By Himangi Jayasundere, ChildFund Sri Lanka
Five-year-old Murugan watches as water trickles out of a gurgling filter. As his cup fills with clear, clean water, the smile on his little face grows larger. Where Murugan lives in Sri Lanka’s Nuwara Eliya district, waterborne diseases like diarrhea are a serious problem and often lead to children becoming malnourished.
Children here have many health challenges, including poor water quality and lack of education about health care among parents. But ChildFund’s Ensuring Nutrition, Health and Children’s Health (ENHANCE) program has helped address the issue of safe drinking water by distributing filters to Early Childhood Development (ECD) centers and conducting awareness programs through local partner organizations.
Eight ECD centers, including Murugan’s, have received water filters, which remove lead and other impurities from water so it can be safely drunk. The filters also reduce the risk of potential diseases.
“This is one of the best water purification systems introduced to us. I want to thank ChildFund Sri Lanka for helping to provide clean water for children,” says Mrs. Puwaneshwari, a teacher at the Walaha ECD center. Together with T-Field, its local partner in Nuwara Eliya, ChildFund has built a dam to collect water from a spring and distribute the clean water through pipelines to the community. The project has benefited 170 families.
The awareness programs have emphasized boiling water before drinking it at home and teaching children and adults to wash their hands after using the toilet. ENHANCE takes an integrated approach to helping children establish good health, addressing nutritional needs, child care, family habits, personal and environmental hygiene, safe water and sanitation practices and food security.
“My child used to fall sick often, but after learning about the importance of boiling drinking water, I always boil our drinking water now, and I can see a difference,” says Malarselvi, a mother at the ECD center. “They don’t fall sick as often as they used to.”
Reporting by Abraham Marca, ChildFund Bolivia
Born three and a half years ago to a 41-year-old mother after a risky pregnancy, Rebeca was small but still within the normal range. However, when Rebeca was 9 months old, her family learned she wasn’t developing properly.
Wiñay Mujo, ChildFund’s local partner organization in her Bolivian village, offers early childhood development evaluations to young children in the area, and Rebeca had her first at 9 months. The evaluation revealed that Rebeca didn’t have enough strength in her back, legs and arms to crawl, so Wiñay Mujo staff members showed her mother some exercises she could do at home with Rebeca to stimulate those muscles, and soon Rebeca began making her first movements around her world.
But then, just before turning 1, Rebeca suddenly began losing weight; she was diagnosed with mild acute malnutrition, so Wiñay Mujo helped her get the dietary supplements she needed. She gained weight over the next few months, but she still couldn’t walk, even at 15 months. After a new course of exercises and diet, she learned to walk, and by the time she turned 3, her growth and development were on track.
But Rebeca developed a parasite infection and suddenly lost weight again. After her successful treatment, Wiñay Mujo looked more deeply into her situation and discovered that Rebeca was spending her days in the care of a teenage aunt while her mother worked. To provide a healthier environment for the little girl, Wiñay Mujo invited the family to have her participate in ChildFund’s center-based early childhood development program in her community.
Today, Rebeca and her family are doing better, and they attend programs at Wiñay Mujo, where they learn about good nutrition and other healthy practices. Rebeca is 3 and a half. She has had all of her vaccinations, and her development is considered normal for her age.
Children in developing countries face many obstacles to healthy development. For the youngest in particular, early nutrition is especially important because it supports their ability to grow and learn — without adequate nutrition in the early years, children may never be able to recoup developmental losses. ChildFund works through local partners like Wiñay Mujo to provide the monitoring, stimulation, nutrition and learning opportunities children need to stay on track.
By Kate Andrews, ChildFund Staff Writer
Today is World Toilet Day. OK, get the giggles out of your system. We do indeed have a world day for just about everything! Despite the funny name, World Toilet Day draws attention to an important problem: the lack of proper sanitation in many communities around the world.
Consider these facts:
Last year, more than 1,000 children died each day from diarrheal diseases contracted through poor sanitation.
One billion people — 15 percent of the world’s population — practice open defecation, which spreads disease.
And 2.5 billion people do not have safe, private toilets.
