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Red Cross Works to Keep Children Healthy
Written by Geno Teofilo, American Red Cross International Delegate
Dominican Republic, May 30, 2001 — The child lay dying from pneumonia. Not yet two years old, the boy hardly had a chance. As his small lungs filled with fluid, his breathing became more and more labored. It would soon be over.
His family had resigned themselves to the fact that he would soon be dead. Concerned neighbors kept a vigil outside. They took up a collection to help the family buy a coffin.
Then there was a knock at the door. It was the Red Cross.
Suddenly there was hope — maybe the child would live.
The boy's name is Freyling, and this happened in the town of Segrado Corazon de Jesus, a poor community in the Dominican Republic. That day the Dominican Red Cross was conducting a survey in his neighborhood in preparation for the expansion of an Integrated Management of Childhood Illness program (IMCI), an initiative aimed at saving children, just like Freyling, who were perilously ill from preventable conditions.
Yuderca Mejia is the Red Cross volunteer who met Freyling and his family that day. "He was lying down, an open abscess in his side, the cause of the pneumonia. I knew if we didn't attend to this child, he was going to die."
Mejia immediately contacted Dr. Bayohan Martinez, the National Coordinator for the program. Together, they quickly arranged transport for Freyling and his mother, and brought them to the hospital in the nearby city of Azua, where he received the treatment he needed.
IMCI Health Promoters Dominga Montero and Daranelis Sanchez weigh a child in Azua province. Monitoring a child's weight is a good way to check for dehydration and monitor growth.
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Integrated Management of Childhood Illnesses
IMCI is a global health strategy developed by the World Health Organization and UNICEF to prevent illness, improve recognition of danger signs and increase the quality of treatment provided to children 5 years old or younger. The American Red Cross is implementing IMCI in the Dominican Republic with funding from USAID. Although the program saved Freyling from his deathbed, more lives are saved with IMCI through prevention and early treatment.
"IMCI is the latest child health strategy designed to prevent the five diseases that are responsible for most child deaths. These include acute respiratory infections, diarrhea, malnutrition, fevers from malaria and dengue, and measles," says Melissa Quimby, the American Red Cross Health Delegate for the Dominican Republican who oversees the program. "Most of these conditions are easily prevented, which is why the program focuses on them. For example, how often do you hear of a child in the US dying of diarrhea or malnutrition? In these countries, it happens all too often."
The program depends on the local community for its success. The Dominican Red Cross, with oversight and support from the American Red Cross, trains local health volunteers. These volunteers know everyone in their neighborhoods, and twice weekly visit families with children under five. They keep track of the children's growth and weight, and when they are in the early stages of an illness, take their temperature and look for the danger signs of a more serious condition. For most of these families, a thermometer is an expensive luxury.
Often dehydration caused by the illness, not the actual illness, is what is most life threatening to the child. To combat the dangerous problem, the American Red Cross provides training and materials about outfitting a home for oral rehydration. The volunteers in these homes are trained to rehydrate ill children with donated rehydration solutions that contain electrolytes. The community volunteers are also able to recognize if a child needs immediate medical attention as opposed to home health care, and referrals are made to local clinics for treatment.
Too often, a well-intentioned relief agency creates a health program and rushes in to the developing world with big budgets and great expectations. They buy x-ray machines, ambulances, even provide medicines. Few of these programs last in the long run, for they weren't designed for long term sustainability. In a few years when the aid program ends, everything is turned over to local government. The money soon runs out, for the governments of these poor countries have neither the money nor the personnel to maintain such expensive programs. The ambulances start to break down. The x-ray machine runs out of film. The medicine expires.
IMCI, on the other hand, was designed with sustainability in mind. Since it focuses on prevention and early treatment, it doesn't require expensive equipment.
Says Quimby, "After the initial training and the purchase of some basic materials, [the program] can continue with very few economic resources required." This means sustainability. Knowledge, community involvement and prevention are the backbone of the program — not expensive hospital equipment.
News of the program is spreading throughout the Dominican Republic. More communities continue to sign up for the program. The Red Cross hopes to include every province on the island nation.
Dominican Red Cross volunteers census the community of Cascajal for the new IMCI health initiative.
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The American Red Cross is implementing similar programs with the Red Cross societies and Ministries of Health in Venezuela, Colombia, Ecuador, Peru, Bolivia, Nicaragua, El Salvador, Guatemala, Honduras and Nagorno-Karabagh in the Caucuses region of eastern Europe. Each program will concentrate on the childhood illnesses prevalent in those communities.
And what of Freyling? He's not back to perfect health yet, but he has vastly improved. Now that the program in his neighborhood is fully operational, it is far less likely that children suffering from diarrhea, acute respiratory infections, malaria, measles and malnutrition will become as gravely ill as he was. With local health promoters visiting twice a week, these diseases will be treated much earlier before their condition becomes life threatening.
Quimby sums it up: "If you know how to prevent and treat these diseases early, then you don't have to go to the clinic."
I think little Freyling would agree.
Related links:
Other parts in the Letter from the Americas series:
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All American Red Cross disaster assistance is free, made possible by voluntary donations of time and money from the American people. The Red Cross also supplies nearly half of the nation's lifesaving blood. This, too, is made possible by generous voluntary donations. You can help those affected by this crisis and countless others around the world each year by making a financial gift to the American Red Cross International Response Fund, which will provide immediate relief and long-term support through supplies, technical assistance and other support to help those in need. You can make a secure online credit card donation or call 1-800-HELP NOW (1-800-435-7669) or 1-800-257-7575 (Spanish). Or you may send your donation to your local Red Cross or to the American Red Cross, P.O. Box 37243, Washington, D.C. 20013. To donate blood, please call 1-800-GIVE-LIFE (1-800-448-3543), or contact your local Red Cross to find out about upcoming blood drives.
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