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Illnesses Don’t Discriminate: Vaccines Work

Co-authored by Carolyn Miles, CEO, Save the Children and William Moss, MD, MPH, Interim Executive Director, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health

Parents work hard to help their children stay healthy. Try as we might, hand washing, good nutrition, and flu shots are sometimes no match for “what’s going around.” A cough. A fever. A stomach bug. If you feel like these illnesses are everywhere – you’re right.

And families around the world are battling the same illnesses. But in some places it’s far from a fair fight. Illnesses that are easily preventable and treatable in the United States can take the life of a child in Africa. More than 1.3 million children die each year from pneumonia and diarrhea, two of the leading killers of children in poor countries.

It surprises many people to learn that pneumonia and diarrhea, not HIV, tuberculosis or malaria, are the leading cause of death in young children around the world. While diseases like HIV and malaria take a toll, pneumonia and diarrhea take more lives of children under age five than all these diseases combined.

In the U.S., routine immunization helps protect against these common sicknesses. Hib (Haemophilus influenzae type b) and pneumococcal conjugate vaccines protect against pneumonia, and the rotavirus vaccine protects against one of the most common and serious stomach bugs. These vaccines have drastically reduced the number of children who suffer from these illnesses. A 2017 study found the rotavirus vaccine cut nearly in half the number of young children hospitalized for diarrhea, saving more than $1 billion in health care costs over five years. Similar benefits have been documented with the vaccines that prevent pneumonia.

Though germs are everywhere, health care sadly is not. Parents around the world share a common goal of protecting their children, yet too many families still lack access to, or even awareness of, vaccines and medicine that could save their children’s lives. As a result, the stomach bug that means a few days off school and a trip to the pediatrician for a child in Maryland can mean severe dehydration and even death for a child in Kenya. The respiratory infection that goes around at a preschool in Atlanta causes life-threatening pneumonia for young children in Ethiopia. What separates parents around the world is not the illnesses their children face, but how the health care systems they have access to are equipped to battle them.

While some may dismiss the challenges parents in poor countries face as inevitable and unfortunate consequences of poverty, this is simply not the case. This is not only a battle worth fighting, it’s also one we can win. We know how to prevent these deaths, and in many places, we are already succeeding. India, Nicaragua, Tanzania and many other countries have increased immunization rates and have saved lives as a direct result. Since 2000 the number of children’s lives lost to pneumonia and diarrhea has been more than cut in half – from 2.9 to 1.3 million deaths annually.

Every year, fewer children lose their lives to preventable diseases. We should be encouraged—but not satisfied—with the progress we’re making. We can do better. We can increase resources to equip families and health care systems around the world with the tools they need to battle our shared infectious foes. We can find new ways to deliver lifesaving vaccines and antibiotics to make sure no child dies from a cough, the stomach bug, or a mosquito bite. And we can muster our political courage and give voice to the needs, worries, and love of parents who, like germs, are the same everywhere.

Ethiopia’s Children Deserve to Have a Childhood

Written by Carolyn Miles, President & CEO, Save the Children

As we drove into the camp area for those displaced from home, the sea of people, goats and cows on the dusty, potholed road parted and flowed around our vehicles, each intent on going somewhere fast. The entrance to the children’s area of the camp was a piece of tin in a fence of sticks and tarps and when it swung open, we could see hundreds of children running and playing and a circle of girls dancing.  This is Gedeb, Ethiopia, a few hours south of Hawassa, where more than 13,000 people have come to escape violence.  

In this rather sad place, we visited the happiest corner, full of children playing and learning in a Save the Children supported area. Small children learned their letters in a huge tent, with local teachers and volunteers coaxing them to the front of the room to practice at posters tacked to the canvas walls. There were few books, and even fewer toys, but the children were intent on learning and squealed in delight when one of us came to the front of the room to “help” with the lesson.

Outside, girls danced and sang in a tight circle and in the large field dozens of older kids were engaged in a lively game of soccer. Even in the worst of circumstances, children just wanted to play, have fun and learn like any child anywhere. 

