Critical threshold

There is good news. Under-age-5 child death rates or “U5MR” were halved between 1990 and 2011. Two decades back 59 kids, out of every thousand births, never made it to age 5.

Despite progress in U5MR, we will flub Millennium Development Goal No. 4. That’s the bad news. We’re committed to cut child mortality by two-thirds come 2015. We’ll flunk, predicts the National Economic and Development Authority.

“For every 1,000 children born in the Philippines in 2011, only 25 under five years of age died,” reports the mid-September study, “Committing to Child Survival: A Promise Renewed,” of the Unicef. “This is a 55-percent drop” from the U5MR levels in 1990.

Globally, U5MR slumped from 12 million in 1990 to 6.9 million last year, the UN Inter-agency Group for Child Mortality Estimation also reports. “About 14,000 fewer children die each day (compared to) two decades ago,” Unicef’s Angela Travis underscores. “Still, almost 19,000 children under five die every day.”

All regions and diverse countries cut their U5MR. That sweeps in affluent Oman, middle-income Brazil and impoverished Bangladesh—which posted a remarkable two-thirds cut in under-5 deaths. Almost half of global under-5 deaths were lumped in India, Nigeria, Congo, Pakistan and China.

Unicef’s latest global survey of 169 nations pegs the Philippines into Slot 83. In last year’s study, we landed in Slot 80 among 193 nations. That shoved us almost on a par with Dominican Republic but behind Malaysia. Is that good enough?

“Our death is not an end if we live on in our children. For they are us,” physicist Albert Einstein wrote. “Our bodies are only wilted leaves on the tree of life.”

This time around, two Asian countries—Japan and Singapore—landed among the world’s top 10 in slashing infant deaths. They ranked alongside Sweden and Norway.

Among Southeast Asian countries, the Philippines’ U5MR was sixth in the study. Malaysia and Brunei, tied for 7th place. Thailand came in 12th and Vietnam, 22nd. Those who posted higher U5MR were: Burma (Myanmar), 47th, Timor-Leste, 51st; Cambodia, 62nd; Laos and Indonesia, 71st.

Odds are stacked against kids born in this country’s penury cesspools. A child delivered in the Autonomous Region in Muslim Mindanao, for example, is four times less likely to reach fifth birthday than a child born in Metro Manila.

Preventable ailments, like pneumonia and diarrhea, are main infant killers. These two ailments strike down almost 30 percent of infants worldwide. Other killers include: complications and infections a month after birth—the critical “neonatal period.”

Babies born preterm—before the 37th week of pregnancy—are specially vulnerable. “The shorter the term of pregnancy, the greater the risks of death.” Almost a third of infant deaths stem from this one cluster.

“Across the human life span, an individual faces greatest risk of mortality during birth and the first 28 days of life.” About half of Filipino children’s deaths occur within this narrow deadly window. Most of these deaths occur at home. Unrecorded, they remain invisible to all but their grieving families.

Almost 90 percent of all child deaths are attributable to six conditions: neonatal causes, pneumonia, diarrhea, malaria, measles and HIV/AIDS, the World Health Organization notes. These are preventable.

Providing clean potable water alone drastically increases chances for child survival. Yet, large majorities, in the ARMM provinces, quaff from easily contaminated wells. These include Tawi-Tawi (94 percent), Sulu (72 percent), Lanao del Sur (69 percent), Basilan (66 percent) and Maguindanao (46 percent).

“There is unfinished business,” writes Unicef executive director Anthony Lake. “Millions of children under five are still dying each year from largely preventable causes. (There are) proven, affordable interventions. These lives could be saved with vaccines, adequate nutrition and basic medical and maternal care. The world has the technology and know-how to do so. The challenge is to make these available to every child.”

“In the Philippines, we now need to focus our energies on the neonatal period,” suggests Unicef Philippines representative Tomoo Hozumi. “This is when 45 percent of the under five deaths occur. We need to ensure these young babies, many of them born too soon, don’t die before they’ve barely had a chance to live.”

Among other things, that calls for greater prioritization—and investment—are adequate sanitation, nutrition, vaccination, prenatal services, etc. These ratchet up prospects for child survival and development.

“The first two years of life are a window of opportunity when nutrition programs have an enormous impact on a child’s development, with life-long benefits,” the International Food Policy Research Institute points out. After age three, the economic benefits dwindle to near zero.

Protein energy malnutrition sends more preschool children to premature graves here, than in Bangladesh, India or Pakistan, the World Bank and Asian Development Bank confirm in their joint report “Early Childhood Development.” Lack of micronutrients saps intelligence quotients. IQs of ill-fed kids can be whittled down by 10 to 14 percent, an ADB study says. This loss is irreversible. “Their elevators will never go to the top floor.” That’s layman’s lingo for permanently impaired lives.

In the 2012 national budget, Malacañang and Congress tacked P200 million in pork to Vice President Jejomar Binay’s office budget of P481.79 million. A government that can underwrite a 260-percent hike for an official can do no less for its kids.

After all, “life is the threshold at which all other hopes begin.”

* * *

E-mail: [email protected]