Saving small lives

January 04, 1998|By Sara Engram

OVER AND over, the lesson comes home. It's the little things, the often-overlooked details, that can make all the difference.

In the life of a child, that difference can be as drastic as life or death, or as fateful as the gap between a fully functioning body and mind or stunted growth and impaired mental abilities.

Each year, the United Nations Children's Fund, still known under its former acronym of UNICEF, produces a ''State of the World's Children'' report. For 1998, the agency has focused on one of those all-important details, the ''silent emergency'' of malnutrition.

This emergency includes those heart-wrenching photos of starving children. But as the report makes clear, nutrition-related deaths don't have to be actual cases of starvation. As scientists discover more about the role of nutrition in human health, they are learning how little it takes to save a life.

A key vitamin

Field trials in developing countries have found that boosting vitamin A intake can reduce child deaths from diarrhea by as much as 35 to 50 percent, while reducing by half the number of deaths from measles. With current estimates putting the number of young children suffering from vitamin A deficiency at more than 100 million, those are promising results.

Add to that the encouraging discovery that supplements of vitamin A and zinc can help boost a child's resistance to malaria, a disease that kills some 600,000 children each year. In a study in Papua New Guinea, one-third of children with mild to moderately high levels of infection by malaria parasites had lower fevers after receiving vitamin A supplements.

A study in Nepal found that low-dose vitamin A supplements given to women in areas where this deficiency is common helped reduce pregnancy-related deaths by an average of 44 percent.

In Malawi, a 1994 study found that HIV-infected women who were also suffering from vitamin A deficiency were four-and-a-half times more likely to pass the virus to their children.

The cost for alleviating this deficiency? About 23 cents for each capsule of vitamin A.

(One note of caution: These vitamin A supplements are low-dose capsules. High dosages of vitamin A can harm a developing fetus.)

The lesson here is that having ''plenty'' of an essential substance is not necessarily the same as having an overabundance. One of the reasons UNICEF's report is always both sobering and inspiring is the annual reminder of just how far a little bit of help can go.

Vitamin A is one of several micronutrients getting increased attention for their role in the health and survival of people living in severe poverty. The body needs only tiny amounts of substances like vitamin A, iodine, iron, zinc or folate. But when it doesn't get them, the consequences can be devastating.

Not too many years ago in this country, swelling of the thyroid gland in the neck provided the tell-tale signs of iodine deficiency. But after iodine was added to the salt supply, that problem was virtually forgotten in the United States.

Worldwide, however, iodine deficiency remains the single most important cause of preventable brain damage and mental retardation, with some 43 million people suffering from varying degrees of physical and mental impairment due to iodine-deficient diets.

But thanks to global campaigns to add iodine to salt supplies, those numbers are dropping.

The heartening stories of successful efforts to boost micronutrients don't ease all the problems caused by malnutrition. In too many parts of the world, poor diets continue to plague the health of millions of families.

To a significant degree, it is the lack of rights and opportunities for women that most heavily stacks the odds against a child's ability to survive and thrive. Women are the primary providers of food and nourishment during the most crucial periods of a child's development -- especially during pregnancy and breast-feeding.

UNICEF's 1998 report provides us with intriguing and useful data. It also reinforces some lessons we already know. It doesn't take much to make a significant, positive difference in the lives of children. Seemingly small details like micronutrients can produce amazing results.

Sara Engram is deputy editorial-page editor of The Sun.

Pub Date: 1/04/98

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