By The Rev. Marcia Tremmel

Not long ago, I had an interesting conversation with a nurse who works in the mother-baby unit at one of our local hospitals.

One of her comments has remained with me. She said, “We don’t get very many ‘bad’ babies here.”

When I asked what she meant, she explained, “Most of our moms are in their late 20s or early 30s and have had superb prenatal care. They come in, give birth to a healthy eight-or-so-pounder, rest up for a day or two and take the beautiful new baby home to the beginning of a great life.”

How unlike this scenario is the arrival of a new baby in most of the countries of the world, particularly those countries we call “Third World” or “developing.” According to the U.N., almost half of births in developing countries take place without the help of a skilled birth attendant, not even a midwife, let alone a physician.

We learn from the U.N. that currently almost 40 percent of deaths of children under 5 occur in the first month of life. These deaths are closely related to the health of the mother and to the care provided to her at delivery.

The most common cause of death is malnutrition of the mother and fetus, leading to low birth-weight babies. This is compounded by poor care during pregnancy and lack of skilled attendants at birth, including doctors, nurses or midwives.

Most mothers in the United States and Europe can reasonably expect that their pregnancies will result in healthy children, but mothers in developing countries might have eight, 10 or even more pregnancies and might end up with two or three children.

The routine doctor visits for prenatal care that we think of as “normal” are unheard of in these countries. Should a new baby in, for example, sub-Saharan Africa be lucky enough to survive early infancy, the next challenge is to survive to age 5 without succumbing to any of a variety of diseases we think of as conquered or from simply not getting enough to eat.

Every year, six million children die from malnutrition before their 5th birthday. Every year, two million children die as a result of dirty water or improper sanitation facilities.

The fourth Millenium Development Goal — to reduce by two-thirds, by 2015, the under-5 mortality rate — addresses the health problems that face children from infancy to 5 years old. Here are some additional painful statistics:

• Close to 11 million children under the age of 5 died in 2003. Most of these children (98 percent) lived in developing countries. Levels of under-5 mortality vary widely across countries — from three to more than 280 deaths per 1,000 live births. That higher figure means that over a quarter of children (28 percent) die before their fifth birthday.
• Forty-three countries in the developing regions account for 90 percent of the world’s deaths in children under 5.
• Regional averages of under-5 mortality in 2003 varied from a low of seven per 1,000 live births in developed countries to a high of 172 per 1,000 live births in sub-Saharan Africa.
• Five diseases — pneumonia, diarrhea, malaria, measles and AIDS — account for about 50 percent of under-5 deaths.
• Most of these lives could be saved by expanding coverage of existing interventions, especially among poor families. Malnutrition increases the risk of dying from these diseases and contributes to more than half of all child deaths.

Goal No. 4 is inextricably linked to Goal No. 3 — promote gender equality and empower women. Women who are educated know how to read and are unafraid to insist on appropriate care for themselves and their children can play a large part in attaining a substantial reduction in infant and early childhood deaths.

It is also tied to Goal No. 5 — improve maternal health. Healthy mothers have a better chance of having healthy babies and raising healthy children.

How are we doing? Better in some places, worse in others. Only 20 percent of developing countries are on track to reduce child mortality, but rates of progress in others are accelerating. In parts of Africa and Latin America, children’s nutrition is worsening, and no progress is being made on child and maternal mortality.

Recently, the British government’s chief treasury official, Gordon Brown, said progress is being made too slowly. “Sub-Saharan Africa will achieve our target for reducing child mortality not by 2015 but by 2165,” he said. “This is not good enough.”

So, what can we do to achieve this goal on time, not 50 years and millions of children’s lives too late? First, pray. Each day, in your prayers, stand in the breach for the millions of innocent children lost to preventable diseases and malnutrition.

Second, learn. The web sites listed at the end of this article are just two that provide many more links to information, ideas and suggestions for ways to help.

Third, give just 0.7 percent of your income to an agency that works to prevent disease and malnutrition in developing countries. Investment in education and health are means to growth as well as ends in themselves.

These children who are dying by the thousands every day are created and loved by our Lord. Let us worship and honor Him by working to give them the full and productive lives God intends them to have.

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