Tuesday, 25 September 2012

Big drop in children under five dying, says UN report: BBC August 2012

The good news is that the health of the little children of the world is improving according to UNICEF, that means that instead of 12 million deaths in 1990, there were only 7.6 million last year. The numbers are overwhelming, and  we shouldn't lose sight of the fact that each one is an individual tragedy.
Our hospital at Guinebor has always had a special place for children, that is at the front of the queue: the same place that Jesus put them . Like him  we got some  initial protests  from the adults who didn't understand, but is now  accepted that the under fives can' push in' at the front as they are often our sickest and most vulnerable patients.
I was initially going to start this blog share with the  exciting news that   we have recently  operated on 2 very young babies and they have both  survived. . One aged about a week  had a meningocoele , a fragile  pouch of spinal cord lining over her lower back; and the other a pyloric stenosis aged 5 weeks , a blockage to the stomach that causes persistent vomiting. Both will now have a normal life expectancy, for Chad. I hadn't done either operation before so as a surgeon I am encouraged because  the reality is that there are now 2 young children who will have the chance to grow up loved by their parents. We can all rejoice and give thanks to God.
However as a project manager I need to see things a bit  differently and keep things in perspective. I need to remember that the vast majority of children die of preventable disease such as  malaria, diarrhoea, malnutrition, pneumonia measles and tetanus. World wide 21 000 die each day and each week some of them are at our hospital .  Unfortunately the  good news  of the title to this blog doesn't apply  if you are born in Chad.  iIt  now reports the highest childhood death rates in the world  209/1000 (over 20%) and  actually is one of 10 countries that are getting worse.
What can we do?  Operating on newborns feels good but isn't the answer. According to UNICEF/WHO  the children of the rest of the world are doing better because of better access to health care and well run immunisation programs so we need  to keep the children at the front of the queue and we need to get integrated into the fledgling national immunisation program.  Last year just before the re-launch there were no vaccines in the country, I know that  has changed and we need to play our part. I will take some time off from clinical medicine each week to visit offices, write letters and establish projects so that we can get involved. Administration saves lives.  
We will also step up our identification and treatment of malnourished children suffering due to the famine following on from poor rainfall in the Sahel last year, BMS are again  collecting special funds for that. And finally what about a really crazy  idea passed on to me by a retired GP friend  whilst I was in the UK ;  using good malaria prophylaxis as well as a  mosquito net prevents deaths in seasonal malarial ( BMJ news section august ) Giving my patients the same protection my children have always had, what a strange idea!
 Whatever next?

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