As we walked through the camp, through crowded rows of tiny huts made of tarp, sticks and dried banana leaves, the delight of the children nearby seemed even more amazing. Inside one of the shelters, I stopped to talk with a mom named Biritu, a mom of five who is pregnant with her sixth child. This was her second time coming to the camp from her home further north, where violence and looting had caused her to flee with her children. The space they were living in was about the size of a basic bathroom here at home, with tarps on the floor of mud and two tiny spaces for sleeping and living. Even on a cool day, it was steamy inside. When I asked when she thought she might go back home, she just shook her head sadly and held up her hands – a universal sign of “who knows.”

We visited the health post in the camp, which is also run by Save the Children. Here there were doctors from a nearby hospital who work 15 day rotating shifts. Mothers lined up on wooden benches waiting to get babies checked for malnutrition and for their children to receive vaccinations or treatment for illnesses. Adults were receiving services too, but the biggest focus was on pregnant women and children, trying to keep them healthy. 

The plight of the internally displaced people (IDPs) in Ethiopia is largely unknown. Yet there are more than one million people in just these two southern regions of Ethiopia and 3.2M country-wide who have been displaced. Many of them live in camps like the one we visited and even more live in the surrounding communities, sometimes with relatives until the resources and goodwill run out and they find themselves in the streets or back at a camp.

The conditions, despite the services offered by Save the Children and other aid agencies, are harsh. There is worry that as the rainy season approaches, this camp will be flooded. The latrines and water points may not hold out and these people could be moved yet again from this place to another. For many this might be the third or fourth move in just the past year. The children can’t go to formal school and the cases of scabies, malnutrition, pneumonia, and diarrhea are growing every day. Save the Children has reached more than 470,000 of the IDPs in this region with distributions and services, but there are still hundreds of thousands of displaced around the country unreached by any aid. With a world full of crisis and disasters, the suffering of these children and their families is largely ignored. 

Ethiopia is a country of great progress – one of the only countries in the world to meet the Millennium Development Goal for two-thirds reduction in child mortality from 2000 to 2015 and a country with strong GDP growth. But that progress and the opportunities it affords children is at risk of being set back for millions of children who can’t get regular access to services, especially to health services and school.

As part of our Return to Learning initiative, Save the Children has been working for the past three years to get refugee children access to school within a few months of being displaced. We’re working to ensure the world pays more attention to the importance of education for refugee children. I came away from this trip to Ethiopia convinced that we need to do the same for IDP children here in Ethiopia and around the world. We can’t afford to let millions of children lose out on the opportunity to go to school for years on end due to displacement. Whether they are refugees in another country or displaced within their own, they deserve the chance to grow up healthy and to get an education.  

 

 

James, age 6, and Heshima, age 8, carry water from a dried up riverbed in Turkana County, Kenya. Photo credit: Peter Caton \ Save the Children, July 2018

When Kenya’s Rivers Ran Dry

Written by Carolyn Miles, President & CEO, Save the Children

Kenya’s people had known droughts, even severe droughts, but they’d never experienced anything like this before.

This World Water Day, I’ve been reflecting on a trip I made to northern Kenya in 2017, when the whole Horn of Africa was experiencing a devastating drought. The rivers had all run dry, crops had failed and livestock had perished. When it finally did rain, flash floods swept away anything left. Children were hungry, malnourished, sick and dying.

I met desperate mothers and little children forced to dig into dried-up riverbeds just to find some muddy water. It was a grueling process that took children many hours, twice every day. First, they walked to the dry riverbed, then dug deep holes into the dirt, sometimes 10ft down, until enough water appeared to fill their water jugs. Then they would haul themselves up and out of the hole to carry the heavy jugs back home to their families. No child should have to spend precious time away from school and their families like this, only to have water unfit to drink.

Children in Turkana County, Kenya dig for water in a dried up riverbed. Photo credit: Peter Caton | Save the Children, July 2017.

