Suffer the Children

Two Worlds: Health Care Standards in Developing Nations and the Developed World

Magazine report

By: Kit R. Roane

Date: December 10, 2001

Source: Kit R. Roane. "Suffer the Children." U.S. News & World Report. (December 10, 2001).

About the Author: Kit R. Roane is a senior editor for the news magazine U.S. News and World Report. Among his journalistic specialties is behind the scenes reporting in areas of conflict or political strife. In addition to his work as a writer, Sloane is a photojournalist and a still photographer, with an extensive gallery Web site.

INTRODUCTION

Every day, according to the World Health Organizaiton (WHO), thousands of people die, both children and adults, in the developing areas of the world. Their deaths often come as a result of lack of food or shelter, lack of drinkable water, and because of preventable infectious diseases. Tuberculosis, AIDS, and malaria are three of the biggest killers, resulting in as many as eight million deaths annually. In Africa, the four leading causes of death are AIDS, malaria, respiratory infections (including tuberculosis), and diarrheal diseases. According to statistics published by Time magazine on November 7, 2005, AIDS is the fourth most prevalent cause of death in the world.

Developing countries are besieged by enormous challenges: they are often rife with poverty; they typically lack an organized, sufficient, wide-ranging, and easily accessible public health care system; they experience famine and drought—leading to widespread malnutrition and dehydration; there is a lack of education about sanitation and preventive (or any) health care; there are frequently cultural biases, practices, norms, or beliefs that render it nearly impossible to prevent certain diseases (such as the spread of AIDS in sub-Saharan Africa); there is often an absence of social and political infrastructure. Coupled with the lack of philosophical infrastructure, there is often a dearth of physical infrastructure as well—there may be no hospital, clinic, or medical office system in many areas, coupled with a lack of basic medical and life-saving supplies and equipment (or a place to safely store those brought in by relief agencies); there is often a lack of centralized roadway systems and no form of public transit, making the transport of supplies and equipment by relief agencies nearly impossible; there may be no effective internal communication system, no set up telephonic electronic relays in place, rendering contact with the outside world virtually impossible—although this is becoming somewhat less so with the progressive advancement of satellite-based communication systems; there is great paucity of local, adequately educated or trained, health care workers or professional providers.

The cultural, social, and political practices and systemic beliefs that impede efforts at widespread education and behavior change aimed at prevention and transmission of infectious diseases are particularly insidious and challenging to eradicate, particularly in areas where belief systems are entrenched and access to personal health care information is grossly deficient. For example, it is nearly impossible to convince a culture that has never used condoms and has no ready access to HIV testing that their use will prolong or enhance lives, or prevent others from dying. In some cultures in far Southern Africa, there are prevalent beliefs that female genital mutilation and having sexual intercourse with a young (female) virgin will cure the disease constellation that the developed world knows as AIDS.

PRIMARY SOURCE

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SIGNIFICANCE

In the developed world, with its modern sanitation, adequate nutrition, safe drinking water, and advanced health care systems, people live longer than ever before. That is not the case for areas mired in poverty, in drought, in famine, in political and economic instability, and struggling against the rising tides of epidemics of infectious diseases (some of which have been virtually eradicated in the western world). Some diseases, such as tuberculosis which had been well-controlled, have mutated into drug-resistant forms. New bacteria and microbial disease agents have emerged, such as Avian influenza and SARS, and could be transmitted globally by air travelers (as has occurred with HIV/AIDS and SARS).

Although the WHO and UNICEF report that early childhood survival rates (birth through age five) have increased dramatically since the middle of the twentieth century, more than 25,000 children below the age of five still die daily, from preventable causes, primarily dehydration resulting from diarrheal diseases, respiratory infections (such as pneumonia and tuberculosis), and malaria. A growing focus of the world's health care and relief agencies is on newborn care. Save the Children estimates that roughly 40 percent of the preventable deaths occurring annually (estimated by that agency as some ten million children under the age of five) occur among newborns. It is their belief that simple solutions, such as utilizing means of keeping underweight babies' skin sufficiently warm by encouraging skin-to-skin contact, making oxygen supplies available throughout labor and delivery, and providing clean means of severing and caring for the umbilical cord area after birth, would dramatically increase survival rates, as would the availability of effective antibiotics for treatment of respiratory infections, and providing mothers with adequate means of nutrition so as to ensure nutritionally enriched breast milk. Providing impoverished countries with a means of establishing maternal and infant health care would go a very long way toward decreasing infant mortality—in many places in the developing world, there is no infant care, no means of saving babies born prematurely or of low birthweight, or providing immunizations for infants.

UNICEF, other international aid organizations, and private relief agencies have been working steadily to control or eradicate disease in developing countries, and to ensure adequate health care for all of the world's citizens. Among their goals is the assurance of safe drinking water, appropriate shelter, and sufficient healthy food for all. By affording the foundation for health, they are attempting to further the goals attained by improving (or providing) health care, creating immunization and vaccination programs, developing oral rehydration systems for children affected by diarrheal and dehydration syndromes, providing high quality vitamin supplements, and establishing educational and occupational training programs, they are working to eliminate the multigenerational poverty cycle. By creating the conditions in which children can grow up with good health, they can gradually—at least physically—strengthen and heal the world.

FURTHER RESOURCES

Books

Marquez, L. Helping Healthcare Providers Perform According to Standards. Operations Research Issue Paper 2(3). Bethesda, MD: Published for the U.S. Agency for International Development (USAID) by the Quality Assurance Project, 2001.

Web sites

NHS in England. "About the NHS—How the NHS Works." 〈http://www.nhs.uk/England/AboutTheNhs/Default.cmsx#primarycaretrusts〉 (accessed January 18, 2006).

PhRMA. "Health Care in the Developing World." 〈http://world.phrma.org/index.html〉 (accessed January 4, 2006).

Roane Photography. "About the Photographer." 〈http://homepage.mac.com/kitroane1/about.htm〉 (accessed January 4, 2006).

The World Bank: News & Broadcast. "Corruption: How the World Bank Fights Corruption." 〈http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,contentMDK:20040922%7emenuPK:34480%7epagePK:34370%7etheSitePK:4607,00.html〉 (accessed January 4, 2006).