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

Something I've heard again and again from UNICEF staff who have spent a lot of time in the field: the truly tough work of emergency response often begins weeks and even months after the immediate emergency is over. This is partly because media attention has dwindled and the donations aren't coming in the way they once were. (Less money means stretched resources.) It's also the case because diseases such as cholera, malaria and dengue fever can get a nasty foothold amongst people who, in the wake of a disaster, find themselves without homes, proper sanitation, adequate nutrition or clean, safe drinking water.

© UNICEF/HQ08-0323/Adam Dean

MYANMAR: A small boy washes his hair with soap in the cyclone-affected township of Kunyangon in the southern Yangon Division.

These days, UNICEF is working harder than ever in Myanmar. Recently, we've been worried about possible outbreaks of dengue fever there. When Cyclone Nargis blasted across the Irrawaddy Delta in early May, it left behind the sort of destruction that makes an attractive breeding ground for the dengue-carrying Aedes mosquito. Stagnant pools of water that collect in debris—scattered pots and pans, tires, bottles, ruined boats, plastic tarps—are like five-star hotels for these mosquitoes.

Dengue fever is a miserable disease. My cousin was unlucky enough to get it when he lived in Thailand. It leaves you with a fever, severe headache, muscle and joint pain, a rash and, in some cases (my cousin's being one of them) hair loss. The extreme version of the disease, dengue hemorrhagic fever, can be fatal. Dengue hits children and the elderly especially hard. There is no vaccine. And bed nets don't help because, unlike malaria mosquitoes which feed at night, dengue mosquitoes prefer to take their meals in the daytime.

It's hard to believe it's that time again, but the 2009 Tap Project is just around the corner. Here at the U.S. Fund for UNICEF, we have been celebrating last year’s success and getting ready for next year. We will soon be asking volunteers across the country to join us again in recruiting restaurants, promoting the Tap Project and more—so stay tuned for upcoming information.

Tap Project City Coordinator positions available

We’re calling for committed Tap Project City Coordinators to help plan and implement the Tap Project in seven key locations (3-5 volunteer positions in each city, depending on location); Atlanta, Chicago, Denver, New York, Los Angeles, San Francisco and Washington, DC.

© US Fund for UNICEF, 2008

2008 Tap Project City Coordinators for New York City (left to right) Rina, Spencer, Emily and Xi pose for a photo taken inside the U.S. Fund for UNICEF national office.

Volunteers wishing to pursue a City Coordinator position with the Tap Project should be prepared to make this role an important priority in their daily lives, especially as World Water Week approaches. These positions offer volunteers a unique and exciting opportunity to shape their UNICEF Volunteer experience and the Tap Project in their communities, while gaining valuable leadership and nonprofit management skills. If you are a registered volunteer, log on to the Online Volunteer Center, and click on “What’s new.” You’ll be taken to the Tap Project Action Center where you can review the position description and learn how to apply to be a City Coordinator.

If you are interested in applying and are located in one of the seven cities above, but not a registered volunteer, please register today, or email volunteer@unicefusa.org for a position description.

Casey Marsh is part of a delegation of U.S. Fund for UNICEF staff and supporters currently visiting UNICEF's country programs in Zambia. She has been reporting on her experiences from the field this past week.

The final few days of our trip to Zambia have been incredible. On Thursday morning, our group flew from Lusaka to Ndola. As we wondered why we were delayed for about an hour, the crew announced that their vehicle had run out of gas on the way to the airport. It is a different world….

Our first stop was the Arthur Davison Children's Hospital in Ndola. This is only one of two children's hospitals in the entire country, and there is only one pediatric doctor on staff. That day, he was out of town for meetings, so there were none.

© US Fund for UNICEF/Casey Marsh

This young Zambian girl's mother died from AIDS. She is now cared for by her 80-year-old grandfather.

We toured the facilities, including new equipment called a PCR machine that detects HIV in babies under 18 months. There are only three such machines in Zambia. And because of the device, this hospital has been able to complete about 4,200 HIV tests since 2007. Approximately 700 babies turned out to be HIV positive, and those results are just from one small region of the country.