The good news is that through Save the Children’s partnership with the P&G Children’s Safe Drinking Water Program, we were able to help purify that muddy water, using P&G’s water purification technology. We met with local mothers, distributed much-needed supplies and taught them how to benefit from this easy-to-use technology. This amazing process, invented by a P&G laundry scientist, transforms dirty water into clean, drinkable water in only 30 minutes, preventing deadly, water-borne diseases – and saving lives. It also helps improve health, enable education and increase economic opportunities for entire communities.

Thanks to supporters like P&G, we were on the frontlines in Kenya, saving as many young lives as possible throughout the unprecedented drought. And we’re still there to this day, working to ensure children and families have what they need to not only survive, but grow up healthy, educated and safe. Together, we’re creating ripples of change in children’s lives, their families and communities – ultimately transforming the future for all of us.

A special thank you to P&G, in partnership with National Geographic, for the honor of being named a Water Champion – and spreading the word about our humanitarian work.

Happy World Water Day!

A Bold Vision for Gender Equality

Written by Carolyn Miles, President & CEO, Save the Children | Photograph by Mauricio Santana/Getty Images

In the time it will take you to read this, at least 45 girls will marry before they turn 18. These are girls that will likely never finish school, will have babies too young and will struggle to break out of poverty.

Statistics like this are still all too common around the world. Gender inequality, discrimination, and gender-based violence persist globally, starting at birth and worsening throughout adulthood. Today, on International Women’s Day, Save the Children is calling attention to what we’re doing to address the gender barriers that children around the world face.

One hundred years ago Eglantyne Jebb, child rights defender, suffragist and visionary, catalyzed a global movement for children when she founded Save the Children. In the spirit of our founder and her resolve to uphold the dignity and rights of every child, we are proud to launch Save the Children US’ first Gender Equality Strategy.

This strategy articulates how we plan to achieve progress toward a more equal world by focusing on gender equality and social inclusion in all our programs, advocacy and organizational policies and practices.

Over the next three years we will work to eliminate all forms of gender-based violence and harmful practices, including child marriage. We will work to empower women and girls and promote positive and diverse expressions of masculinity. We will continue to keep gender equality at the heart of our advocacy work and integrate gender equality into how we think, plan, and operate as a global organization.

As Save the Children enters its second century of change, we are doing whatever it takes to ensure all children grow up the way they deserve — healthy, educated and safe. As we work to create positive, lasting change for children, we need an ambitious plan for promoting gender equality. Our vision is a world where girls, boys and youth of diverse gender identities are heard, valued and have access to equal opportunities. We believe that all children should be empowered to live their lives, speak their minds and determine their own futures. Placing gender equality at the center of our work will have a resounding impact on the lives of children and families that we serve, creating positive and sustainable change in their communities across the globe.

As our founder Eglantyne Jebb once said, “Humanity owes the child the best it has to give.” It’s time to ensure a more equal world for all. We owe it to children around the world.

Save the Children Team in Yemen Recognized for Family Planning Program Achievements in a Humanitarian Setting

Written by Carolyn Miles, President & CEO, Save the Children

Yemen is currently experiencing the largest humanitarian crisis in the world. More than two-thirds of the population is in need of humanitarian assistance, with one-third in acute need. Of the 22.2 million people in need, more than five million are women of reproductive age, including an estimated half a million pregnant women. Before the current crisis escalated in March 2015, the average fertility rate was four children per woman and the lifetime risk of maternal death was one in sixty. In only 30 other countries do women face a greater chance of dying due to complications of pregnancy or during childbirth. Access to family planning is limited with only 20 percent of women using a modern contraceptive method and a high unmet need for contraception of 33 percent.

In the dire context in Yemen, Save the Children staff work tirelessly to support children and their families, and we are so pleased that our family planning team that includes was recognized for the work they do in the face of tremendous adversity. At the International Conference on Family Planning, our Yemen team was awarded an Excellence in Leadership for Family Planning Award for their “significant contributions to the family planning field.”

