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Despite Progress, Too Many Children Are Still Dying From Diarrhea

Originally published on HuffPost

Photo by Amr Dalsh / Reuters

Why are children still dying from this preventable and treatable illness?

In the decade between 2005 and 2015, the world changed dramatically. The smart phone was introduced. New planets were discovered. Yet children were still dying from a preventable and treatable illness that has plagued the world since the beginning of time.

A recently-published study in the medical journal “The Lancet” showed that deaths from diarrhea among children under 5 dropped by 34 percent from 2005-2015 — a major step toward ensuring that no child dies of a preventable or treatable disease. But half a million children still die from diarrheal diseases every year and millions more are sickened by unsafe drinking water, which turns a simple sip of water into a potentially life-threatening act for a vulnerable child.

As the fourth-largest killer of the world’s children, diarrhea is a particularly infuriating enemy. Clean water, proper sanitation and good hygiene practices can keep children safe from the water-borne illnesses that make them sick and deaths can be prevented with low-cost interventions like oral rehydration salts and, more recently, vaccines. These seem like simple solutions — but for a child living in poverty, without access to basic health care, and with a body that may already be compromised by malnutrition or other preventable illnesses, a simple fix is anything but.

Over the past 15 years or so, Save the Children has been working to strengthen the communities where children at risk of childhood death live — to reach children in the hardest-to-reach places in the world. By training and equipping community health workers to correctly diagnose and treat pneumonia, diarrhea and malaria, we have been able to contribute to a massive reduction in child deaths worldwide.

In Bangladesh, which the study notes saw a 60 percent reduction in under-5 deaths from diarrhea from 2005-2015, Save the Children has helped decentralize pneumonia and diarrhea treatment from formal health facilities (mostly in large population centers) to community-level facilities. More than 1.2 million sick children received services from trained village doctors working in local clinics and communities, and 2,000 children were referred to formal health facilities for further treatment as needed.

The progress in Bangladesh and around the world is encouraging, but it’s not good enough and it’s not happening fast enough. Approximately 1,400 children still die every day in the world’s poorest communities and diarrhea-related illness, which can leave a child weakened and susceptible to other illnesses, has only fallen by about 10 percent in the past decade. So if we want to give every last child the opportunity to have a healthy childhood, we’re simply going to have to do better.

Using what we know works and leveraging local communities to deliver life-saving medication, we can further reduce diarrheal death and illness—and make huge progress toward Sustainable Development Goals #3 (“Ensure healthy lives and promote well-being for all at all ages”) while we see the benefit of fulfilling #6 (“Ensure access to water and sanitation for all”). This study is a great start, and it reminds us that we need more data to build the evidence for what we know works and to spark innovation around new solutions that will help save more lives.

The data shows us what’s possible. Our experience shows us what’s doable. Now we must show children that we refuse to measure progress in decades or centuries or even millennia, but in the healthy childhoods that all children deserve.

Innovation Born of Crisis

The woman, wrapped in a colorful head scarf and long flowing dress, sat on a cement step in the middle of a remote village in northeastern Somaliland.  She proudly showed me the small mobile phone and the Save the Children registration card bearing her photograph.  Then she told me how it was transforming her life, in the midst of a horrific drought.

The small phone, with money transferred from Save the Children’s drought relief program into a monthly account, meant her children could eat and continue to go to school. It gave her the independence to ensure that funds were going to meet her family’s greatest needs.  And it allowed her to go to local shops and buy what she needed, using funds of about $90 per month transferred from her phone to the merchant’s phone in small increments—so no actual money changes hands. This allows her to pay for her weekly needs each time she goes to shop, despite the fact that all her assets had been lost.

A woman with cash transfer via mobile

 

The people in this region depend on livestock like goats and camels.  Their whole life revolves around moving from place to place with their animals to graze, selling a few goats a month or a camel twice a year to support the entire family.  But when the drought started last year and the rain failed to come, there were no more grasslands for grazing and no water to give to the animals. First a few died, then several more each day. Many of the women I spoke to on my visit this week had lost all their animals.  Those with larger herds had gone from 200 goats to just 40 over the last few months.

