Good News for the New Year

What do Tonga, Kuwait and Zimbabwe have in common?  They are the only three countries in the world which did not see a reduction in deaths in children under 5 years old in the last 20 years.  These three countries don’t get to blame poverty for their poor showing in infant mortality.  A mammoth study, “The Global Burden of Disease” published in The Lancet, takes into account every country on earth.  Think of all of the bastions of poverty, inept government, violence and corruption that dot this planet like a pox.  Yet, in each of these countries, save the three mentioned, early childhood deaths have been reduced—by a lot.  For example, Bangladesh dropped its under 5 death rate by two-thirds between 1990 and 2010.  In Africa, Malawi reduced mortality by 56.6%, in Asia, Laos saw a 55.6% decrease, in Central America, Nicaragua reduced their deaths by 61.9%.  The list goes on, thank God.

            In a year that has seen precious little to be joyful about concerning how we treat and guard out children, a world class study has shown that the world is doing a much better job of getting our most vulnerable citizens through the first five years of their lives.  What is more, during the past twenty years, gains have been made in countries of virtually every socio-geo-political description possible.  More children are surviving in countries as small as El Salvador and as huge as China; in Muslim Oman and Catholic Portugal; in dysfunctional North Korea and much more functional South Korea.  Global success is so ubiquitous that it is the failures that make the short list.  

The results of the study are certainly not a constant parade of good news.  There are too many humans dying of preventable causes.  But dramatic improvement in surviving infancy has got to be a cause for joy.  The primary decreases in death have come from measles, diarrhea, pneumonia, malnutrition, tuberculosis and neonatal tetanus.  While none of these conditions have the dramatic impact of AIDS, they are killers that are now being kept at bay.

            If you are searching in vain for some commonality to the countries that have seen improvements, and find the list of conditions being improved without a uniting thread, you will find the same confusion in searching through medical causes of such positive effects.  Instead of a simple, single, movie ending breakthrough that leads to a swift and satisfying dénouement, you will find a collage of good practices.   The key to much of this improvement is a, “…house that Jack built…” string of quasi-related initiatives.  Vaccines, nutritional supplements, oral rehydration salts, bed nets, improved hygiene education and sanitation lead to babies that live.  These are fairly low cost activities that need small scale capital, boots on the ground and a will to get the job done.  Unicef and the World Health Organization began their global effort to vaccinate children against common diseases only in 1985.  This dedication to saving all lives comes from a recent world-wide feeling of shared responsibility, the democratization of health care. 

            So we have found a thin line of connection.  We perceive the problem; we examine the problem; we attack the problem; we measure our success against our failure…rinse, lather, repeat.  When people operate at their best, good things happen.  I choose to begin the New Year with knowledge that we can do both good and right. 

            Small successes help me keep the faith. 

[Much of this column comes from information provided by Tina Rosenburg in her New York Times column, “At Year’s End, News of a Global Success.”]