RotaFlash, April 2016
I consider it my life’s mission to catalyze innovations and mentor startups that would help develop a cutting edge biotechnology industry for India and the world. This would simultaneously help solve some of India’s pressing public health impact problems. Part of my motivation is rooted in my personal health circumstances from childhood observing my extended family’s young ones suffer from respiratory disease infections, and part of it is rooted in my analyzing and reflecting on the constellation of risks that infants in India have to face just to reach their fifth birthday.
Rais Akhtar and Andrew Learmonth have documented in their work in medical geography that India has the unique distinction of being on the cusp of two disease ecological patterns, South-West and South-East. As a result of this, the country’s tropical climate tends to be a fertile Petri dish for a bubbling cauldron of mutating viruses and bacteria, to which our little ones are most vulnerable. Since surviving this onslaught is a yearly cyclical problem, many of our children do not have the bodily resources to fight these threats, due to among other issues problems like fetal, child and neonatal malnutrition. Coupled with these risks, is the tendency among service providers to indiscriminately use antibiotics for handling patient volumes, which has resulted in a drug resistance epidemic.
As India hosts the Call to Action Summit 2015, I feel very heartened that some of our best and brightest innovators are wrapping their minds around designing diagnostics and drug innovations, aimed at solving problems like drug resistance. PATH, too, has contributed to this discussion, my colleague Dipika Matthias, who leads PATH’s Global Health Innovation Hub practice, has spoken on the changes in innovations that have targeted maternal and child health problems throughout the years. This gives me hope to realize that through adversity, the seeds of creative thinking are flourishing in a highly unique way that is a part of the Indian reality.
Photo credit: PATH/Gabe Bienczycki.Read more
Worldwide each year 3.3 million infants die in the first month of life. India takes the lead with 779,000 deaths (29 deaths/1000 live births). Neonatal mortality constitutes 56% of the total under-five mortality (52 deaths/1000 live births) in India .
As New Delhi hosts the Call to Action Summit 2015 – to gather momentum around ending preventable child and maternal deaths, it is important to underscore that breastfeeding is one of the most powerful interventions for reducing infant mortality, including neonatal mortality. India can reduce preventable newborn deaths by integrating breastfeeding promotion into antenatal and postnatal care, increasing accessibility to human milk banks (HMB), and adopting Kangaroo Mother Care into the newborn care program.
Eminent professor of neonatology at the All India Institute of Medical Sciences in New Delhi, Dr. Ashok Deorari, has often emphasised that evidence has shown that the nutrition and immunity in donor human milk is superior to formula; it reduces the risk of deadly infections—particularly sepsis and a condition called necrotizing enterocolitis. Human milk improves survival rates and reduces the duration of hospital stays, making HMB a lifesaving and cost-effective intervention. Although HMB is not a new concept to India, it has not yet scaled to its full potential, with only 20 milk banks established from 1989 and 2015.
Earlier this year, PATH and the Norway India Partnership Initiative (NIPI) facilitated a learning exchange programme in Rio de Janiero, Brazil. This opened new avenues for India to step up its HMB initiative. This learning exchange has helped act as a stimulus and is facilitating discussions among the medical fraternity and Government in India to scale up and strengthen HMB in the country through stronger government involvement, network formation, and investment in implementation research to support the formation of simplified and localized HMB systems.A HMB network formation meeting is now being organized to formalize robust India-specific Standard Operating Proceduresand the sharing of best practices to promote the Mother Baby Friendly Initiative+ (MBFI+) model, which integrates HMB systems and Kangaroo Mother Care into breastfeeding promotion.
Participants of the learning exchange programme in Rio de Janiero, Brazil.
Mr. Arthur Chioro, Minister of Health of Brazil, has also invited the Indian Minister of Health, Mr. J. P. Nadda, to attend the International Cooperation Forum being organised by the Brazilian Government to celebrate 30 years of public policy for the Human Milk Banking cooperation.
While recently chairing a panel discussion at the India Academy of Paediatrics conference, Dr. Ajay Khera, Deputy Commissioner of Child Health and Immunization for the Government of India, stated that the government had already established 575 Sick Newborn Care Units (SNICU) in the country, formulated guidelines for Kangaroo Mother Care, and committed to formulate guidelines on the HMB system and scale it up across the 575 SNICUs as an integrated model.