The cash program managed by Save the Children and other partners and funded with money from the European Union serves as a lifeline for these families.  And because mobile money can be transferred directly to the phones (which are also provided if recipients don’t have one), it is a secure and efficient way to ensure that money gets into the hands of mothers who will use it to benefit their children.  We can also benefit from the data available through the telecom companies, which details how much has been used each month and at what merchant—allowing us to track usage and patterns to improve our programs for families in dire need.

Carolyn in village

 

Best of all, the children of this community are not going hungry, they are staying in school and they are able to survive one of the worst droughts to hit Somaliland in decades.

And even halfway around the world in the middle of an extreme drought, I found that some things about new technology are true everywhere.  When I asked one of the women if they had trouble learning how to use the phone, they said no…they just got one of their children to help them.

Just like me and every other mother around the world!

Shashank Shrestha/Save the Children

Midwives, Mothers and Families: Partners for Life!

Originally published on HealtyNewbornNetwork.org

Midwife Rita helped deliver Rupa and Rajkumar’s first-born daughter this year at the newly constructed Taruka health facility in rural Nepal, a facility Save the Children helped rebuild after the devastating 2015 earthquake. The proximity of a health post and availability of a skilled auxiliary nurse midwife helped save the newborn’s life. Even though Rupa had visited the health post often to ensure her pregnancy was proceeding, she was still anxious as her delivery approached. She had heard awful stories of women losing their lives during childbirth. But by delivering in a health facility with a skilled, well-equipped, and respectful midwife, both mom and baby survived childbirth and the days following without complication.

Rita’s story is just one of many we should celebrate today on International Day of the Midwife. However, there are other stories that won’t end as happily. Today, nearly 830 women will needlessly die giving birth, more than 7,200 babies will not survive childbirth or the last three months of pregnancy, and another 7,300 babies will die within the first hours and days after birth. That adds up to 303,000 women and 5.3 million infants every year whose lives are lost. Nearly all of these deaths could be prevented if high-quality services were available to every woman and baby everywhere.

And while 99 percent of these deaths happen in developing countries, rich countries like the United States are not exempt. Thousands of families suffer the tragedy of maternal and newborn mortality and morbidity every year in developed countries.

This week, US celebrity Jimmy Kimmel shared his emotional story about his son’s heart defect on national television and expressed praise and appreciation for the midwives who supported his family throughout the process. Jimmy said, “If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make.” This statement is no less true in low-income countries, especially those in sub-Saharan Africa and South-East Asia. And for marginalized populations, like those who live in hard-to-reach areas, and are victims of conflict and humanitarian crises.

No mother – anywhere – should have to risk her life or that of her baby by going through childbirth without the expert care of a midwife or other skilled birth attendant. Yet, globally, one in four women gives birth without such care. And 2.2 million give birth all alone. The World Health Organization estimated that in 2015 there would be a shortage of more than 3.5 million health workers – including a million midwives. This means that mothers and children have no one to diagnose and treat their illnesses, provide immunizations, or help them stay healthy.

The theme of this year’s International Day of the Midwife is Midwives, Mothers and Families: Partners for Life! Partnerships are central to midwifery. Midwives partner with women, families, and communities to provide lifesaving healthcare to mothers and babies, from before pregnancy to the first months after birth. They collaborate with doctors and facility staff to devise treatment plans and deliver high-quality, respectful care. They serve in government ministries and other decisionmaking bodies to make policy and funding decisions that ensure midwives have the resources they need. And they teach, mentor, and supervise to ensure midwives both practice what they know and learn new skills.

Ending preventable maternal and newborn deaths and stillbirths requires more qualified midwives, more empowered midwives, better resourced midwives, and more respect for midwives. How can we strengthen these partnerships? For one, we can listen to midwives’ voices. The upcoming Congress of the International Confederation of Midwives is another opportunity to engage with midwives to strengthen support of their work. I am making it a priority this week and in the coming weeks to listen to the voices of midwives.

If you are a midwife or want to recognize a midwife for her partnership for life, please write to the Healthy Newborn Network with your story and we will be sure to share it.