This year, World Toilet Day (designated Nov. 19 by the United Nations General Assembly) is calling attention to the special challenges women and girls face when they don’t have safe toilets. School attendance decreases among girls, especially once they reach puberty. According to a 2012 study published by WaterAid, more than 50 percent of Ethiopian girls reported that they missed school one to four days a month due to their menstrual cycles, often out of embarrassment from a lack of privacy. Women also are more vulnerable to violent attack if they must leave their homes to use the toilet. One of the ChildFund Alliance’s primary goals is to promote child protection worldwide, through our Free From Violence initiative.
Nongovernmental organizations including WaterAid and the Water Supply & Sanitation Collaborative Council are advocating for the following goals to be included in the U.N.’s post-2015 agenda:
No one practices open defecation.
Everyone has safe water, sanitation and hygiene at home.
All schools and health facilities have safe water, sanitation and hygiene.
Water, sanitation and hygiene are sustainable, and inequalities in access have been progressively eliminated.
Below, see pictures of some of the latrines children in ChildFund-supported communities use, and consider sharing this information today on your social media networks (use #wecantwait on Twitter or Facebook). World Toilet Day may have a funny name, but it addresses a serious topic.
By Himangi Jayasundere, ChildFund Sri Lanka
“Soap and water, scrub, scrub, scrub,” hums Sashini as she washes her hands.
Like many of her friends, the 11-year-old did not bother too much with washing her hands properly before. Sometimes she and her friends would come home after playing outside or helping with paddy cultivation and wash their hands a little with water to get the mud and dust off. But now things have changed with a program organized by ChildFund Sri Lanka to promote proper hand washing, especially before meals.
Sashini was among 90 children age 6 to 14 who participated in the hand-washing program conducted at Mayurapada Kanishta Vidyalaya, a school in the Polonnaruwa district in north central Sri Lanka.
“We teach children about the importance of washing their hands, especially before meals,” says K.M. Chandralatha, a teacher. “But it happens within the classroom. This program was a practical experience in correct hand washing, and I think many of them got first-hand experience on the proper way to do it.”
Access to clean water is crucial for hand washing and other good hygienic practices.
The program commenced with an introduction to hand-washing day, followed by a practical demonstration by a science teacher, illustrating how harmful bacteria can be neutralized with the use of soap and water.
A midwife who works in public health taught the children good hand-washing techniques. “We talk regularly with parents on this subject, but we rarely get an opportunity to talk to children about the importance of hand washing,” says H.M. Chamali Piyaratne, the midwife. “It was a good experience, and I look forward to doing more sessions with children.”
Sashini adds that the program has helped many of her friends, who have in turn taught their younger siblings about proper hand-washing techniques.
“We were never taught to wash our hands like this before,” she says. “The experience of doing it with clear instructions has taught us how important it is.”
To further assist and promote hand washing and good hygiene among children, ChildFund Sri Lanka also provided two sinks to Sashini’s school.
By Christine Ennulat, with reporting by Joan Ng’ang’a, ChildFund Kenya
On any given day, Halima has her work cut out for her. As a community health volunteer in a rural area outside of Mombasa, she makes one or two home visits per day, checking in on families participating in ChildFund’s program to help children and families affected by HIV and AIDS in Kenya’s Coast and Nairobi provinces. Halima has 50 children on her list.
Launched in 2011 and run by ChildFund and several other partner organizations, the USAID-funded program takes a comprehensive approach to ensuring that these children and their caregivers have a safety net so they can build toward a more hopeful future. The program works to ensure that basic needs are met, including:
Today, Halima’s first visit is with Nadzua, age 35, mother of 11; she is a second wife, married into a family who lost their mother to HIV. In her packed-dirt front yard, she greets Halima warmly, a sleepy toddler balanced on her hip. Her 2-year-old son, Mbega, is the only one of Nadzua’s children home this morning — the others are at school, and her husband is in town.
The women sit outside, facing each other, and begin. Before moving on to today’s subject — how Nadzua can gain skills to improve her family’s income — there’s a lot to talk about: the children’s health and immunizations, how things are going at school, how their improved hygiene practices are working out, whether the family is getting the nutrition they need, how Nadzua is doing in the literacy classes Halima encouraged her to take.
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It’s all hard with 11 children to care for, but life has improved since Halima’s visits began. “I have gained a lot from Halima,” Nadzua says. “I am more educated, more informed on how to take care of my children and my household.”
And she’s especially proud of herself on this day: She just harvested and sold 10 bags of green lentils, which meant she could cover her oldest son’s high school fees.