We also visited the hospital's severe malnutrition ward, which was heartbreaking. There were about six mothers and babies crowded in a very small, shabby room. The babies eyes' looked lifeless and their faces were gaunt. The staff told us that the rainy season is the worst time for malnutrition. The rains wash away most of the crops, and the hospital becomes overcrowded.

Sure, the Olympics have been exciting, but there's another sporting event this August that's had us here at UNICEF sitting by our TVs and cheering like crazy—the 2008 Disney Channel Games.

For the third year in a row, each of the teams competing in the Disney Channel Games is playing for one of four children's charities. This year, it's the green "Cyclones" who are playing for UNICEF.

The games feature relay races, obstacle courses and other events, which can be seen every Saturday night at 8 pm (ET) on, of course, The Disney Channel. Be sure to tune in on Saturday, August 30 for the finals.

In the meantime, check out The Inside Track, a special behind the scenes broadcast about the games exclusively on disneychannelgames.com, hosted by Disney Channel stars Meaghan Jette Martin ("Camp Rock") and Cody Linley ("Hannah Montana"). Also on the site, you can vote for your favorite players and dive into the action via online versions of the games seen each week.

Be sure to check it all out at disneychannelgames.com.

Casey Marsh is part of a delegation of U.S. Fund for UNICEF staff and supporters currently visiting UNICEF's country programs in Zambia. She will be reporting on her experiences from the field all week.

We have learned a lot about water and sanitation during our time in Zambia. The schools that we visited yesterday featured "hand-washing corners" and the schools and villages told us proudly about the fact that they are striving for one toilet for every family. For many years, villagers have defecated in the fields for lack of better facilities. This caused all kinds of diseases, and UNICEF is supporting a widespread effort to bring healthy sanitation, including pit latrines and water wells, to the region.

© UNICEF/ HQ96-1166/Giacomo Pirozzi

Children drink and play with water from a handpump financed by UNICEF at Nthombimbi Primary School, a community school in the village of Nthombimbi, Zambia.

When our group woke up this morning in our lodge, there was a problem with the water tank and there was no water available for most of the guests. We take clean water, toilets and showers for granted every day, but for hundreds of thousands of people in this tiny country alone, there are no such facilities. When we missed one shower, complaints were filed on our behalf by our hosts, and apologies were made. However, everyone has a right to clean water and safe, hygienic facilities, and the irony did not escape us!

Casey Marsh is part of a delegation of U.S. Fund for UNICEF staff and supporters currently visiting UNICEF's country programs in Zambia. She will be reporting on her experiences from the field all week.

© US Fund for UNICEF/Casey Marsh
Moms and their kids came from miles around when we came to visit their schools, even though the school year doesn't start for another month.

While en route to visit UNICEF programs in the southern province of Choma, Zambia on Tuesday, we learned that Zambia's President, Dr. Levy Mwanawasa, had died. And so, the rest of our travels here will correspond with a seven-day national mourning period. It's aparent that the country is in quite a state of shock and grief. But in this time of crisis, everyone is being urged to stay calm and resume normal activities as soon as possible.

Carrying on ourselves, our first stop out in the field was Child Hope Africa, a pre-school with capacity for 150 children. It seemed as though all the mothers and their children—hundreds of them—walked for several kilometers to greet us at the school today, despite the fact that classes are not in session until September. But despite their numbers, there are unfortunately more than 1,000 pre-school-age children in the area that want to attend the school, and many have to be turned away because of overcrowding.

Training and early-childhood education are key priorities for our colleagues at UNICEF Zambia, in close conjunction with the Zambian government. In fact, everything that UNICEF does is in partnership with the government and typically with other NGO partners as well. The idea is for the government to be self-sufficient, and ultimately, for there to no longer be a need for UNICEF in the country in the future.

We can always tell that summer is nearly over when the temperatures start falling, the sun sets a little earlier, and our summer interns wrap up their work and say goodbye. Tomorrow is the last day for our last intern in the Volunteer and Community Partnerships (VCP) Department. Pictured here are Ay-Nur, Josh, Anna and their supervisor, Rachael.

