Fieldnotes: Blogging on UNICEF's child survival work in the field

Mark Engman, Director of Public Policy and Advocacy for the U.S. Fund for UNICEF, was recently in Panama for a conference involving UNICEF’s national committees from around the world, and UNICEF’s Latin American and Caribbean offices.

Fact: Between 1990 and 2006, Panama lowered its overall under-five mortality rate by a third, from 34 to 23 per thousand live births.

Fact: Among rural, indigenous communities, the poorest people in Panama, the under-five mortality rate is about 57 per thousand live births, more than twice the national average.

Those facts highlight both the progress and the problems facing the Americas and Caribbean region. At our UNICEF workshop in Panama, we heard Nils Kastberg, UNICEF's Regional Director, talk about the "tyranny of averages." Throughout the region, national progress in many areas – child health, education, access to AIDS treatment – masks the underlying reality that the poorest communities have been left behind.

© Mark Engman

The latest statistics from China are now telling us that over 67,000 have died from the devastating May 12 earthquake, about 20,800 people are still missing and an astounding 5 million people have been left homeless. (That's the equivalent of the entire city of Atlanta.)

Huge aftershocks continue to rattle the area, not to mention the population. As a man quoted in this New York Times article described, "Everyone is paralyzed with dread, and each new tremor just prolongs our misery." That ongoing sense of fear can be particularly tough on children. Now, in China, there are so many children whose main places of stability and comfort—home and school—no longer feel safe to them.

© UNICEF/ HQ08-0456/Adam Dean

A boy sleeps on blankets spread on the ground outside a temporary camp at Mianyang Stadium for people displaced by the earthquake, in the city of Mianyang in Sichuan Province. The city is in one of the worst-affected parts of the province.

	© US Fund for UNICEF/Burnham
	A Swazi child has a meal while visiting a Neighborhood Care Point.

This weekend I will be meeting with 4 teenagers: Abigail, Lance, Anna and Jared, who are members of Key Club International, the largest high school service organization in the world.

For years, Key Club has been supporting UNICEF through the Trick-or-Treat for UNICEF program. Three years ago their leadership (made up entirely of high school students) voted to designate all funds raised toward HIV/AIDS programs in Africa. In just two years, they've raised nearly $1 million, most of which was designated to Kenya. Last year, their international board committed to raise $2 million to support the Swazi Children Care Project, which supports Swaziland’s most vulnerable children.

© UNICEF/HQ06-0213/Michael Kamber

A woman holds her malnourished son in the UNICEF-supported therapeutic feeding center.

Food and water. These are the basic elements for survival. Yet some people in this world do not even have access to these fundamental things.

As part of our series of blog posts on UNICEF's Humanitarian Action Report—which lists the 39 countries in the world that need emergency funding—we've been highlighting some of the countries in the report. Djibouti is one of these countries. And Djibouti needs food and water.

Not having access to safe water has a devastating effect on children's lives. Some children, especially girls, walk up to 18 miles a day in this semi-dessert country to fetch water for their families. They miss out on going to school, making it difficult to break out of the cycle of poverty. And if clean water and sanitation is just too far away, children can become sick or die from water-borne illness.

On top of the lack of adequate water supplies, one fifth of all children in Djibouti are malnourished.

Since Cyclone Nargis hit Myanmar earlier this month, we've been getting reports from across the United States of people moved to action. Here's one that especially inspired us:

Five-year-old Zack, with a little help from his mother Isla, created a lemonade stand fundraiser for UNICEF to help benefit victims. He set a goal of raising $200, but he surpassed it, raising $319 by selling glasses of lemonade along with cookies.

Zack's commitment to the children of Myanmar reminds us that everyone can join in the fight for child survival, and that every dollar donated to UNICEF can help a child in need before, during or after a natural disaster strikes.

Please use the Comments feature below to add your voice to our virtual "round of applause" for Zack and to share what you've been doing to help kids in need.

Ethiopia is a country that has experienced more than its share of hardship. Now, once again, its people find themselves in dire straights. UNICEF is there, and we hope you can support our response to the current crisis.

The severe increase in global food prices and a terrible drought have left 126,000 children severely malnourished and up to 6 million children under-five in need of preventive health and nutrition interventions.