As Halima leaves a little later, she breathes a happy sigh: She loves her work. She loves seeing families thrive despite the devastation of HIV and AIDS. Because she knows exactly how hard it is.
Halima, a single mother of four, has taken in the three children left behind by her two sisters, whom she lost to AIDS. All three children are HIV-positive.
And, thanks to Halima and all she’s learned, all seven children are thriving.
On her way to her next appointment, Halima passes a school she visits nearly every week, educating parents about children’s needs, sanitation and more. “I’m proud to see that the parents in the village understand the importance of growth monitoring, and that they’re interested in their children’s school performance and attendance,” she says.
She’s also had a hand in one important improvement to the facility itself: Until recently, the toilets were dirty, spilling human waste outside — a biohazard. Halima contacted the local public health officer, who ordered the school administrator to either fix the latrines or close the school.
Halima’s next client, Mwau, is a widowed father of four, and he’s waiting. His wife died four years ago. “When one parent dies, it gets even more difficult to take care of the family,” he says. His children are a girl, 16, and three boys, 8, 12 and 14.
Mwau has participated in several of ChildFund’s workshops — on child rights, nutrition, health and economic empowerment. With other farmers, he’s a member of one of ChildFund’s village savings-and-loan groups. The men are also working together to find better markets for their wares. Thanks to what he’s learned and earned through the overall program, Mwau has been able to move his family from a rickety mud hut into a stone house.
Still, he worries about his children — especially his daughter.
“My daughter was most affected when her mother died,” he says. When the 16-year-old began coming home late after school, he wanted to yell at her, but he didn’t — in the workshops and from his talks with Halima, he knew there were better ways to handle teenagers. But this was really a job for a mother … and his children’s mother was gone. So, at his request, Halima stepped in.
“I explained that while she may want to enjoy the company of friends, some will not have good intentions toward her,” Halima remembers. “There are risks such as rape, and the consequences can be unwanted pregnancies and dropping out of school.”
Halima also encouraged the girl to help out at home — her family needs her. They all need each other.
It’s moments like this that keep her moving forward. “My drive is that people in the community listen to me,” she says. “I have a deep desire to see them grow and lead better lives.”
By Sagita Adesywi, ChildFund Indonesia
In this blog post, we meet Nuren, a woman who worked for REACH, a project in Indonesia run by ChildFund and UNICEF that promoted health care of pregnant women and young children to help lower the infant mortality rate. REACH ended in December 2013, but the health-care training continues to make a big difference in these communities.
Nuren works in East Nusa Tenggara, training community health volunteers (known as cadres) and families about keeping infants and young children healthy and safe. Beginning in 2011, she traveled to homes and clinics in remote villages, where women traditionally have given birth without access to prenatal care or emergency assistance when it’s needed.
Most health cadres come from non-medical backgrounds, so they received regular support and monitoring during the project’s duration. Nuren’s routine visits helped to remind the volunteers how to provide basic health services, and she checked the amount of medical supplies to make sure health posts were fully stocked. Some visits took hours to accomplish.
“When we had two new cadres in Sotual, we went there for a monitoring visit,” Nuren recalls. “We left the city at dawn to reach Nuapin village. We then walked for three hours through the forest from Nuapin village to finally reach Sotual. The return trip was more difficult, because it was uphill. We took a shortcut, and I almost fell off a cliff on the way back.
“The wife of the health cadre gave us pineapples, but unfortunately, none of us carried a knife. We walked all the way up the hill to our car before we saw an old man with a big dagger to help us cut and eat the pineapples. We weren’t even wondering if the dagger was clean or not, we were just so thirsty from the long walk!”
Upon reaching Nuapin, the group stopped by a health center. “The health worker asked where we came from. He was surprised when we told him that we had just visited our health cadres in Sotual, since they had never gone there before,” Nuren says. “With basic medical supplies in such a remote area and limited access, the health cadres are able to provide basic health care for young children. Seeing this is really rewarding for me.”
In 2011, the REACH project covered 40 villages and 14 health centers. By January 2013, it had expanded to 49 villages and 15 health centers, with more than 200 trained health cadres. Since the project ended, Nuren has continued her work with ChildFund in the eastern program areas.