© US Fund for UNICEF/Grebstein

Today the interns made a presentation on the work that they have been doing this summer. The VCP Department supports our Online Volunteer Center, the UNICEF Campus Initiative, our relationship with Key Club and Circle K, and others. From working on the CNN Viewing Parties, to supporting Trick-or-Treat for UNICEF and the Tap Project, to developing resources for our Campus Clubs and answering volunteer inquires, and much, much more—our interns not only completed a great deal of work, they helped our department achieve our objectives by producing quality products and resources.

We are sorry to see them go, but are very appreciative for all the work that they have accomplished!

If you are interested in an internship, they are available throughout the year in multiple departments within the U.S. Fund for UNICEF. We’re currently accepting applications for fall interns. Enthusiastic, independent individuals, with an interest in international development will be most successful. If you are interested, please email a letter of interest and resume to hr@unicefusa.org.

I've always wanted to travel to Ethiopia. From all I've read and seen, it is a strikingly beautiful country with ancient temples and churches, and a geographical bonanza of tropical forests, mountain ranges and desert. (You can see some of it quite nicely on The Long Way Down.) Ethiopian food is fabulous—complexly spiced stews eaten with a spongy flatbread called injera.

© UNICEF/ HQ08-0440/Grum Tegene

ETHIOPIA: Five-year-old Khesna, who is severely malnourished, drinks therapeutic milk at the UNICEF-supported feeding unit of Bissidimo Hospital in East Harerghe Zone of Oromia Region. The milk is rich in micronutrients and is the first phase of a feeding regimen—eight times daily—that helps the body recover from the shock of malnutrition and conditions it to digest food. Khesna must initially be fed small portions, slowly.

But as we've reported before, that wonderful Ethiopian food has become dangerously scarce. The global food crisis has hit Ethiopia incredibly hard—in the last year, food prices have nearly doubled. Severe drought has exacerbated an already bad situation. Now, 4.6 million people are in need of humanitarian assistance. Crops are dying, livestock is dying, children are dying.

Casey Marsh is part of a delegation of U.S. Fund for UNICEF staff and supporters currently visiting UNICEF's country programs in Zambia. She will be reporting on her experiences from the field all week.

	© US Fund for UNICEF/Casey Marsh
	Mother and child receive medical care at a UNICEF-supported health clinic in Zambia.

Today was a fully-packed day! Our group visited the UNICEF Zambia office where the staff made several presentations about the nature of their work.

There are four key areas of UNICEF's work in Zambia: child health, which includes nutrition and HIV/AIDS prevention; basic education, which includes life skills and information on HIV prevention; water and sanitation projects; and child protection, such as the prevention of child trafficking, child labor, and other forms of child abuse.

Of course, UNICEF is always there in emergencies. Recently, there have been more floods and droughts in Zambia as a result of climate change, so more frequent urgent emergency intervention is needed.

The staff faces a variety of challenges on a regular basis, too. Zambia is a large country—similar in size to Texas—with a relatively small population of about 11 million. This means that people are scattered far and wide throughout the country, making it difficult to make services such as health clinics and schools accessible to everyone. Plus, out of 177 countries, Zambia is ranked 165th in terms of poverty on the Human Development Index.

Every once in a while, I’ll see a movie on T.V. with a pivotal scene in which a damsel in distress is giving birth. In the majority of these films, the woman goes into labor in the backseat of a cab or a secluded wooded area with—gasp!—no doctor in sight.

But then, lo and behold, the movie hero dashes to the rescue. After a few pushes from the mother-to-be, the hero safely delivers the baby, who is always adorable and always suspiciously older-looking than a newborn.

I always find these scenes completely preposterous because they make childbirth look so easy. And it's absolutely not. Childbirth is a huge, complicated process during which a lot of things can go wrong.

A century ago, nearly 1 in every 100 live births in the United States resulted in a mother’s death. Thanks to modern medicine, that figure has since plummeted to 13 deaths per 100,000 live births.

© UNICEF/ HQ05-2402/Anita Khemka

INDIA: Putul Mondal and Mithu Mahato hold their newborns, while others lie in cribs, at Purulia District Hospital in West Bengal State. The women are part of a program that helps premature and underweight infants avoid hypothermia, feel secure and bond emotionally. Where incubators are not available, mothers are required to hold their babies constantly against their skin to keep them sufficiently warm.

