Times of India, May 2013
A pivotal clinical study of India's first indigenous rotavirus vaccine...
Warning: this blog might fall into the category of TMI, but we can blame Hope Randall. She’s relentlessly on the look-out for blogs, tweets, and posts, and when I told her I had to be out of the office for a colonoscopy, she dared me to blog about it. Now a better – and more discreet – person might have let that go, but I went with, “It’s on, Hope.”
I’ll be anesthetized for the procedure itself, but today, I have to empty out my system so that the doctors can have clear sailing.
Oh the pity party I have been having for myself about today: I can’t eat any solid foods (beef broth for breakfast, sigh). I can’t have coffee (because I never developed the talent for drinking it black). I have to drink lots of water all day. Tonight, I’ll miss my book club because I have to take a purgative and hang out near the bathroom as it takes effect. WOE is me.
And then, Reader, I came to my senses.
I have plenty to eat every other day – and frankly, I could stand to lose a few (or more!) pounds. I can drink safe water from the tap today and every day. I can use a toilet any time and just about anywhere: home, office, the grocery store. I’m having the colonoscopy as a precaution and if the doctors find a problem, I have access to health care.
And, of course, most don’t have what I take for granted. Which is why today is a good day to reflect on the disparity between what my family has and what so many families do without. And why, when I’m back to work, I’ll be grateful for the chance to contribute to defeating diarrheal disease.Read more
We’ve all heard it: There is no “I” in team. There is no “me” in “we.” Whatever the phrase, we all learned about sharing, the benefits of collective action, and the idea of everyone working toward a common, unified goal. But the more I think about it, the more I think there really is an “I” in team. I mean, after all, who is the “we” behind the newly released mortality figures from UNICEF that show child mortality dropping below 7 million deaths annually? How did “we” do that? And who is this “we”?
It is hard to conceptualize the individual pieces behind a global change. We know it was a communal, group effort, but by whom? What did you do to cause the reduction in child mortality? I, for one, wasn’t in a rural community vaccinating children or ensuring every household had a bed net. For much of my day, I sit at a desk, likely attending meetings, wholly unaware of the weather outside, let alone the activities of saving children’s lives globally.
However, I do feel like I contributed – in my own very small, yet meaningful way. And so did you. We are the “we.” Together, the global “we” achieved a remarkable feat this year in the goal of saving children’s lives. It wasn’t a team of donors or civil society organizations alone. It wasn’t rural clinics or community health workers alone. It was the proverbial team effort.
Donor organizations, multi and bi-laterals, private foundations and globally minded grassroots contributors bring a certain crucial funding, ideas, and incentives to global efforts. Civil society organizations, non-profits, and local organizations in developing countries are critical middle-men (and women), turning funding and technical expertise into programming where it is needed most. Ministries of health and other government entities are fundamental in changing policy and increasing access to health. And vitally, the health teams in countries are the integral key: hospitals, clinics, pharmacies, cadres of traditional birth attendants and community health workers delivering key treatments and services to even the remotest communities.
We must remember, though, that each of those organizations, foundations, hospitals, and cadres are made up of individual people. People each doing their part to contribute to the larger whole: drivers, warehouse managers, pharmacists, finance and contracts officers, program managers, directors, doctors, presidents, ministers… the list could (and does!) go on. The sum of each of those individual “I’s” is the whole of the “we.” There is no such thing as not making a difference or not contributing. Every single individual role is integral to the global effort. When one piece of the team goes missing, the team suffers collectively. The “we” wins together, but also loses together.
Today, on Global Handwashing Day, remember your part in the global effort. A global reduction in child mortality is not achieved by a single person on a single day; rather, the collective actions of all those people, on consecutive days, weeks, months, years, (decades, even!) are what really create the change. “The power of We” is an amalgamation of all those “I’s” out there, doing our part to ensure that health is a reality for everyone in our world.
