diarrhea

{Photo credit: MSH staff, Afghanistan}Photo credit: MSH staff, Afghanistan

In 2013 diarrhea killed 578,000 children under the age of five, 9 percent of all deaths in this age group globally. The tragedy of these deaths is that they are avoidable at many levels. The risk of contracting diarrhea can be drastically decreased through basic hygiene measures, such as consistent and exclusive use of a latrine and washing one’s hands with soap. Once a child becomes ill with diarrhea, most cases can be managed with oral rehydration salts and zinc. But the gap between what is known in the public health community regarding prevention and treatment of diarrhea, and what is practiced in many settings, is wide and deadly.

In Afghanistan, diarrhea killed 13,000 children under the age of five in 2013 and was the third most frequent cause of mortality (after neonatal conditions and pneumonia) in the age group. Many organizations, including Management Sciences for Health (MSH), have worked to improve access to treatment for children with diarrhea, but less attention has been paid to prevention.

We know what works to save the lives of children under five years old: We know which antibiotic to give for treating pneumonia, for example. Yet only 31% of children with suspected pneumonia receive antibiotics. And two million children die from pneumonia and diarrhea each year.

A community-based distribution agent discusses family planning options with a family in the DRC health zone of Ndekesha. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted from Frontline Health Workers Coalition.

Evidence of the need to scale up the number of frontline health workers in developing countries abounds throughout sub-Saharan Africa, as described in a recent post on the Frontline Health Workers Coalition blog by Avril Ogrodnick of Abt Associates. Yet training new health workers is not sufficient, in itself, to sustainably address the crisis: governments must also invest in providing management support to harvest the full value of these trainings.

Global Handwashing Day. {Image credit: MSH.}Image credit: MSH.

Today, October 15, children, schools, and communities around the world mark Global Handwashing Day.

Washing hands with soap is the "most effective and inexpensive way to prevent diarrheal and acute respiratory infections, which take the lives of millions of children in developing countries every year." In addition to handwashing with soap, proper sanitation and safe drinking water are key to preventing disease.

"Most of what we need to do to bring down the rate of child deaths is inexpensive & straightforward," USAID Administrator Raj Shah said today on Twitter. In addition to handwashing with soap, "add a bednet, vaccines, nutrition, rehydration, newborn care; we know how to drastically reduce child deaths."

A new hand-washing station in Toghak, Afghanistan. {Photo credit: Nikmohammad CLTS Facilitator/MSH.}Photo credit: Nikmohammad CLTS Facilitator/MSH.

In the small Afghan village of Toghak, where open defecation affected the sanitation and health of the community, two women took the initiative to mobilize themselves and others into transforming Toghak.

Ms. Fatima and Ms. Rukhsar attended a community-led total sanitation (CLTS) workshop in the neighboring village of Gheyas Said Abd and learned life-saving lessons they wanted to take back to their village. They learned that flies tend to breed in bacteria infested places, particularly human feces, and then transport the fecal matter to food meant for human consumption.

Knowing that this knowledge would motivate their community to improve their sanitation efforts, the women did not waste any time.

When the women returned from the workshop, they recruited twenty women from Toghak willing to help them improve the latrines. They also requested the assistance of CLTS facilitators to come to Toghak and map the high frequency defecation areas in order to identify the best locations for new latrines.

Within a week the women made improvements to 20 latrines. Within three months 50 new latrines were built.

 {Photo credit: Mahjan CLTS Facilitator.}Washing hands. Itarchi Hakimabad, Badakhshan, Afghanistan.Photo credit: Mahjan CLTS Facilitator.

The USAID-funded Sustainable Water Supply and Sanitation Project, Afghanistan (SWSS) project increases access to potable water and sanitation services in Afghan communities and decreases the prevalence of water borne diseases through household hygiene interventions. Led by the Association for Rural Development, in partnership with Management Sciences for Health, SWSS has led nearly 400 communities in Afghanistan to become Open Defecation Free. The MSH components of the project have succeeded under the astute leadership of Dr. Abdul Hatifie, the team leader for Sustainable Health Outcomes, and Dr. Logarwal, the BCC Material and Media Specialist. Together they have led the successful implementation of innovative approaches in all aspects of the SWSS project. To learn more about SWSS’s accomplishments, please see the cover article in this month’s USAID Global Waters magazine.

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

MSH President Jonathan D. Quick, age 5. {Photo courtesy of Dr. Quick.}Photo courtesy of Dr. Quick.

Cross-posted on USAID's IMPACT blog

My most vivid early childhood memory is waking up to excruciating pain in my throat, and seeing the goldfish swimming in the aquarium of the pediatric surgical ward. Although penicillin had been discovered 30 years earlier, doctors had not learned yet that treating "strep throats” with penicillin was better than operating. I didn't need the tonsillectomy. But, I was lucky to receive quality care in a health facility, close to my home.

Millions of children today are not so lucky. Over 7 million children under the age of 5 die each year; 70 percent of child deaths occur in sub-Saharan Africa and South-East Asia. The vast majority -- over two-thirds -- are entirely avoidable with existing safe, effective, low-cost prevention and treatment.

Nator Namunya, 6-months old, receives a vaccination in Kapoeta North County. Credit: Save the Children.

 

A version of this post originally appeared on the Save the Children website.

The healthcare system in South Sudan is struggling to get on to its feet after the devastation of over 20 years of war. The biggest killers of children in southern Sudan are malaria, diarrhea and respiratory infections. These preventable diseases can be easy to treat. But, on average, only one in four people in South Sudan are within reach of a health center. Only 3 percent of children under two in South Sudan are fully immunized against killer diseases and only 12 percent of families have a mosquito net in their home.

Deborah Nyantiok is 56 years old and lives with her grandchildren in Kaya, near the border of Uganda. She lost her husband during Sudan’s 20-year civil war and now takes care of her grandchildren. In order to pay for food and school fees, Deborah operates a small business and keeps animals to generate income. Despite her hard work, in the past Deborah found life difficult as she and her grandchildren often fell ill.

Lacking a source of clean drinking water, residents of Kaya gather drinking water from the nearby Kaya River. While the river provides vital irrigation which makes the surrounding land lush and green, unfortunately it also carries dangerous viruses and bacteria. These pathogens cause many waterborne ailments like typhoid, diarrhea, and parasitic diseases. Deborah and her grandchildren often suffered from these diseases, and while they sought medical treatment, it always seemed only a matter of time until their suffering returned.

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