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Nutrition
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3/6/2012
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Pakistan: the simple solution of breastfeeding Laila Salim, Technical Advisor, Health and Nutrition, Save the Children | Once, a child suffering from chronic diarrhea was brought to the clinic in Pakistan where I worked. After the birth of their twins - a girl and a boy - the parents believed that they should put the boy on formula milk so that he would get the best nutrition, while the girl should be fed on breast milk exclusively. The discrimation of being a girl helped Despite spending so much money on buying formula milk, the boy continuously suffered from diarrhea and did not gain proper weight, while the girl was doing fine. The father was carrying the girl, who looked happy and healthy, while the boy looked sick and undernourished. I thought that for once, the discrimination of being a girl helped this girl – thanks to breastfeeding. I felt bad for the boy because his parents, who were quite poor, were spending so much money and still the child was suffering. | |  A doctor at a district hospital in Pakistan, where Save the Children is working to promote breastfeeding. In Pakistan, around 68 babies in every thousand born die before they are one year old. Photo by Madhuri Dass / Save the Children. | I thought about the thousands of other parents who, due to a lack of awareness, might be spending money on formula milk with an assumption that they are providing better nutrition to their babies. Formula milk producing companies spend millions on advertizing, particularly in developing countries, showing healthy beautiful babies and misleading the parents. I am sure this problem is not restricted to developing countries. Many mothers in developed countries also rely on formula milk - some with an assumption that they are providing better nutrition. Promoting exclusive breastfeeding Public health organizations and the media need to highlight the problems associated with formula milk and promote exclusive breastfeeding. Exclusive breastfeeding not only provides numerous health benefits to child and mother, it is economically beneficial as well. Research shows that immediate and exclusive breastfeeding promotes health and helps prevent diseases in children. Infants who are exclusively breastfed for 6 months experience less morbidity and mortality from gastrointestinal infection. Hormones released during breastfeeding help to strengthen the maternal bond with their child and also delays the return of fertility. The World Health Organization recommends exclusive breast feeding till the child becomes six month old. All governments should develop and implement such a policy on infant and young child feeding in the context of their national health and nutrition policies. Community based health workers should also be trained to provide effective breast feeding counselling to mothers in their own communities. Governments around the world, including here in Canada, should enact legislation to protect the breastfeeding rights of working women and establish a means of enforcement. Simple Solutions Sometimes we think that modern practices are always better than traditional ones. But that isn’t always the case – and certainly not in the case of breastfeeding. When the parents of the twins I met in the clinic were shown that their boy’s health would improve if he were breastfed like his sister, they were relieved that the solution was so simple. The mother was so happy when she switched to breastfeeding and saw her son gain weight and his health improve.
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Extreme Hunger
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2/27/2012
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Niger: A Responsibility to Protect Jean Valea, Save the Children Field Manager in Zinder, Niger Iwas in the bush of my home country, Burkina Faso, working as a health program coordinator when I first heard of Save the Children. In that remote part of the world, Save the Children provided health support to people in need. I could tell the charity held strong values and I was immediately drawn to them. Since that day I’ve worked with Save the Children across the Sahel region and in the Democratic Republic of Congo. I’ve been working for them for over 15 years. Barefoot and hungry Right now, a food crisis is affecting the people of Niger and I’m here to manage one of our three bases – Zinder, a sprawling region bordering the neighbouring Nigeria. I’m already seeing signs of the distress in the population here – not only are more children arriving in our health centres, but children are arriving barefoot into the town from the surrounding villages. Begging, looking for work and food and vulnerable to exploitation – the outlook for these children is bleak. I worry all the time about the neglect and abuse these children may face. A motivating thought I originally came to Niger for just this purpose – I arrived in Zinder in the midst of a food crisis in 2010. Starting any new job is a challenge, but arriving when millions of children are facing hunger was in a whole new league. Two years on and my days are still never-ending. I’m at work at 6am and don’t leave until 12 hours later. We have about 60 staff members here all working flat-out to reach children in need. It’s extremely important not to be behind – a missed report, briefing or phone call can impact on our staff’s security and our ability to help children. Everything must be done now, today, not tomorrow. I have a responsibility to protect these children. You cannot see children suffering, know you can help and not do anything. That thought motivates me everyday. Please donate to our Sahel Appeal today.
