Investing in the future Editorial
Stabroek News
April 20, 2002

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"I believe the children are our future," diva Whitney Houston sings in one of her famous early songs, reaffirming what most of us already know. Guyana's Ministry of Health is demonstrating its acceptance of this tenet by training health-care workers to manage childhood illnesses and thus reduce the incidence of child deaths.

Health Minister, Dr Leslie Ramsammy, has slammed the child death rate of 300 a year as unacceptable, especially since statistics show that the causes for these deaths are controllable and preventable diseases. And he has doomed the programme to failure if the community and more importantly parents, do not get involved.

The Pan American Health Organisation/World Health Organisation (PAHO/WHO) and the United Nations Children's Fund (UNICEF), partners with the Guyana Ministry of Health in this initiative launched the 'Healthy Children: Goal 2002' programme on 1 December, 1999, with the objective of preventing the deaths of 100,000 children under five years of age in the Americas by this year, through the use of the Integrated Management of Childhood Illness (IMCI) strategy, which was introduced in 1996 as the principal strategy for improving child health. Ramsammy has assured that Guyana's programme will be ongoing.

Among the illnesses that cause death in children under five in Guyana are malnutrition, acute respiratory infections, acute diarrhoeal diseases and HIV and AIDS, all preventable and all, with the exception of HIV and AIDS, curable.

The IMCI strategy involves several interventions which include prevention, early diagnosis and treatment. It also involves the education of parents and community health workers with regard to making the environment healthy for children in order to reduce their risk to illnesses and noticing early warning signs and acting on them, among several other initiatives.

Sensitisation and education are two of the areas that would need to be stressed in Guyana, since local lore promotes the tendency to label many early childhood illnesses "teething problems". Guyanese are not generally known to be a health-seeking people and insufficient access to adequate health care coupled with the bad attitude of some health-care workers, which the minister has been commenting on at different fora, only serve to reinforce the reluctance to visit health centres and hospitals.

Minister Ramsammy placed his finger squarely on the issue when he said that recognising what the problems were and doing something about them would be possible but not easy. And he also rightly noted that if the strategy were properly entrenched, the result would be a significant dent in the mortality and morbidity rates among children under five.

Training health-care workers to spot and manage childhood illnesses is doable, changing their attitudes is a whole different ball game. Key to a short-term solution to this problem would be improved remuneration and working conditions. Stamping out the problem entirely would require the setting of more rigid criteria for entry to nursing and medical training programmes. Anyone who does not have a calling or who does not genuinely love people, should be immediately denied entry. Professional health care is not about prestige and money, it is about compassion and caring, which our children surely deserve.