 in the country. The cost was less than $1 per child.

In addition to being an issue of humanity and compassion, reducing child mortality may be one of the best ways to stabilize world population growth . There has never been a reduction in birth rates that was not preceded by a reduction in infant mortality. When parents are confident that their children will survive, they tend to have only the number of children they actually want, rather than "compensating" for likely deaths by extra births. In Bangladesh, where ORT was discovered, a children's health campaign in the slums of Dacca has reduced infant mortality rates 21% since 1983. In that same period, the use of birth control increased 45% and birth rates decreased 21%.

Sri Lanka, China, Costa Rica, Thailand, and the Republic of Korea have reduced child deaths to a level comparable to those in many highly developed countries. This child survival revolution has been followed by low birth rates and stabilizing populations. The United Nations Children's Fund estimates that if all developing countries had been able to achieve similar birth and death rates, there would have been nine million fewer child deaths in 1987, and nearly 22 million fewer births.

See also Demographic transition

[William P. Cunningham Ph.D. ]