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Extreme Hunger
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2/14/2012
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Niger: A mother’s tragedy Katie Seaborne, Save the Children in Niger When Firdaoussi passed away she was four years old. Her short life was already marred by tragedy — three older sisters died before her. One in six children don’t live to see their fifth birthday in Niger. Firdaoussi and her family were already poor when this crippling food crisis started taking hold on the country. Having enough to eat Sitting with her two daughters in her village, Firdaoussi’s mother Nana, 25, told us the story of her life. “My husband, Ibrahim and I have been married for over a decade and we have two daughters, who are alive — my eldest, Rahila and second daughter, Naima. I have a beautiful family but we live in poverty on a daily basis. “The most important thing in my life is having enough to eat, because without food a person can’t do anything. The lack of food makes me very angry. We need food and we don’t have any.” The loss of my child “My family had been suffering from vomiting and diarrhea. This caused the death of my daughter Firdaoussi just days ago. My daughter was vomiting and had diarrhea before she died. Both illnesses are common in our village.” When children are malnourished they are unable to fight the most basic of illnesses. In Niger, diarrhea is deadly. Often unable to access medicine, clean water or food, the poorest children are in constant danger. I do it for the money Nana has no time to mourn. Living on the poverty line means Nana has to work every hour of the day. “Both me and my husband farm other people’s land for money when they need the extra help and I grind millet for wealthier families in the village. “We also sometimes have to beg and receive help from others in times of need. I do it for the money to buy something for my children and me. The most important people in my life are my family — especially my daughters and my husband.” A better future “Our life is always the same because we suffer from the problems of poverty and a lack of health care, over and over. But despite all these problems when I talk with my neighbours every day I can still laugh,” says Nana. Like any mother, Nana wants a better future for her children. “I hope that my children will go to school and become teachers. We take care of them, we find it difficult to feed them, especially this year when things got complicated and we have not had good harvests. I want my two daughters to stay alive and grow up.” One ask She left us with one ask that demonstrates the depth of the poverty in Niger, and the simplicity of her needs. “Please, help us. With 70p I can buy a day’s supply of millet for my family.”
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Health workers
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1/20/2012
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Community health workers saving lives in rural Mozambique In the Nataleia Mesa community in Malema District of Nampula Province, mothers and children are sitting in the shade patiently waiting to be attended by the local community health worker. It is 8 o’clock in the morning and José Chapalia, the community health worker (pictured right), has already attended five mothers and their sick children. Most of the children have fever, cough, or diarrhea. Fever and cough are symptoms of malaria and pneumonia, two of the most common killers of young children in Mozambique. Improving child survival José Chapalia is one of the 326 community health workers (CHWs) who have been trained by Save the Children’s Community Case Management (CCM) project, in collaboration with the Ministry of Health. Through community health workers, CCM increases access to treatment for pneumonia, malaria and diarrhea in remote communities with poor access to health clinics. Treatment of these childhood diseases by CHWs is known to significantly improve the chances of child survival in these hard-to-reach areas and is an important contribution to the EVERY ONE campaign here in Mozambique. 3-month old Cristina While examining 3-month old Cristina Agostinho, her mother explains that the child has had a fever for three days. José does a malaria test and takes the child’s temperature. The malaria test is negative, but since Cristina’s mother says she has had a fever, José refers her to the nearest health center just to be sure. Cristina’s mother explains, “I came to the CHW because my child is sick. I had heard from many of my fellow community members that he is very helpful and since his health post is much closer than the hospital I came here. If the CHW says my child needs more medical attention, then I can make the long journey to the hospital. Having a CHW in our community has improved our lives because we cannot always walk the long distance or pay for transport to the hospital. But knowing that Mr. Chapalia is here, we can bring our children to him and they have a better chance of getting better again”. Supporting rural communities Having a CHW in distant communities has increased access to life-saving health services in Mozambique. Not only are the distances that people have to travel for health care significantly reduced, they have a trusted community member to whom they can turn when their child is sick. CCM is a community based initiative that is saving the lives of young children every day in rural Mozambique. It only takes one CHW to make a difference in the lives of hundreds of children.