Since the beginning of 2013, and through the escalation of the crisis, our reproductive health program has reached nearly 60,000 new family planning users through support to 16 health facilities in Hodeida and Lahj Governorates through funding from private foundation. The program has also expanded access to long-acting reversible contraceptives (intrauterine devices and implants) that are more effective than other methods and are often a good choice in humanitarian settings where supply chains may be disrupted. This high quality work was leveraged to secure a new two-year award for Save the Children from the U.S. Agency for International Development to strengthen family planning services in Yemen.

In addition to the recognition of our Yemen team, other Save the Children teams from Egypt humanitarian response for Urban Refugees in Cairo and Mali were recognized for their excellent work by winning “best poster” awards during the conference. Our submission was one of the twelve (out of 325 applications) named a finalist of the Quality Innovation Challenge sponsored by the Packard Foundation for a concept to pilot a digital, interactive contraceptive decision-making tool for young people in acute humanitarian emergencies in Somalia and Yemen. Through 41 posters and presentations, our staff demonstrated the positive impact our family planning programs have on the lives of children, adolescent girls, women and their families around the globe.

To learn more about how family planning saves lives and our presence at the International Conference on Family Planning, click here.

Delivering Quality Family Planning for the Hardest to Reach

Written by Carolyn Miles, President & CEO, Save the Children

Furah is a mother of four children who lives in the Democratic Republic of the Congo. The eastern part of the country where she lives is marked by chronic poverty and decades of violence. With four children and living in a crisis-prone area, Furah wanted to avoid another pregnancy. At a Save the Children-support health facility, she was able to get an intrauterine contraceptive device to provide her with long-acting contraception. She, and others in her community, have noticed the positive benefits that family planning have brought to their community: “Children don’t get malnutrition or get sick as much as they did before the family planning program started.”

Satisfying demand for family planning services has the potential to drastically reduce maternal and child deaths. Nearly 1 in 3 maternal deaths and 1 in 5 child deaths could be averted if the 214 million women with a need for family planning were able to use modern contraceptive methods. There are also benefits to children’s education and girls’ ability to stay in school.

Save the Children delivers high impact reproductive health and family planning interventions for women and girls around the world. We do this by:

  1. Prioritizing the hardest to reach, including adolescents
  2. Improving clinical capacity and supply chains, particularly at the lowest level of service delivery
  3. Engaging men, women and communities to create an enabling environment for family planning use, including address inequitable gender norms
  4. Delivering family planning in humanitarian responses
  5. Advocating for supportive policies for family planning in partnership with local leaders and organizations
Furah and her four children outside the Health Facility in DRC. She has noticed the positive benefits that family planning have brought to the community.

Our family planning programs focus on postpartum women by capitalizing on the opportunity of service integration through maternal, newborn or child care services. Using our multisector approaches and expansive reach through newborn and child health, we reach postpartum mothers through vaccinations campaigns and other touch points at the community and facility level.

In humanitarian settings, we support reproductive health services by training and mentoring frontline health providers, providing commodities and supplies, strengthening supply chains and supporting communities to increase awareness and use of reproductive health services. We deploy quickly and stay long term to deliver family planning in any setting.

Our adolescent sexual and reproductive health and rights programs fill critical information and service gaps, foster the development of positive social and gender norms, build linkages to health systems and equip adolescents with the skills, information and supportive social environment needed to navigate the challenges and opportunities during this critical life stage. Our programs address barriers through facility- and community-based strategies to increase access to health services that respond to the needs of adolescents and offer a full range of contraceptive methods.

More than 50 Save the Children staff members from 16 countries will be in Kigali, Rwanda this month for the International Conference on Family Planning – where we will share our expertise and thought leadership with the international community.  Together, we can all ensure mothers like Furah have the future they deserve.

To read more about how family planning saves lives, click here. 

Moms Saying No to Child Marriage

“How many of you were married before the age of 18?” This was the first question I asked the mothers I met in the Duhok refugee camp in Iraq, near the Syrian border. Of the 10 or so moms gathered in the Save the Children center, only one raised her hand. However, the reality for Syrian girls in refugee camps now is very different.

