Stephanie Nieuwoudt
CAPE TOWN, May 30 2008 (IPS) – When four-year-old Alice Were suddenly developed a fever, her mother Miriam took her to the local medicine woman close to her house in Kangemi, a poor, cramped settlement on the outskirts of the Kenyan capital, Nairobi. Two days later, Alice was unconscious. Her frantic mother rushed to hospital with the child in her arms. But it was too late. Alice died of malaria.
Infant mortality is down, but sub-Saharan Africa lags behind schedule on health-related MDGs by 2015. Credit: Manoocher Deghati/IRIN
Alice is one of the more than 10 million children around the world who die before their fifth birthday every year, according to a new report by UNICEF, the United Nations Children Fund.
The report, The State of Africa s Children 2008, was launched on May 28 at the Fourth Tokyo International Conference on African Development in Japan. It looks at the successes and failures of governments regarding the health and survival of the children of Africa and is complementary to a broader UNICEF report on the health of the world s children.
The facts are shocking. Although Africa accounts for only 22 percent of births globally, half of the 10 million child deaths annually occur on the continent. Africa is the only continent that has seen rising numbers of deaths among children under five since the 1970s.
Many of these children die of preventable and curable diseases. UNICEF s report says malaria is the cause of 18 percent of under-five deaths in Africa. Diarrhoeal diseases and pneumonia both illnesses that thrive in poor communities where sanitation is severely compromised, and where residents are often undernourished and exposed to pollution account for a further 40 percent of child deaths. Another major killer is AIDS.
At the launch of the report in Tokyo, Ann M. Veneman, chief executive director of UNICEF, said limited gains have been made in sub-Saharan Africa overall, the mortality figures have declined by 14 percent between 1990 and 2006. These gains can be attributed to dramatically expanded immunisation programmes, the increased use of insecticide-treated bed nets and the provision of vitamin A supplements to children. Other interventions in Africa include exclusive breast-feeding practices up to six months and the prescription of anti-retroviral medication to prevent mother to child transmission of HIV.
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In Ghana, all pregnant women are now covered by an intervention programme which includes iron and folic acid supplementation and preventative treatment for malaria. All children between six months and five years of age are vaccinated against childhood diseases like measles and polio.
In Malawi, the government has rolled out immunisation programmes as well as micronutrient supplementation small amounts of vital minerals like iron, cobalt, chromium and copper. The government is also building wells to improve access to clean water for people living in remote towns and villages.
According to the report, five countries in North Africa have made huge strides in decreasing child mortality rates. In Algeria, Egypt, Libya, Morocco and Tunisia the figures came down by at least 45 percent between 1990 and 2006. These relatively wealthy countries are on target to meet Millennium Development Goal (MDG) Number Four: to reduce by two thirds the child mortality rate among children under five.
But sub-Saharan Africa is unlikely to achieve any of the health-related MDGs by 2015; the continent lags behind on progress towards eradicating extreme poverty and hunger, improving maternal health, and halting and reversing the spread of HIV. One in every six children in sub-Saharan Africa will still die before his or her fifth birthday. The region is described by UNICEF as the most difficult place in the world for a child to survive.
In South Africa, 250,000 children under 15 are HIV-positive a huge proportion of the estimated 400,000 children under 15 who have been infected with HIV in Africa. Despite the expanded provision of anti-retroviral drugs, 64,000 more children contract the virus in South Africa each year. Across the southern African region, under-five deaths have risen by 17 percent between 1990 and 2006; these deaths are mostly attributed to HIV/AIDS.
In West and Central Africa, there were more people without access to clean drinking water in 2004 than in 1990. Unsafe drinking water can cause diarrhoea, dysentery and other water-borne diseases. Women and children who have to go out to find water for household needs are at particular risk of becoming victims of marauding gangs when they fetch water; cases of abduction and rape of women and children who fetch water are well-documented in the Sudan, for example.
The UNICEF report calls for intervention packages which include vaccines for children, pre- and post-natal care for pregnant women, exclusive breastfeeding for at least six months and the establishment of more and more accessible health care centres.
Rethinking the supply and management of water systems is also crucial. In Ghana, a water reform programme introduced in the 1990s has met with huge success. Responsibility for water supplies was transferred to local governments and rural communities and by 2004 access to clean water sources had increased to 75 percent from a low 55 percent.
Richard Lee, the South Africa-based media officer for the Sub-Saharan Services Unit of UNICEF told IPS that dedicated intervention on both national and international levels is required. If the mortality figures are to be brought down health care has to be provided from the womb to birth through childhood to adolescence. And this will require large amounts of funding. Governments have to focus their attention on using their resources more effectively, but it is true that most African countries do not have the means to implement different initiatives. Donor funding will be needed to scale up interventions.
However, in Kangemi, Kenya, the small grave of Alice Were is silent testimony to the fact that for millions of African children, these interventions are already too late.
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