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Health Workers
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1/16/2012
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India: Bringing healthcare to people’s doorsteps Driving around parts of Delhi gives one of the clearest impressions that India is a big booming economy. The expanded metro, hordes of cars in the road, busy shops and big houses all point to rising affluence. From one of the main roads, a quick turn into Sanjay Colony gives a view of very different world. There is no road to speak of, make-shift structures abound and a proper sanitation system is obviously absent. Sanjay Colony and similar places are often referred to as “pockets of poverty”—deprived communities within well-off areas that have become a fixture in many cities. Mobile clinics Save the Children runs a mobile health clinic here. Mothers and children can access basic health services for free. The day I went some women were getting ante-natal check-ups, while one mother was seeking treatment for her baby sick with pneumonia. I was told that the nearest hospital is not very far but it costs 200 rupees to get there. That’s only £3 but in a country where 75% of the population lives on less than $2 a day, that’s still out of reach for many families here. India has very high child and maternal mortality rates. In 2009, about 1.7 m children died before their fifth birthday making it the country with the highest burden of under-five mortality globally. While it is true that cases of child mortality varies from one state to the other, the harsh reality is that huge numbers of households do not have access to basic healthcare which leave children at great risk of dying from preventable causes. "Healthcare deserts" is a term which sometimes describe geographical area where health services are too physically remote to be reached. In many cases however it describes a situation in which services are unaffordable, or of such poor quality that healthcare is not sought, or is sought and not available. Urban poor communities tend to fall under this state. Many like Sanjay Colony are within reasonable distance from a health facility but poor households are still unable to access them. Prevented Transport costs, lost daily income from going to a hospital, cultural beliefs, unaffordable treatment or poor quality services prevent people from seeking health services. Efforts are being implemented to improve poor people’s access to healthcare. Some have removed user at the point of use for basic health services. Others are giving conditional cash transfers, i.e. giving cash to poor households on the condition that they let their mothers and children attend a health centre. Rising demand Many other schemes exist worldwide. What is clear however is that measures to boost household demand for healthcare should be matched with improvements in the supply side. Removing user fees or giving cash transfers won’t significantly improve outcomes among the poorest households if the health facility is too far, health workers are absent or services are inadequate. Non-economic barriers to accessing healthcare should also be addressed to improve health-seeking behaviour. Otherwise, these schemes will miss the poorest and most marginalised communities which might risk deepening health inequalities between them and the rest of the population.
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Health Workers
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1/16/2012
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South Sudan: the long trek to eradicate Polio Volunteers across South Sudan are battling to eradicate polio among children under five in South Sudan, through a five-day “house to house” campaign. The campaign is organized by the South Sudan health ministry, and Save the Children is supporting it by lending vehicles and in Mvolo county. The effort is to catch the children who have not been vaccinated at a health centre or through an outreach program. Delivering polio vaccinations To ensure that children get the two drops each of the polio vaccine, vaccinators must walk for long distances, where they find families eagerly waiting for them. Villages are far apart and roads are very poor, so vaccinators have to trek long distances between each village on foot or by bicycle. In Mvolo, Western Equatoria state, the mobile immunization team shared their experience with me, of conducting house-to-house immunization in the county. Immunization and access “It is difficult for us to achieve full immunization here in Mvolo County, because there is a big population that stays deep in the rural areas. They’re not easily accessible. In Lessi Payam, five of the villages are not reachable and this is a big challenge for us,” said County Health Officer William Dalli. “I have no bicycle to move around when I am carrying out the immunization, so I move on foot. It is very far because the families live far apart and I have to go to each family,” Asumpta Achol shares. Those who have bicycles face challenges too: “I use my own bicycle, but when it breaks down, it becomes difficult for me to move. Even with the bicycle I get tired when I ride for the whole day,” says Manase Dogbanda. Final push to eliminate crippling disease Save the Children conducts vaccination against polio, measles and tetanus on a regular basis both at health facilities and in outreach programs. We also provide support to the annual nationwide immunization campaign, alongside World Health Organization (WHO) and UNICEF. South Sudan is one of few remaining countries that still has a serious polio problem and the disease has crippled many children.
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Health Workers
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1/16/2012
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Giving birth safely in rural Rwanda
Uwurukundo is barely 24 hours old. Beatrice smiles as she breastfeeds him in the brightly-painted room at the new Maternity Ward in Kirambo. She looks as though she has fully recovered from giving birth. “This was my third baby so I have some experience” she explains, “and it was so much easier this time giving birth at the maternity ward. I know because my two daughters were born at home.” Care at a crucial time Save the Children has built a maternity ward in Kirambo which is now ready to support pregnant mothers. As their due date approaches, mothers-to-be come to the health centre where there’s waiting room for them to rest. When the time comes they give birth in one of two equipped delivery rooms with skilled birth attendants; then they can recover in a safe environment in the room for post-partum care. Being prepared for a big day Before they even give birth, pregnant women are provided with antenatal care. Each woman attends a minimum of four separate sessions during where they’re given professional advice about how to manage their pregnancy, the importance of eating nutritious foods, not carrying out manual labour, how to prepare for birth, etc. These sessions provide an important space for pregnant mothers to share experiences as well as learn. They’re facilitated by community health workers, who strongly encourage husbands to attend so they can better support their wives. - “I think my labour was short partly because I had peace of mind – I just wasn’t worried about giving birth this time because I was at the health centre”, says Beatrice.
- Taking control
Beatrice says she’s very proud of Uwurukundo and is happy to have had a son. However, she and her husband have decided that he will be their last child. “Three is enough!” she laughs. It was during the antenatal care sessions at Kirambo that she and her husband learned about family planning methods, and have chosen one which suits them. The buildings and equipment of the Kirambo Maternity Ward make such a difference with their trained health workers, good facilities, and a safe environment for giving birth – it is a great start for Beatrice and Uwurukundo.
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