Save the Children research in 2014 showed that the rate of marriage for Syrian refugee girls rose to 25%. This is a relatively new phenomena for Syrian families, as the rate of early marriage prior to the start of the bitter civil war that has raged for more than seven years was only 13%. We want these moms who had gathered that morning in the Save the Children facility to continue to help us stop what was happening in the camp.

Early marriage is something Save the Children is working on in places like Nepal, Bangladesh, and Niger. It is an ender of many things for young girls – an ender to their education, an ender to many of their dreams, and, sadly, an ender to their lives in some cases. A girl married before the age of 18 is three times more likely to drop out of school. Girls married at an early age are more likely to have children at an early age. Sadly as a result, complications from pregnancy and childbirth are the leading causes of death among girls 15–19 years old. Their children are also more likely to be under weight and have complications during birth. A child having a child is rarely a healthy way to start a family.

A mom named Fatima explained that sometimes families are living in such poverty that the chance to have another family take on the responsibility of food and shelter for a young girl is too much of an opportunity to pass on. Girls are still seen as a “cost” to families with little recognition that girls can go on to become wage earners for the family if they get a basic education and are allowed to seek work outside the home. Sometimes, families are worried that their teenage girls will become pregnant before they are married and see an arranged early marriage as a way to avoid such a shameful event. And in some cases dowries will be paid and there is an economic incentive to marry off daughters to benefit the rest of the family.

All these factors point to an underlying reality in many parts of the world – that girls are just not valued as people in the same way that boys are. The mothers I met are trying to change that outlook, one family at a time. They celebrated International Day of the Girl in the Duhok camp in mid-October by speaking to their neighbors about the harmful practice of early marriage, meeting face-to-face with other mothers and working to convince them that early marriage is not the best path for their girls. Instead, they should stay in school and get an education. For these women, they had so many more opportunities before choosing to marry and have children. One mother named Adima who was sitting next to me admitted this was hard work, but that they were dedicated to making it happen.

Carolyn Miles, President & CEO of Save the Children, visits mothers in a refugee camp in Duhok, Iraq.

As we talked, my admiration for these mothers grew – even in the midst of a refugee camp, with very basic shelter, with food still rationed out to families, where many had been living for years, these women had a passion for their children that shone through. They recognized that girls did have the right to choose their own path and that the new tradition of early marriage was not in the best interest of their daughters. And they were willing to stand up and say so to girls, to other mothers, and perhaps most importantly, to men and boys too.

Through these kinds of programs in many parts of the world where child marriage is the norm – or has become so because of conflict and displacement – Save the Children works to empower girls and mothers to reduce the numbers of girls marrying before 18. Our latest analysis shows that 51 million girls will marry before 18 by 2030 given current trends. But we can change that story by engaging everyone in standing up and saying no to early marriage.  Click here to learn more about how you can support our work for girls around the world and help moms like Adima and Fatima be heard.

 

 

A Case for Gender Equality on this Day and Every Other

Written by Carolyn Miles

Today, on International Day of the Girl, the world celebrates the many things a girl can be – a doctor, an artist, a judge. Lean in. Dream big. Those are the empowering messages we all tell the girls in our lives.

But despite remarkable progress in some quarters, gender inequality and disempowerment still persist and are a root cause of many barriers to sustainable development around the world. Discrimination against girls critically impacts children’s ability to survive, learn, and live a life free from violence.

Without a strong start in life, a girl’s future is likely to be determined for her. Gender inequality leaves entire regions behind: according to the United Nations, Sub-Saharan Africa alone loses US $95 billion per year due to gender inequality. As a universal human right and a means to overcoming poverty and discrimination, gender equality must remain at the center of our U.S. foreign policy and development assistance.

The journey of nations to meet their own development needs depends on breaking down the barriers to enhance powerful contributions of women and girls. To improve development outcomes everywhere, the U.S. government must invest in gender analysis to look at the differences between progress for girls and boys. Only then can we identify and work to transform the root causes of gender inequality, including addressing discriminatory social norms and institutions, as well as advocating for and fostering legislation and policies that promote gender equality.

