RUTONDE/KIGALI, Rwanda (June 11, 2012) — With heavy breathing, fever and no appetite, 8-month-old Elie arrived at the Rutonde health clinic in rural Rwanda. There, he was diagnosed with pneumonia.
According to a new UNICEF report, pneumonia and diarrhea kill more than a million African children a year, a number that could be greatly reduced if the poorest children had access to vaccines as well as earlier and better treatment for these preventable diseases.
Now, after 24 hours on a drip, along with a course of antibiotics, Elie is on the road to recovery. His mother, Isimbi Xavaeie, who came on the advice of a community health worker, is relieved she does not need to take him to the district hospital. But she is anxious about the other son she has left at home.
Fortunately, fewer Rwandan children are ending up at the health center in need of the intensive treatment Elie received. With the pneumococcal conjugate vaccine, children are now better protected against pneumonia, meningitis and sepsis.
In 2009, Rwanda, with financing from the Global Vaccine Initiative and support from development partners, became one of the first countries in sub-Saharan Africa to introduce this new vaccine as part of an ambitious national plan to reduce child mortality.
In the past 20 years, Rwanda has built a formidable primary health care system that has reduced child mortality by almost half. According to the government’s figures, released in February 2012, under-five mortality has fallen from 152 deaths per 1,000 live births to 76 in 2010. Not only is Rwanda set to meet the Millennium Development Goal on reducing child mortality, but it may exceed it.
The success can, in part, be attributed to the country's ambitious roll-out of ten vaccines as part of its routine immunization services. These include the new rotavirus vaccine, which protects against diarrhea—a disease that accounts for about 1/5 of all childhood deaths in Rwanda. Launched by the Rwanda Ministry of Health just a week earlier, the rotavirus vaccine is now being rolled out across the country.
“The introduction of the new vaccines, as well as the emphasis on strengthening the whole health system, as well as working intimately at the local level through the community health care centers, village committees and through district hospitals, has been a magic recipe for child survival,” explained UNICEF Representative in Rwanda Noala Skinner.
Bonheur Ukakjusuve, director at Rutonde Primary Health Centre, is proud of her country’s success in public health. “We now have more time to focus on investing in prevention and working with the community health workers to make sure they can more easily identify and treat the symptoms of these types of illnesses,” she said.
Across the country, there are 60,000 community health workers, four for each of the country’s 15,000 villages, all trained and equipped to deliver basic health care to the remotest homes and poorest families.
Monique Laminba has made the hour-long walk from her village to restock her supplies of basic medicines. She was elected six years ago by her village to serve as community health worker; she is now available 24 hours to help her neighbors when they are sick.
Moise, just two years old, has been sick with diarrhea. His mother came to see Laminba about his condition and now, a day later, she is making a house call to see if he is feeling better. She carefully mixes a packet of oral rehydration salts (ORS) with safe water and gets him to take slow sips. She also gives Moise’s mother zinc tablets to administer to Moise over the coming week. Zinc and ORS quickly rehydrate children and help them recover.
Laminba knows she and other health workers are having an impact. “We very rarely see a child now die in their home,” she said.
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