Fieldnotes: Blogging on UNICEF's child survival work in the field

I'm often saddened by how little the conflict in Iraq shows up in the news these days. It was already fairly underreported, and then the election and financial crisis knocked it even farther off the media radar. The good news is that there actually is less violence in Iraq to report these days. The country has stabilized quite a bit from when I was a reporter there in 2004.

But it's still a very dangerous place. And the daily UNICEF operations briefs I read almost always include some disheartening news from Iraq. (Two recent ones contained subheads Five killed, one injured north of Baghdad and Iraq violence leaves 14 dead.)

© UNICEF/NYHQ2007-2321/Michael Kamber

IRAQ: Children follow American soldiers as they patrol the streets of a neighborhood in the town of Falluja. The levels of violence in the city have fallen dramatically over the course of the year. But critical shortages of medicines and vaccines have left nearly one-third of children in remote areas without basic services. One in five Iraqi children has stunted growth, 1 in 13 is underweight, half are missing routine vaccinations and 1 in 5 girls is not in school.

I sometimes think that one of the reasons we Americans don't want to know too much about the situation in Iraq is that it's just so complicated. There are a lot of different combative groups, and it can feel as though it's sometimes hard to know who are the good guys and who are the bad guys. But for UNICEF, it's simple: kids are always the good guys.

What if you knew a child whose life was in danger?

And what if you knew you had the power to save that child?

Of course, you would do whatever you could.

© UNICEF/NYHQ99-0884/LeMoyne

VIET NAM: A man lifts up his baby son as he stands on their houseboat on a canal in the Mekong Delta in the southern province of Dong Thap.

Around the world, there are more than 25,000 children who are alive today but will not be tomorrow. They will die even though the medicines and technology that could save them readily exist. They will die from utterly preventable causes.

Today, on Universal Children’s Day, I think we should all pause to consider these 25,000 youngsters who will not live to see their fifth birthday. It is a day to mourn their tragic and cruel loss.

But it also a day to stand up and say enough—enough young lives needlessly extinguished, enough unnecessary suffering, enough squandered promise.

I invite you to join me in committing to a future in which the number of children who die from preventable causes is not 25,000 per day—it is zero.

Zero children killed by malaria, diarrhea and tetanus, zero children fatally sickened by unsafe water, zero children wasted by malnutrition. I believe in zero—zero preventable child deaths.

It is a fate difficult to imagine for an adult, much less a child:

As fighting engulfs your community, your family is forced from their home. In the chaos that ensues, you become separated from your loved ones. Around you, people are being assaulted and killed. You run, but you don’t know where to go. You are terrified and alone. Soon, you are hungry. Soon after that, you are sick.

But for many children separated from their families during recent fighting in the Democratic Republic of the Congo (DRC), this is only the beginning of the nightmare.

Reports of forced recruitment of children by armed groups are on the rise throughout the conflict-riddled North Kivu province of the DRC. UNICEF has warned that unaccompanied children are particularly at risk of exploitation. Displaced children are also made vulnerable to other forms of abuse, including rape.

One day last month, twelve-year-old Saliu came to his father, complaining of terrible stomach pains. Saliu's health quickly deteriorated, and his father rushed him to a hospital in Bissau, the capital of Guinea-Bissau, where he was diagnosed with cholera.

Saliu is among many thousands who have fallen ill since cholera broke out in Guinea-Bissau in May. We wrote about it in early September. But, according to Reuters, the disease has still been spreading at a rate of more than 1,000 infections per month. Worst hit are the capital and regions in the west and south.

© UNICEF/UGDA01084/Hyun

UGANDA: A child affected by cholera receives an intravenous drip as his father sits by his bed inside the Cholera Treatment Center of Kitgum Government Hospital in northern Uganda. The center was established with UNICEF support to respond to a cholera outbreak in 2006.

Cholera is a highly contagious water-borne disease that causes acute diarrhea and vomiting. And in severe cases, it can lead to death from dehydration within hours. Cholera spreads where sewage is left untreated and people don't have access to clean drinking water. The prevalence of the disease is considered a key indicator of social development.

An earthquake measuring 6.5 on the Richter scale struck Baluchistan province overnight. Initial reports have the death toll at 150, with hundreds injured.

UNICEF staff in Quetta (the provincial capital) have been dispatched to the worst-affected areas and are coordinating an emergency response, including distribution of supplies such as tents, blankets, food, medicine and water.

Humanitarian response in the first 48 hours of a disaster is perhaps the most critical factor in preventing the deaths of children. If you would like to support UNICEF's relief efforts in emergencies, please click here to make a donation.

We'll share more information as it is available.