We are in this game together – it is us versus diarrhea, pneumonia, malaria, malnutrition, measles – and so many other killers of children. Remember the commitment we made during the Call to Action and the Promise Renewed? Now is the time to make good on your piece of the promise. Together, our collective “we” will beat these formidable foes, but we must remain a committed community, at every level, to truly harness the “power of we.”
For more information:
-- Celebrate Global Handwashing Day and Blog Action Day! Follow the conversation on Twitter at #Iwashmyhands and #BAD12.
-- Clean hands save lives. Spread the word by writing a poo haiku!
-- Photos: Children are the best champions. Learn how they are spreading the word about hygiene in their communities.
Photo credit: PATHRead more
Everybody poops / but not everybody knows / that poo can kill, too.
Raising awareness that diarrhea is a leading killer of children is our central focus at defeatDD.org. Here in the US, we have the luxury of laughter, because diarrhea is merely an inconvenience rather than a fatal threat.
But is it okay to joke about diarrhea, a serious health problem for so many? When I was a newcomer to PATH, I was surprised by the levity with which my colleagues approached the issue; they welcomed me to my place on the “Poo Crew” and quipped that we don’t really do anything but “talk sh*t” all day! But @oh_mara spoke truth when she said:
It's more indecent / to let kids get sick from poo / than writing this tweet.
Many of the puns exchanged in our office banter have since made their way to social media, and I’ve learned that humor has the power to spark conversations that catalyze change. Last year’s inaugural Poo Haiku contest was an experiment that became a resounding success; we received more than 100 entries and lots of support and awareness for defeating diarrheal disease. When we announced that we were running the contest again this year, responses were enthusiastic, and we’re hoping even more participants will join the movement!
Saving children’s lives from preventable illness can sometimes seem like an overwhelming endeavor, but it’s heartening to know that laughter and creativity can not only boost our spirits, but generate meaningful conversation. Isn’t it great to know that making the world a healthier place can be fun, too?
Big change can start with a few strategic syllables. Will you join us?
We have all the tools. / Combat diarrheal disease / Do your part. Re-tweet!! - @SumDPRead more
Zinc deficiency places children at greater risk of illness and death due to diarrhea and pneumonia, particularly children under five years old in low-resource settings. Evidence shows that zinc is beneficial in managing acute or persistent diarrhea in children ages 6–59 months, showing clinically important reductions in illness duration and severity. Preventive zinc supplementation has been shown to reduce the incidence of diarrhea, and research has also demonstrated that zinc supplementation reduces the incidence of acute lower respiratory infection among children under 5. Several studies show that preventive zinc supplementation reduces by 18 per cent deaths among children ages 12–48 months. However, use of zinc in countries with the highest under five mortality rates due to diarrhea is limited.
Kenya is ranked 14th among countries with highest number of under-five deaths due to diarrheal disease with 32,000 children dying annually from diarrhea. According to the Kenya Service Provision Assessment 2010, only 49% of children with diarrhea received treatment from a skilled health care provider. In addition, zinc sulphate is used in fewer than 1% of diarrhea cases, despite its proven effectiveness as a high-impact, low-cost intervention for children under five years old.
