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Pneumonia: The Killer No One Suspects

Shiloh

Editor, Senior Moderator
Source: http://www.nytimes.com/2009/05/10/opinion/10kristof.html?ref=opinion

Op-Ed Columnist
The Killer No One Suspects

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By NICHOLAS D. KRISTOF
Published: May 9, 2009

On this Mother?s Day, let?s not only reach for flowers and dinners but also think of how we might make motherhood itself a bit happier.
One answer would be to confront the disease that kills more children than any other around the world. Quick, what do you think that might be? Hint: It?s not diarrheal disease (the No. 2 killer), malaria, measles or AIDS.

A further hint: It was threatening to kill an 18-month-old boy, Ousseynou Thiam, in a hospital in Dakar, Senegal. He lay on his back, his chest heaving, struggling frantically for breath, as his mother, Khady Thiam, hovered over him, her eyes ablaze with fear.

?He?s very seriously ill, for he?s not getting oxygen,? said the doctor, Boubacar Camara. ?It?s too soon to tell what will happen. He may live. Or he may die.?

I?m taking a University of South Carolina sophomore, Paul Bowers, with me on my third ?win-a-trip? journey through Africa, and watching a child at the edge of death marked a somber first leg of our trip. But traveling with a student gives me an excuse to step back and focus on immense challenges that we in journalism neglect because they?re not new enough to be ?news.?

One of these is pneumonia, the ailment that was threatening to destroy not only Khady?s Mother?s Day but also her child?s chance of living even one more day. Pneumonia gets very little attention from donors or the public health community, yet it kills more than two million children a year, according to Unicef and the World Health Organization.

To put it another way, if you spend five minutes reading this column, at least 19 kids will die of pneumonia in that time. That?s more than will die of AIDS, malaria and measles combined.

Yet pneumonia goes ignored. It is the orphan of global health, attracting negligible investment.

To their great credit, advocates working against AIDS and malaria have goaded Western governments into spending significant sums on prevention and treatment. The result is that an AIDS diagnosis is no longer an immediate death sentence, and malaria infection rates are tumbling in some countries.

Meanwhile, pneumonia keeps on killing, while barely registering on the public consciousness. On Friday, the biggest pneumonia-related cause on Facebook (PS ? Pneumonia Sucks) had 785 members ? while the top five health-related causes had a combined 14.1 million.

But pneumonia is finally beginning to get traction. Last month, a group of health advocates including Save the Children announced that the first World Pneumonia Day will be Nov. 2, backed by an informative new Web site, worldpneumoniaday.org. At the same time, Hedge Funds vs. Malaria, an advocacy and fund-raising group, changed its name to Hedge Funds vs. Malaria and Pneumonia.


This incipient campaign against pneumonia could make a huge difference in Africa and Asia, because this is a cheap and simple way to save children?s lives.

On the second stop of our win-a-trip journey, Paul and I visited the impoverished former Portuguese colony of Guinea-Bissau, farther down the coast of West Africa. A 2-year-old boy named Paulino Biague arrived half-dead in the National Hospital suffering from convulsions; he turned out to have both malaria and pneumonia.

?If he hadn?t come in, he would have died,? said the doctor, Alfredo Manuel Biague. ?And if he lived in a village in the countryside, he would have died.?

The hospital in Guinea-Bissau is dark and bleak, with women in labor crowded two to a bed, with electricity periodically failing and plunging the buildings into darkness. Yet doctors were able to put Paulino on anti-malarials and antibiotics immediately, and within a day he was out of danger.

A course of antibiotics used to treat pneumonia can cost only 27 cents.

Many Americans doubt whether foreign aid is effective, and it?s true that helping people is harder than it looks. Yet health programs have a particularly strong record (as do education and business-related initiatives like microfinance). One result of health campaigns is that the number of children dying by their fifth birthday has been cut in half since 1960, from 20 million annually to less than 10 million.

Children with AIDS and malaria already have advocates, so anyone looking for a cause should grab pneumonia and run with it. Think of it not as a grim and depressing initiative, but as potentially a happy turnaround opportunity, for these kids? lives can be so breathtakingly easy to save.

In Dakar, doctors put an oxygen mask on little Ousseynou, to help him breathe, and gave him antibiotics. Already, doctors tell me via e-mail that he?s much improved and will almost certainly pull through ? making this the most joyous Mother?s Day imaginable for Khady.

?

I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.



Source: http://kristof.blogs.nytimes.com/2009/05/09/your-comments-on-my-pneumonia-column/

May 9, 2009, 10:05 pm
Your comments on my pneumonia column
By Nicholas Kristof

My Mother?s Day Column is about a disease that perhaps causes more grief to more mothers than any other ? pneumonia. And I should say right off the bat that I seek pardon from my wife for not being there with flowers today, although I know that she believes at least as much as I do that the best way to celebrate Mothers Day is to try to improve the lot of mothers worldwide ? which means keeping their children alive.

It?s quite extraordinary that pneumonia doesn?t get more attention, considering the number of children it kills. And the 2 million deaths per year figure I quote may be a significant understatement, partly because it excludes all deaths before four weeks of age. Unicef believes that if you include those neo-natal deaths from pneumonia, the figure may come close to 3 million.

I?m writing this partly because I?ve seen the way malaria was discovered about five years ago by the public in a way that led to far more resources for it. The impact on malaria of becoming a high-profile disease has been extraordinary, most notably far fewer kids dying from it. One of the factors that helped with malaria is that it was easy to slice and dice, for donors could give individual nets, at about $10 each. The nets are tangible and real and have a measurable impact. In contrast, support for fighting pneumonia is more difficult to divide up like that, but smart people should be able to figure out similar ways of asking for and apportioning tangible contributions. Half the battle in raising money is figuring out clever ways of giving credit, and if universities can sell naming rights to the same building 10 times over, there should be equally creative ways to encourage people to support a cause like pneumonia.

I?d welcome your comments, particularly from anyone who can offer specific suggestions about what readers can do to help, and from those in the field who deal with pneumonia. And do check out the World Pneumonia Day site.
 
Re: Pneumonia: The Killer No One Suspects

Source: http://www.nytimes.com/2009/05/17/opinion/l17kristof.html?ref=opinion

Letter
Fighting Pneumonia

Published: May 16, 2009

To the Editor:
Re ?The Killer No One Suspects? (column, May 10):

Nicholas D. Kristof is right to point out that pneumonia is the leading cause of death for children around the world. When the Women?s Refugee Commission researched the adverse effects of firewood collection by refugee women and girls, we found that in addition to rape and environmental degradation, acute respiratory infections caused by burning wood indoors were a huge problem. These infections, left untreated, often lead to pneumonia and other infections.

We are working with an international network of humanitarian agencies, inventors, technical experts and donors to develop stoves and fuels, like solar cookers and mud-brick stoves that conserve fuel, for use in humanitarian settings worldwide, including both conflicts and natural disasters. We are also promoting use of existing technologies, like alternative fuels (ethanol, kerosene, liquid propane gas) where appropriate.

Alternatives to cooking with wood could be used in developing countries worldwide to lessen this avoidable scourge.

Carolyn Makinson
Executive Director
Women?s Refugee Commission
 
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