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

Earlier this month, I posted an entry on this blog about girls in Darfur being sexually assaulted when they collect firewood in the wilderness. One of our readers left a question that may have crossed many people’s minds: “How about letting the MEN collect the firewood?!”

When I first researched this subject, I also wondered why girls in Darfur were left to do this risky chore in secluded areas while boys stayed behind at camp. But I later learned that boys in war-torn countries also suffer horrible abuse, violence and exploitation.

In Darfur, when militias raid villages, they sometimes immediately execute the boys along with the men. In times of war, many fighting groups see young men and boys as threats or as potential soldiers, so boys are either killed or kidnapped and forced to serve in militias.

© UNICEF/ HQ05-1018/Ron Haviv

Lucky to be alive, three nomadic boys wander amid the remains of a village reputed to harbour Janjaweed militias in North Darfur State, Sudan. But until these boys relocate to a protected camp for displaced people, their lives remain in great danger.

Not long ago, my very curious niece asked me to explain UNICEF's work. I told her about child survival issues, about how, in certain parts of the world, kids get sick and even die from things that she will never have to worry about: they don't have clean water, don't get enough to eat, come down with pneumonia…

© UNICEF/ HQ06-2554/Giacomo Pirozzi

A baby with severe pneumonia lies in the pediatric ward of a hospital in the Solomon Islands. He has a breathing tube in his nose and an intravenous needle taped to his hand.

"Pneumonia!" she said. "Isn't that what old people get when they go outside in winter without a coat?" She's not alone in imagining pneumonia as an elderly man in a wheelchair, coughing quietly from the dim corner of a nursing home. Would you be as shocked as she was to learn that pneumonia is the number one killer of children under five? That more children die from pneumonia than from AIDS, malaria and measles combined?

UNICEF Ambassador Clay Aiken recently returned from Somalia, where UNICEF provides children in the war-torn nation with health care, education, nutrition, clean water and sanitation. This is the second in a series of blog posts he will write about his experience in the field.

For children in Somalia, the situation is dire. But, it's just amazing to me that UNICEF is still able to make a difference in children’s lives in one of the most dangerous places on earth.

© US Fund for UNICEF / 2008 / Nick Ysenburg

For instance, while I was in northwest Somalia—where 45 percent of the population are children and women—I observed how UNICEF improves water, sanitation and hygiene conditions for everyone in the region. One of the ways they do this is by drilling "borewells" so that clean drinking water is easily accessible and readily available. Without these borewells, children would have to walk hours to fetch water instead of going to school and getting an education.

Have you ever visited a city and been followed down the street by a scrum of children asking for money or pens, or desperately trying to sell you gum or some limp flowers? Our visit last week from UNICEF Laos Child Protection Officer Amy Delneuville got me thinking about one of the world's saddest, most overlooked groups: street children. Here in the U.S., there aren't many street children but in developing countries, poor countries, countries fractured by conflict, there are many.

© UNICEF/ HQ07-0072/Giacomo Pirozzi

A boy sleeps on a cardboard box on the street in Bangui, the capital of the Central African Republic.

It's impossible to know for certain just how many children spend their time living in the streets. Not surprisingly, it's a very difficult group to track. An estimated number that often pops up, though, is 100 million. If accurate, that's 100 million kids living, working, struggling and sleeping on the streets of cities. I can't imagine what it must feel like to be a kid and not know where you'll sleep that night. Or whether you'll be safe.

In a one-of-a-kind television event this Sunday, July 6, CNN will examine why 26,000 children die every day from preventable causes and what UNICEF is doing to save these young lives. Hosted by CNN's chief medical correspondent, Dr. Sanjay Gupta, "The Survival Project: One Child at a Time" will air at 8 and 11 pm (ET).

This historic broadcast will highlight four areas where UNICEF demonstrates its remarkable on-the-ground expertise in doing whatever it takes to save a child:

• Child protection in Iraq
• Water and sanitation in Laos
• HIV/AIDS in Peru
• Child survival interventions in Ethiopia

Leading experts in each of these key areas will contribute to a panel discussion moderated by Dr. Gupta.

"The Survival Project: One Child at a Time" is a chance to get a first-hand look at the plight of millions of children around the world, struggling each and every day for survival. We hope you'll tune in.

	© UNICEF/HQ02-0580/Jim Holmes
	LAOS: A boy bathes with water collected at a handpump, in the remote northwestern province of Luang Namtha. The handpump, installed at a health center, is now also being used by the community.

