Photo credit: Sacha Myers/Save the Children, April 2019.

Child Protection and Emotional Support for Cyclone Idai Survivors

Written and Photographed by Sacha Myers, Emergency Health Unit, Save the Children

“Tell me about your average day when you get a chance.” The message, from a friend thousands of miles away in Australia, popped up on my screen. I leaned against the car and looked up from my phone at the tents surrounding me.

There was a hum of activity as people started their evening routine. Women milled around the
water points waiting to fill their buckets. Children ducked and weaved between the tents playing their last game of tag. Smoke from small wood fires created a haze across the darkening sky.

I looked back down at my phone. My average day?

Before and after
I’d spent that morning with children who had lost their homes when Cyclone Idai tore through central Mozambique a month ago.

They were doing an exercise in one of our child-friendly spaces – drawing their home before and after the cyclone.

The children took such pride in their “before” drawings. They used rulers to carefully draw the
outline of their house with their bed inside and food in the kitchen. Later they added pictures of their family members holding hands with love hearts between them.

In stark contrast, the pictures they drew of their community post-cyclone depicted an entirely
different reality: mothers crying as they clung to their babies; trees stripped bare and uprooted; great torrents of brown water; pieces of metal flying through the air; homes in ruins.

Photo credit: Sacha Myers/Save the Children, April 2019.
When Cyclone Idai struck Mozambique, 13-year-old Suraya recalls running out of a house carrying her brother after a tree crashed through the roof.

How did they survive?
Once the children had finished the activity, they took turns in presenting what they had drawn. As I listened to them, I couldn’t help but wonder how they had survived.

They described scenes of chaos. The walls of their bedrooms collapsing on them. Falling into
floodwaters as they ran for safety. Spending a week in waist-deep water waiting to be rescued.
Thirteen-year-old Suraya told me: “While we were sleeping, a tree fell down on top of the house. My mum told us to get out. We ran out of the house. The wind was increasing. We were running and I was holding my brother. On the day of the cyclone, I thought I was going to die.”

“My family is all over”
When 14-year-old Beatriz* sat down to present, her story silenced us.

She explained in a quiet voice how she was an orphan before the cyclone. She lived with her
grandmother. When the cyclone stuck, their house collapsed, and Beatriz’s grandmother was hit by a tree as they were running for safety. She later died in hospital.

Beatriz is now entirely alone. She lives in a tent with eight other people she doesn’t know. I alerted Save the Children’s child protection team immediately about Beatriz. They support separated and unaccompanied children and work with the government to try and reunite them with their family or caregivers.

Tragically, Beatriz’s story is not uncommon. Many people lost loved ones in the flood waters or became separated from their family in the rush to find safety.

Fatima, a mother of three, told me: “My family is all over. I don’t even know where [my husband] is. Even my two sons are not with me. We separated when we took the boat. I don’t know where they are. The way I’m living is hard. It’s painful.”

Rebuilding children’s lives
This was just one day in post-cyclone Mozambique. An average day.

While I felt emotionally wrecked afterwards, I also had hope. Because children are extremely
resilient, and with the right support and a safe environment, they can recover from the stressful events they’ve experienced. And that’s why mental health must be included in the recovery plans for Mozambique.

Mental health is a core part of Save the Children’s work. We’re rolling out a comprehensive child protection and emotional support program in some of the worst-hit areas in Mozambique. As part of this, we have set up six child-friendly spaces in and around Beira and will open up to 50 more spaces in the coming weeks.

*Name changed to protect identity

To learn more about the work Save the Children is doing to support emergency response following Cyclone Idai, visit our website.

YOUR SUPPORT CAN HELP MAKE THE DIFFERENCE FOR CHILDREN AND FAMILIES IN NEED. MAKE A DONATION TODAY!

Illnesses Don’t Discriminate: Vaccines Work

Co-authored by Carolyn Miles, President & 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.  

 

 

Newborn babies and their mothers receive care in a health center located in Malawi where Save the Children supports proven programs, such as Kangaroo Mother Care. Photo credit: REDD BARNA / JONAS GRATZER

Customizable Hospital Furniture for the Smallest Babies in Malawi: A Potential Disruptive Innovation

Written by Bina Valsangkar, MD, MPH, FAAP

© 2015 | Kristina Sherk Photography 

Bina Valsangkar, MD, MPH, FAAP, is a pediatrician, adviser at Save the Children and a changemaker for children. She leads a team of health experts, industrial engineers and industrial designers under a Save the Children innovation grant to re-design newborn hospital units in Malawi to deliver family-centered care. In previous roles at Save the Children, she drafted policy, conducted research and developed newborn health programs in Africa and Asia. 

While many aid agencies, academic institutions and traditional and non-profit companies work to ensure access to essential medical equipment in low-income countries, less attention has been paid to the importance of suitable medical furniture. In the newborn units of Malawi, where Save the Children has been working to improve quality of care for the last several years, a well-designed chair, neonatal crib and staff workspaces have the potential to make care more family-centered, comfortable and safer. Well-designed furniture can improve patient, family and health worker comfort, but can also improve health outcomes. A well-designed chair for the newborn unit, for example, can facilitate greater amounts of skin-to-skin time between a mother and her newborn infant—which can be life-saving for infants born prematurely in Malawi. Well-designed workspaces and neonatal cribs can improve patient flow and visibility and reduce infection risk.

Malawi currently buys and imports the majority of its hospital furniture from India and China. While these pieces offer a relatively affordable option for hospital furniture with basic function, the furniture does not fully suit the needs of patients, families and health care workers in Malawi. Hospitals there face a different patient profile, medical demands, space limitations and set of cultural beliefs and practices.

Customizable hospital furniture offers a potential solution to the problem of functional fit. Headway in this market, however, has been largely made in high-income, high-end markets, with little or no market share in low-income countries.

With seed funding from the Save the Children Innovations Council as well as Purdue University’s I2D Lab, our team of experts in health, industrial engineering and design led by Professors Yuehwern Yih and Steve Visser, is working to create a set of space-saving furniture with accompanying layout design to allow for greater family-centered care and meet the needs of patients, families, and healthcare workers at Ntcheu district hospital in Malawi. The set includes a stacked neonatal crib, lounge chair for mothers and babies to be in skin-to-skin contact together and a mobile nurse’s station. Our project was born out of research and experience from the Saving Newborn Lives (SNL) program, a now 19-year old newborn health project at Save the Children.

While getting the individual furniture pieces and layout just right and within budget for the hospital is of utmost importance, it is the process of customization in the low-income setting, and creating and using customizable blueprints to make locally-sourced pieces with learnings from prior users that we hope will be a new market foothold in Malawi, with the potential to move across markets and upmarket to other countries and regions.

To learn more about Save the Children’s changemakers, visit our website.