Foreign aid works for us all

Sorghum bags being dispatched from Jijiga to drought-affected areas in the Somali region of Ethiopia. Photo by: U.S. Embassy Addis Ababa / CC BY-ND

Originally published on Devex.com

Leaked documents reported this week suggest the Trump Administration would like to cut foreign aid by more than 30 percent and possibly merge the U.S. Agency for International Development with the State Department. This proposal comes despite the fact that we are facing the worst humanitarian crisis since World War II—there are more people fleeing war and persecution than ever in history—and famine conditions are threatening parts of the Middle East and Africa.

I’ve recently heard some critics say that foreign aid does not work. This could not be farther from the truth. Dollar-for-dollar, it is one of the most effective uses of our taxes. One penny of every dollar in the total U.S. budget goes to helping families in other countries—a small investment that saves lives and helps millions of people every year. Strong U.S. leadership during the last 25 years has helped cut extreme poverty in half and led to half as many children dying around the world from preventable illnesses like malaria, diarrhea and pneumonia. We need to build on this progress rather than allow it to lapse.

America currently spends nearly 50 percent less on foreign assistance, as a percentage of gross domestic product, than during the Reagan administration. Further reducing this budget would hinder the U.S. government’s ability to help respond to disasters – natural and man-made – including those that know no borders, like the recent Ebola and Zika outbreaks. Being prepared to respond quickly to the next disease is just as critical for U.S. citizens as it is for those at the epicenter of the outbreak.

Countless times, I’ve seen firsthand how U.S. foreign assistance works and saves lives. I recently visited Jordan, a country that is committed to welcoming families fleeing violence and persecution in neighboring countries. More than 650,000 Syrian refugees, half of them under the age of 18, are now in Jordan, and the U.S. provides significant foreign aid for refugee programs in the country. That support feeds young refugee children, offers children the chance to get back into school after years of being away from home and provides vocational training for Syrian youth to give them hope for a productive future. This U.S. funding is essential if we are to avoid a lost generation of young people who can eventually help put their country on a better path.

In addition, today nearly 20 million people in Somalia, Nigeria, Yemen, and South Sudan face the threat of starvation, and famine has already been declared in South Sudan. Save the Children is on the ground working with partners, including USAID, to provide lifesaving water, food and treatment to these children and families whose lives depend on our help. U.S. foreign aid is critical for preventing and addressing famine, yet proposed budget cuts would eliminate funding for the Famine Early Warning System Network (FEWS NET) that helps us prevent and respond faster and more efficiently to famine conditions around the globe.

Preparing for drought before its worst effects take hold is on average three times more cost-effective than emergency response, as illustrated by studies in Ethiopia and Kenya. Pair this with the World Bank study that calculated disaster risk reduction saves $4-7 for every $1 invested, and it’s clear that our foreign aid investments are not only the right thing to do from a humanitarian perspective but also from a fiscal perspective. To put it simply: an ounce of prevention is worth a pound of cure.

Promoting health, education, gender equality and economic opportunities for communities around the world leads to more stable societies, which are critical to our national interests. A group of more than 120 retired generals and admirals agree and sent a letter to Congress in February stating, “The military will lead the fight against terrorism on the battlefield, but it needs strong civilian partners in the battle against the drivers of extremism – lack of opportunity, insecurity, injustice, and hopelessness.”

The international affairs budget is a triple win: it helps U.S. economic and national interests, it helps people prosper, and it saves lives. These proposed budget cuts and the folding of USAID into the State Department would deeply hurt America and our neighbors. We all need to do our part by telling our members of Congress that this funding is critical to our wellbeing.

Hope is Running Out

As I sit on the plane on the way back from Beirut, Lebanon, typing at 30,000 feet, my mind keeps going back to one of the more emotional moments I’ve experienced in a long time.  I’m back to a small set of chilly cement rooms where a mother, father and three children live in northern Lebanon, listening to them tell me about how they fled here after years under siege in their home village of Hamah in Syria.  The family had seen such heartbreak that it was hard to take it all in during our brief time together but now, at cruising altitude, it hits me like a fist.