© UNICEF/ HQ08-0452/Grum Tegene

A severely malnourished child lies inside a tent, at a feeding centre on the grounds of Ropi Catholic Church, in Sirano District in Oromia Region.

Droughts are particularly deadly in this country where 80 percent of the population lives off the land. Livestock has died, fertilizer is scarce, fuel prices are through the roof and an ongoing conflict in the Somali (Ogaden) Region is making it all worse. In short, people—especially children—are suffering.

© UNICEF/ HQ08-0429/Grum Tegene

A woman feeds her severely malnourished child therapeutic milk F75 at the UNICEF-supported feeding unit of Bissidimo Hospital, in the East Harerghe Zone of Oromia Region. The milk, rich in micronutrients, is the first phase of a feeding regimen – eight times daily – that helps the body recover from the shock of malnutrition and condition it to digest food.

The Myanmar cyclone and the China earthquake. It's unusual for two natural disasters of such massive scale to occur within such a small window of time. Luckily, UNICEF is used to dealing with more than one emergency at once, while also ensuring that none of the ongoing programs in more than 150 countries where we work suffer. I guess you could say we're very good at multi-tasking on a global level.

In Myanmar, our round-the-clock efforts continue. We've landed several planes filled with supplies: tents, tarps, blankets, medicines, emergency health kits, mosquito nets, cooking materials, school supplies, therapeutic milk, oral rehydration salts and three million water purification tablets. As we've mentioned before, UNICEF is working very hard to make sure survivors of the storm don't now contract potentially deadly cholera or diarrhea because their only sources of water are contaminated.

In China, we just landed two cargo planes of relief supplies, including 16 tons worth of tents and 15,000 blankets. Shelter—even temporary shelter—is absolutely essential to children and families who have lost their homes. They need a dry space to sleep at night. And intense fear of aftershocks has led many families that still do have homes to sleep outside, making tents nearly impossible to obtain by regular means.

© UNICEF/HQ08-0375

This time, it's the children themselves who are taking the pictures. Recently, two groups of kids participated in UNICEF-supported photography workshops in Liberia and Rwanda. The children were given digital cameras so they could document their lives and, by working on specific themes, get a better understanding of the difficulties their countries face. UNICEF has just received the extraordinary images these children took, and we'd like to share some of them with you. The photos will also be shown in a traveling exhibition in Canada, Liberia, Rwanda, Japan and other countries.

© UNICEF/ HQ07-2164/Gay Handful

Liberia: An adolescent boy walks through standing water, a common breeding ground for malaria-bearing mosquitoes, in Fiamah, a slum area of Monrovia, the capital. The photograph was taken by Gay Handful, 14.

	UNICEF/ HQ98-1137/Giacomo Pirozzi
	In this photo, taken during a different trip, a girl is examined at one of the many hospitals and health clinics in Angola that receive vaccines and other essential supplies from UNICEF.

We saw Maria on Tuesday. The U.S. Fund delegation visiting Angola was observing UNICEF-supported services at a pediatric hospital in the southern city of Lubango. In a small room off a corridor, a tiny, striking child—too tiny to be 15 months of age—lay in a bed near a window. Feeding tubes snaked out of her little body. Her wide eyes stared at some other place. Rows of scars marked her stomach—evidence of a traditional healing ritual.

Sitting next to her on the bed, Maria's mother quietly watched her daughter cling to life. Maria suffered from severe malnutrition and diarrhea. Because she was taken to traditional healers and brought to the hospital only as a last resort, her chances did not look good.

On Thursday, we learned that Maria had died. The burdens of malnutrition, diarrhea, and perhaps other complications were too much for her to withstand—especially because she had not been taken to the hospital until she was very sick.

We did not know Maria, or her family, but we know she was an innocent child who deserved the right to live. Her death—the death of any child—is an unnatural, world-splitting event. In Angola, it is also horrifically commonplace.

	© Mark Engman
	Edith (at right) and her daughter Isabel. Isabel says, “I am so proud of my mother.”

Mark Engman, Director of Public Policy and Advocacy for the U.S. Fund for UNICEF, is in Panama for a conference with UNICEF’s national committees from around the world. Prior to the conference, UNICEF Panama took several visitors to learn about its work in the field, including its partnership with the Panamanian NGO, PROBIDSIDA.