But for a lot of women in developing countries, maternal deaths are not a horror of centuries past. They continue to be a very real threat.

Each year, 500,000 women die during childbirth. The overwhelming majority of the deaths—99 percent to be exact—occur in developing countries.

Casey Marsh is part of a delegation of U.S. Fund for UNICEF staff and supporters currently visiting UNICEF's country programs in Zambia. She will be reporting on her experiences from the field all week.

I arrived this afternoon in Lusaka, Zambia after being 'stuck' overnight in Johannesburg. It seems that everyone in our group experienced some type of delay, and we all agreed that we need to adjust to a new cultural rhythm in Africa. Nothing moves quickly.

Betty Chella Nalungwe, the Communications Assistant for the UNICEF office in Lusaka, greeted me at the airport. It was wonderful to see a bright blue UNICEF t-shirt and a warm, friendly smile as soon I stepped into the terminal. I was quickly moved through the VIP/Diplomat line at passport control, which is an indication of the esteem in which UNICEF is held within the country.

© US Fund for UNICEF

Maryanne and Paul Harvey with Betty Chella Nalungwe stand next to the UNICEF Range Rover at Lusaka Airport.

Betty gave up most of her weekend to fetch me and the other visitors, which she seemed to do happily. In fact, Friday was her birthday, and she spent many hours at the airport waiting for Sean and Griffin Flannery, 2 members of our group from the Boston area, to arrive. None of that put a damper on her energy, though!

© UNICEF/ HQ06-2059/Pablo Bartholomew
INDIA: Sunita cradles her malnourished daughter, who weighed just 2.2 lbs. at birth, in the UNICEF-supported Sick Newborn Care Unit at GB Pant Hospital in Port Blair, capital of the Union Territory of Andaman and Nicobar Islands. The child also has congenital pneumonia. The 12-bed unit, which provides top-tier delivery services and offers the best chance of survival for newborns, is an essential part of UNICEF health interventions on the islands.

We can’t do it without India and China.

That’s one assessment from UNICEF’s first-ever The State of Asia-Pacific’s Children 2008: Child Survival report, which measures regional efforts to improve child and maternal health.

Unless both countries—and India, in particular—make major strides to curb child mortality, global efforts to meet the U.N. Millennium Development Goals will fall short, said the 60-page report released earlier this month.

Among the 9.7 million deaths of children under age five in 2006, more than one-quarter occurred in these two countries alone. India's share was far bigger, with 2.1 million.

Those sobering stats were tempered by these heartening ones: the overall number of child deaths throughout Asia and the Pacific Islands has decreased significantly over the last several decades, dropping from 10.5 million in 1970 to about 4 million in 2006.

Bipartisan support bolsters U.S. efforts to fight AIDS, TB and Malaria

Back in July, Congress passed an important piece of legislation—the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008. Here at the U.S. Fund for UNICEF, we applaud President Bush for recently signing the legislation into law, reauthorizing the dramatically successful initiative known as PEPFAR—the President's Emergency Plan for AIDS Relief—originally launched in 2003.

This new bill—let’s call it PEPFAR II—authorizes $48 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria worldwide. That sounds like a lot of money, but it will take every penny to reach the legislation’s lofty goals:

• Preventing 12 million new HIV infections over the next five years
• Providing care and support for 12 million people with AIDS by 2013, including at least 5 million orphans and other vulnerable children
• Making sure at least 2 million people receive treatment for AIDS
• Training for 140,000 health care workers in developing countries

Last week we attended the Circle K International Convention in Denver, where we debuted Six Cents Online. This new online fundraising tool will allow Circle K members to have access to all the resources they need and electronically raise funds to save children’s lives.

Diarrheal dehydration is one of the deadliest threats against children. At a cost of only six cents, a mixture of sugar and salt called oral rehydration salts (ORS) offers the most effective way to help save lives during episodes of dehydration. The Six Cents Initiative is designed for Circle K International members to help children get the rehydrating salts they need to survive dehydration spells.

But that’s not all. Contributions to the Six Cents Initiative will also help provide aid for UNICEF's water and sanitation programs and long-term solutions.

