By Dr. Joy Wright June 27, 2022 Topics: Disease Outbreaks Maternal Health Refugees Over five million children under five die each year from preventable causes. Nearly half of those deaths are babies in their first month of life. The top health threats to children are from causes we know how to prevent and treat. So why are children still dying of these causes in 2022? And how is Medical Teams working within crisis affected communities to tackle these problems? Here are the top five causes of death in children under five globally and how we are responding. Health Threat #1: Preterm birth complications When babies are born too early, their immune system and lungs are not fully developed. This makes them more vulnerable to infections and breathing problems. They’re usually smaller and may find breastfeeding difficult, so they’re more likely to become malnourished. Staying warm enough is hard without the fat reserves of a full-term baby. Our response Good prenatal care is vital to preventing premature birth. In Colombia, Sudan, Uganda, Tanzania, Ethiopia and Bangladesh, we are providing prenatal checkups for pregnant women. At these appointments, our staff make sure that any infections are identified and treated early. They ensure that women are getting iron supplements and that they get extra nutritional support if they are malnourished. All of this helps to reduce premature deliveries as health threats to children. If a baby is born early at one of our birthing units, our trained staff will be on hand. They will teach mom how to keep the baby warm and will refer on for more specialist care if needed. In Uganda, we have also opened the first NICU (newborn intensive care unit) in a refugee settlement, where premature babies can receive around-the-clock, specialized care. Dr. Raphael provides care to newborns in a neonatal care unit in a refugee settlement in Uganda. Photo by Lauren Odderstol. Health Threat #2: Problems during labor and delivery About one in eight of those young child deaths is due to problems during the actual birth. Perhaps the labor was very prolonged and a C-section was needed, but there was no one trained to recognize that. Or perhaps the baby was delivered but needed help to start breathing, and the equipment needed to resuscitate the baby wasn’t present. Our response In many of our health programs, our community health workers go to each household to identify women who are pregnant. They encourage women to give birth in a health facility, explaining to them and their partners how much safer it is for mother and baby. After nearly two years of work in Bangladesh among Rohingya refugees, we’ve seen the percentage of women giving birth in a clinic go from 14% to 90% percent. Formin, a Rohingya refugee, holds her newborn baby who she delivered at a Medical Teams clinic. Photo by Nihab Rahman. When women arrive at the delivery ward, they are looked after by a trained nurse or midwife who can recognize and treat complications. We also work to ensure clinics have the supplies and equipment they need. For example, we donate resuscitation equipment to health facilities and provide refresher training to staff. Health Threat #3: Respiratory infections Ten percent of deaths in children under five is due to a respiratory infection. Although antibiotics could treat most of those infections, there are several common barriers to treatment. Parents may delay seeking help if the clinic is far away. Families may not be able to afford a consultation. Or they might get to a clinic and find it doesn’t have antibiotic syrups in stock. Our response Medical Teams clinicians are trained to be able to distinguish between a simple cough and a more serious respiratory infection when they examine an unwell child. Our logistics and pharmacies teams ensure that antibiotic syrups are always available in our clinics. In some areas we work, it can be a long walk to the clinic, so we train community health workers to assess and treat children at home for mild cases. In other programs, we train parents to spot the signs of a chest infection in young children, such as fast breathing, so they can be confident about knowing when to go to the clinic. A Community Health Worker visits the homes of newly arrived refugees in a settlement in Uganda. Photo by Lauren Odderstol. Health Threat #4: Diarrhea Diarrhea is the cause for one out of every ten deaths in children under five years old. The tragedy of this is that it’s very straightforward to treat diarrhea and it shouldn’t be a top health threat to children. Most of the time children just need rehydration with an easy to absorb salt and sugar drink, Oral Rehydration Solution (ORS), and immune system support with some zinc. Very occasionally they might need an intravenous drip if they are severely dehydrated. And, if parents are aware of the importance of hand washing and have a clean water source available nearby, children are much less likely to get diarrhea in the first place. Our response We train community health workers to go house to house reminding parents of the need for handwashing. They make sure families have soap and know good handwashing technique. At our clinics, staff are trained to assess how critically dehydrated a child with diarrhea is and start the right treatment. In Guatemala, we saw a huge improvement in health because of community health work. One crucial piece of information is knowing the key times for handwashing, such as before preparing food. By sharing this information with families through trained community members, knowledge of key handwashing times improved from 0.7% of mothers to 99.7% of mothers over a three-year period. Similarly, with community training, children with diarrhea who were treated with oral rehydration salts increased from 34% to 83%. Health Threat #5: Malaria In many of the countries we work in malaria is widespread, transmitted by mosquitos carrying the parasite. The primary way to prevent malaria is through sleeping under insecticide treated bed nets. But many of the families we work with have fled conflict with the few possessions they could carry, so they don’t have bed nets for their children to sleep under. Particularly if young children are already malnourished or anemic, the malaria can become serious very quickly, by spreading to the brain or causing organ failure. Our response To reduce death from malaria, we work through prevention as well as treatment. For example, in Tanzania, we distribute insecticide treated bed nets to families. Our community health workers also educate parents about the signs and symptoms of malaria. We use rapid finger prick blood tests in the clinic to diagnose malaria, so children can start treatment right away if they need it. And if they are severely ill, our staff will make sure they are referred to a nearby hospital. A family in Tanzania stands next to their new insecticide treated bed net. You can help save the lives of children Medical Teams is on the front lines, working to prevent and treat the most common and deadly health threats to children. But we can’t do this work without the support of people like you. When you give, your gift goes directly to provide the medicines, supplies and training needed to save lives. Often, the interventions are basic and simple and they don’t cost much. Yet, the impact — a healthy child, a grateful parent, hope for the future — is beyond measure. Give a gift that provides loving and life-saving care for people in crisis. Dr. Joy Wright As a health advisor at Medical Teams, Dr. Joy provides medical and public health expertise and guidance to ensure the highest standards of care. Her work includes helping design effective programs and working with country office staff to monitor and evaluate health activities.