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A joint 2009 publication by UNICEF and WHO, Diarrhoea: Why children are still dying and what can be done, revives action-oriented discussion about diarrheal disease — one of the world’s direst threats to babies and infants living in unsanitary, under-resourced environments. The report provides current data on the distribution and burden of the disease and on how the most affected countries are working to reduce the toll of infant diarrhea. The report also includes a strategic seven-point plan for diarrhea control, describing prevention, intervention, and treatment practices that can and should be brought to scale.

Diarrhea is the second leading cause of death for children under five globally — with pneumonia being the first — and kills approximately 1.6 million children under five each year. Eighty percent of these entirely preventable deaths occur in the poorer regions of South Asia and Africa. Although major efforts in delivering treatments and effective prevention campaigns have reduced the global impact of infant diarrheal death, many low-resource communities still face barriers to accessing low-cost, life-saving remedies for their sick children. According to the World Health Organization (WHO), only 39% of children afflicted with diarrhea receive the recommended, inexpensive treatments of fluid replacement, zinc supplementation, and continued feeding.

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Mother and Child in Bolivia

According to the World Health Organization (WHO), if you are a young Bolivian, you have a 6 percent chance of dying before your fifth birthday. Diarrhea and malnutrition, conditions rooted in poverty, are the leading causes of child mortality in the South American country. Against this background, a UNICEF-funded government health insurance plan will allow doctors to provide unrestricted care to children under the age of five as well as pregnant women. Bolivia’s health services still have much work to do to ameliorate the underlying causes of childhood diseases. UNICEF estimates that 2.5 million Bolivian children are living in poverty, leading to the compounded problem of chronic malnutrition.

While the UNICEF program, which covers the costs of the medical treatment of children, is an important step in making care readily available to Bolivians, the government still needs to reach out to the destitute rural and indigenous populations. Prohibitive distance and cost are not the only factors that separate these Bolivians from medical professionals. The systemic degradation of trust may stem from a communication barrier: Many doctors and nurses do not speak Quechua or Aymara (indigenous Bolivian languages). Cultural traditions, such as keeping a male child’s umbilical cord long to symbolize masculinity, or the association of white walls, such as those in hospitals, with the burial of babies, exacerbate the already dangerously poor health outcomes for these individuals. UNICEF’s health insurance program, while a critical first step in improving child life expectancy, will be unable to achieve lasting change in the most under-served populations until cultural dynamics, along with endemic poverty and rural inequality, are addressed.

More information on Bolivia below the fold. Read more