For many children around the world, fall means it’s time to go back to school after the long summer holiday. Not so this year in Haiti, which has been pummeled by four back-to-back hurricanes in the past few weeks. Storm winds and floods have destroyed many thousands of homes and businesses, left large parts of the country under several feet of mud, and disrupted the lives of 800,000 people—including 300,000 children.

© UNICEF/ HQ08-0744/Roger LeMoyne

HAITI: A boy walks at dusk across a flooded street in the older part of the flood-damaged city of Gonaives. Several weeks after successive hurricanes and tropical storms hit the country, many of the city’s streets remain covered in water and mud.

In the coastal city of Gonaïves alone, almost 70,000 people have had to leave their homes. Two-year-old Fernando Thermidor and his mom, Judith, were forced to flee when the waters rose, and they’re now living with several thousand others in a school that’s been converted into a temporary shelter.

Though safe from the flooding, Fernando, Judith and the rest of the family are facing other dangers: crammed into a room with almost 200 other people, with no access to clean water or proper sanitation, the risks of contracting diarrhea and water-borne diseases are high. UNICEF is shipping many tons of emergency aid to Haiti, including blankets, hygiene kits, water purification tablets and oral rehydration salts. But with all roads and bridges connecting Gonaïves to the rest of the country washed away, the lifesaving shipments have had to be delivered by boat and helicopter.

This year, it sometimes feels like every day brings news of another natural disaster. I've written a lot about China and Myanmar (where we're still heavily involved in relief efforts), but UNICEF is actually dealing with scores of emergencies all over the globe. One major natural disaster you may not even be aware of—the massive flooding in Nepal and the Bihar state of India.

© UNICEF/HQ07-1067/Rundrajit Das

INDIA: Three boys, displaced by last year's major flooding in Bihar, peer out from under a UNICEF tent at a temporary camp in Madhubani Village.

It all started when heavy monsoon rains swelled the Kosi River in Nepal, causing a damn to break only miles upriver from the Bihar border. Water quickly jumped the embankments, spread like wildfire and went on to flood an area roughly the size of Belgium. In Bihar, water destroyed over a quarter of a million homes. Hundreds of thousands of people have been displaced, and up to 2.7 million have been affected in one way or another. And women and children have been particularly hard hit.

It gets worse. Just last year, Bihar endured terrible flooding. It's a poor area where 70 percent of its population of 90 million relies on the land. A young man named Shankar, interviewed in this New York Times article, had just lost his home and possessions for the third time. And, because he makes a living working off the land, his livelihood is now gone as well.

First Aid Kits
Each UNICEF First Aid Kit contains supplies for mobile health workers to treat two injured children in emergency situations.
Basic Water Kits
Each basic water kit contains buckets, collapsible water containers, soap, and water purification tablets.
Wool Blankets
Your purchase will provide 10 blankets to help keep children warm and protected from the elements.

Having grown up on Long Island, hurricane season always brings back memories of 1985's Hurricane Gloria. I remember watching my parents prepare for the hurricane. They boarded up the windows on our home, filled coolers with clean water, packed up sleeping bags and clothes, and had plenty of books and games to keep the kids busy and distracted.

We all took shelter in the hallway of our home where my sisters and I pretended we were camping. We even convinced our parents to take in a stray kitten we found in the yard after crying about how he wouldn't survive the storm.

The storm passed us, and we were lucky enough to emerge unscathed—well, with the exception of a few scratches from the cat. However, the destruction Gloria left in our adjacent communities was significant. Fortunately, everyone got back on their feet, and New York's Atlantic coast continues to thrive.

Nearly 23 years later, I see the devastation that hurricanes Hanna, Gustav and Ike have recently left in Haiti. The poorest country in the western hemisphere, Haiti is particularly susceptible to storms because of massive deforestation and poor infrastructure.

They need our help in order to get their communities stable. Help us do whatever it takes to save lives. Please do your part and purchase real, lifesaving emergency supplies through UNICEF Inspired Gifts today.

Emergency supplies, such as tents to provide temporary shelter; blankets to keep children warm and dry; first aid kits to help heal wounds; clean water to drink and bathe with, so that waterborne illness doesn't make a bad situation worse; and educational supplies to help kids learn, grow, prosper and feel like kids again.

These are simple, basic items, not unlike the items my parents prepared for my family. They can easily help prevent further loss of life and help restore some degree of normalcy for children, quickly.

Do you remember watching news coverage of the Beslan school siege? September 1 marked the four-year anniversary of that awful day when terrorists stormed Middle School No. 1 in Beslan, North Ossetia of the Russian Federation. They held 1,100 people—schoolchildren and their families—hostage for three days in a packed gymnasium.