Interestingly, there are mothers in India who are now aware and want to give their excess milk to any baby in need. It is also a reality that thousands of mothers face challenges due to malnutrition, complications in childbirth, and a lack of knowledge and of optimal lactation support in India. Human milk banks could provide an answer to the high under-five mortality rate in India.
Photo credits, top to bottom: PATH/Arvind Chengi; Kimberly Amundson.Read more
As part of the India Sanitation Coalition, WaterAid has been collaborating with the Federation of Indian Chambers of Commerce and Industry (FICCI) to enable and support an ecosystem for sustainable sanitation in line with the Clean India Campaign. The coalition’s role is that of a catalyst to make technical and capacity strengthening processes easily available for key corporate constituencies.
The coalition was launched on June 25, 2015, by the Union Minister for Drinking Water and Sanitation, Chaudhary Birender Singh. Since then, the coalition has been focused on bringing diverse organisations and individuals together on a common platform to find sustainable end-to-end solutions for sanitation that can be built, used, maintained and treated in both rural and urban areas.
The coalition is also working closely with the Government of India on its flagship programme, “Member of Parliament Model Village Scheme – Sansad Adarash Gram Yojana (SAGY),” which covers around 680 villages in India. Under the scheme, Prime Minister Narendra Modi has requested all Members of Parliament (MPs) develop one model village in their constituency by 2016 and two more by 2019. By keeping the onus on the MPs to become directly involved with sanitation progress in their districts, the SAGY program has served as a catalyst for the MPs to leverage convergence funds and amend schemes to make them more meaningful at the grassroots level.
From the PM’s call to the nation on last year’s Independence Day (August 15, 2014) for a Clean India, things have been meticulously planned and near impossible deadlines are being met. While the main focus is on an empowering process to gain community involvement for individual household toilets and to keep a robust monitoring and evaluation plan in place, there is also a focus on the “soft” behavior change components that have often been ignored.
The government is placing greater emphasis on training the district administration and the frontline workers who are at the forefront of implementation of the scheme and on changing people’s attitude towards using a toilet. As of today, 517 village development plans have been made. The SAGY has appointed charge officers: senior administrators who use information and communication technology (ICT) to make transparent, real-time status of progress in their areas available.
Although the coalition was initiated in 2013 by a group of people from different organisations engaged in the sanitation space, the pace towards realising possible goals has only just begun. The coalition today includes 51 organisations and several individual experts.
Going forward, the coalition, through its members, will focus on supporting the Prime Minister’s vision of a Clean India and help in ensuring not only construction but usage and maintenance of sanitation facilities in both rural and urban areas. This will build the momentum towards the goal of India being open defection-free by 2019.
The coalition provides the platform to learn, share and support through a multitude of organisations who see sanitation as a priority for India!
-- Neeraj Jain is the Chief Executive of WaterAid in India and is heading the task force on ‘Engagement with Central and State Governments’ at the India Sanitation Coalition.
Photo credit: WaterAid/Poulomi Basu.Read more
Suited up and ready to run.
Shortly after the Mile 2 marker, doubt started to creep in. Mile 2 might sound easy enough, but let’s clarify one important detail straight off: I am not a runner. Given the choice, I will gladly walk, thank you very much. But a recent move to a new home and a tricky commute have made me a reluctant jogging commuter. Shortly after I moved, I learned of the first ever 5K sponsored by my favorite hometown team (Seattle Sounders FC, of course!), and well… I blame post-workout endorphins for making me sign up.
At the starting line: Off we go!
So around Mile 2 (of 3.1 miles total), when the adrenaline rush I anticipated wasn’t quite kicking in, I remembered who I was running for. Running might not be my favorite pastime, but it is my choice. I found motivation for that last mile thinking of the women and girls who don’t have a choice, who trek just as far—and often quite farther—every day, to bring home safe water for their families. If they don’t make that journey, their families simply don’t survive. So their strength (boosted by a healthy dose of girl-power courtesy of Beyonce), saw me through. And once I committed to these women? Yep, sure enough. There was that adrenaline kick.
Adrenaline-infused on the home stretch.
