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House foreign aid cuts could hurt children

Global health advocates worry deep cuts to development funding in the US House of Representatives' State and Foreign Operations appropriations bill could hamper efforts to lower child mortality rates.
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A Sudanese mother holds her 12 day-old baby on her lap as a nurse feeds him medicine to fight diarrhea and dehydration 16 September 2004 at a Save the Children/US Aid Clinic in the Internally Displaced Persons camp of Krinding on the outskirts of the western town of El-Geneina. (Cris Bouroncle/AFP/Getty Images)

Budget bills from both Senate and House appropriations committees leave important child-centric initiatives like immunization and anti-malaria programs relatively untouched, signaling strong bipartisan support for global child survival. In more indirect ways, though, global health advocates argue, the House's budget bill takes a dig at child health.

Most of the money for US global health programs comes from the State and Foreign Operations budget, which also funds anti-poverty initiatives. Overall, the House cut foreign aid by $8 million, while the Senate cut it by $2.7 million.

Moving forward, the bills, which got committee approval last week, will go to the House and Senate floors so the general assembly can weigh in. Then the two houses will have to reconcile differences before the end of the fiscal year Sept. 30 — or risk government shutdown.

Both Senate and House verisons of the the State and Foreign Operations budget keep funding at or above FY 2012 levels for maternal and child health, which includes immunization programs. The House met the President’s request for $680 million — a $74 million bump over FY 2012 — and the Senate set aside $706 million. For malaria, which is a leading cause of death for children in the developing world, the House kept spending level at $250 million and the Senate threw in an extra $17 million. Both bills met or exceeded the White House’s recommendations for nutrition and vulnerable children.

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Opinion: Take the poison out of India's food

In the aftermath of the school lunch poisoning in Bihar, India, which resulted in the deaths of 23 children, two Indian doctors make an argument for organic farming.
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Indian schoolchildren recovering from food poisoning receive medical treatment at the Patna Medical College and Hospital in Patna on July 20, 2013. (Stringer/AFP/Getty Images)

NEW DELHI, India — On July 16, school children in Dharamsati village, 50 miles north of Patna, Bihar were served food laden with the organophosphate pesticide, monocrotophos — a deadly poison that is used in agriculture to save crops from pests. Within three days, the death toll reached 23; many more were critically ill. Even those who survived the effects of acute poisoning may still face permanent damage of tissues and organs.

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A picture of health in Zambia for children under five

Health correspondent Marissa Miley reflects on the country’s recent pneumococcal vaccine rollout.
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Vaccines, including some to protect against pneumococcal disease, at the Shimukunami health clinic in Lufwanyama, Zambia (Marissa Miley/GlobalPost)

BOSTON — It’s been several days since I returned from Zambia. The jetlag has eased its grip and I can sleep past six o’clock in the morning. As I prepare to write about what I saw and heard for our Special Report on child mortality, “The Seven Million,” I’ve been poring over the photographs I took throughout my trip to invigorate my reporting.

As I look through the nearly 1,000 photos I snapped, their thumbnails dotting one scrollable window on my computer, I’m struck by the still images of Zambia’s health system: dusty benches outside a health clinic in the rural northern district of Lufwanyama; tall brick and iron fences bordering a private health facility in a suburb of Lusaka; two pediatric pharmacies housed at the nation’s premier hospital, University Teaching Hospital – one for those who can afford the 750 Kwacha (around $140) “high cost” fee that makes them eligible for expedited services and more plush accommodations, and the other for those who cannot.

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The royal baby and the twins of Panna

As the world focused its lens on the future King of England, GlobalPost Fellow Harman Boparai focused his on the twin girls born in India's Panna District, which has one of the nation's highest child mortality rates.
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(Emily Judem/GlobalPost)

Editor's Note: This is the third in a series of posts about child health in India, where, in 2011, 1.7 million children under the age of 5 died. Health reporting fellow Harman Boparai travels to India, where he once practiced as a physician, to take a deeper look at child health in his home country. "A Doctor's Notes" is part of a GlobalPost Special Report titled "The Seven Million," about the many challenges faced worldwide in an effort to reduce child mortality.

 

PANNA, India — Pooja 1 and Pooja 2, twin girls named after their mother, lay side by side on a green cloth in the special newborn care unit.

The monitors beeped in the background as another baby cried in an incubator. Their bodies pale and shrunken and their eyes hardly open, the twins had thin cannulas up their nose to give them oxygen and intravenous lines fixed to their feet.

They both weighed about 1 kilogram each, severely underweight, and at risk of many life-threatening complications. Their breaths came fast and in grunts, and Pooja 1 seemed to have a harder time, but other than that they looked identical.

“Their chances of survival are fifty-fifty,” said Dr. LK Tiwari, the only pediatrician at District Hospital in Panna, as he flicked the feet of Pooja 2 to test her muscle reflex.

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On the trail of two very different parasites in Uganda

International donors yanked 90 percent of Uganda's aid money for the 2013-2014 fiscal year. How will this affect the battle against Malaria, the country's leading cause of death? GlobalPost correspondent Sasha Chavkin heads to Uganda to investigate.
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Kagutu Ocam, two and half years old, suffers from malaria. He is being cared by sister Nakawooya Margaret, 14, in the malaria ward at Kiboga Hospital, Kiboga District, Uganda. (Walter Astrada/AFP/Getty Images)

NEW YORK — Tonight I’m flying to Uganda for GlobalPost’s Special Report on child mortality, The Seven Million. I’ll be examining the heavy toll taken on Ugandan children’s health by two pernicious, but very different, sorts of parasites.