Considering that majority of children with diarrhea are treated at home, it is imperative for Kenya to increase access to Zinc Sulphate and oral rehydration salts (ORS) at the community level using the existing Community Strategy through the Community Health Workers (CHWs). The Kenyan Division of Child and Adolescent Health, together with civil society partners, including PATH, has been advocating to the Pharmacy and Poisons Board (PPB)— the national drug regulatory authority—to revise the legal categorization of zinc from a prescription-only drug to an over-the-counter drug. In August 2012, the PPB granted this application, creating an opportunity in scaling up management of diarrhea at community level through access to zinc sulphate, a commodity that has been prioritized at a global level for saving lives of children. Scaling up access to zinc sulphate is already a priority in the policy guidelines, whose development, printing and launch was supported by PATH on control and management of diarrheal diseases for children under five years in Kenya. Besides accessing zinc sulphate through the healthcare facilities, parents and other caregivers can now access it through nearby pharmacies, local chemists, shops, and kiosks. More importantly, zinc sulphate will now be much more available through the community health workers (CHWs) who are especially effective at reaching the marginalized and poorer children even at household levels, who have limited access to healthcare.Read more
Something great happened this week. Having worked in global health for some years now, I’m used to the madness that seizes New York City every September during the Clinton Global Initiative and UN General Assembly sessions. A head-spinning array of political leaders, global health legends, and celebrities come together to celebrate progress, wrestle with persistent problems, and make bold commitments. It is epic and amazing at what can be accomplished in such a few short days. At the same time, it’s easy to lose sight of some of the truly remarkable accomplishments amidst the media frenzy, traffic gridlock, and general hullabaloo of meetings and receptions. But great things happen at the little and big moments in these sessions – things that make a difference to the lives of millions of people across the globe.
One of the great accomplishments this week was the bold recommendations of the UN Commission on Life-Saving Commodities for Women and Children. Every year, nearly 7 million children die from preventable diseases and nearly 300,000 women die from complications during pregnancy and childbirth. The vast majority of these deaths could be prevented by existing medicines and supplies – but these products are not reaching the patients who need them. For example, over 700,000 children die from diarrhea annually – the #2 cause of death among children worldwide; even though over 90% of these children could be saved by treatment with zinc and oral rehydration salts (which cost less than $.50), less than 2% of children globally are receiving this recommended treatment. The goal of the Commission was to identify actionable, time-bound strategies to dramatically improve access to 13 priority commodities (including ORS and zinc) that will have the greatest impact on reducing child and maternal mortality.
It’s no secret that many global reports end up as dust collectors on neglected office shelves; but this report is different than most. First, it is focused. Rather than tackling every cause of mortality – the report distills out the greatest drivers of maternal and child deaths – where existing high-impact and cost-effective medicines and products are available to prevent these deaths. It highlights opportunities that we can seize now to reduce these unnecessary deaths. The recommended steps include bulk buying, local manufacturing and innovative marketing to help transform the supply, demand and use of these life-saving products.
Second, strong leaders are involved. The Commission is driven by country leadership; President Goodluck Jonathan of Nigeria and Prime Minister Jens Stoltenberg of Norway co-chaired the effort, and from the outset, they have made sure that solutions are practical and realistic for implementation in the countries where these deaths are occurring. The Commissioners included executive level participation from the private sector, government, donors, and NGOs alike, and Executive Directors Anthony Lake (UNICEF) and Dr. Babatunde Osotimehin (UNFPA) serve as vice-chairs of the Commission.
Third, tangible support for implementation is already underway. Good ideas lead to nothing without implementation. The Commissioners have made headway in generating momentum and resources to support implementation. For example, the Government of Nigeria has set an ambitious goal of saving one million lives and improving the quality of care in Nigeria by scaling evidence-based interventions including childhood essential medicines. Additionally, the both the Governments of Norway and Sweden have made commitments to significantly expand their global health investments in 2013 by over 100M. Former President Bill Clinton announced a new partnership that cut prices of long-acting contraception in half, allowing access for 27 million women in the developing world. Private sector firms have also made remarkable new commitments, such as the IKEA Foundation which announced this week that it will provide USD $24 million over the next four years to save 40,000 lives by 2015 by increasing access to diarrhea treatment for children in Kenya and one of the poorest states of India, Madhya Pradesh.
Overall, the real impact of this report will only be known in the coming weeks and months. Implementing these recommendations has the potential to drastically reduce child and maternal mortality – but success depends on continued focus, leadership and resources. As UNICEF Executive Director Anthony Lake said, “It is simply wrong that millions of children and women still die every year when we have the products and the knowledge to save their lives. With the Commission’s help, we have still more practical solutions. What is needed now is the political will to implement them.”Read more