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Rx for Child Survival: Dispatches from the Field
We Know How; We Just Have to Do It
By Kathryn Bolles
As it appeared in the Chattanooga Times Free Press
October 23, 2005 edition
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Kathryn Bolles, child survival specialist, with children who benefit from Save the Children's programs in Con Phia, Ta Rut, Vietnam.
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I had an odd moment the other day in Huong Loc, an isolated hamlet in Vietnam's central mountains, when I suddenly thought of Chattanooga. I had walked hours with a Save the Children team to this village to check the progress of our program for the 106 badly malnourished children we counted there in January -- half of all the town's children. I was particularly concerned about 10 children who had been near death.
One of them had died. But to my team's surprise, the others had recovered, and the number of malnourished was down to 73. I realized that in nine months, this tiny village of illiterate ethnic minority people had become one more example of the good work for children that Chattanooga will celebrate this week.
I lived for eight years in Chattanooga off and on, working first for the AIDS resource center Chattanooga CARES and later for the Children's Nutrition Program in Haiti, which is headquartered in Chattanooga. I plan to be back in the city for the Thursday evening candlelight vigil on the waterfront that will honor all the children the world has lost this year -- in the Asian tsunami, in Hurricanes Katrina and Rita, and in the earthquakes in Pakistan and Guatemala, of course -- but also the 30,000 children who die every day of ordinary causes that are hardly ever fatal in the United States. These include diarrhea, pneumonia and malaria as well as malnutrition and lack of vitamins and minerals.
With WTCI -- the local PBS station -- Save the Children and the Creative Discovery Museum, Chattanooga is a focal point in the nationwide Rx for Child Survival™ campaign. It starts next week with a six-part PBS television series and includes additional public health learning events at the museum and by the Girl Scouts, the University of Tennessee at Chattanooga and the Regional Health Council. The goal is to raise public awareness of the situation in places like Huong Loc, and to persuade more Americans to get involved in saving children's lives.
People think the problem of child mortality in places like Huong Loc is too big to solve, or that it would cost too much to reduce it. The truth is that we know what to do, and it isn't hard. We could save up to 6 million children under age 5 every year with a few cost-effective measures: antibiotics to treat pneumonia, vaccinations against six major childhood diseases including measles, vitamin A capsules to prevent blindness and early death, an insecticide-treated bed net to prevent malaria, and oral rehydration solutions to treat diarrhea. I know from personal experience in Haiti and in Vietnam that they work.
In the village of Ban Let, I saw the "before" story: I met Ho Thi Klinn, who doesn't know her age but knows she was married at 17 and now has three children, with a fourth due in December. She still walks three hours each day to get to the rice fields to work, and when she brings the rice home she has to pound the hulls off the grains. I saw her and two other women using their whole bodies to lift a heavy stone over and over again to do this while their husbands sat in the shade of a house and watched. Dr. Tam Thanh, the district health services director, told me, "The men like to watch because it looks like a dance."
More than 80 percent of Vietnamese women in the poor areas give birth at home without any trained attendants or medical care, and few babies are breast-fed or given the vaccinations, antibiotics and vitamins they need to survive. As a result, one third to half of all children in that area are underweight. In 2002, Save the Children began training "Hamlet Health Workers" to go door to door and hold community meetings to bring in new ideas.
At one of those community meetings, in a hamlet called Ban Ha in the commune of Tan Thanh, I saw the "after" story: a father was sitting with his wife holding their 5-month-old baby and playing with their two other children. The youngsters had all been vaccinated and had been given oral rehydration solutions after having diarrhea, because the father had learned from our trained field worker that all this was important. He was even still working in his wife's place in the rice fields because he had learned that both she and her children would suffer if he sent her back only a few days after childbirth, as everyone in his village usually does.
Things are changing in Vietnam because of people like Dr. Chau Van Hien, coordinator of Hamlet Health Workers in more than 100 villages. After Save the Children gave him our training program, he recruited more women volunteers to talk to other women about child care and nutrition, and 75 percent are now women. The messages are getting across.
We know what to do in Vietnam and around the developing world to save children's lives, and Chattanooga is leading the way in making it happen. With political commitment and the right investments, we can save these young lives. It's just a question of doing it.
Back for Rx for Child Survival™ Overview
™2005 WGBH Educational Foundation and Vulcan Productions, Inc. Major funding for Rx for Survival – A Global Health Challenge has been provided by the Bill & Melinda Gates Foundation and The Merck Company Foundation.