Clean water was at the top of my thoughts thanks to the partnership benefitting from Sunday’s #RaveGreenRun. The Water, Wealth, and Health partnership is a one-of-a-kind, exciting new initiative that will bring far-reaching expertise to bear on water issues in rural Tanzanian communities. Water is health in these communities, but it also livelihood. Daily lives center on agropastoralism – it’s a new term to me (and has a beautiful sound, doesn’t it?). And I was excited to learn that within agropastoralism, integration is inherent. Fields and fauna. Leaves and livestock. Farmers who support their families through crops and herds depend on strategic irrigation and sustainable water management. And with a stronger season comes greater wealth, resources to invest in a family’s wellbeing with clean drinking, safe sanitation, and nutrition on the table.
With Seattle Sounders FC Director of Community Outreach (and former midfielder) Roger Levesque. The only reason we make it look easy is that these water cans were empty... and our balance lasted for about 1.5 seconds.
The Water, Wealth, and Health effort will harness each partners’ strengths and experiences, building a comprehensive model to help families take steps toward their own stronger, healthier futures. World Vision’s relationships with community farmers matched with Washington State University’s insight into agropastoralist livelihoods and woven together with PATH’s proven market-based model for WASH promise to empower families and allow them the resources and awareness to invest in health. Top it off with coordination from the Washington Global Health Alliance and support from Seattle Sounders FC (who happen to have the best fans in the country, by the way), and it’s absolutely a winning combination!
I crossed the finish line just under 30 minutes. Not too shabby for my inaugural performance (though that’s not to say I’ll be signing up for an encore anytime soon). I met my goal of jogging the entire 5K, which made me feel strong and healthy. And even more, proud to take part in ensuring the health of many more.Read more
Knowing all of the health benefits of breastfeeding, there was no question that I wanted to breastfeed my son. I was lucky. He was born healthy and full term; and while we had our challenges initiating breastfeeding, we had all of the advantages of being in a supportive environment which enabled me to exclusively breastfeed (including lots of pumping!) for his first six months of life.
Ask any breastfeeding working mom about the logistics of pumping and she will regale you with stories. I know other working mothers who have pumped in fast food restrooms, in post-offices and even in a Congressional hearing room. In addition to childcare, the logistics of pumping at work is a major topic of conversation (and source of anxiety) for new moms in the office.
While most traditional workplaces in the US are required to provide time and a clean place to express milk, those of us who spend part of the work day out of the office must plan ahead to find a clean (ideally private) place to pump, be flexible when plans change, and be prepared with all the necessary supplies – including a cooler with an ice pack to store and transport milk until a refrigerator is available.
Since becoming a breastfeeding mom, I’ve lived first-hand all that is necessary to create the enabling environment to make breastfeeding work – even in (theoretically) high-resource settings. I can only imagine what this would be like for working mothers in the developing world – especially considering that 75% of jobs are in the informal sector, where there is no employer to provide time and a clean space to express and safely store milk, let alone affordable access to pumping supplies, electricity, clean water and soap to sterilize supplies, and refrigeration. We must do a better job to make it easier for breastfeeding working moms if we want the world’s children to reap the benefits of exclusive breastfeeding for the first six months of life.
I can’t help but think if our situation were different. What if my son had been born premature or with a health complication where he could not nurse? What if I wasn’t able to breastfeed? What if we lived in a low resource setting?
When mothers want to give their children the benefit of breastfeeding, but are unable to provide their own milk, donor milk is the preferred option. And increasingly, this option is becoming available to mothers and babies facing breastfeeding challenges, no matter where they live.
Human milk banking is particularly important for babies born prematurely with low birth weight or other conditions that leave them unable to breastfeed, as they are more vulnerable to sickness and death. Providing donor breast milk to these babies can save newborn lives, improve newborn health and development, and improve overall breastfeeding rates—not to mention put anxious mothers somewhat more at ease. Human milk banks enable mothers to donate their extra breastmilk to special facilities where it is tested, treated and distributed to vulnerable newborns who don’t otherwise have access to their own mother’s milk.
With the imminent launch of the new Sustainable Development Goal to end preventable newborn and child deaths by 2030, PATH has joined other organizations around the world to call upon governments, the United Nations and its agencies, civil society and business leaders, and all institutions with a stake in healthier generations of children to commit to ensuring that all newborns have access to human milk by increasing investments in human milk banks as part of integrated breastfeeding, newborn care, and infant nutrition programs, with a special focus on the countries where newborn deaths are concentrated.
I am grateful for all of the factors that enable me to breastfeed my baby. All mothers and babies around the world deserve the same.
Photo: PATH/Tony KarumbaRead more