Stories

The Heart of the Problem: Children of Poverty

As RESULTS volunteers, we are not asking for something for our own families, but for our human family. This brief excerpt from a New York Times article on child labor in Africa makes clear why it's so important that we do this work and why our requests of our leaders are necessary. The article is titled: "Africa’s World of Forced Labor, in a 6-year-Old’s Eyes." Here is how it starts:

Just before 5 a.m., with the sky still dark over Lake Volta, Mark Kwadwo was rousted from his spot on the damp dirt floor. It was time for work. Shivering in the predawn chill, he helped paddle a canoe a mile out from shore. For five more hours, as his coworkers yanked up a fishing net, inch by inch, Mark bailed water to keep the canoe from swamping.

He last ate the day before. His broken wooden paddle was so heavy he could barely lift it. But he raptly followed each command from Kwadwo Takyi, the powerfully built 31-year-old in the back of the canoe who freely deals out beatings.

“I don’t like it here,” he whispered, out of Mr. Takyi’s earshot.

Mark Kwadwo is 6 years old. About 30 pounds, dressed in a pair of blue and red underpants and a Little Mermaid T-shirt, he looks more like an oversized toddler than a boat hand. He is too little to understand why he has wound up in this fishing village, a two-day trek from his home.

But the three older boys who work with him know why. Like Mark, they are indentured servants, leased by their parents to Mr. Takyi for as little as $20 a year.

We are clear that microfinance targeted to the very poor can allow parents to take care of themselves and their children. RESULTS' founder asked Muhammad Yunus, the "grandfather" of microfinance, “What’s the first thing a woman does with the proceeds from her loan?” He expected Professor Yunus to say that she would put her children in school, or feed her family better. What the Nobel Peace Prize laureate said was, “Usually, the first thing she does is bring her children home. She couldn’t afford to feed them so she had sent them off, as young as 5 or 6 years old, to work for other families in exchange for barely a handful of rice. But with microfinance, she can bring them home."

We have decided to use our power as citizens to make a difference, and so we ask for the support of our leaders for microfinance programs that help the very poor.

The Heart of the Problem and the Solution: Nutrition and Child Survival

As RESULTS volunteers, we are here to speak not for ourselves, but on behalf of those who do not have a voice. The most vulnerable and voiceless are children. Over 24,000 children die every day, mostly from preventable causes. But we know how to save them. As an illustration, here is a brief excerpt from a story about the fate of children in Ethiopia:

Mubarek weighed barely eight pounds when he arrived at the Kuno Alimena Health Post in Ethiopia’s drought-affected Gurage Zone. His weight would be average for a newborn baby, but as a toddler, he weighs approximately one-third of what he should. His diagnosis is severe acute malnutrition.

Still, Mubarek was lucky; his mother brought him to the weekly UNICEF-supported therapeutic feeding program that has been set up to save the lives of severely malnourished children. He did not have medical complications that would require clinical treatment and was able to begin home-based care, receiving weekly rations of ready-to-use therapeutic foods.

But Mubarek’s twin brother was not so fortunate. He died even before his mother could get help.

While therapeutic feeding saved Mubarek’s life, if there is not enough nutrient-rich food when he returns home, he will likely become malnourished again. UNCIEF warns that children with severe acute malnutrition have a 25 to 50 percent chance of dying if they don’t receive help. While this is a story about the acute food shortage in Ethiopia, children are suffering and dying of malnutrition all around the world. It is critical that the U.S. invest in proven, effective child survival programs to help children like Mubarek.

The Heart of the Problem: Maternal and Infant Mortality

As RESULTS volunteers, we try to ensure that suffering is not ignored because it is not seen. Sadly, many of the invisible are mothers and their children. Over 24,000 children die every day, mostly from preventable causes. And rather than a time of joy, child birth is too often a death sentence for women. This story from the Washington Post, about a mother-to-be in Sierra Leone, encompasses all the challenges the poor face in trying to access health care:

Saio Marah, nine months pregnant and two days into labor, lay on a hospital bed and groaned loudly with each contraction. She had arrived at the rural hospital earlier on the back of a motorcycle, about the only public transport available in this muddy little town in the distant back-country bush of one of Africa’s poorest nations. Now, in a dark and hot labor ward with rain blowing in the open windows and puddling on the floor, Marah grimaced as James Konteh slapped on rubber gloves and examined her.

Konteh, an ophthalmologist by training, is one of only two doctors who serve 300,000 people in this remote district, so he has become a de-facto obstetrician. He placed a plastic Pinard stethoscope — a cheaper, funnel-shaped alternative to a standard stethoscope — to Marah’s massive belly and listened.

“The fetal heart rate is very rapid,” he said. “The labor is obstructed. The baby is in distress so we must operate right away.” Konteh pulled out his cellphone and began dialing his four surgical nurses. It was 6:30 pm, and they had all gone home when their 10-hour shifts ended a half-hour earlier.

Marah had waited too long to come to the hospital, and now the baby, her first, was in trouble. The surgery was urgent, but it would take time to get the operating room team back.

“What can I do?” Konteh said. “There’s nobody here.”

The story now describes the challenges health care workers and mothers like Marah face, which include no electricity or running water and impassable roads. Samuel Kargbo, the British-trained director of the hospital and the only other physician in the country’s largest and poorest district, also explains that:

“. . . many women delay seeking medical care for their pregnancies because many don’t fully understand the risks and are daunted by the costs and distances they need to travel for care. So they tend to rely on poorly trained local midwives. When problems develop, they end up walking, or being carried in makeshift hammocks, for hours or even days to reach the hospital. He says that every pregnancy is a “chance of dying.” The doctor couldn’t help Marah right away because his staff had been working since early morning, he noted, and had needed to go home to eat and rest. They came back as quickly as they could.

