Afghanistan’s mountain ranges are beautiful to the eye. Rugged peaks and ridges are separated by valleys, carved out over the centuries by streams and rivers supporting the green web of vegetation along their banks.

But many of the small villages that cling to the walls of these valleys are often cut off for months by heavy snow or the floods that follow the spring melt. The cold wet climate, together with smoke from household stoves, increases the risk of pneumonia, particularly among babies and children. One in five deaths of young Afghan children is caused by pneumonia, an infection easily treated with antibiotics if diagnosed early enough.

The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas. The US Agency for International Development's (USAID) BASICS Benin project is increasing the capability of villages as far as 50 km away from health centers by training Community Health Workers (CHWs) to perform community case management of children five years-old and under.

The carefully irrigated and shaded kitchen garden provided welcome splashes of different shades of green against the surrounding dry brown soil and rocks. We congratulated Shukria, a community health worker (CHW), on the lush vegetables and ripening fruits as we entered her home.

Shukria explained that the gardens that she and other women were growing started with the community-based growth monitoring program through the Family Health Action Groups. The growth monitoring is successfully identifying children under two who were not gaining enough weight or were undernourished. She and other mothers spent time counseling the mothers of the identified underweight children.

Many children in Afghanistan die each year of easily preventable diseases; nearly 25% of those deaths are due to diarrhea. However, it is not only the fatal cases of severe diarrhea that are imperative to address. Between a quarter and a half of mothers of children less than five years old report their child had diarrhea in the two weeks prior to questioning. These frequent cases of diarrhea are among the main causes of under nutrition, which delays development and is implicated in over half of all childhood deaths.

One of the most effective ways of preventing diarrhea is to improve hygiene in the home, especially through regular hand washing with soap before preparing and eating food, after using the toilet or handling a child’s feces.