The political struggles of Pakistan are well publicized: party offices under attack, pre-election bombings, and entire cities being shut down due to domestic terrorism. Unfortunately, it is politically unstable places like Pakistan that struggle the most in terms of health care, especially when it comes to children. This month, news network Al Jazeera has been running a story on the problems Pakistan faces with early childhood deaths from pneumonia and diarrhea.
Pneumonia and diarrhea are responsible for the global deaths of more than two million young children every year. In 2010, Pakistan saw 126,000 children under the age of five die from one or both of these two diseases - mortality rates that make Pakistan one of the countries most in need of better pneumonia and diarrhea prevention and care techniques.
Why the concern over these two illnesses in particular? Because this month, the World Health Organization (WHO) along with UNICEF have launched a Global Action Plan aimed at fighting pneumonia and diarrhea. Entitled The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, this Action Plan aims to help children in countries like Pakistan, where instability and poor economy has resulted in too few health care personnel, a lack of access to basic health and sanitation services, and a systemic increase in factors leading to both pneumonia and diarrhea deaths in young children. At the moment, 29 percent of early childhood death worldwide is a result of either or both of these illnesses.
With this Global Action Plan, WHO and UNICEF have set the goal of ending preventable child deaths from pneumonia and diarrhea by 2025. To achieve this ambitious goal, these organizations want to help local and international health agencies and clinics to employ a number of useful interventions.
For example, one of the most important Action Plan interventions is breastfeeding. In communities where rates of childhood mortality from pneumonia and diarrhea is high, mothers typically feed their babies breast milk along with other liquids during the first six months of infancy. This eating paradigm is not ideal: giving a child breast milk, and only breast milk, during their first six months can greatly protect the infant against both pneumonia and diarrhea. In their research, the Action Plan authors found that feeding the baby anything other than breast milk during their first six months can increase the risk of diarrhea by 165 percent. Breastfeeding can prevent pneumonia as well - children who are only given breast milk during those first months are 23 percent less likely to become ill with pneumonia.
Another intervention that can reduce both pneumonia and diarrhea, is better vaccination practices. The Action Plan makes it clear that more health clinics should be equipped and eager to vaccinate children against the main bacteria that causes pneumonia, as well as against the rotavirus which is the main cause of childhood diarrhea. Interestingly, the Action Plan also wants to see more children vaccinated against measles, because this illness can easily lead to pneumonia, and to diarrhea.
Also important for tackling these two diseases is better hygiene and sanitation standards. Simply washing hands with soap and water reduces a child's chances of getting diarrhea by 50 percent, and safer drinking water at home can likewise cut the risk of diarrhea in half. However, in many countries such as Pakistan where the prevalence of pneumonia and diarrhea is high, children do not have access to soap or a consistent sanitation system. Therefore, WHO and UNICEF want to see more local governments and actors in the private sector take a leading role in improving hygiene.
The Action Plan notes some examples of nations that have already begun to implement programs to improve sanitation and better educate parents and children about hygiene. In Mali, for example, the Ministry of Health has released a plan distributing sanitation and education responsibilities amongst the nation's ministries and stakeholders. In Ethiopia, the Ministry of Health, the Ministry of Water and Energy, and the Ministry of Environment are all increasing communication and coordination with one another in order to implement better surveillance of water quality.
Of course, some of the Global Action Plan's suggested interventions, only focus on pneumonia, or only upon diarrhea. WHO and UNICEF want more awareness about the danger of indoor cookstoves; the type which produce a great deal of smoke, leading to pollution inside the home and causing or exacerbating pneumonia in adults and especially in children. Cleaner-burning cookstoves are now on the market, and the Action Plan calls for helping rural communities to replace their stoves with these newer, safer models.
As for diarrhea, the Action Plan recommends wider use of oral rehydration salts, which are inexpensive and can save lives. Most deaths from diarrhea occur as a result of dehydration. Oral rehydration salts give the body important glucose and electrolytes, preventing dehydration and helping the body recover from diarrhea.
If all of these interventions can be put into action, WHO and UNICEF hope to see a widespread reduction in early childhood deaths from pneumonia and diarrhea. The goal is that, by 2025, the mortality rate of pneumonia in young children will be less than three for every 1,000 births, and for diarrhea, less than one death for every 1,000 births.
With better coordination amongst health and environmental agencies, and a bigger focus upon breastfeeding, vaccination and hygiene, there is certainly hope that the WHO and UNICEF Global Action Plan can reduce childhood mortality from pneumonia and diarrhea. By finding common causes and preventions, two diseases can be stopped with the same set of positive health care interventions.
So although the Action Plan will do little to end Pakistan's political woes, fighting pneumonia and diarrhea could make all the difference for the health of the nation's next generation; and indeed, the next generation of children around the globe.