Though Panama's AIDS prevalence rate is less than one percent, the disease is growing most rapidly in young women. Unfortunately, though testing is free, only half of all women are tested for HIV.

Eleven years ago, Edith's life turned upside down.

Happily married and the mother of a young boy, Edith learned that she was HIV-positive—and so was her son. Her husband, who had hemophilia, contracted the disease from a transfusion; he passed it to her, and she passed it to her son. Her husband and son both died from the disease, leaving Edith to care for her daughter Isabel and fight the disease alone.

	© Frank Susa
	Girls from the Taboada school's student government wear traditional Panamanian dress to greet their visitors from UNICEF.

Frank Susa is in Panama for a conference with UNICEF’s national committees from around the world. Prior to the conference, UNICEF Panama took several visitors to learn about its important work for children in a variety of Panama City's most marginal neighborhoods.

At first, it might not seem so novel to consider putting children's needs at the center of a school's mission. But in Panama City, the idea has far-reaching implications for how a school works and how successful it can be.

On Thursday, we visited one such school in the neighborhood of Tocumen, which has been successfully implementing its "child friendly" approach to education for four years with the support of an alliance between UNICEF, Panama's Ministry of Education and COPA Airlines.

Tocumen is a fast growing neighborhood largely populated by an influx of Panama's indigenous peoples, but with very little infrastructure and even less governmental support. Unemployment is high, so the cost of private education is outside the reach of most. But public schools here have been underfunded and incapable of supporting the growing needs of children in the area for years. Not only are qualified teachers in short supply, but basic things like running water and food are sometimes scarce.

	© UNICEF Myanmar/2008/Win Naing
	UNICEF staff travel to a remote village in western Ayeyarwady Division.

When the cyclone struck Myanmar, many of the worst-hit areas were unreachable by road. Plus, there was the problem of getting permission to enter the country. A lot of relief organizations were turned away or had to wait for government-issued visas—a long process when time is critical.

But not UNICEF.

UNICEF didn’t need special entry because it’s been in Myanmar since 1950. So when it came time to respond, UNICEF was ready with 130 staff members and pre-stocked emergency supplies inside the country. It quickly distributed family health kits, tents and water purification tablets (to prevent waterborne diseases like cholera and diarrhea—top killers in post-disaster environments) to more than 150,000 people within days.

UNICEF is now scaling up their efforts to reach all survivors and is working to achieve longterm solutions for cyclone-affected regions. For children, this means restoring normalcy in their lives and helping them overcome their trauma. One of the best ways to do this is by creating child-friendly spaces, which can serve as both safe play-areas and make-shift schools.

	UNICEF/ HQ96-0110/Giacomo Pirozzi
	This photo, taken during a different trip, shows an Angolan boy in a UNICEF-assisted centre for children orphaned by the war.

Greetings from Angola. I arrived here early Sunday morning as part of a U.S. Fund for UNICEF group visiting this captivating, yet struggling, country on Africa's southwest coast.

Angola is a nation of stark contrasts. After 40 years of war, and only six years of peace, this former Portuguese colony now has the second fastest growing economy in all of Africa, and a wealth of natural resources including oil and diamonds. But the majority of Angola's estimated 18 million people have been left out of the country's new prosperity, with 62 percent living on less than two dollars a day. The child mortality rate is staggering—one out of every four children dies before their fifth birthday.

We've had an incredibly supportive response to the work we are doing in Myanmar right now. As mentioned in this situation report, UNICEF has been present in the country since 1950, and UNICEF's staff on the ground there has been working exhausting days and long nights to get help to the children and families affected by the cyclone.

Some of you have left comments on the blog asking how you can go to Myanmar with UNICEF and volunteer there in person. First off, thank you for feeling so passionately about both wanting to help, and wanting to be part of UNICEF's efforts there. It says a lot. Unfortunately, for a whole host of reasons, we're not able to place volunteers overseas as part of our programs. We do work with volunteers who come to us through the United Nations Volunteer Program. This program is very much like the Peace Corps and it requires specialized skills and a long-term commitment. If it sounds like something you'd like to pursue, I encourage you to check out the UN Volunteer Program website.