Circle K International is the largest collegiate community service, leadership development and friendship organization in the world, and we're proud to partner with them in the Six Cents Initiative.

While Circle K is taking the lead, anyone can contribute to the campaign, so check out Six Cents Online today!

When I was a kid, I watched the Olympics in a cozy pair of footy pajamas, curled up on the couch with my siblings and our dog. At some point, I'm pretty sure I ate ice cream.

When Lopez Lomong was a kid, he watched the Olympics by leaving the refugee camp he was living in and walking five miles to get a glimpse of track and field events on a black-and-white TV. He was one of the Lost Boys of Sudan, orphaned by the fighting in Darfur. By the time he watched the Sydney Olympics of 2000 on that black-and-white TV, he had experienced more fear, violence and hardship than most people endure in a lifetime.

© UNICEF/ HQ04-0899/Shehzad Noorani

SUDAN: Hamudi Abdullah Mohammed witnessed the death of his parents during an early morning militia attack on his village in Darfur. This phopto was taken at the Kalma camp for displaced people, near Nyala, capital of South Darfur.

Lopez Lomong spent 10 years in the Kenyan refugee camp and was eventually adopted by an American family. Now he's 23 years old and is, himself, an Olympic runner. Last week in Beijing, he carried the flag for the U.S. team during the Olympic opening ceremonies. He is also active in a group called Team Darfur—a coalition of approximately 400 international athletes who work to keep a spotlight on the continuing crisis in Darfur.

	Ludmila Nikolaeva, age 14, Switzerland
	Living in the abundance of nature.

Award-winning drawings by children age 7-15, from the International Environmental Children’s Drawing Contest, will once again be shown in a free exhibition in the United Nations General Assembly visitors’ lobby. The exhibition opens tomorrow, August 13, and runs through September 4, seven days a week from 10 am to 5 pm. Entrance to the lobby is at First Avenue and 45th Street. UNICEF volunteers will be on hand at all times to answer visitors’ questions about the show and UNICEF issues.

The annual drawing contest was established by the International Certification Network and the Japan Quality Assurance Organization to encourage the world’s children to think about the environment that surrounds their everyday life, and how to protect it. The winning drawings are selected from over 14,000 submissions from children in over 60 countries. In addition to covering all expenses, Japan Quality Assurance is making a generous contribution to UNICEF.

The exhibit is under the aegis of the United States Fund for UNICEF. For more information, phone Herb Frank at 212.830.9130 or email hfrank@unicefusa.org.

Did you happen to catch the New York Times interview this weekend with U.S. Fund for UNICEF President and CEO Caryl Stern?

In the article, Stern discusses how UNICEF is the world's leading child survival authority, and notes how our access and influence enabled UNICEF to respond so quickly in the aftermath of Cyclone Nargis in Myanmar and the earthquake that hit Sichuan Province in China.

© David Forbes

Caryl M. Stern joined the United States Fund for Unicef in 2006 and became the president and chief executive in June 2007.

The article appeared in print on Saturday, August 9 on page C2 of the New York edition. You can also read it online here.

The General Federation of Women’s Clubs (GFWC) recently honored Caryl Stern, president and CEO of the U.S. Fund for UNICEF, as one of four women of distinction at the Empowering Women Banquet, held during the 117th Annual GFWC International Convention in Chicago. Other honorees included Anne Burke, Illinois Supreme Court Justice and a founder of the Special Olympics; Elena Poptodorova, Ambassador of Bulgaria to the United States; and Jaclyn Smith, actress, entrepreneur, philanthropist and breast cancer survivor.

Stern thanked the gathering of over 650 GFWC members for their long-standing support of UNICEF and commitment to the empowerment of women. She pointed out that gender inequality creates a burden on both women and children, and therefore remains a high priority in UNICEF’s work.

In case you hadn't noticed, we're always reaching out to people. We want them (and that includes you) to have the chance to learn about all the ways we help kids around the world. We have so many programs in so many countries, it's not an easy task.

Recently, some of the very talented people I work with made this video, which beautifully illustrates UNICEF's work to do whatever it takes to save a child. As far as I can tell, it's impossible to watch this video and not be moved by the scope of UNICEF's efforts—and by the happy kids that are our reward.