Perched on thin mattresses on the cement floor, we asked the mother and father about their journey and what life was like for them.  They started by thanking Save the Children for the help we had given by putting doors and windows into the bare concrete walls, in installing a sink and toilet in the apartment, and making the stairs safe to use.  The father talked about how he has only been able to get sporadic work in the northern Lebanese village; Syrians are only allowed to work in construction, agriculture or low-skill odd jobs and it meant their resources were incredibly stretched.  A young boy, less than two years old, sat in his mother’s lap and a cute, energetic 4 year-old played peekaboo with me and giggled loudly.  Then one of our team asked an innocent question – why was their 8 year-old son, stirring under a blanket on the raised platform bed in the room, not in school?

The father looked down and we saw the pain cross his face as he told us that his son, Haddi, fell from a two-story balcony in the unfinished building eight months ago, shattering his hip.  After two unsuccessful operations, he had a third one three weeks before our visit; this operation cost the family all of their savings and put them further into debt.  His mother began to cry as she told us how they had tried to get him to the best doctor they could find and showed us the X-rays—images that showed three screws in a small, fragile hipbone. This boy was not in school because he was in intense pain and had barely moved since they brought him back from the hospital.  I saw the shocked look on the face of our local team member who managed the work on the apartment, who had not seen the family since before the accident and had no idea it had happened.

We tried to think of what to say to this family, to give them some hope that their son would be okay.  In a circumstance I can only describe as fate, one of our visitors with me on this trip was from the Pacific Northwest and her daughter had been in an accident as a young girls and had the same operation for her crushed pelvis.  She comforted the weeping Syrian mom as best she could, telling her about her daughter’s story and full recovery.  But we knew that was with some of the best medical care in the world and months and months of rehabilitation. This was not after three surgeries, laying on a wooden bed with few medicines, no wheelchairs and no daily visits from a physical therapist. We wanted to give some hope but you could see in the parents’ faces that for this family, hope was fading.

Later we spoke to our team about trying to get more medical care for Haddi, care that would probably stretch the emergency fund we keep for such dire cases to the limit. We will somehow find a way to help him.

But there are so many sad cases as the Syria crisis moves into its seventh year.  So many thousands of cases of children’s lives lost or shattered, of childhoods cut short when 11 year-olds begin to work picking vegetables, when 14 year-old girls are married to “keep them safe”, when children leave their families to go on their own to try to get somewhere safer, better, saner.

As we spoke to some of UN partners the next day, I sensed some hope that, though it would be difficult, maybe on the horizon there will be a time when some of the 1.5 million Syrian refugees living in Lebanon feel safe enough to begin going back home. But as the war now stretches past the duration of World War II, I worry for the Haddis that we don’t reach, that we don’t know about, for whom hope and time is truly running out.

Please help us provide support and hope to Haddi and his family—and so many others like them—by donating to our Syrian Children’s Relief Fund.

The day the Syrian war becomes longer than World War II

Originally published on Devex.com  

After six years of war, people were weary and on edge. Neighborhoods were hardly recognizable. Fresh food was a luxury that no one had. Schools were closed or moved elsewhere. Children’s bodies displayed pealing burns that only a bomb could cause. Nearly everyone knew someone who had been killed.

It’s hard to know whether I’m describing the end of World War II, or Syria today. Both wars battered entire generations of people, but one notable date separates these two horrific events. Today inexcusably begins the seventh year of the war in Syria, and on Friday, the war in Syria will become longer than World War II.

Sadly, the psychological toll of war is one of the greatest similarities between the two and will have the longest lasting impact in Syria, just as it did after WWII. We need to invest more in psychosocial support and make another concerted effort to convince all sides to end the violence.

Daily exposure to the kind of traumatic events that Syrian children face will likely lead to a rise in long-term mental health disorders such as post-traumatic stress disorder, depression and social anxiety. Living in a constant state of fear can create a condition known as “toxic stress,” which, if left untreated, can have a life-long impact on children’s mental and physical health. Harvard University’s Center on the Developing Child reports that toxic stress can disrupt the development of the brain and other organs and increase the risk of stress-related diseases, heart disease, diabetes, substance abuse, depression and deep-rooted emotional scars.