Child marriage is a good example of a harmful practice that affects not only girls but whole societies.  Around 1 in 5 women and girls in the world today were married as children – 1 in 3 of those were married before the age of 15. To a policymaker seeking to put an end to this, legal interventions may seem like the answer. But while they’re a key piece of the puzzle, new analysis by Save the Children shows that a startling 51 million child marriages could be averted by achieving universal secondary education for girls.1  This is what putting gender equality at the center of all areas of foreign policy and international assistance looks like: Reducing the harmful ways in which gender inequality combines with other factors to make it so much harder for girls to reach their potential.

The U.S. State Department and the U.S. Agency for International Development (USAID) need robust funding and staffing to continue making critical investments in peace and security, economic development, education, nutrition, healthcare, and more. But if gender equality and women’s and girl’s empowerment aren’t at the center of all of these, the results just won’t be what we all want for children.

USAID has found that when 10 percent more girls go to school, a nation’s GDP increases, on average, by 3 percent. That’s something they wouldn’t have seen without a gender equality approach. Without sex- and age-disaggregated data, they wouldn’t even know that of the 25 million children currently out of primary school around the world, 15 million are girls.

Without gender analysis, they would overlook many of the reasons: boys’ education is often prioritized, girls face an increased risk of violence between home and school and from their teachers, and girls who marry before they reach adulthood almost always abandon their formal education.

Salam, pictured here with her young son Mesfin, was able to leave the abusive marriage she was forced to enter at age 13. Save the Children’s “Keep it Real Program” supported her return to school, where she rose to the top of her class.

But what about the other 134 million girls who will be married as children between 2018 and 2030 if the world doesn’t act? They too can become teachers, journalists, and entrepreneurs, but both research and experience tell us they’re more likely to become mothers, before their bodies are ready for it, or experience domestic violence. An investment in gender equality and girls’ empowerment yields tremendous results – not only in the individual lives of women and girls, but for the future we all share.

That’s why we at Save the Children have put gender equality at the top of our agenda.  On this International Day of the Girl, tell the U.S. government to do the same.

Share this post, check out our many others on Twitter under #SheCanBe, #EndChildMarriage, and #DayOfTheGirl, or join us in taking action!

 

1. Working Together to End Child Marriage 

The Children of Baidoa

By Carolyn Miles, President & CEO, Save the Children

When I met him, Isaac was hungrily drinking the milk his mother gently brought to his lips in a little plastic cup. At thirteen months old, he was stick thin but already so much better than when he arrived a week ago. The doctor told me he was so weak from pneumonia on top of severe malnutrition that he had to be fed by an intravenous tube in his tiny arm – now he was sitting up to eat. In about a week, he’ll go home with a two-week supply of peanut-based food and come back to the out-patient facility to ensure he’s putting on weight. Once the health workers are assured of his progress, he’ll hopefully transition to a regular diet of breast milk and porridge – the perfect meal for a growing baby boy.

There were about 40 other children at the Save the Children stabilization center in Baidoa, Somalia when I visited – some so malnourished they couldn’t hold their heads up or eat on their own and others on the way to recovery.  The children in the stabilization center are not only suffering from severe malnutrition but other complications like diarrhea, pneumonia, or malaria – illnesses that prey on immune systems weakened by hunger. Conflict in Somalia between the government and Al Shabab has displaced millions of families, and the center’s two doctors and their staff are busy every day taking care of children whose families are struggling to provide food in the middle of the conflict. The conflict keeps families from their farms and pastures and makes the country one of the most food insecure in the world – more than one million of Somalia’s children are acutely malnourished. While the stabilization center is making a big difference, the staff is worried about new funding and when it might come to keep the center operating.

Isaac at Save the Children’s stabilization center in Baidoa, Somalia.

