For Babies In Big Cities, It’s Survival Of The Richest

The following blog first appeared on The Huffington Post

I will never forget the moment when I looked out the car window at a bustling, steamy intersection in the heart of Manila, and locked eyes with a young woman. She was holding a tiny baby while begging in the street.

 

I glanced down at my six-month-old son, sleeping contentedly in my arms inside our air-conditioned car. The enormous inequalities between my world and hers struck me as never before. The child in my arms was about the same age and no smarter, cuter, or better than hers. Yet due to mere circumstance of birth, I knew my son would have many more opportunities in life, while this mother and her child would struggle to survive each day to the next.

 

It’s been 20 years since that fleeting moment, but the vision of the mother and her child has stuck with me. It drove me to change careers and join Save the Children, where we work tirelessly to ensure that every mother and child has a fair chance in life.

 

These days, more and more mothers in urban areas are seeking better opportunities for their children. That’s why Save the Children’s new report, State of the World’s Mothers 2015: The Urban Disadvantage — released with support from Johnson & Johnson — focuses on the health and survival of moms and babies in cities. The findings reveal a harrowing reality: for babies in the big city, their survival comes down to their family’s wealth.

 

I have been back to Manila many times. I am happy to report that, along with other urban centers in the Philippines, it is an example of how cities can narrow survival gaps between the rich and the poor by increasing access to basic maternal, newborn and child services, and making care more affordable and accessible to the poorest urban families.

 

A child’s chance of dying before his fifth birthday has been steadily declining over the years among the poorest 20 percent of urban families in the Philippines. From when I first visited that country in the mid ‘90s until today, child mortality rates among the urban poor have been cut by more than half and the urban child survival gap has narrowed by 50 percent between wealthy and poor kids.

 

Sadly, the Philippines is one of just a few countries with such dramatic improvements for poor urban children. In too many countries, urban child survival inequality is worsening, even as those nations have been successful in reducing overall child mortality rates.

 

In my travels throughout the developing world, I’ve never had to look very far to see evidence of these differences. For example, in New Delhi, India – a city with one of the largest health care coverage gaps between rich and poor – it is not unusual to see a gleaming hospital steps away from a sprawling slum, and to have babies literally dying on the doorstep.

 

But it’s not just in the developing world where our report found stark disparities between the haves and have nots. In our nation’s capital, Washington, D.C., a baby born in the lowest-income district, where half of all children live in poverty, is at least10 times as likely as a baby born in the richest part of the city to die before his first birthday. And while Washington, D.C. has cut its infant mortality rate by more than half over the past 15 years, the rate at which babies are dying in the District of Columbia is the highest among the 25 wealthiest capital cities surveyed around the world.

 

We all have a lot more work to do to ensure that every mother has the same opportunities for her baby, whether she lives in Manila, Washington, D.C. or anywhere else in the world.

 

Find out more about Save the Children’s new report atwww.savethechildren.org/mothers.

Where Health and Education Meet, Children Win

The following blog first appeared on The World Bank.

 

Every mom wants a healthy baby. And in the early days of a child’s life, parents and doctors understandably focus on how the baby’s physical development—is she gaining weight? Is he developing reflexes? Are they hitting all of the milestones of a healthy and thriving child?

 

But along with careful screenings for physical development, there is an excellent opportunity to tap into those same resources and networks to promote early cognitive, socio-emotional, and language development. This helps children everywhere have a strong start in life, ensuring that they are able to learn as they grow and fulfill their potential throughout childhood.

 

Save the Children works with partners around the world to integrate early childhood development interventions into programs in innovative ways—figuring out what works in local contexts and building an evidence base with governments to effectively support children and parents in the early years.

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In El Salvador, for example, we worked jointly with the Ministry of Health and National Academy of Pediatricians to design a screening tool to measure development in children under five. This empowers doctors and health workers to screen for development alongside health check-ups. Now when parents take their children to “healthy child control’’ checkups, children receive a comprehensive developmental evaluation so that the medical staff can identify risks early and advise on age-appropriate activities. By encouraging parents to exclusively breastfeed for the first six months or mimic the babbling sounds that their two to four-month old baby makes, these health experts are putting parents and young children on the path to success.