We're all getting excited about the upcoming CNN program, The Survival Project: One Child at a Time, which will really shine a light on the child survival issues we care about so much. The show will include four documentary-type segments that look at UNICEF programs in four different countries: Iraq, Peru, Ethiopia and Laos. Since I don't know that much about Laos—officially known as the Lao People's Democratic Republic—I thought I'd do a little research and pass it along to you.

My research project was made infinitely easier when I learned that Amy Delneuville, a UNICEF Child Protection Officer based in Laos, would be stopping by our offices to give a talk about the country and UNICEF's programs there. Child protection is one of UNICEF's major focuses in Laos, as are water, sanitation, nutrition and education (among others).

For the past two months, I’ve been working on a feature story for our quarterly magazine Every Child that focuses on the rape epidemic in the Democratic Republic of the Congo. As a woman and mother of a daughter, this has been an extremely disturbing subject to tackle.

© UNICEF/HQ07-0244/Giacomo Pirozzi

Girls stand outside their school at the Djabal refugee camp, near the town of Goz Beida in south-eastern Chad. The majority of the camp’s residents have fled here to escape the ongoing conflict in Sudan’s Darfur Region. UNICEF provides the camp with education, therapeutic feeding, and water and sanitation services.

This form of violence not only plagues the DRC. It's a problem in just about every conflict situation around the world. Rape has become so common that many people accept it as a byproduct of war, as if it were something natural and beyond anyone's control. Even more appalling is that many rape victims are children—some as young as four years old.

Iodine is probably not something many of us routinely think about.

This natural chemical element enables the thyroid gland to produce hormones and is essential to human development. In much of the world, iodine is found in soil. It is absorbed by crops and then consumed by livestock and humans.

But in some parts of the world, the soil—and thus the food supply—lacks iodine. The results are devastating. Iodine deficiency is the world’s leading cause of preventable mental retardation and brain damage and also increases the risk of infant mortality, miscarriage and stillbirth.

A new UNICEF report, released this week, shows tremendous progress in the effort to protect children and mothers from the cruel consequences of iodine deficiency.

Two decades ago, only 20 percent of households received adequate levels of iodine. Now—thanks to a huge worldwide campaign including UNICEF and partners like Kiwanis International—70 percent are getting sufficient iodine through iodized salt.

There’s been a lot written about the global food crisis on this blog. And it definitely warrants more attention.

Soaring food costs are pushing a lot of families around the world into poverty. In some parts of the world, food prices have doubled. A UNICEF colleague recently reported that many families are coping with the price hikes by having only one meal a day. For young children, this is especially dangerous.

Not getting enough food or the proper nutrition can stunt a child’s growth, weaken her immune system and, in extreme cases, lead to death. Actually, malnutrition plays a significant role in half of the 9.7 million child deaths each year, which is why the food crisis is such a critical threat to children around the world.

© UNICEF/HQ06-2763/Bruno Brioni

Two-year-old Ilias of Cote d'Ivoire drinks UNICEF-supplied fortified milk to help him recover from malnutrition. These therapeutic food supplements have saved millions of children's lives. And with the current food crisis, UNICEF is distributing these lifesaving foods to children around the world.

While world leaders work to find a solution, UNICEF is responding with a life-saving basket of therapeutic foods that prevent malnutrition and help affected children recover quickly.

High-protein biscuits, therapeutic milk and Plumpy’nut have been described as “magic” foods by aid workers who have witnessed their quick turnaround success.

What does the word "Jamaica" conjure up in your mind? Long, glittery beaches? Azure-colored water? Fancy resorts? Those are some of the images I would have thought of until recently. But, as I've learned, they're only part of Jamaica's very complicated reality.

© UNICEF/ HQ08-0267/Susan Markisz

You see, for years now, Jamaica—that small vacation paradise about the size of Connecticut—has had one of the highest murder rates on the planet. In fact, it's often referred to as "the murder capital of the world." In 2007, more than 1,500 people, out of a population of only 2.7 million, were murdered. That equals more than four people a day, and includes an estimated 100 children. This year over 700 persons have already been killed.

Have you noticed from our recent efforts in China and Myanmar that UNICEF goes to extreme lengths to make sure children always have access to education, even in emergency situations?

© UNICEF/HQ07-1110/Shehzad Noorani

Education is like a magic wand for children—it can provide them with a secure, happy and safe place to spend time (ping!); it can turn a scary future into one filled with possibility (swoosh!); it can even make a child healthier (tadaaa!).

Yes, education enables children to lead healthier lives, and to make improved choices for themselves and their future families. A recent study actually shows that better education leads to longer life expectancy. It is, as much as anything, a child survival issue. And achieving universal primary education by 2015 is one of the UN's Millennium Development Goals.

