Friday, February 13, 2009

Salma Hayek and Sierra Leone

So it seems that Salma Hayek’s breast is all it takes to get pediatric health in Sierra Leone on the public’s radar.

We should have thought of that a long time ago.

In this ABC News piece, Salma first visits the Ola During Children’s Hospital, Sierra Leone’s only government children’s hospital, where the Welbodi Partnership works to help improve the standard of care provided to sick children. There she watches a week-old baby die a terribly painful (and utterly preventable) death from tetanus.

Tragically, this is not unusual. One in six children in Sierra Leone die in infancy. One in four die before their fifth birthday.

Salma then goes upcountry, to the provincial capital (misleadingly called “a remote corner of the country” by the ABC folks) of Makeni. Once there, she decides to breastfeed a tiny baby whose mother did not have milk to give.

This, of course, is what set the news media and blogosphere abuzz. Famous Hollywood actress gives breast to poor African child. History upended as light-skinned wet nurse feeds dark-skinned child. Bodily fluids shared on camera.

Breastfeeding is incredibly important to the health of young children, particularly in places like Sierra Leone, and is one of the best ways to ensure proper nutrition and protect against illness. And if Salma Hayek’s breast helps raise awareness of the importance of breastfeeding, so be it. (Though I can’t help but point out that Sierra Leoneans are much less abuzz about this than the rest of the world. The vast majority will never see this footage or the headlines that have accompanied it, and in any case have no idea who Salma Hayek is. At the hospital, we turned up the day after this film crew and were told only that some white people had visited the day before; none of the staff knew how famous she was.)

But the film’s focus on breastfeeding and on other preventive measures – specifically a vaccine to prevent tetanus – ignores another reality, one evident in the first few minutes of the piece when Salma watches that tiny baby die in what should be Sierra Leone’s premier pediatric care facility.

The Ola During Children’s Hospital should be in a position to provide accessible, high-quality care to sick children. Parents should come to the hospital early, as soon as their children get sick. Drugs and supplies – at least for the most common illnesses – should be available and free of charge. Nurses and doctors should be properly motivated and trained, and should have the medical tools and enabling environment they need to provide care.

In reality, however, the dedicated staff of the children’s hospital struggle to provide even a basic standard of care. The hospital has no x-ray, rudimentary laboratory facilities, and no back-up power supply. Doctors and nurses are forced to charge impoverished and severely ill patients fees for consultations, laboratory tests, and drugs and supplies in order both to provide the hospital with revenue to meet its running costs, and to supplement their own meager salaries. (A trained and experienced nurse makes less than $50 per month, not nearly enough to feed a family).

These fees mean that many parents wait far too long before they seek medical care for their children, and that too often they cannot afford urgently-needed medical interventions – medicine to treat malaria or pneumonia, a blood transfusion for a severely anemic child, fluids to treat dehydration in a baby with diarrhea. These delays cost the lives of hundreds if not thousands of children each year.

Prevention of childhood illness is absolutely essential, and UNICEF is right to invest in vaccines and the promotion of exclusive breastfeeding.

But even with the best prevention, many children will still get sick. If there is not a pediatric health system capable of providing effective, low-cost treatment for the most common illnesses, the country will continue to lose far too many young lives.

The Welbodi Partnership supports pediatric health care in Sierra Leone by partnering with the Ministry of Health and Sanitation and the Ola During Children’s Hospital. To learn more and to find out how you can help, please visit our website.

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