 

Medical staff in communities throughout El Salvador have been trained on this screening tool, and among 100 health centers evaluated, Save the Children found that not only are medical staff using the screening tool, but 95% are using it properly. The program has been brought to schools nationwide, and the Ministry of Health expects to reach hundreds of thousands of children, from birth to age five, in the early years of implementation.

 

Non-state actors like Save the Children can work with governments to find innovative approaches that meet the specific needs of the local population, and government commitment can turn this approach into scalable, sustainable change for children. This type of partnership is a win-win: When all parties are willing to look at a problem from new angles, real and lasting solutions can help children in those critically important first few years of life.

 

Thanks to our early experience and success, Save the Children was invited to be part of the El Salvadoran government’s team to design the new national early childhood development curriculum. We are now, along with other organizations, supporting the national roll-out of the curriculum and providing feedback to the government on community and center-level implementation.

 

Early childhood development is not limited to health, and it begins long before a child enters the classroom. Now, thanks to the leadership of the El Salvadoran government, the partnership of NGOs like Save the Children, and the support of health workers, parents and communities, children across the country are getting a stronger start in life—and the chance to build a better future for themselves.

The World’s Ebola Crisis: Disastrous for Mothers and Daughters

In the course of a regular day with my 13 year-old daughter, I check in on how her day went and tell her I love her.  It’s pretty standard stuff for moms.  And as President and CEO of Save the Children, I’ve seen how children’s health, happiness and safety are paramount to mothers in every corner of the globe. That’s why last week, when I called my daughter from Liberia, I stayed on the phone a little longer than usual—so grateful to hear her voice and know she was safe and well.

 

The conditions in Liberia, where Save the Children is responding to the Ebola epidemic, are some of the worst I’ve ever seen.  Children are always among the most vulnerable in a crisis and this is no exception—2.5 million children under five are living in the hardest-hit areas across the region, and 75% of all children infected in the current epidemic have died. Even those who are not infected themselves risk losing their parents to this terrible disease and often end up alone and ostracized by their communities. Fear, like the virus, is spreading rapidly.

 

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Martheline with her three younger siblings, who she is now caring for in the wake of their mother’s death from Ebola.

I met a young girl named Martheline, who is about my own daughter’s age. When her mother became ill with the Ebola virus, there was no money for a doctor and no way to access local services. Martheline nursed her mother at home, and then mourned her when she passed away.  Having lost her father several years before, Martheline was left to care for her three younger siblings—while a fearful community left them to fend for themselves. Even though they were not infected by the virus, every day has become a struggle for survival.

 

This crisis is also taking a toll on the incredible progress the world has made to reduce maternal, newborn and child deaths in Liberia and around the world. Already weak health systems are collapsing under the strain of the outbreak and many health facilities are closed—meaning that children are missing out on vaccinations and basic health care, putting them at great risk for preventable childhood diseases, and more women are giving birth at home in dangerous conditions. The effects of this virus are devastating and far-reaching.

 

The people I met in Liberia are no different than those I’ve met anywhere else in the world. They want the chance to be self-sufficient. They want to be able to support their families. They want to live with dignity and pride.

 

The most important thing we can do now is to focus on giving those affected by Ebola the chance to live safe, healthy lives once again. That’s why Save the Children is joining forces with those in the region to halt the spread of Ebola. In Liberia, we’re building Community Care Centers to provide community-based care closer to home, training health workers, and providing medical equipment and protective kits to families. We’re also working with orphans and other vulnerable children to ensure they are protected in this time of crisis by providing survivor kits to meet their basic needs and reuniting them with extended family whenever possible.

