Apr 07, 2009
In Pakistan’s Sindh province, child mortality rate is alarmingly high and is, in fact, worse than the national average. Children in this region have little immunity to diseases like diarrhoea, acute respiratory infections and TB due to malnutrition.
Mithi, Pakistan: Malnutrition - combined with diarrhoea, pneumonia and tuberculosis (TB) - is the biggest cause of child mortality in Tharparkar district in Pakistan’s southern Sindh Province. Infant and child mortality (children under 12 months and 5 years respectively) is much worse here than the national average, according to local officials.
In the district capital, Mithi, infant mortality is 123 per 1,000 live births and the child mortality rate is 140 per 1,000, according to official records at the Civil Hospital in Mithi quoted by Jawahar Lal, the chief resident medical officer.
The figures compare unfavourably with Pakistan’s overall infant mortality rate of 75 per 1,000 live births. Each year 396,000 infants die, according to the Population Reference Bureau, a US-based body.
“Diarrhoea, acute respiratory infections and TB are the biggest threats to children in this region. Malnutrition due to poverty is a big contributing factor as the children here have little immunity,” Lal said.
The average daily income of most patients at Mithi’s state-run hospital was less than Rs 150 (US$1.86) and there was little awareness about how to protect oneself from such illnesses, he said, adding: “The use of dried dung and wood, used for cooking…releases toxins and gases which damage the lungs and health...They have low immunity because of their poor diet…It’s all about immunity. The stronger it is, the better their chances of survival.”
Mohan Lal Khatri, a local paediatrician, said: “We have had cases here of one-year-old children weighing 5kg. Twenty percent of children at the hospital have pneumonia. Fifty percent have diarrhoea and TB while the rest have other malnutrition-related ailments.”
TB and DOTS
Explaining the rise of TB in children, he said: “There is a DOTS [Directly Observed Therapy, Short-course] programme by the government and many NGOs, but people do not tend to follow the whole course. So if one parent is infected, or anyone in the family is, it’s there, and this laid-back approach runs throughout the family, making treatment harder.”
Ismat (not her real name), a nurse at Mithi hospital, said high population growth aggravated the problem. “Pakistan’s total fertility rate is 4.1 live births per woman, but… the number of children each woman has is way higher. Seven kids are very common but this number does not include those that die during the first year or at birth,” she said.
Often basic medicines are unaffordable, she said: “A sachet of oral replacement supplement can be a financial burden. If a man earns Rs 100 [$1.25], how do we convince him to buy multivitamins, iron supplements and consume a healthy diet?”
According to the UN Human Development Report 2007/2008, 32.6% of Pakistan’s population live below the national poverty line.