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Save a child in Africa has almost become a cliche in certain charities' advertising campaigns. In the 1970s and '80s, images of starving Ethiopian kids stared down from billboards and out of news photos. Ethiopia, however, is no longer the land of dying children. NPR's Jason Beaubien reports on one program that helped change things.

JASON BEAUBIEN, BYLINE: This is the Walgo Yar health post in eastern Somali region of Ethiopia. It's a simple cement brick building with just enough room for the health worker to live in one room, have a consultation room in the next. There's no electricity. There's no lights. Despite its simplicity, it's health posts like this one which have allowed Ethiopia to dramatically cut its child mortality rate over the last two decades.

FOOS MUHUMED GUDAAL: (Foreign language spoken)

BEAUBIEN: Foos Muhumed Gudaal is one of 35,000 rural health extension workers in Ethiopia. She's part of an army recruited, trained and deployed by the government to provide barebones health care across the country.

GUDAAL: (Foreign language spoken)

BEAUBIEN: One of the main conditions she deals with is malaria. She describes how she can treat most malaria cases right here in her small clinic. She also sees a lot of kids with diarrhea and respiratory infections. These are conditions that continue to be major killers in many parts of the developing world, and 20 years ago, claimed tens of thousands of lives each here. But they're relatively easy to treat.

UNIDENTIFIED MAN: (Foreign language spoken)

BEAUBIEN: Because there is no electricity at the clinic, Gudaal has to rely on a kerosene-fired refrigerator to keep her vaccines cold. The aging fridge sits in a small shed next to the consultation room.

GUDAAL: (Foreign language spoken)

BEAUBIEN: Gudaal lifts several vaccine vials out of the fridge. She not only administers the immunizations, it's also her job to make sure kids in her village get vaccinated. She keeps records and reminders of who needs what boosters and when. Gudaal's role is a bit like the old image of a small-town pediatrician, but she isn't even a nurse. Instead, Gudaal, along with all the other health extension workers, has gone through a special one-year training program. Her salary also isn't anywhere near that of a pediatrician's. She earns roughly $35 a month.

Since being launched a decade ago, Ethiopia's health extension worker program has had a huge impact in the country. Peter Salama, the head of UNICEF in Ethiopia, says quite simply, it's saved kids lives.

DR. PETER SALAMA: If you're a kid born in 1990, you had one in five chances of not surviving to your fifth birthday. One in five children did not survive to their fifth birthday. Today, they've dropped that mortality by around two-thirds. So a tremendous achievement in the space of two decades.

BEAUBIEN: Ethiopia used to have one of the highest rates of child mortality anywhere in the world.

SALAMA: And if you take something like severe acute malnutrition, what Ethiopia was famous, if you like, in the 1970s and '80s, today, successfully, these same lady health workers treat 300,000 children for severe acute malnutrition successfully who would otherwise almost invariably die.

BEAUBIEN: Every year, it's been...

SALAMA: Every year, 300,000. These children are now treated right across the country at a scale that was previously unheard of around the world.

BEAUBIEN: Salama says, part of the beauty of Ethiopia's health extension workers program is that it is not an international development project. It's run by the government. So as long as there's the political will, the program is sustainable and is able to reach kids across the entire country. Jason Beaubien, NPR News.

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