 

I know it can be easy to feel hopeless in the face of such devastating death and disease. But the global health community has already proven that by working together and partnering with people on the ground, progress is possible. Together, we eradicated smallpox. We are well on our way to do the same with polio, yellow fever and measles. 17,000 fewer children die each day than in 1990. There are millions of children alive today because we believed in the power of local health systems and we believed in the power of working together.

 

We must act now to support mothers, daughters, families and communities in Liberia, Guinea and Sierra Leone. Martheline didn’t just lose her mother to Ebola—she lost her childhood to the virus. It’s up to us to make sure she doesn’t lose her future too.

 

Donate today to help Save the Children build and manage Community Care Centers for Ebola patients and their families and distribute Survivor Kits to meet orphaned children’s basic needs.

Inside the Heart of an Epidemic

I am not sure that in my 16 years with Save the Children that I have seen—and felt myself—such  palpable fear in a place as I did last week in Liberia.  But it is a fear that comes at you in waves, an undercurrent that runs under what looks on the surface to be the normal daily life of a very poor country in West Africa.

 

In the market, people are going about their business, buying and selling wares, going to work, cooking in small sidewalk stalls. But right away you start to notice the billboards, the signs, all calling out that Ebola is real and what to do to keep safe. You see the washing stations at every store, every stopping point—and after just a few hours, the fear starts to seep in. My colleagues point out the sirens, signaling another Ebola case has been picked up, and images of the victims flash through my head.

 

The fear comes as I wash my hands in chlorinated water from a small bucket with a spout everywhere I go, as my shoes are sprayed with the same chlorine solution each time I get in and out of a vehicle or go into a building, as I try to remember to shake hands with no one, to touch no one, to not get too close, even to my own colleagues. Fear comes with the constant message on the radio inside the car as we drive—”Ebola kills”—over and over again.

 

But the real face of fear in this epidemic is in the faces of the families and children I met – children and families that have lost mothers, fathers, wives and husbands, brothers and sisters.  Those who have survived quarantines, but who are now shunned by their communities and cut off from basic services.  I see the fear in the children I met who have been orphaned by the virus and are living in makeshift shelters, under houses, inside storerooms.  Whole families of children living day-to-day as best they can without their parents. Their fear, and the fear of those around them, shows starkly in their eyes. WP_20141003_13_34_02_Pro

 

There are an estimated 3,700 orphans across the three hardest hit countries of Liberia, Sierra Leone, and Guinea.  In Liberia alone, the number is estimated at 2,000, with new children becoming orphans each day as the virus ravages mothers and fathers. One little girl I met, seven year-old Elizabeth, was living under a house with her older brother just steps away from where their mothers body had been taken over a month ago.  They had come and burned all their belongings and sprayed down the room but the children would not go back inside.  While they survived the 21 day incubation period, they now faced the prospect of starvation and stigma as people in their town are too scared to even look at them.

 

One of the key pieces of our response is to work with the Department of Social Welfare in Liberia to ensure we know where these children are and get them basic survival kits which include food, household items, soap and hygiene supplies and clothing. Then we begin to try to reunite them with extended family whenever and wherever possible, a painstaking process to trace family members that may be hundreds of miles away.

 

But the bigger issue in this crisis is breaking the back of transmission of the disease, reducing the reproductive rate of cases to below 1—and bringing down the fear.  The messages, chlorinated water, and radio programs have done part of their job but people must leave their houses and get into care and stop infecting others at the first sign of symptoms. Tragically, there is just not enough care and beds available.

 

Save the Children is building 10 Community Care Centers in Margibi county—smaller centers where people can go and get tested, where those testing positive are isolated from others before being transferred to a more sophisticated Ebola Treatment Unit, getting basic care while waiting for a bed and receiving visits from a mobile team of doctors and nurses. We are also building an additional Ebola Treatment Unit to serve Margibi, one of the epicenters of the epidemic, modeled after a center we already built in Bong County.