The masked terrorists strung bombs above the heads of the children and families, and shot anyone who questioned them. By the siege’s bloody end, 334 hostages (including 186 children) were dead. And young children had seen hundreds of people—mothers, fathers, best friends—killed right in from of them. Just unimaginable.

© UNICEF/ HQ04-0622/Giacomo Pirozzi

A young survivor of the Beslan school siege, Luize, looks at the flowers, bottles of water and soda, and other mementos placed in the ruins of the gymnasium of Middle School No. 1, where hostages were held for almost three days. Luize's mother was wounded during the siege.

I've been thinking about the Beslan siege because of the anniversary, and because of the recent conflict between Russia and Georgia in nearby South Ossetia. UNICEF has helped children and their families who fled the fighting in that region by supporting a number of shelters, including one just 20 miles or so from Beslan.

Something I've heard again and again from UNICEF staff who have spent a lot of time in the field: the truly tough work of emergency response often begins weeks and even months after the immediate emergency is over. This is partly because media attention has dwindled and the donations aren't coming in the way they once were. (Less money means stretched resources.) It's also the case because diseases such as cholera, malaria and dengue fever can get a nasty foothold amongst people who, in the wake of a disaster, find themselves without homes, proper sanitation, adequate nutrition or clean, safe drinking water.

© UNICEF/HQ08-0323/Adam Dean

MYANMAR: A small boy washes his hair with soap in the cyclone-affected township of Kunyangon in the southern Yangon Division.

These days, UNICEF is working harder than ever in Myanmar. Recently, we've been worried about possible outbreaks of dengue fever there. When Cyclone Nargis blasted across the Irrawaddy Delta in early May, it left behind the sort of destruction that makes an attractive breeding ground for the dengue-carrying Aedes mosquito. Stagnant pools of water that collect in debris—scattered pots and pans, tires, bottles, ruined boats, plastic tarps—are like five-star hotels for these mosquitoes.

Dengue fever is a miserable disease. My cousin was unlucky enough to get it when he lived in Thailand. It leaves you with a fever, severe headache, muscle and joint pain, a rash and, in some cases (my cousin's being one of them) hair loss. The extreme version of the disease, dengue hemorrhagic fever, can be fatal. Dengue hits children and the elderly especially hard. There is no vaccine. And bed nets don't help because, unlike malaria mosquitoes which feed at night, dengue mosquitoes prefer to take their meals in the daytime.

© UNICEF/ HQ06-2059/Pablo Bartholomew
INDIA: Sunita cradles her malnourished daughter, who weighed just 2.2 lbs. at birth, in the UNICEF-supported Sick Newborn Care Unit at GB Pant Hospital in Port Blair, capital of the Union Territory of Andaman and Nicobar Islands. The child also has congenital pneumonia. The 12-bed unit, which provides top-tier delivery services and offers the best chance of survival for newborns, is an essential part of UNICEF health interventions on the islands.

We can’t do it without India and China.

That’s one assessment from UNICEF’s first-ever The State of Asia-Pacific’s Children 2008: Child Survival report, which measures regional efforts to improve child and maternal health.

Unless both countries—and India, in particular—make major strides to curb child mortality, global efforts to meet the U.N. Millennium Development Goals will fall short, said the 60-page report released earlier this month.

Among the 9.7 million deaths of children under age five in 2006, more than one-quarter occurred in these two countries alone. India's share was far bigger, with 2.1 million.

Those sobering stats were tempered by these heartening ones: the overall number of child deaths throughout Asia and the Pacific Islands has decreased significantly over the last several decades, dropping from 10.5 million in 1970 to about 4 million in 2006.

It’s been nearly three months since monster storm Cyclone Nargis buffeted Myanmar, but the Southeast Asian nation is still reeling from the blow.

The cyclone affected some 2.4 million people, damaging or demolishing hundreds of thousands of homes and thousands of schools. A recent report (PDF, 665K) released by the UN and the Association of Southeast Asian Nations (ASEAN) detailed the cyclone’s colossal devastation—including the destruction of 75 percent of health facilities in affected areas, and the flooding of 600,000 hectares of farmland—and the continuing hardships facing survivors.

Last week, UNICEF warned that 700,000 children in Myanmar are still in need of assistance.

Recently, I had a great conversation with Shanelle Hall, director of UNICEF's Supply Division. As if I didn't know it already, she really gave me a vivid sense of how many essential, lifesaving supplies UNICEF gets to children all over the globe, every day.

In 2007, for example, we shipped enough educational kits to supply over 12 million children and 100,000 teachers. We procured 3.2 billion doses of vaccine, at a value of $617 million—that's enough for 40 percent of the world's children. But, as massive as these achievements are, we're always thinking about the children we haven't yet reached: children who don't have the tools they need to learn, or who are dying from a disease that 27 cents worth of vaccine could have prevented.