One of the biggest challenges in the project area is the traditional activity called Sei, in which firewood is burned underneath a platform and mattress that a mother and her newborn lie on in a room with very limited ventilation, sometimes as long as a month. It is believed that this practice will make them strong and healthy, but in fact, it contributes to many respiratory problems. Another challenge is that the community’s water source is far away.
Nuren says that although the region continues to face some hardships, “I see the changes happening in the community. People now have a reasonable access to health services. This really helps in obtaining basic health care in critical situations, especially for young children who suffer fevers or stomach aches, as malaria and diarrhea are common in the area.
“I have seen the community is really enthusiastic about the health services they have in their neighborhood. Even though they know the health cadres are trained specifically to help young children, people now choose to go to the health cadres instead of the traditional healer when they are sick,” she adds. “People are also more aware of health issues. They learned not only to be aware of the common symptoms of diseases, but also how to prevent contracting them with healthy living habits.”
By Meg Carter, ChildFund Sponsorship Communication Specialist
Are you a smoker? Maybe you’ve quit, or have you never taken a puff? Perhaps, like many of us, you fall somewhere in between.
I have a lifetime count of less than 100 cigarettes, but I’m not protected: One in ten tobacco-related deaths involves a never-smoker. And of those deaths, one in four is a child — because there is no safe level of second-hand smoke.
Tomorrow, May 31, is World No Tobacco Day, a time to contemplate these grim facts and consider what we can do to make a difference.
In my early 20s, working in Saint-Louis, Senegal, I occasionally smoked, even though I hated cigarettes. Smoke filled that sleepy town’s only nightclub, and on Saturday nights, my Gauloises burnt down to my fingertips. Smoking was my cover charge for entertainment.
Several years ago, when I lived in Guinea, I watched children buy single cigarettes at the same shacks where they purchased food: hard-boiled eggs, bread cut to order, powdered milk packets, tea leaves by the gram, hard candy by the piece, tomato paste by the tablespoonful and Maggi stock cubes. Errand boys ran groceries for Mom and cigarettes for Dad, making shopping a gateway activity.
Nearly half of the world’s children regularly breathe second-hand smoke in public places, and two in five have at least one smoking parent. Among Cambodian, Thai, Senegalese, Filipino and Vietnamese, three in five children live in smoking homes, while in Belarus, Indonesia and Timor-Leste, it’s four in five. Southeast Asians suffer disproportionately from second-hand smoke.
By age 15, many boys in developing countries have become smokers, but years can pass before their health deteriorates. Tobacco smoke contains 4,000 chemicals, including 50 carcinogens and another 200 lesser toxins. In Timor-Leste, fully half of all boys between ages 13 and 15 smoke. Among Belarusians, it’s one in three. But boys aren’t the only ones at risk; substantially more Brazilian girls than boys smoke.
Mothers who smoke often deliver babies prematurely or with lower birth weights, and exposure to second-hand smoke causes one in four sudden infant deaths.
Globally, tobacco consumption is on the rise, and so are its opportunity costs. Tobacco’s direct costs to Thailand could fund the country’s energy services. In Mexico, treatment of tobacco-related illness accounts for one in 10 health care dollars.
According to the World Health Organization, tobacco kills up to half its users. Every six seconds, tobacco takes a life. Every minute of every day, two die in high-income nations, and eight more die in developing countries.
ChildFund works in the world’s second, third and fourth largest tobacco-producing countries: Brazil, India and the United States. Indonesia also ranks in the top ten and, during the past decade, Mozambique, Zambia and Cambodia have experienced the greatest increases in tobacco production. In low-income countries, tobacco contributes to deforestation and supplants food crops. And it’s inefficient; agricultural land yields up to 15 times tobacco’s weight in edibles, which contributes to high rates of malnutrition.
Tobacco plants, like coca and opium, also are biohazards. Children often work in the fields, topping and harvesting green tobacco leaves covered with dew and raindrops. In the heat, that coating of water dissolves nicotine from the leaves. The nicotine solution can cross the skin barrier and pass into the bloodstream, causing acute poisoning. A day’s worth of absorbed nicotine is equivalent to smoking anywhere from 12 to 50 cigarettes.
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By Meg Carter, ChildFund Sponsorship Communication Specialist
One in a series this week for World Health Day (April 7)
One bright morning, I was administering the English language section of a four-hour exam in a high school in Saint-Louis, Senegal. About halfway through the test, which divides high school graduates who go on to university from those who return to their villages to farm, I felt dizzy and feverish.
