Why Child Mortality Is Worse In South Africa
This is WEEKEND EDITION from NPR News. I'm Rebecca Roberts.
Ten years ago, world leaders gathered at a U.N. summit and agreed on a global action plan to improve life for the world's poorest by the year 2015. Included in that plan was a goal to reduce the mortality rate of children under the age of five. But in South Africa, the child mortality rate has grown worse over the last 10 years.
Reporter Kyle G. Brown has the story.
KYLE G. BROWN: It's a warm day in DuNoon Township, in Cape Town, where the streets are strewn with rubbish. Children play near large pools of stagnant water. Local health care worker Nduthu Debessa(ph) is paying home visits.
Ms. NDUTHU DEBESSA (Health Care Worker): They play and then they take their money, they buy chips and then they eat without washing their hands. So it's not health. That's why there's a lot of diarrhea, it's because there's a lot of dirty running water in the streets.
(Soundbite of a creaking door)
Ms. DEBESSA: Hello.
BROWN: Nduthu enters a small tin shack to see Nortvie Magada(ph), whose four-year-old daughter has been suffering from diarrhea, something that can be fatal for children when untreated. Unemployed and unable to afford transportation to hospitals, Nortvie and her husband are grateful for the visits by Nduthu and her colleagues.
Ms. NORTVIE MAGADA: Every day they're coming and look for her. They take her to the hospital. And then every time they came and wash her and put the cream on her.
BROWN: Ndthutu Debessa is one of some 30 women working for just over $100 a month to give basic care and advice to families in an effort to prevent illnesses from becoming deadly. They check to see whether children are immunized, they provide medication and arrange for visits to health clinics and hospitals.
Ms. DEBESSA: Most parents, they don't know what they must do; but especially grandmothers, they stay with the kids, not knowing what's the problem with the kids. But we, as carers, we see the symptoms that maybe the child has got TB or is HIV-positive. Then we help the grandmother to take the kids to the clinic. And then we visit every time to see if there is a progress.
BROWN: Since the U.N. Millennium Development goals were announced in 2000, some of the world's poorest countries have managed to reduce child mortality. South Africa's record, however, is getting worse. In 1990, for every 1,000 children in the population, 60 died before their fifth birthday. That number has now risen to 67, largely because of malnutrition, unsanitary conditions and HIV-AIDS.
Dr. ELBETH HOFFMAN (Health Instructor): And you'll see from the first chapter is that it's completely preventable.
BROWN: Dr. Elbeth Hoffman is holding training sessions for Nduthu and a dozen other women from the DuNoon community.
Dr. HOFFMAN: But even if you're pregnant, even if you're HIV-positive, listen, in future, and even today, women that are HIV-positive can have children and normal lives and families. Okay? But they need a lot of counseling. They need a lot of support...
BROWN: The lay health workers are improving their skills to become more effective, as an early warning system for families requiring treatment and care.
Dr. HOFFMAN: Recently we started workshops with them, where I teach them what it takes to treat a child for HIV or TB or malnutrition, 'cause this is something they lacked. They were not always aware of what it really takes to adequately provide a child with medication. So now, I provide them that information so that when they do visit a home, they might be aware of those things and support the parents better.
BROWN: South Africa's health care system was in the spotlight earlier this year when six newborn babies were found dead in a Johannesburg hospital in one day. A health department investigation revealed the hospital was unhygienic, ill equipped and understaffed. To buttress the beleaguered national health service, care at the local level would have to be scaled up.
Professor DAVID SANDERS (Public Health, University of the Western Cape): That means community health workers in much larger numbers than there are now, and equipped with a broader set of skills than they are now.
BROWN: David Sanders is a pediatrician and professor of Public Health at the University of the Western Cape.
Prof. SANDERS: Most of them now are involved only in HIV and TB care. And that needs to be expanded to include at least child health.
BROWN: There are plans to build new health clinics in South Africa, including in DuNoon. But in the time it will take to build them, more can be done at the local level, where the country's poor continue to wait for better care.
For NPR News, I'm Kyle G. Brown.
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