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April 07, 2005

UN: World Health Day Report Focuses On 'Invisible Crisis' In Maternal, Infant Mortality

by Grant Podelco

The UN's World Health Day is being observed today

The UN's World Health Organization (WHO) calls it the "invisible health crisis" -- the preventable deaths of millions of mothers during childbirth, and of newborns and small children due to disease and other factors. The theme of this year's World Health Day -- observed today -- is the well-being of mothers and children around the world.
Prague, 7 April 2005 (RFE/RL) -- Bibigula lives in Jalalabad, in eastern Afghanistan, a country with one of the highest levels of infant and maternal mortality in the world.

"There is not a home where there is not concern," Bibigula told RFE/RL's Afghan Service "Our neighbor, who had three children, became pregnant for the fourth time. I was there during her delivery. She was in bad condition. After the delivery of the baby, we were waiting for her placenta. She had massive bleeding, but we did not have a health center to visit. She had retention of her placenta. Her abdomen looked swollen. Finally, because of losing a lot of blood, she closed her eyes forever, and her innocent children lost their mother."


Sadly, Bibigula's story is an everyday occurrence in most of the world's developing countries -- a fact borne out by the findings in the World Health Organization's "World Health Report 2005," which was released today.

The statistics are staggering.

Joy Phumaphi, assistant director-general of family and community health at the WHO, calls it an epidemic, with 11 million children under the age of 5 dying each year. Mothers are also dying in numbers difficult to comprehend:

"It is absolutely unacceptable that as I speak to you today, every minute we are losing a woman, a young girl, in childbirth and in pregnancy," Phumaphi said. "It is equally unacceptable that every year we lose 4 million children before they reach the age of 28 days to preventable causes."

As Phumaphi says, most of these deaths are entirely preventable, through common and affordable health practices and medicines.

Almost three-quarters of all maternal deaths are caused by five factors -- hemorrhaging, infections, unsafe abortions, high blood pressure, and obstructed labor. The greatest threats to newborns include things such as low birth weight and birth trauma, severe infections -- such as pneumonia -- and sicknesses, including diarrhea.

Thomson Prentice, managing editor of the "World Health Report 2005," says, "These are not necessarily complicated or serious conditions in the sense that there is no treatment or intervention possible. There are many, many treatments and interventions that can be applied at no great cost or without any great need for high technology that would make the difference between life and death for mother and child."

But how much of an impact can a UN report really have?

Prentice believes the "World Health Report 2005" can make a substantial difference in the way in which countries view the health of mothers and children. But he acknowledges that the effects are long-term -- that there won't be sudden visible changes in people's health or even in the development of policies that would have rapid impacts. That's simply not the way governments tend to work, he says:

"What we do know is that in previous reports, the recommendations have been widely accepted around the world. Many countries have made policy changes within their own health systems that take on board much of the information and advice that the report contains."

The goal, he says, is for each country to adapt the report's recommendations to suit its particular health systems.

The WHO report strongly emphasizes the need for what it calls a "continuum of care" -- providing support for women and children throughout the entire pregnancy cycle, from the earliest stages, through delivery, and into those crucial hours, days, and weeks after birth:

"What has been the case until now [in many countries] is there has been rather a compartmentalization of care. Somebody's responsible for antenatal care for a woman, but not particularly concerned with the birth of the child. Somebody's concerned with the birth of a child, but not much concerned with its later development, and so on."

Doctor Wim Van Lerberghe, is editor in chief of the new WHO study, says the report classifies countries into four groups -- those that are making good progress toward maternal and infant mortality goals; those that are making slower progress; those that are stagnating; and those that had once made progress but are now in reversal:

"Good progress are countries like Albania, Armenia, Croatia, Serbia-Montenegro, Macedonia -- countries like that. Countries that are making slower progress [include] Azerbaijan, Bosnia, Kyrgyzstan, Latvia, Lithuania, Tajikistan," Van Lerberghe says. That means that child mortality is reducing, but not as fast as in the preceding group."

Iran is considered to be making good progress, while Russia, Ukraine, and Uzbekistan are classified as making slower progress.

Afghanistan is one of those countries that is stagnant -- remaining at extremely high levels of maternal and infant mortality. But the worst category, Van Lerberghe says, includes those places that at one time appeared to be making progress but are now slipping back -- countries like Kazakhstan, Turkmenistan and Iraq.

Top model Liya Kebede is the WHO's new goodwill ambassador for maternal, newborn, and child health. She says she was shocked to learn that 500,000 women die during pregnancy each year, most of them from developing nations such as her own -- Ethiopia:

"The sad fact is that they are largely ignored -- a baby is buried, a mother is mourned, and a family grieves invisible to the rest of the world," Kebede says. "It is inconceivable that in the early part of the 21st century, mothers and children continue to die when solutions exist."

The WHO says the lives of more than 6 million children could be saved each year by a few simple steps, such as vaccines and common treatments for serious illnesses. These interventions are possible even in the poorest countries.
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