By noon, I was walking slowly across a quarter-mile-long cantilever bridge, clinging to the handrail. The bridge connects the island portion of the town to the mainland, where I lived. It felt as if a vise was crushing my head; I could barely see.
Reaching the mainland, I sat down on a pile of rocks on the bank of the Senegal River, shaking uncontrollably in the intense sunlight. Eventually, a cool hand grazed my forehead. I heard a sharp intake of breath, then a familiar voice saying, in French, “malaria.”
I stared at the child in front of me, unable to move or speak.
“Miss Meg, it’s me, Amadou N’Diaye. I’m taking you home now.”
He ran back to the street and flagged down a taxi. Together, Amadou and the driver lifted me inside. When we arrived at our apartment block, Amadou ran first to my Peace Corps colleagues, who carried me up the stairs and into bed. Then he found my French friend. “Bring your medicines, quick,” he told Christian.
Christian’s cocktails of anti-malarial and tetracycline drugs worked. Three days later, I came out from under my mosquito net, no longer wanting to die.
I’d slept under that net for nearly two years. And I’d taken tonic water daily for its quinine benefit, lit a mosquito coil in my bedroom each evening at sunset, and swallowed my weekly pills. But despite these precautions, on restless nights when I bumped up against my net, mosquitos feasted on my arms and legs. Anti-malarial drugs don’t entirely destroy plasmodium parasites, which carry malaria; they merely keep them under control. In those days, the West African breeds were increasingly drug-resistant.
Now imagine what it’s like for children without bed nets or medication who are bitten every night of every rainy season by hundreds of mosquitos.
This year, World Health Day is turning its focus toward vector-borne infections; its motto is “small bite, big threat.” Epidemiologists refer to insects and snails as the vectors for parasites and viruses they transmit to our bloodstreams.
Malaria is the world’s most prevalent vector-borne infection, but dengue fever, a mosquito-borne virus, is the fastest growing. In the countries where ChildFund serves, other parasitic diseases such as Chagas, from kissing bugs, and trypanosomiasis, from tsetse flies, threaten children’s health. Viral illnesses, including chikungunya (mosquitos), schistosomiasis (freshwater snails), and the hemorrhagic fevers — Yellow Fever (mosquitos), Rift Valley Fever (mosquitos) and Crimean-Congo Fever (ticks) — are less widespread but still deadly.
Urbanization, deforestation and damaging agricultural practices all contribute to the spread of malaria. Deforestation and urbanization also led to resurgences of Yellow Fever and the sudden emergence of dengue and chikungunya.
Mosquitos breed in stagnant water, hiding in tall grass during the day and tracking their human targets nightly by the carbon dioxide we exhale. Although we can’t yet eradicate malaria, giving families access to medicated bed nets is a step in the right direction.
By Saroj Pattnaik, ChildFund India
One in a series this week for World Health Day (April 7)
On a hot afternoon in southern India, the atmosphere inside the small community center was unbearably sultry. But for a group of women, the heat was not terribly bothersome, as they were in the middle of an informative and eye-opening session on child care and parenting skills.
Led by Beula Ruth of the Kalaiselvi Karunalaya Social Welfare Society, one of ChildFund’s local partner organizations in the state of Tamil Nadu, the workshop was aimed at educating pregnant and lactating mothers about prenatal and postnatal care.
“I had no idea about exclusive breastfeeding. I didn’t know that a child needs only breast milk for six long months,” says Saraswathi, a first-time mother of a 5-month-old baby. “This is something that I am hearing for the very first time.”
Beula agrees and adds, “Every time, we come across some women who don’t have the basic knowledge on child care. This is why we continuously conduct such awareness sessions in our project area.”
There has been substantial improvement to government health services in India, but a majority of people living in rural areas still don’t have access to health care. And that’s where ChildFund comes into the picture, by working with the government and local partners to bring public health services to underserved communities.
Here are some of the stark facts about the lives of rural Indians:
(Sources: National Rural Health Mission, Government of India; WHO; Indiafacts.in)
As part of our Early Childhood Development program, ChildFund and its partners in India conduct training sessions for mothers, discussing good nutrition (both for themselves during pregnancy and for their children under the age of 5), developmental benchmarks and preventive health care, among other issues.