Among the 3.5 million Jewish people who survived World War II in Europe, and the 183,000 people who survived the atomic bomb blasts in Japan, many are known to have suffered from physical and psychological problems decades after the fighting ended. Research done by the Never Ever Again organization in Scotland even shows that the grandchildren of Holocaust and bomb survivors have experienced secondary and transgenerational trauma.

A new study conducted by Save the Children inside Syria shows that people are feeling the psychological effects of war: 84 percent of adults and almost all children said that ongoing bombing and shelling is the number one cause of psychological stress in children’s daily lives. And 48 percent of adults have seen children who have lost their ability to speak or suffer from speech impediments as a result of living in such a dangerous and uncertain environment.

A teacher we work with in the besieged town of Madaya told us that children are psychologically crushed and tired. “When we do activities like singing with them, they don’t react at all, they don’t laugh like they would normally. They draw images of children being butchered in the war, or tanks, or the siege and lack of food.”

Another teacher told us that children have been so traumatized they express wishing they were dead because at least heaven would be warm and would offer food and a place to be safe and play.

While the world has clearly not learned the lessons of past wars in many respects, as the war in Syria continues, one lesson we can learn from World War II is the importance of addressing psychosocial issues among children early and often.

U.N. Security Council members, and other countries that have been unable to bring warring sides to the negotiation table, need to increase investments in mental health care inside the country and insist that all sides agree to a minimum set of measures to ensure the protection and safety of children in Syria.

Programs that support children’s resilience and well-being must also be given special attention and additional funding. Children are incredibly resilient but only if they are given the proper outlets and tools to recover and thrive. Programs to support parents could also help children feel more supported.

Finally, relatively small investments to train teachers and school personnel in conflict sensitive approaches to education, such as art therapy, would yield positive results now and into the future.

In the U.S., Congress should take such critical investments into consideration as it determines the 2017 international affairs budget. Cuts now will hurt Syria’s children in the short and long term.

Children who survived World War II in Europe and Asia went on to become Nobel laureates, actors, scientists, fashion designers, teachers and more. Syrian children hold the same potential, but as the war drags into its seventh year, individuals and leaders must summon the will and the means to support children during this horrible time.

Save the Children Statement on U.S. Executive Order on Suspension of Refugee Resettlement

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FAIRFIELD, Conn. (January 26, 2017)

In response to executive action by the United States Government regarding refugee resettlement, Carolyn Miles, President & CEO of Save the Children, released the following statement:

“The United States has long been a beacon of hope for the millions of children and families trying to escape war and persecution. The world is facing its largest crisis of displaced people since World War II, with more than 65 million people forced to flee their homes. More than half of all refugees are children, whose only chance for survival and a better future relies on access to safety. We all have a moral obligation to help. Refugee children have been terrorized; they are not terrorists.

“I have met with hundreds of refugee families—in the U.S., Germany, and throughout the Middle East and Africa. I have heard firsthand their stories of unrelenting war, and triumph over incredible hardship that no one should have to endure. Nearly every family I’ve met has told me that their main reason for fleeing was so their children could have a childhood, an education, and a chance at a future. Now is not the time to turn our back on these families, or our core American values, by banning refugees. We can protect our citizens without putting even more barriers in front of those who have lost everything and want to build a better future in America.

“The reality is that the U.S. refugee resettlement program saves lives—namely of women and children under 12, who make up 77 percent of the Syrian refugees in the U.S.—while helping to ensure the safety of our country. Refugees already go through extensive vetting: a refugee’s identity is checked against law enforcement and intelligence databases of at least five federal agencies, a process that takes nearly two years. If there is any doubt about who a refugee is, he or she is not admitted to the United States. Save the Children takes no issue with proposals to further perfect the vetting process to protect our nation’s safety, but we must remember that resettling refugees reinforces our security by supporting key allies that are disproportionately affected by forced displacement.

