Child Mortality in the News

FACTBOX: Fighting child mortality around the world

Source: Thomson Reuters Foundation - Fri, 13 Sep 2013 11:58 AM

Author: KatyMigiro                                                                                                                                                                                                                                                                                                                                                                                                    

More on: Health and Disease

A woman feeds her malnourished child at a paediatric ward in Banadir hospital in Somalia's capital Mogadishu August 7, 2011. REUTERS/Omar Faruk

 

   

NAIROBI (Thomson Reuters Foundation) – Eastern and southern Africa are reducing child mortality faster than any other regions in the world, the United Nations children’s fund (Unicef) said in a report on Friday, but more than 18,000 children die needlessly every day.

The report, 'Committing to Child Survival: A Promise Renewed’, highlights the extent of child mortality globally and discusses what steps need to be taken to prevent babies and young children from dying.

Below are some facts and figures from the report:

• 216 million children died before the age of 5 between 1990 and 2012 – more than the total population of Brazil, the fifth most populous country in the world.

• Half of all under-five deaths occur in just five countries: India (22 per cent), Nigeria (13 per cent), Pakistan, Democratic Republic of Congo (both 6 per cent) and China (4 per cent).

• In sub-Saharan Africa, one in every 10 children dies before their fifth birthday, nearly 16 times the average rate in high-income countries.

• Globally, the leading causes of deaths among children under five include pneumonia (18 per cent), pre-term birth complications (15 per cent), birth-related complications (10 per cent), diarrhoea (9 per cent) and malaria (7 per cent).

• Immunisation is among the most successful and most cost-effective health interventions, saving two to three million lives globally every year.

• The 24 hours around the time of childbirth carry the greatest risk. Each year, more than 1 million babies die on the day they are born.

• If a mother is under 18, the risk of her infant dying in its first year of life is 60 percent greater than an infant born to a mother older than 19.

• To end preventable child deaths, women must be provided with good quality maternal care and nutrition and newborns need a safe delivery. Insecticide-treated mosquito nets, vaccines, proper breastfeeding, nutritional supplements, rehydration treatment for diarrhoea, safe water and sanitation are also important.

• In Rwanda, community health workers are using SMS to track pregnancies, report on danger signs during pregnancy and to send alerts to health services to ensure women can access emergency obstetric care quickly.

New Doulas!

I haven't written in awhile!  Life's been busy.  Two wonderful women have decided to join me in my "doula-ing" efforts.  We did this countries first official "doula training."  It was fun and I'm excited. Last time I was at the hospital I brought one of the new doulas with me.  She is a natural.   We rejoiced in being able to help a young woman narrowly escape a vacuum extraction.  Squatting is AWESOME during pushing when things are just taking a long long time.  More updates to come!

Sweet Babies

    The post partum ward....

Baby Heads and Doula Smiles

I smiled a lot yesterday while I was with all the laboring moms.

I smiled when Rosa pushed out a baby boy with ease.

I smiled when Rosa dressed him up super cute and I could tell she was in love with her new little bundle.  She had her tubes tied a few years ago, so he was quite a surprise.

I smiled when Helley gave me a skeptical look when I told her that her baby was coming soon and she was going to be okay.  It was a look that said "you are insane, I know I am going to die."

I smiled when Helley came back from the bathroom a few minutes later and lifted her skirt to show me what was going on.  I could see quite a bit of baby head.  She was holding a baby boy just a few minutes later.  Now she had a look on her face that said she was quite pleased with herself for having delivered her first child.

I smiled when Toola and I finally worked out a system to get her calmly through her contractions without going screaming and rolling around in panic and terror.  I had never seen a woman quite so active and creative with her laboring postitions. 

I smiled when Toola's baby girl finally emerged.  It took awhile and the little one arrived with a short cord 3x around her neck. I smiled because she was okay despite that.  I was so glad the midwife had arrived on that one, her head was halfway out before the midwife came.

I smiled when Toolah made it safely through a post partum hemmorage and when her baby girl finally latched on and nursed.

I smiled when Mallinah delivered her ten and a half pound baby boy (most babies here are between 5-7lb).  She was 44 weeks pregnant.  Yes, I meant to write 44.  She measured 44 weeks, and her dates said 44 weeks.  She had been completely dilated for hours, but the head was too high and not engaged.  She walked, she lunged, she sat on the toilet.  We had no birthball, that would have been helpful.  She was so drained and still the babe was high.  Her water finally broke and eventually she felt like pushing.  After 2 more hours I finally convinced her to squat and push.  She did and within 15 minutes there was a baby head.  The midwife was there just in time to see the rest of it's body slide out.

There were five births and 7 moms and it was just really fun as well as really amazing.  I'm getting more comfortable in my role as a doula and in trusting the mom's own instincts.  I am also amazed at what a woman can birth if she squats instead of laying on her back!

Double Doula-ing

I have been mastering the art of double doula-ing.  No, I am not talking about mom's having twins. I'm talking about two moms moving into one space so that I can support them both at once.  I would never ask them to do this, it's their idea.

It is much easier if their contractions are opposite of each other in timing.  Then I can support through the pains one at a time.  Unfortunately this is not usually the case, which leaves me trying to massage/focus on two women at once.  It reminds me of trying to pat my head and rub my stomach at the same time.

I feel rather silly looking, rubbing two backs at once, but I'm glad to be there for them.  I think it is time to train some more doulas to come along with me.

Is He Dead?

I thought he was dead, but I prayed and prayed that he would be okay.

 I had been attending his mother as her labor support person for many hours.  There was no sign that there would be a problem, but when he was born, he was grey, limp, and he did not start breathing or crying on his own.  There was a cord around his neck that was not removed by the student that was delivering him.  Maybe that was the problem, I don't know.

After a couple of minutes, the student realized that this baby needed more than a little stimulation.  I had run and gotten the ambu bag thingy for them just in case.  Sure enough, they started to try and resuscitate him and after what seemed like a very long time he started to cry.  Soon he was nursing. 

I thanked God for another little one that lived.  It was the 2nd close call in one day.

In the tribe I lived with for years, they do not stimulate a baby after it is born.  They just watch and wait to see if it is alive or not.  They never pick it up or touch it unless it cries.  So many of their babies were "stillborn."  In reality though I wonder if they could have lived if they were helped along a bit to take that first breathe. 

Whatever the case, I hate that 50% of children there never have the chance to grow up.  I want to help see that change.

Walk that Baby Out!!!!!!!

I volunteer in the labor and delivery ward here mostly because the laboring women are not allowed to bring even one support person with in with them.  I love it though when a brave mother in law or grandma comes marching in anyway.  I never tell on them, so sometimes they manage to hide out for a hour or so. 

Yesterday this wrinkly, ancient and very wise looking old woman came bursting in.  Policy meant nothing to her.  She had squatted on banana leaves and borne 13 babies in her lifetime.  This is what she had to say to her granddaughter who was in labor with her first child.  "Get up! Walk, walk, walk,  faster.  GO!  Do want this pain to last all day? If you do, then lay down.  If not, then get up and go!"

Amen Grandma!  I have seen many other veteran mothers here offer the same advice.  I also noticed that the women who just walk and walk have their babies so much faster than the ones who just lay on their sides.  I personally was a walker in all of my 4 labors and recommend it to anyone!