Please give it a look. And let us know what you think, by posting your comments below.

You’ve read our advocacy requests and updates here before. But does anyone notice if you actually advocate for UNICEF? Yes!

Congress reviews many issues and makes important decisions that will affect how many children UNICEF will be able to help in the coming year. A few weeks ago, we asked our volunteers to contact their elected officials on behalf of UNICEF and the world’s children because the U.S. House and Senate were reviewing the bills that support UNICEF funding for fiscal year 2009.

We asked our volunteers to write their Congressional Representative to endorse the U.S. Fund for UNICEF's request of $135 million in funding for UNICEF in FY09. In just weeks, 881 letters were sent in support of a $135 million U.S. Government contribution to UNICEF in 2009.

That's a lot of letters. Thank you!

But our work is not done yet. In the coming months, Congress still needs to complete their appropriations process, and we may need to send another round of letters depending how it's going. Plus, we’ll be asking volunteers and supporters like you to contact Congress on other issues important to saving the world’s children.

I hope you'll remember results like these the next time you wonder if making a few cllicks really makes a difference.

	© UNICEF 2006
	Mr. Joan Laporta, President FC Barcelona and UNICEF Executive Director Ann M. Veneman hold a club jersey with UNICEF logo at partnership launch in September 2006.

Tonight, the New York Red Bulls and FC Barcelona will play an exhibition soccer game at Giants Stadium. The match can also be seen on ESPN2.

The New Yorkers here at the U.S. Fund for UNICEF love our home team. But we also have to give our props to FC Barcelona, because they are huge supporters of UNICEF. They wear the UNICEF logo on their team jerseys as a token of their five-year commitment to raise awareness and funds to benefit children affected by HIV and AIDS.

Good thing it's a friendly match, so we can cheer for both sides!

Andrea Penagos, a junior at the University of Southern California (USC), became passionate about children's issues when she lived in Guatemala as a teen. She witnessed firsthand the challenges faced by kids in impoverished communities and became determined to help. Now, as the president of the UNICEF Campus Initiative club at USC, she's rallying other students to the cause.

Presented by the i'm Initiative, this great video from mtvU's "Cause Effect" tells her story:

I often joke with my friends that my daughter was born hungry.

Immediately after being born, the nine-pound little porker wanted to eat. A kind nurse at the hospital who noticed how exhausting labor was for me thought I could use a break and offered me formula. It was tempting, but I chose to breastfeed instead, which has been one of the best decisions I’ve made as a mother.

Breastfeeding comes with so many benefits. It creates a special bond between a mom and her baby. It helps raise a baby’s IQ level. And—one of my favorite reasons—it’s free.

But the chief reason for my decision was the simple fact that breastfeeding is the healthiest thing a mother can do for her baby. And when it comes to child survival, it’s one of the best (and earliest) lifesaving interventions. UNICEF estimates that if every baby were exclusively breastfed from birth to six months, about 1.3 million children’s lives would be saved each year.

© UNICEF/ HQ05-2393/Anita Khemka

Jayawanti, an Indian mother from the state of Gujarat, nurses her newborn. Breastfeeding exclusively for the first six months can greatly reduce the number of deaths caused by major childhood killers like acute respiratory infection and diarrhea.

This week is World Breastfeeding Week, an observance started in 1992 by the World Alliance for Breastfeeding Action to promote exclusive breastfeeding for the first six months of life. This year’s theme—support for mothers—focuses on providing encouragement and assistance to women who choose to nurse.

It’s been nearly three months since monster storm Cyclone Nargis buffeted Myanmar, but the Southeast Asian nation is still reeling from the blow.

The cyclone affected some 2.4 million people, damaging or demolishing hundreds of thousands of homes and thousands of schools. A recent report (PDF, 665K) released by the UN and the Association of Southeast Asian Nations (ASEAN) detailed the cyclone’s colossal devastation—including the destruction of 75 percent of health facilities in affected areas, and the flooding of 600,000 hectares of farmland—and the continuing hardships facing survivors.

Last week, UNICEF warned that 700,000 children in Myanmar are still in need of assistance.