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One Way to Save Millions of Lives from Pneumonia

November 10, 2012

What happens when a young child becomes seriously ill in remote villages around the world?  Often there is no appropriate, proven treatment within easy reach.  Even if families can get to a health worker, that person may not have the proper training or medicines to respond effectively.

That’s what happened not long ago to Sonia, a young mother in rural Bangladesh whose 17-month-old daughter became too sick to sit, eat, or sleep.  She took little Juthi to a local pharmacy where an untrained “doctor” examined the little girl and prescribed cough syrup, vitamins and a drug for fever.  But within two days, baby Juthi’s fever was back and Sonia became very concerned.

That may be why she decided to listen, although skeptically, when Afia Afroze, a young community health volunteer came by her house on her regular village rounds.  Sonia later confided that she had little faith that this neighbor would be of any help. 

With proper training, supplies and support, more local people like the “village woman” Afia can effectively treat childhood diseases in their own communities.

Afia took out a timer and watched the rise and fall of baby Juthi’s chest as she counted her breaths. Her breathing was too fast. It was pneumonia her daughter was suffering from, Afia told Sonia.

“To be honest, I did not believe her.  I did not trust her knowledge,” Sonia said later. “I thought, how much can a village woman like her know about such difficult health issues?  I told her she might be wrong since I visited a doctor and he did not say the baby had pneumonia.”

But Afia was right, and after Sonia was convinced to at least try the antibiotic she prescribed, the baby’s recovery was dramatic and fast.  Thanks to Afia’s training in community case management (CCM) of childhood disease and the proper follow-up treatment instructions she gave, baby Juthi slept well that very night and soon was back to full health.

Monday, November 12 is World Pneumonia Day, which seeks to bring awareness to the largest killer of children around the world.  It is also the day my co-editors from Boston University, the World Health Organization and Stockholm’s Karolinska Institute and I, of Save the Children, will unveil a special supplement to the American Journal of Tropical Medicine and Hygiene devoted to 21 research articles on CCM at the Society’s annual meeting in Atlanta.

This is the first such collection to focus exclusively on the impact, effects, and challenges of CCM – while offering guidance on how to effectively implement it.  We believe that expanding this approach has the potential to reduce child deaths quickly.  In fact, one Ghana-based study in the supplement showed a 44 percent reduction of child deaths in just over two years.

That means with proper training, supplies and support, many more local people like the “village woman” Afia can serve as frontline health workers and effectively treat childhood diseases in their own communities.  Currently, three diseases—pneumonia, diarrhea and malaria—needlessly kill an estimated 2.8 million children a year, almost all of them in developing countries.

It also means the world could get much closer to the 2015 Millennium Development Goal for reducing child deaths faster than most people think is possible.  We urge all those involved in global health to accelerate investment in community case management.  It’s not too late to save millions.

David Marsh, Senior Advisor for Child Survival at Save the Children, wrote this blog on behalf of the global Community Case Management Operations Research Group, which includes Davidson Hamer of Boston University, Franco Pagnoni of the World Health Organization and Stefan Peterson of the Karolinska Institute. The journal supplement they edited is available here.

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