Bolivia's Childhood Death Rate
April 2, 2001 -- In Bolivia, for every 1,000 children born, 87 die by age 5.
That's the highest childhood death rate in South America, four times more
than Argentina next door -- and 10 times more than the United States.
On the road to Huayllamarka, Bolivia
Photo by Joe Palca
Poor sanitation, lack of clean water and poverty are obvious
culprits. So is inadequate health care. But as NPR's Joe Palca found on a
recent visit, even when health care is available, it can be hard to get the
services to the people, and the people to the services.
In the city of El Alto just north of La Paz, community activist
Libertad Navia goes block by block, encouraging people to go to the clinic
for prenatal care, nutrition counseling and vaccines for their children. But
Navia says many people in El Alto, especially members of Bolivia's native
Indian tribes, are relucant to go to government-run clinics where they may
face unfamiliar Western medical practices, disdainful doctors and
Community Activist Libertad Navia
Photo by Joe Palca
Apart from the Bolivians who won't seek medical help are the
Bolivians who are often beyond medicine's reach. Palca rode with Ned Olney,
executive director of Save the Children in Bolivia, to a village 120 miles
south of La Paz to check on a promising childhood nutrition program.
Flooding and mudslides often complicate Olney's rounds; this year, heavy
rains have made some routes nearly impassable.
When Olney's driver tried to guide the 4-wheel drive vehicle around a washed-out stretch of road, the car
plunged halfway over a ledge and began to fill with water. Olney, Palca and
the driver scrambled out unhurt and locals dragged the car from the water -- but
the travelers never got to the village. The episode, Palca says, drove home
that "building better roads, along with creating a sanitation system and
providing a steady supply of clean water, are all things the Bolivian
government could do to lower childhood deaths. That hasn't happened."
Listen to Joe Palca's report as aired on All Things Considered.