“The United States should continue to show leadership and share in our global responsibility to provide refuge to the most vulnerable, regardless of religion or nationality. Welcoming refugees sends a strong message to groups that want to do us harm: the United States remains a leading pillar for stability and liberty in the world.

“Since its founding in 1919, Save the Children has worked tirelessly to help millions of refugee children and families—providing lifesaving assistance, improving access to education and quality healthcare, and protecting children from exploitation. We are committed to continuing this vital work, regardless of ethnicity, religion or any other factor.”

To help us support refugee children and families, click here.

Save the Children gives children in the United States and around the world a healthy start, the opportunity to learn and protection from harm. We invest in childhood — every day, in times of crisis and for our future. Follow us on Twitter and Facebook.

Make the world great for all of our children

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Originally published on thehill.com

In the weeks following the election, when many of the divisions in our nation have come to the forefront, it has become clear that we need to find ways to bring Americans of diverse viewpoints together around issues we all care about. A divided America will not be made great again no matter how much we might wish it to be unless we focus on the foundation of our future: our children.

In my work for Save the Children over the last 18 years, I have visited children and families in more than 80 countries and across dozens of states. The desire of parents to give their children a healthy and safe childhood and an education that helps them gain the skills they need to find jobs and happiness is something I have seen in all corners of the world. Whether living in a wealthy suburb in America, a poor rural town, or in a refugee camp in the Middle East, the biggest sacrifices parents and communities often make are for our children.

We have a lot of work to do for kids here in America. Visiting a literacy program in rural Mississippi this October, I met children struggling with basic reading but who were making progress thanks to extra support for books and technology and caring teachers and specialists. Yet one in four children in the United States never learns to read. That’s 25 percent of our future parents, leaders, and workers. According to the Council for Advancement of Adult Literacy, as of 2011, America was the only free-market OECD country where the current generation was less educated than the previous one. Schools in poor neighborhoods of the United States are, and have been for decades, woefully under-resourced with too few books, no access to computers, and where parents are unemployed, or are working far from home. Kids in these communities are working against long odds and we need to put funding into these schools and provide parents with paths to real employment.

A brighter future for America must mean a better future for our poorest kids. In Mississippi, I met families – white and black – living in the toughest conditions you can imagine in a state that voted solidly for Donald Trump. These are the families that are truly disenfranchised and hoping that change in the White House will bring better opportunities for their children.

Last month, I also visited Jordan, a country that has taken on an enormous number of refugees from the Syrian crisis. More than 650,000 Syrian refugees, half of them under the age of 18, are living in Jordan – in refugee camps, or in poor communities where residents are often struggling, too. Jordan is working hard to meet its international obligations to refugees from neighboring countries, and the United States provides significant foreign aid for refugee programs there. Funding is used to feed young refugee children, to provide them with a chance to get back into school after years of being away from home, and on vocational training for Syrian youth to give them hope for a productive future.

This funding from the United States is critical for a country in the Middle East like Jordan, on the frontlines of a refugee crisis and doing its best to meet its responsibilities, and which exists in a complicated neighborhood. It is also essential if we are to avoid a lost generation of young people who eventually can help put their country on a better path to the future. The good news is that the cost is tiny in relation to the overall federal budget, with all foreign assistance to all countries of the world adding up to less than 1 percent of the U.S. federal budget. When I speak with Americans, they agree that programs for young Syrian refugees is one of the right things – and the smart things – on which to spend our small foreign assistance budget. They often donate to our work as private citizens, adding to the funding from the U.S. government to make those dollars go further.

There will always be people trying to divide humanity up into various formations of “us” and “them” – whether by race, nationality, class or geography. But in my work, I’ve seen people break down these barriers in the interests of children. We can help children both in the United States and around the world, and we must. A focus on making America – and the world – great again for every last child would be a lasting legacy for the new administration and something around which we could all support proudly. To make a safe and secure future for us all, we need not choose “our” children over “other” children. Many stand ready to help on this effort that unifies us rather than divides us, as parents and as humans.