UNICEF’s first ever comprehensive report assessing the status of Africa’s children cited major challenges and some significant gains in the effort to cut that continent’s stubbornly high child mortality rates.

The State of Africa’s Children 2008: Child Survival, released late last month, noted that among the nearly 10 million children who die each year before they reach age five, half of these deaths occur in Africa.

© UNICEF/HQ08-0563/Win Naing

While the school year is ending here in the U.S., in Myanmar the new school session is, despite all obstacles, getting under way. It's only been a month since the violent hurricane there left as many as 135,000 people dead or missing. And more than 4,000 basic education schools—affecting approximately 1.1 million children—were either damaged or totally destroyed.

But UNICEF believes it's essential to help children get back to school, and we're putting tremendous effort into seeing it happen. As Ramesh Shrestha, UNICEF Representative in Myanmar, recently said, "In any disaster affecting entire communities, the opening of local schools is an important step in the recovery process. Children rely on their daily routines for a sense of security, including the routine of attending school."

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.

© 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.

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

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.

	© UNICEF/HQ99-0619/Giacomo Pirozzi

As we work to get a sense of the full extent of damage from the cyclone in Myanmar, we're also continuing to stay on top of news connected to the food crisis. And the news in that department is not good.

Food prices have increased so much, so quickly that in countries like Haiti, Bangladesh, Egypt, Somalia, among others, people have been protesting and even rioting to convey the full extent of their hunger. A recent article in the New York Times quoted a Haitian man, Saint Louis Meriska, describing what it means to have no food to give his children. "They look at me and say, 'Papa, I’m hungry,' and I have to look away. It’s humiliating and it makes you angry."

The anger Saint Louis Meriska feels over not being able to feed his kids is being experienced by millions of others like him all around the globe. Even the U.S. military is concerned over the worldwide unrest stemming from the food crisis and has begun conducting its own investigation into the crisis, which, it worries, could become a potential "defense issue." In Afghanistan, the 75 percent increase in the cost of wheat flour has fueled widespread anger against the U.S.-backed government there, raising fears that the food crisis may actually be boosting recruitment for the Taliban insurgency.

We've mentioned tetanus a few times in recent blog posts (like here and here) and I thought I'd briefly explain just why tetanus is such a big deal for us. In the U.S., we're routinely vaccinated against tetanus as kids. We generally don't have to worry about it unless we have an accident that makes us vulnerable, like stepping on a rusty nail or falling down some old stairs (as I did a few weeks ago, necessitating a tetanus booster shot).

But, in many countries, tetanus remains a very big problem. It's a truly awful and painful condition that develops when a bacteria, Clostridium Tetani, contaminates a wound or cut. (For more information than you may want about tetanus, check out this Wikipedia page.) And in some countries, the fatality rate for tetanus is 70 to 100 percent.

© UNICEF/ HQ00-0003/Giacomo Pirozzi

If you've followed the news at all in the last few weeks, you're probably aware of the developing worldwide food crisis. This has been THE story of late, and it's news we are watching very closely.

So what, exactly, is going on? Well, a whole lot, actually. First off, destructive weather events (which, some argue, are due to climate change) have caused whole seasons of crops to fail in certain parts of the world. In Bangladesh, for instance, Cyclone Sidr tore through the costal districts of the country last November and now, six months later, there's no rice harvest. In Somalia, the worst drought in decades is scorching plant life and killing livestock.

© UNICEF/ HQ98-0527/Giacomo Pirozzi

Jointly authored by a broad coalition that includes UNICEF, the World Health Organization and many other groups, the report found that although there have been some strides in providing vaccinations, insecticide-treated bed nets and other interventions, the majority of countries with high child and maternal mortality rates were failing to provide vital health services to most women and children.

	© UNICEF/ HQ06-1461/Giacomo Pirozzi

Today I'd like to address one last comment to my original post on child survival. Kathryn Hornbein wrote, "In your comments today, I saw nothing about the issue of conflict and child mortality/morbidity. Yet I think a majority of problems are caused or aggravated by war…."

Even though I'm focusing my posts on certain core child survival issues, I don't want to leave anyone with the impression that UNICEF isn't incredibly dedicated to children impacted by armed conflicts. In fact, UNICEF was created in 1946 to come to the aid of children devastated by WWII. And we've been helping children in war ever since.

Let's take Darfur—the ongoing conflict there has created one of the worst humanitarian crises in history. Over a million children forced to flee their homes are now living in refugee camps in Sudan and Chad. And Kathryn is absolutely correct when she writes that the fallout from such a conflict is massive—lack of clean water and sanitation, malnutrition, destruction of the education infrastructure, increase in disease, compromised health care, land mine danger, etc. The list is depressingly long.