 

While the fear of this visit was very real, there was also hope.  In my last hours in Liberia, I visited a transition center for orphaned children in Montserrado, with 10 children who still could not yet be reunited with their families.  While you could still see traces of fear and certainly sadness in their eyes, they lit up when asked to sing a song and proudly told me about their dreams.  One little boy, Edward, told me with a confident smile, that he wanted to be President.  Right at that moment, I believed it could come true, if we could just end the fear and death all around us that have no place in a child’s life.

 

Please help us do more to halt the outbreak and provide lifesaving outreach and protection for children.

Pre-School, Helping to Build Healthy Habits

Abilio Cossa

Abilio Cossa, Program Officer

Gaza Province, Mozambique

July 30, 2014

 

Save the Children has opened 35 preschool classrooms in 15 communities in the Gaza province, giving 1,225 children an early start to school success. Parents and caregivers have reported on the importance of early development of their children and change in the hygiene habits in the community. “Children that go to pre-school get knowledge about things that are not common in the community and they teach their parents…” said the community leader Nosta.  Laila (with her sister Leila) ready for the graduating cerimony

Getting ready for preschool, Laila, 5, and her sister, Leila, 3, brush their teeth behind their home in a small village outside of Mozambique’s Gaza province. Both girls attend the local Save the Children-supported preschool, where they learn not only the alphabet and counting, but also the importance of good hygiene. These healthy habits are very appreciated by parents, caregivers and other children in the community.

“Preschool is very important because kids develop good habits. They know that when they wake up they have to brush their teeth and comb their hair, get dressed and go to school”, said Laila’s mom, Maria Jose, 35. “These practices were not common in the community and we (parents) are learning from our children… note that… today the children are transmitting us habits that we did not have before.”

Laila and her ECCD colleagues exhibiting their certificatesWhen I asked Laila about what she learned in the pre-school she answered,” We learned that we have to wash our hands before eating and after using the latrine, we also learned that after waking up we have to wash our faces and comb our hair to be beautiful.”

During the interview Laila added, “Today is a special day for me and for my family.” Laila was part of a graduation ceremony. Her mother’s last remarks were, “I feel like I am flying. I am really proud and happy to see my daughter graduating.”

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Moms are the Heroes

We’ve all heard it before in one form or another: “Don’t get between a mother and her baby,” “There is nothing better (or worse depending on your position!) than a fired up mom” or “Mothers are their kids’ best advocates. However you phrase it, I see evidence of this everywhere I go for my work as Save the Children’s CEO and, I guess, Mom-in-Chief. It plays out whether I’m in Washington, DC or Lexington, Kentucky or the Bekka Valley of Lebanon. And during my trip last week to rural Nepal, I saw it again in full force.

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No Birth Should Be Left Up to Chance

This blog first appeared in the Huffington Post

 

Giving birth ranks among the scariest moments for any mother. It certainly was for me. I was living in Hong Kong at the time when my second of three children was born. And he was born in a hurry. He came so fast that I actually thought I’d give birth in our car on the way to the hospital! Fortunately, that didn’t happen and I safely delivered my son Patrick surrounded by a team of well-trained doctors and nurses, not to mention my loving (and relieved!) husband by my side.

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But I’m one of the lucky ones.

 

As new research released today by Save the Children reveals, 40 million women give birth without any trained help whatsoever. What’s more, 2 million women give birth entirely alone.

 

I met one

Put the Frontline Health Worker Into the Post-2015 Framework

This post previously appeared in the Huffington Post and on the Skoll World Forum.

 

As world leaders gather this week to discuss the achievement of the Millennium Development Goals and the Post-2015 Framework, no subject of conversation will be more important than the need for more frontline health care workers. In the last two decades, the world has made tremendous progress in reducing child and maternal mortality, due in no small part to the contributions of the local health worker delivering lifesaving care. Millions of people in impoverished countries are alive today because a midwife was by their side when they gave birth, or they were vaccinated as infants by a nurse, or because their families learned from a community health worker to adopt healthy behaviors like breastfeeding, hand washing, birth spacing, and sleeping under a mosquito net.