How to Save the Children of Mosul

November 20, 2016. Qayyarah, Iraq. Children stand in the back of a truck as their family prepares to return home from Qayyarah Jad’ah camp.
Children stand in the back of a truck as their family prepares to return home from Qayyarah Jad’ah camp in Qayyarah, Iraq on Nov. 20, 2016.

                                  Originally published on time.com

The Mosul offensive continues—both militarily and in terms of help for civilians—but it is not too soon to help the region’s children start to recover from years of suffering. As Iraqi forces enter Mosul, they are not only faced with ISIS militants but also up to 1.5 million civilians still trapped, including about 600,000 children, who are growing increasingly desperate. In the short term, safe routes must be established so these families can escape the violence. We risk another Aleppo, where civilians are trapped inside a warzone, if safe passage is not possible.

As thousands of families flee and others are caught in the crossfire or by snipers and landmines, children must urgently be protected. However, in the long run, we will fail Mosul if we are unable to help a whole generation of children recover from the violence, uncertainty and lack of schooling that they have faced in recent years.

Thousands of babies were born in Mosul in 2003 and 2004 as the war in Iraq was taking place and fighting raged in the city. Now in their early teens, these children have lived the vast majority of their lives in a state of uncertainty.

By 2008, when these children should have been starting kindergarten, armed militants were using the city as their strategic center of gravity—a hub for funding and violence. UNICEF reported at least one-third of children in Mosul were out of school. Even as active conflict subsided, it remained a dangerous place to be a child. In December of that year, a bomb detonated outside a primary school as students were leaving for the day, killing three children and injuring 18.

The situation grew even direr in 2014 when ISIS invaded the city—just as children born in 2003 should have been finishing primary school. The group took control of schools, burned textbooks and instituted a new extreme curriculum. Children were to be drilled in lessons on ISIS doctrine. The curriculum was also militarized and encouraged children to fight and learn how to use weapons.

More than one million children who have been living under ISIS in Iraq have either been out of school or forced to learn from an ISIS curriculum. Many parents refused to send their children to school out of fear for their safety and well-being. Other families had to make the difficult decision to flee their homes to escape violence and intimidation and are now living in camps or non-camp settings that don’t always have educational opportunities for young people.

Now, with the offensive to retake Mosul underway, Save the Children staff positioned in nearby camps report meeting families with children who have escaped the fighting and who say their children are getting sick from breathing air filled with smoke from oil wells that ISIS set on fire. Many have already lost loved ones and they are dehydrated and hungry from long journeys made on foot as they flee ISIS-held areas.

Mahmoud, a father we met, recently escaped Shura, south of Mosul. As fighting approached the village, he and his family were taken deeper into ISIS territory, where they were reportedly forcing people to act as human shields. The family escaped and is now in a temporary camp.

“I have four daughters. Before IS the older ones were going to school and loved it,” he said. “When IS took over, the content of the curriculum changed, so we stopped sending them. Every lesson became militarized. Even math lessons—they would teach the children ‘one bullet plus one bullet equals two bullets.’ They’ve now been out of school for two years.”

We know from our work in Iraq and other conflict zones that getting children back into school is absolutely critical. Being in a classroom setting provides a child with a sense of normalcy that they miss during times of conflict or displacement. Trained teachers can help students process the trauma they have experienced, and a quality education can help young people acquire the knowledge, tolerance, and critical thinking skills necessary to help rebuild their country and make a constructive contribution to society.

The government of Iraq and international partners can show their commitment to education in Iraq in four ways:

For those families who have already fled or who are desperately trying to, children need to be provided with quality education and psycho-social support inside camps established for internally displaced people and refugees. Save the Children is establishing temporary learning places in tents in one of the camps where people have fled, but much more is needed.

The Iraqi government should also work with international partners to reopen schools in retaken areas as soon as it is safe to do so. Repairs to schools should be prioritized, and school buildings should only be used for classes, not by the military.

Additionally, special attention needs to be given to children who have been forced to serve as child soldiers. They need extra help to make up for time lost in the classroom, tools to regain their self-confidence, and assistance reducing stigmas that might exist in their communities.