During my recent trip to Baidoa, I also visited a camp for internally displaced persons – people who have had no choice but to leave their homes. I met with Issa, who arrived at the camp six months earlier with her four children when the fighting reached her village 60 km away. As a divorced woman, she was left with no resources after her small livestock herd died and she was concerned about getting her infant daughter, Laila, the medicine she needs to combat an upper respiratory infection that makes her wheeze. The conditions inside the camp are grim, and mothers and children pick their way around the huts covered in plastic, clothes and cardboard to keep out the rain that turns the ground to mud.

Issa’s own challenges are made more difficult by the many layers of problems most people in Somalia face. In addition to the threat from Al Shabab and the persistent drought that jeopardizes the livelihoods of millions of people like Issa who depend on livestock and grazing land to survive, 60% of the population lives in persistent poverty with less than $1 a day. All of these factors conspire to make Somalia one of the most difficult places on earth to be Isaac, Laila, or any child – as shown in this year’s End of Childhood report.

But my visit also showed me there is hope here. My Save the Children colleagues, the under-resourced but remarkably determined Baidoa government, and the many partners working together are making a difference for these children and so many others. There’s no denying that life here is extremely hard, but progress can be seen little by little as children recover and heal and mothers find the strength to keep going and look to the future.

Humanitarians Are #NotATarget

By Carolyn Miles, President & CEO, Save the Children

Today is World Humanitarian Day 2018 and far too many children and families, from Syria to Bangladesh, El Salvador to East Africa, are trying their best to survive dire conflicts and crises.  Right at this moment, Save the Children is responding to more than 65 humanitarian emergencies. Today, like every day, I am immensely grateful to my colleagues who are responding to these crises. They refuse to believe that the health, protection and education of children are impossible goals.

Just yesterday I returned from South Sudan and Somalia where I was witnessing the work Save the Children’s humanitarians are doing to save children’s lives.

The humanitarian crisis in South Sudan is severe—armed conflict, economic hardship and food insecurity are feeding into each other, affecting millions.  An estimated 5.3 million people are lacking enough food and water this year—a full 40 percent more than last year.

And every day, the aid workers combating this crisis go to work in the world’s most dangerous place to deliver humanitarian assistance. The need for humanitarian assistance in South Sudan is only growing, but attacks on aid workers are increasing, too.

I learned that violent attacks on aid workers and their supplies is such a problem that they are preventing humanitarian services from reaching the people who need it. Recent attacks have forced us to curtail service and stop programs until we can ensure safety.  When we say that humanitarians are #NotATarget, we speak up for them and the millions more who rely on their work.

Many families rely on the nutrition stabilization center Save the Children supports in Kapoeta, where I meta brave male nurse named Bosco. When a child is admitted to the center, Bosco measures her arm, checking for indicators of life-threatening malnutrition. While he records the child’s height, weight and medical history, he tells her parents that he will do everything he can to stop her diarrhea and add weight to her small frame. Bosco works seven days a week at the small center and brings healthcare to hundreds of families in the area who have no other services.

Bosco will use medications, therapeutic foods and other resources in an attempt to stop the vicious cycle of malnutrition and illness. He smiled telling me about why he does this work – because he knew he could “save the children!” And when a child leaves the center, his Save the Children colleagues will continue to monitor the child’s health weekly through our Outpatient Therapeutic Program.

In Somalia I saw similar Save the Children programs. There the combination of conflict and a stubborn drought adds even more misery for families, especially those who earn their livelihoods through herding animals.  When the rain stops, the animals run out of food and families are forced to live in camps for the displaced and are dependent on food rations and trucked water.  It is a difficult way to live for anyone, but especially for the youngest children. Child mortality rates among these displaced people are high and children are dying from diarrhea and pneumonia in far too large numbers. We know that children are among the most vulnerable in any crisis, which is why our aid workers are active in these communities, addressing their unique needs.

Children in South Sudan and Somalia  – and in too many places – are facing many threats, but humanitarians are committed to changing that reality. They will continue making sacrifices to make that change possible and I am so proud to work with these selfless individuals.