This conflict has undermined children's chances of survival both directly,
causing many to be placed in the line of fire, and indirectly - compromising the
provision of basic services that are essential to good health in children.
As a result, West Africa faces a particular challenge when it comes to
meeting the fourth United Nations Millennium Development Goal (MDG):
reducing child mortality by two thirds, by 2015. (Mortality rates are
typically measured according to the number of children who die in countries
before the age of five.)
Alvin Winford of the Liberian branch of the African Network for the
Prevention and Protection Against Child Abuse and Neglect (a group headquartered
in the Kenyan capital, Nairobi) believes strides could be made towards reducing
child mortality in his country if disease was tackled. In an interview with
ystein Meland, he said the issue of teenage pregnancies also deserved
AW: Most West African states have a high rate of child mortality due to
social, economic and political developments. Most of these deaths are the direct
result of pneumonia, diarrhoea, measles, malaria and malnutrition, which can be
prevented if the political will is cultivated - and backed by allocation of the
requisite resources of national governments.
In Liberia, there is an increasing number of teenage pregnancies. Lots of
girls who have not reached the age of 18 are bearing children. With no proper
care for themselves as well as their babies, some of their children die during
childbirth, while others die before reaching age five due to the lack of good
Some of these girls are just too young to have babies most of them being
single parents, with no skills for earning a living, lack the basic necessities
of life for taking care of themselves and their babies.
OM: What role does diet play in reducing child mortality rates?
AW: The high level of many people living below the poverty line is increasing
child mortality. Living on less than one (U.S.) dollar a day, most pregnant
women can hardly have a proper diet. The fortunate ones can afford one meal per
day. This poor nutrition during pregnancy and during the childs early life
leads to death. It also reduces the flow of breast milk.
OM: Could you give us an insight into the state of health facilities in your
country at present, now that it has been at peace for almost three years?
AW: Most people in rural areas do not have access to health facilities.
Some pregnant women and mothers walk far distances, on bad roads, seeking
medication. Before reaching the health facilities, at times death occurs --
claiming the lives of mother, child or both.
The lack of health facilities in these areas gives rise to the use of the
traditional midwifery system, where unsterilised instruments are at times used.
This contributes to more deaths. The lack of necessary drugs in most public
health centres also contributes in large measure.
OM: Is the situation necessarily better in urban areas?
AW: The rapid rural-to-urban migration as the result of the war has made the
capital of Liberia, Monrovia, overpopulated. Most rural dwellers have yet to
return home despite the ending of the war. With no running sewage system, poor
hygiene is occurring: there are inadequate toilet and drinking facilities waste
is deposited in the streets.
The debris and stagnant water breeds mosquitoes, hence children contract
malaria through mosquito bites. Chloroquine, which was used to treat malaria,
seems no longer to be effective. Mosquito nets are not affordable by most
OM: What are the most important steps that need to be taken in West African
states -- and nations further afield in Africa -- to tackle child mortality?
AW: Practical steps than need to be taken in West Africa in combating child
mortality include governments committing resources to preventive programmes from
the grass roots to the sub-regional level.
Massive public awareness campaigns should be launched at all levels to
stimulate behavioural change, taking into consideration the attitudes and
beliefs of the different target audiences. Family planning methods, especially
child spacing, should be encouraged among both women and men.
More health facilities should be set up and equipped with instruments and
drugs in rural areas. The road network needs to reach the remotest villages.
More training should be made available to health workers, and salaries should
be attractive to keep them in the profession -- while poverty alleviation
programmes need to be encouraged at the community level to enable families to
have a proper diet.
Hygiene should be encouraged at the local level, immunisation against early
childhood disease carried out at all levels, and mosquito nets with required
insecticides need to be made available to communities.
Myths such as that which states that having more children is a sign of
prosperity should be worked against.
OM: At present, Liberia is struggling to overcome the effects of years of
civil war, with limited resources. How does one make an argument for devoting
resources to reducing child mortality in this context, when there are so many
other things that demand money and attention -- attending to the needs of
ex-combatants, for instance, to ensure they are not tempted to return to the
AW: Liberia's future depends on how the welfare of children is improved now.
High mortality rates will affect this future. Liberia needs a strong human
resource base. Without a population, this will only be a myth -- so children
must be prevented from dying now.
While it is true that ex-combatants remain a priority so that they will not
be lured back to violence due to the volatile situation in the country, what is
even more paramount is to save the very future of Liberia by protecting children
When there is stability and healthy children growing up to become societal
assets, the needs and aspirations of all are secured, thus reducing the threat
of ex-combatants returning to war -- as healthy children make a happy
environment. Stopping children from dying when we can is a moral obligation
which must not be sidelined.
* Statistic taken from 'The State of the World's Children 2006:
Excluded and Invisible', published by the United Nations Children's Fund.