Finally, make sure that all Iraqi children can go to school. Iraq was once a country where more than 90% of children were in education, but it now has about 3.5 million children out of school. Donors must ensure that the UN’s 2016 Humanitarian Response Plan is fully funded—at the moment education has only 40% of the funding it requires.

Securing Mosul is crucial, but unless we include education in the immediate recovery plan, it will be almost impossible to build a prosperous city and region. Children of Mosul have suffered for many years and have missed out on enough of their childhoods. Getting them back into a safe positive school environment is critical to starting the recovery process, giving them hope for the future and breaking the cycle of suffering in Mosul.

Haiti Is Facing A Humanitarian Crisis We Can Solve — So Why Aren’t We?

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Originally published on huffingtonpost.com

Of the many humanitarian crises challenging the world today, none is as solvable as the human disaster that Hurricane Matthew has wrought in southwestern Haiti. The threats to human life in Haiti’s Sud and Grand Anse departments are entirely within our grasp to address immediately: starvation, exposure and disease—cholera, from contaminated water. And we have the solution at hand: food, shelter, clean water, medicine and sanitation supplies.

The only barrier is the collective will and resolve to act. Not doing so now — as we approach the one-month mark — means certain death for thousands of people, perhaps tens of thousands.

Hurricane Matthew hit the United States with wind, rain and floods that have tragically killed more than 40 people, but gave its hardest punch to southwestern Haiti. The category 4 storm made a direct hit on the remote peninsula, killing hundreds and pummeling the landscape with brutal 145 mph winds and as much as 40 inches of rain. The wind stripped trees, ripped off roofs and toppled block walls. Overflowing rivers tore out bridges and spread cholera bacteria. Crops not killed by wind were drowned by a surge of seawater; ocean water also flooded wells, contaminating precious sources of fresh water.

As a result, an estimated 1.4 million people are in need of assistance, many without food, safe water, shelter or basic health services, and children are often the most vulnerable.

Because the few roads that serve this region are badly damaged, towns along the southwestern coast were without help for days. In Port-à-Piment and Port Salut, some health clinics and cholera treatment centers are damaged, but functioning with limited supplies and an increasing patient load. Food is scarce and the vast majority of homes are damaged or destroyed.

Cholera, a deadly diarrheal disease, is a serious concern with more than 3,400 suspected cases in the three weeks following the storm. Patients are arriving at cholera centers, but without additional, ongoing deliveries of large quantities of IV fluids, water purification supplies — tablets or even bleach — and basic sanitation items such as soap and gloves, the disease will most certainly expand its deadly reach, making the hurricane’s death toll a footnote. In some damaged health facilities cholera patients are treated alongside children and pregnant women, increasing the risk of infection.

In the hardest hit communities, 100 percent of homes are destroyed, there is no food, little water and no aid deliveries. Understandably, people in the region are becoming increasingly desperate. With their livestock dead and crops stripped, survivors can’t subsist without outside help. Without shelter, they are at risk of exposure. When all water sources are most likely contaminated with cholera bacteria, they can’t safely take a drink. And with roads blocked and no aid trucks in sight, all hope is gone.

The Haitian government and local communities are doing their best under tough circumstances. Our organizations with decades of experience working in Haiti are also mounting significant relief responses. Like partners and peers, we have qualified teams on the ground with many Haitian staff members leading the charge and are rushing aid to as many communities as we can. But our experience tells us that these collective efforts are not enough. As UN Secretary General Ban Ki-moon said, “A massive response is required.” The need for food, shelter, medicine and cholera prevention and treatment supplies is too urgent. The United Nations is seeking $119 million for Haiti’s recovery but so far only 28 percent of that has been raised. Will the commitment be met by member nations? If so, when? There is no time to find out.

This disaster requires mobilization at a huge scale and fast. The U.S. government has deployed resources but if it does more, it will signal the urgency to others. Individuals, corporations and foundations need to support the work of qualified relief agencies that can save lives.

Amid the spin and noise of the news cycle, let’s not tune out the voices expressing human needs. There are a lot of complicated things in the world. This crisis is not one of them.