© UNICEF/ HQ05-1695/Josh Estey

INDONESIA: A girl holds a UNICEF school kit bearing outside her new school in Banda Aceh, capital of Aceh Province. The school kit contains workbooks, pencils, pens, crayons, rulers and sharpeners.

You may have gotten an email recently about becoming an online monthly donor. If you aren't on our email list, you can read about it here. Regularly scheduled giving—where you commit to an ongoing monthly, quarterly or yearly donation paid automatically through your credit card—is a godsend to us. It makes it easier to sustain those programs that kids around the world need so badly. Because there are always new babies to vaccinate, and there are always children who want and need to learn.

Scheduled giving also saves us tons of money on fundraising, which means more money going straight to helping kids. And it means we're not sending you regular paper mailings, asking you to renew a pledge (this, of course, has the added bonus of saving trees).

On Friday, the United Nations issued a new appeal for international aid to assist with earthquake recovery efforts in central China. The aid sought will be used across UN agencies, including UNICEF, to support mid to long-term recovery and reconstruction efforts in earthquake-affected areas.

© UNICEF/ HQ08-0627/Adam Dean

UNICEF Water and Environmental Sanitation Specialist Yang Zhenbo is surrounded by students at a primary school in the town of Danjing Shan, Sichuan Province, China. Yang is assessing related needs in the area. UNICEF will provide water-purification equipment at the school, which was damaged during the earthquake. Students are now attending classes in a temporary school on the grounds.

The total appeal amounts to $33.5 million for the period of July to December 2008. UNICEF's portion of this appeal totals $6.7 million—which will fund just the first phase of UNICEF's three-year recovery plan for the region.

UNICEF Ambassador Clay Aiken recently returned from Somalia, where UNICEF provides children in the war-torn nation with health care, education, nutrition, clean water and sanitation. This is the second in a series of blog posts he will write about his experience in the field.

For children in Somalia, the situation is dire. But, it's just amazing to me that UNICEF is still able to make a difference in children’s lives in one of the most dangerous places on earth.

© US Fund for UNICEF / 2008 / Nick Ysenburg

For instance, while I was in northwest Somalia—where 45 percent of the population are children and women—I observed how UNICEF improves water, sanitation and hygiene conditions for everyone in the region. One of the ways they do this is by drilling "borewells" so that clean drinking water is easily accessible and readily available. Without these borewells, children would have to walk hours to fetch water instead of going to school and getting an education.

© UNICEF/HQ08-0563/Win Naing

While the school year is ending here in the U.S., in Myanmar the new school session is, despite all obstacles, getting under way. It's only been a month since the violent hurricane there left as many as 135,000 people dead or missing. And more than 4,000 basic education schools—affecting approximately 1.1 million children—were either damaged or totally destroyed.

But UNICEF believes it's essential to help children get back to school, and we're putting tremendous effort into seeing it happen. As Ramesh Shrestha, UNICEF Representative in Myanmar, recently said, "In any disaster affecting entire communities, the opening of local schools is an important step in the recovery process. Children rely on their daily routines for a sense of security, including the routine of attending school."

We've all been following the devastating news about the earthquake in China. 67,000 people have died and 5 million have been displaced, schools have collapsed and entire villages have been buried by landslides.

Though the earthquake struck three weeks ago, the emergency is still happening. Children and their families are threatened by aftershocks and flooding, and survivors are also facing a second crisis: Many children are terribly traumatized by what happened to them, and those that are living in displaced persons camps or are homeless are vulnerable to the spread of disease. Often, it is the aftermath of a disaster that poses the greatest threat to children's lives.

© UNICEF China

UNICEF staff member Kirsten Di Martino talks with boys who have shown signs of withdrawal due to their traumatic experiences. UNICEF helped organize a psychosocial support mission with the Chinese government to assess the status of children affected by the quake.

The latest statistics from China are now telling us that over 67,000 have died from the devastating May 12 earthquake, about 20,800 people are still missing and an astounding 5 million people have been left homeless. (That's the equivalent of the entire city of Atlanta.)

Huge aftershocks continue to rattle the area, not to mention the population. As a man quoted in this New York Times article described, "Everyone is paralyzed with dread, and each new tremor just prolongs our misery." That ongoing sense of fear can be particularly tough on children. Now, in China, there are so many children whose main places of stability and comfort—home and school—no longer feel safe to them.

© UNICEF/ HQ08-0456/Adam Dean

A boy sleeps on blankets spread on the ground outside a temporary camp at Mianyang Stadium for people displaced by the earthquake, in the city of Mianyang in Sichuan Province. The city is in one of the worst-affected parts of the province.