Last year, there were more than 9,000 training sessions across India, with more than 180,000 parents and other caregivers participating. As a result, more than 86 percent of births occurred in hospitals or other health institutions, and more than 68,000 children have been fully immunized.
“We make sure that all the communities have the access to government health facilities and if they don’t we bring those services to their doorsteps,” Beula says. “Our ECD workers and volunteers continuously monitor the health of children, pregnant women and new mothers and refer them to nearby hospitals whenever necessary.”
Like Beula, Anita Ghalekar in Chochinde Kond — a remote village in Maharashtra State’s Raigad district — is a busy woman. Even after her retirement from ChildFund’s local partner Pride India, she is committed to maintaining access to health services for local families.
Besides overseeing ChildFund’s home-based ECD intervention activities in her region, Anita leads 15 health camps, which provide workshops and care in individual villages.
“We make sure that all the villages in and around our program area are covered under our programs designed to ensure basic health care of the people, especially children, new mothers and adolescent girls,” says Virendra Kulkarni, manager of Pride India.
“And we implement these programs in such a way that the communities take ownership of them,” he adds. “For example, when we conduct health camps, villagers provide us accommodation, beds and other logistic support required. And this has helped us reach out to a wider population and implement our program successfully.”
Dr. Vijay Kumar Singh, who led a health camp in Uttar Pradesh recently, says, “ChildFund is doing a great work. They are reaching out to people in those places where the government health service has not yet reached.”
By Sagita Adesywi, ChildFund Indonesia
Yuliana, a mother of five, lives in far eastern Indonesia in a simple house made with bamboo, tree bark and other wood.
Like many others in her community, Yuliana’s family has a wooden rumah bulat or “roundhouse” that serves as a kitchen and a storage place for harvested crops. The outbuilding has a door but no windows, and the walls and ceiling are black from smoke.
Aside from these uses, the rumah bulat is also a birthing room. According to local tradition, mothers and their newborns need to be “baked” to become strong and healthy. Mother and child lie on a wooden platform with a fire burning underneath it — often for a month or more.
Yuliana did this for all five of her children, but now she discourages other mothers from doing the same. “It was so hot, I felt like dying, but we didn’t dare to say no to our village elders,” Yuliana recalls. “It was such a miserable time. My children fell ill easily when they were younger, coughing all the time. As I now know the harmful impacts, I want people here to stop doing this.”
Today, Yuliana is a volunteer with a health project in the village called REACH. ChildFund and UNICEF work in partnership with community-based organizations, training health volunteers to raise awareness about proper health care for expectant mothers and young children.
The rumah bulat practice contributes to a significant number of young children suffering from chronic respiratory diseases and malnutrition. “It is not easy to change people’s views, since traditional norms are held in high esteem in the community,” Yuliana notes. “From the training, I understand it is not just about what a bad experience it is, but most importantly how badly it impacts the health of the mother and the baby. I want people here to understand this too.”
As part of her efforts, Yuliana helps the local midwife facilitate counseling sessions at the village health post. She carries a first-aid kit and keeps information about basic health care with her at all times.
“I am very happy to have Yuliana as a health volunteer,” says Adel, another community member. “She visits pregnant mothers regularly and discourages the rumah bulat practices.” It’s difficult to break old habits, though.
“I still underwent this practice for my niece when she gave birth,” Adel says. “I know it is wrong, but I was terrified of going against the village elders here. Yuliana has been telling us we shouldn’t keep doing this, but we’ve been told we will be cursed and that if we don’t follow the practices we will go crazy.”
However, Adel did make some adjustments to the norm. Her niece was confined to a rumah bulat with a bamboo wall that allowed more ventilation than the customary solid wood wall, and Yuliana checked on mother and baby.
Indonesia’s government supports the abolition of this practice, having introduced a new fine of US$30 if a woman gives birth at home instead of at a health center. This is a hefty fine in Yuliana’s province, where the average income is US$17 a month. The government’s regulations and the sharing of health information among mothers are helping to reduce the harmful custom.
“I was really scared of the rumah bulat practice. I chose to stay at my uncle’s house in town so that I could give birth at the health center,” says Dorsila, who, inspired by Yuliana, has also become a community health volunteer.