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Location matters for child health in India

In the bleakest days of India's fight against child death, the country lost more than 3 million children every year. Now the problem, at least in urban centers in Punjab, is fast becoming that of childhood obesity.
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(Emily Judem/GlobalPost)
AMRITSAR, India — In the bleakest days of India's fight against child death, the country lost more than 3 million children every year. Malnutrition and stunting were rampant, with a majority of the children underweight and exposed to illnesses. Now the problem, at least in urban centers in Punjab, is fast becoming that of childhood obesity.
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Filling the medical treatment gap in rural Zambia

On the road in Lufwanyama, Zambia, locals volunteer five to eight hours a day to get health care to children living in hard-to-reach areas.
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Elina Makopo, left, with her son, Give, visits with community health worker Elizabeth Kafumo at the Kamupundu Primary Health Care Unit in Lufwanyama, Zambia. (Marissa Miley/GlobalPost)

Editor's Note: This post is part of a GlobalPost Special Report titled "The Seven Million," about the many challenges faced worldwide in an effort to reduce child mortality. As part of this project, GlobalPost health correspondent Marissa Miley is reporting on pneumonia in Zambia.

 

KITWE, Zambia — In this mining city in the country’s northern Copperbelt region, a can of multi-insect killer sits on my desk, a container of insect repellant lies on my bathroom counter, and a mosquito net shrouds my bed – all practical complements of the small hotel I’m staying at. Even though I’m on prophylactic antimalarial medicine and it’s not peak mosquito season – it’s winter here – with malaria so prevalent in the area, it feels like no preventative measure can be too great.

Over the past few days, concern about malaria, a disease spread by just one bite of a parasite-carrying mosquito, has come up repeatedly in conversations at the health centers I’ve been visiting in this area of the country. I worry about malaria, the mothers bringing their children for check-ups say. We’re testing for malaria, the health workers say. If a child has a fever, it seems, the community’s thoughts immediately turn to the infectious disease.

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India's economy is booming, but its children are dying

In Part One of GlobalPost's continuing series, "A Doctor's Notes," reporting fellow Harman Boparai travels home to India, where he once practiced as a physician, to take us inside the country's child mortality problem.

 

Editor's Note: This is the first in a series of posts about child health in India, where, in 2011, 1.7 million children under the age of 5 died. Health reporting fellow Harman Boparai travels to India, where he once practiced as a physician, to take a deeper look at child health in his home country. "A Doctor's Notes" is part of a GlobalPost Special Report titled "The Seven Million," about the many challenges faced worldwide in an effort to reduce child mortality.

BOSTON — On the second day of clinical rotations during my medical training in India in 2008, I found myself in the pediatric intensive care unit. Four-month old Dhruv lay in his bed fighting for his life with severe pneumonia. His breaths came fast and in grunts, as his rib muscles stretched in gasps from the effort. He had been brought from a nearby village and needed emergency care. We started intravenous antibiotics, but with the only two mechanical ventilators at the hospital already in use, I had to put a hand-held self-inflating bag on his face to help him breathe. He opened his eyes a few times and closed them, but after a while he seemed to breathe easier.

I went home late that night after handing over his care, and when I returned the next morning I found that the pneumonia had taken Dhruv. But was it really the pneumonia? Or was it the fact that his parents, both migrant laborers, were uneducated, poor and could not afford to bring him to the city hospital in time? Or maybe the fact that we had only two ventilators, both unavailable? And this was Punjab, one of the more affluent states in India.

Despite being hailed as an economic miracle, India’s rapid growth has failed to bring about corresponding gains in controlling child mortality. India still accounts for one-fourth of the world’s child mortality. Of the 27 million children born in India each year, nearly 2 million never make it to their fifth birthdays.

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Jenny McCarthy's hiring on 'The View' raises public health concerns

Critics worry Jenny McCarthy will use her new position as a host for ABC's "The View" to promote her widely discredited belief that vaccines cause autism.
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Actress Jenny McCarthy arrives at the 2013 Billboard Music Awards at the MGM Grand Garden Arena on May 19, 2013 in Las Vegas, Nevada. (David Becker/AFP/Getty Images)

After ABC announced plans this week to hire vocal anti-vaccine proponent Jenny McCarthy as a host on "The View," critics roasted the network for providing her a megaphone to spread misconceptions that are killing children.

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Civil war is killing children in the Central African Republic — but it's not doing it with bullets

Experts weigh in on the short- and long-term ways war negatively impacts child health.
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A girl pauses in a camp for internally displaced peoples in Kabo in the northern Central African Republic. (Spencer Platt/AFP/Getty Images)

Getting health care has never been simple in the Central African Republic, where there’s a 16 percent chance a baby won’t make it past his or her fifth birthday and life expectancy tops out at age 50. But as violence has escalated in the wake of a coup in March, workers have fled government health clinics and many of the humanitarian organizations that have been propping up the country’s medical system have withdrawn from the country or cut back services.

At the same time, people who were forced from their homes by marauders are living in fields, where food is hard to come by and mosquitoes are plentiful. Malnutrition is rife, according to a new report from Médecins Sans Frontières. Cases of malaria, a leading cause of death, are climbing at an alarming rate.

Children have been hardest hit, said Ellen van der Velden, who heads up MSF’s head of mission in the Central African Republic. But that’s not surprising — research shows children who grow up in war-torn countries are more likely to be malnourished and more susceptible to disease. Eight of the 10 countries with the world’s highest child mortality rates are engaged in conflict. The Central African Republic ranks number six.

“For children, the biggest casualties of war are not caused by bullets,” said Philip Verwimp, an associate professor of development economics at the Université Libre de Bruxelles in Belgium. “Children are far more likely to die from malnutrition, exposure to infectious disease or lack of access to health care.”

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