 

I saw the lifesaving power of local health workers first-hand last month when I visited Save the Children’s programs in Pakistan, a country with some of the worst health indicators on the planet. According to our latest State of the World’s Mothers report, the lifetime risk of maternal death–the probability that a 15 year old woman will eventually die from a maternal cause–is 1 in 110 in Pakistan. Compare this to the United States, where it’s 1 in 2,400 and you see my point. Pakistan’s children aren’t any better than their moms. For every 1,000 children born, 72 of them will die before they reach the pivotal age of five, more than ten times the rate of their American counterparts.

 

But as harrowing as these statistics are, you would never know it from visiting the maternal and child health clinic in Haripur district. It is one of the most impressive facilities I have seen anywhere in the world at the primary care, or village, level. The spotlessly clean unit is staffed by two female doctors and several nursing staff as well as a pharmacist–all health care workers. A warehouse stocked with supplies is available on-site and the facility provides services 24/7 as needed. Women come here for prenatal visits, for family planning counseling and products, and to give birth in a simple, clean and safe facility with excellent care. Three women were in labor the day I visited and when I saw the care they received, I knew I would have felt comfortable having one of my own children there.

 

Unfortunately, not everyone in Pakistan–or the rest of the world for that matter–is as lucky to have a health worker in such close proximity. By some estimates, there is a shortage of at least 1 million frontline health workers in the developing world. And many existing health workers are not trained, equipped and supported to deliver basic lifesaving care close to the community. The consequence of failing to close this gap is grave. Every 3 seconds, a child’s death is prevented thanks to care provided by a frontline health worker. When a health worker is not accessible, the situation is, predictably, far less rosy.

 

The challenge for all of us in the business of saving mothers’ and children’s lives is to ensure that every person, no matter where they live in the world, is within reach of a health worker. We can–and should–start at the UN General Assembly, and continue the drumbeat at the Third Global Forum on Human Resources for Health in Recife, Brazil in November. But, it will take more than a few high-level meetings to make this a reality. That’s why Save the Children, in partnership with the Frontline Health Workers Coalition, created The REAL Awards, a first-of-its-kind, annual global awards platform designed to develop greater respect and appreciation for the lifesaving care that health workers provide in the U.S. and around the world. Anyone can take a few moments to nominate an inspiring health worker and help spread the word about the countless unsung heroes who go above and beyond the call of duty. It will make a REAL difference.

A Mom’s Best Or Worst Day

The following blog first appeared on The Huffington Post.

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Every day, thousands of women celebrate one of life’s most amazing experiences — becoming a mother. But every 30 seconds a mother’s first moments with her baby are cut short, on the very day she gives birth.

 

Until now, we didn’t know how common this heartbreaking experience is in the United States and around the world. But Save the Children’s new report shows that one million babies die the day they are born.

 

State of the World’s Mothers 2013: Surviving the First Day also shows that today we have the evidence and cost-effective tools to save up to three quarters of newborn babies, without intensive care.

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The Real Breastfeeding Scandal

The following blog first appeared on The Huffington Post.

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Last year, Time magazine’s “Are You Mom Enough?” cover practically shouted “Scandal! Women breastfeeding too long!”

 

The unforgettable image stirred up controversy and I’m sure it sold magazines. But are moms and kids any better off?

 

Now, imagine funneling all that outrage and punditry into something that really helped mothers and their babies when it came to breastfeeding — especially in the developing world where it can literally save lives.

The real scandal is not breastfeeding late, but that too many moms don’t get the support needed to breastfeed early — or to keep breastfeeding, should they want to.

 

In our new report, “Superfood for Babies,” Save the Children estimates that 830,000 babies could be saved every year if they were breastfed in the first hour of life. The colostrum, or first milk, provides a powerful shot of antibodies that can stave off deadly disease. And immediate breastfeeding more often leads to exclusive breastfeeding for six months, which can save even more lives.

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