Marah’s husband Barrie had to run out to a pharmacy and buy a catheter and urine bag for $3. Patients must pay for all supplies, in addition to hospital fees, which is about $10 for a regular deliver, and $70 or more for a C-section. Some operations are delayed while husbands run out to buy rubber gloves for the surgeon.

We learn in the story that Barrie earns $100 a month making jewelry in a local market, and he is very worried how he will pay the full bill. But can imagine how someone earning less than $1 a day would cope? Or if they would even bother going to the hospital? I would like to finish reading a bit of the story so you can find out what happened:

The doctor pressed the plastic funnel against Marah’s belly again, listening for the baby’s heartbeat — an hour and 45 minutes after he first checked. . . . He shook his head. . . . Marah’s baby was dead. . . . There was no oxygen, heart monitor, or blood available. The air conditioner remained off, despite the heat and humidity. The performed an emergency C-section, just in case there was still a chance at life.

The nurse hurried the silent baby over to a small examining table and pressed its chest with her forefinger. “Nothing,” she said. “No sign of life.” She turned the baby over. “This is a fresh stillbirth,” she said. “This baby has just died.” She put the body on a scale: 6.5 pounds. A good size, otherwise apparently healthy and well developed. “If she had come to the hospital earlier, this baby could have survived.” . . . In this part of the world, the bodies of stillborn babies are often disposed of by the hospital. Stillbirth is such a common occurrence that the hospital has a small, unmarked graveyard set aside for them. Sierra Leone has the highest rate of infant mortality in the world, with 16 percent of babies dying before their first birthday.

A woman’s lifetime risk of maternal death is one in 75 in the developing regions, compared to one in 7,300 in developed regions. In Sierra Leone, the rate is one in eight. Every minute, at least one woman dies from complications related to pregnancy or childbirth — that’s 529,000 women every year. And for every woman who dies in childbirth, around 20 more suffer injury, infection, or disease. That's approximately 10 million women — 10 million mothers — each year.[8] We would like to work with you to help these women and their children.

The Heart of the Problem and the Solution: Small Changes, Big Effects

As RESULTS volunteers, we are here to speak not for ourselves, but on behalf of those who do not have a voice. The most vulnerable and voiceless are children. Over 24,000 children die every day, mostly from preventable causes, but we know how to save them. This excerpt, from a story about the fate of children in Mozambique, shows that solutions are often simple, but profound:

Like many women in rural northern Mozambique, Atea Mussa started giving her children water to drink in addition to breast milk on the day they were born. Her own mother taught her that without water, the babies’ throats would dry out and they might die.

But finding clean water near Atea’s village of Ampivine in Nampula Province is a daily struggle. The area lacks piped water and sanitation is poor because most households have no toilet or latrines. The available water often carries microbes that cause diarrhea, putting children at risk of malnutrition even when food supplies are adequate.

When Atea was pregnant with her third child, new ideas about child rearing came to the village and surrounding areas. The radio began to play messages about the benefits of exclusive breastfeeding and ways to improve children’s diets with local foods. A community volunteer trained through a USAID program offered free nutrition and hygiene classes, which Atea attended. Although others initially were skeptical, Atea trusted Amina Abubakar, the new community volunteer or “animadora” in Portuguese. . . .

When Atea gave birth to her son Nelson Aldi in late 2003, she broke with tradition and followed the animadora’s advice, giving the baby nothing but breast milk for the first four months. Then she added porridge mixed with nutrient-rich foods like peanuts and sesame to his diet. Nelson not only survived without water, he thrived. At six months, he is a happy, chubby baby known and even envied in the community for the fact that he is rarely ill and has never suffered from diarrhea.

When a visitor asks the animadora how she knows her program is working, she takes Nelson from his mother and lifts him into the air with a big smile. Because of his example, more mothers are adopting new ways of feeding their children. “The children are healthier and the sicknesses are less severe,” Amina observes. “The mothers always congratulate me and are grateful.”

Beliefs are changing even among the older generation. “The grandmothers see the advantages because the children are growing well and don’t suffer,” says Atea, who is proud that her son has a healthy start in life. She hopes Nelson will grow up “to help others in the community” as a nurse, a highly respected profession. If Nelson could talk, he would say “thank you” because he is growing well and when you grow well, school is easy. Sadly, UNICEF reports that the majority of the children in this region have stunted growth. But thanks to U.S. leadership, there are fewer children today suffering from malnutrition, but even one is too many when the world has the resources for smart, proven interventions to save these lives. It is critical that the U.S. invest in proven, effective child survival programs to help mothers like Atea.

Sharon LaFraniere, “Africa’s World of Forced Labor, in a 6-year-Old’s Eyes,” The New York Times, 29 October 2006, http://www.nytimes.com/2006/10/29/world/africa/29ghana.html

UNICEF, 26 June 2008, http://www.unicefusa.org/news/news-from-the-field/unicef-deputy-executive.html.

Kevin Sullivan, “In Sierra Leone, Every Pregnancy Is a ‘Chance of Dying,’” Washington Post Foreign Service, 12 October 2008.

UNICEF, “Fighting Childhood Malnutrition in Mozambique,” http://www.usaid.gov/stories/mozambique/ss_mozambique_atea.html