© UNICEF/ HQ08-0368

A woman holds her child amid the debris of their village in Kawhmu Township, Myanmar. The child's face is smudged with thanaka—a paste made of ground wood which women and children in Myanmar have used for over 2000 years to cool down, decorate their skin, and protect themselves from sunburn.

Téa Leoni, Ben Stiller, Nicole Ritchie and Joel Madden have recorded public service announcements in support of UNICEF's relief efforts in Myanmar.

We've posted all of them to our YouTube channel (http://youtube.com/unicefusa), where we're continuing to post video updates on the Cyclone Nargis emergency response. Here's Téa Leoni's spot:

Check them all out, spread the word, and subscribe to our channel to be alerted whenever new material is posted.

The situation for children continues to worsen in Myanmar as thousands of children have been separated from their families, many more are living in desperate conditions in relief camps, and some are drinking water from ponds covered with dead bodies.

Below, a man collects wood near the carcass of a cow killed by the cyclone, some 50 kilometres south-west of the township of Kunyangon. As bodies decompose, the water supply is further contaminated.

Here, a woman breastfeeds her infant in the temporary shelter of a monastery near the village of Pyanpon in the southern Irrawaddy Division. Behind them, another woman and child share the same bed. They have all been displaced by the cyclone.

UNICEF has distributed pre-positioned supplies to hard-hit areas. Below, a man secures a UNICEF aid package to the back of his bicycle, with the help of his two sons, in the cyclone-affected township of Kunyangon in the southern Yangon Division.

More to follow.

In the meantime, if you want to help, please consider making a donation or posting a badge on your website or blog.

Thank you for your support.

Tomorrow is Mother's Day, but it's not too late to honor that special woman in your life with gifts that will make a lasting impression—UNICEF Inspired Gifts.

Inspired Gifts is an innovative program that allows you to purchase real, lifesaving products—like family water kits and oral rehydration salts—to be shipped directly to one of over 150 countries where UNICEF is saving children's lives.

Unfortunately, we know mothers in Myanmar are facing unbelievable challenges this Mother's Day. Thankfully, UNICEF's Myanmar office has already delivered essential supplies—including first aid kits and oral rehydration salts—to the hard-hit areas of Myanmar.

Help us restock our warehouse shelves with family water kits, oral rehydration salts, and mosquito nets before the next disaster strikes. Then, let her know about your gift with a personalized ecard. 

She'll be honored, and both of you will be proud. Happy Mother's Day!

Greetings news buffs! My NewsNet posts will be on hiatus for a few weeks while I travel to Angola and Swaziland on U.S. Fund field visits.

I’ll be accompanied by additional U.S. Fund staff, among others, on both trips. I will attempt to submit some Fieldnotes posts during my travels, if technology allows it. Meanwhile, I encourage you to follow the important work of UNICEF as it responds to the Myanmar cyclone and many other crucial challenges.

Stay tuned.

Yesterday a UNICEF representative brought UNICEF's concerns about the impact of the global food crisis on children to the attention of Members of Congress and Congressional staff at a packed hearing room on Capitol Hill. The briefing, chaired by Rep. Sheila Jackson Lee (D-TX), was cosponsored by the Congressional Children's Caucus, the Congressional Global Health Caucus, and the Foreign Affairs Subcommittee on Africa and Global Health.

Annalies Borrel, Chief of the Humanitarian Policy Section of UNICEF's Office of Emergency Programs, thanked the U.S. Government for its initial response to the deteriorating global food and nutrition situation. Ms. Borrel stressed that while adequate food is necessary, children also need a healthy environment that includes access to health care, water, sanitation, and protection from exploitation and abuse. UNICEF's message is that children are the most nutritionally vulnerable to any disruptions in the availability and quality of food–and children must be at the center of the global response to the growing food crisis.

The U.S. Fund for UNICEF is working to support legislative initiatives on this issue being advanced by Rep. Sheila Jackson Lee (D-TX) and Rep. Donald Payne (D-NJ), two of the key legislators who co-chaired the briefing.

We'll keep you posted here.

UNICEF is racing against time to save kids' lives in Myanmar.

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