Haruka Mitoma writes:

You will realize health inequity if you see the gap between the developed and the developing world in terms of infant and child survival.

It is sure that developing countries have improved child health; the gap in infant mortality between developed and developing world has narrowed by 50% during the years 1960-1993, from 113 to 54 per 1 ,000 live births. Also, the number of children dying from vaccine-preventable diseases has greatly reduced in the poor countries.

Yet in parts of the developing countries the rate of infant mortality is more than thirty times as high as that in the developed countries.

Now I'm going to describe the problems which still remain in the developing world. In 1990 as many as 43% of children -230 million- have low height for their age. Malnutrition of micronutrients particularly affects children. As a result of iodine deficiency - a public health problem in 118 countries - at least 30,000 babies- are stillborn each year and over 120,000 are born mentally retarded, physically stunted, deaf-mute or paralysed. A quarter of all children under age 5 are at risk of vitamin A deficiency. Around 2.4 million children under 5 years are still die every year from such diseases, particularly measles, neonatal tetanus, tuberculosis, pertussis, poliomyelitis and diphtheria. There are also worrying signs that recent immunization gains are being eroded or even reversed by economic and social conditions.

How could we (people in Japanese medical community) achieve significant reductions of these problems?

First, we can make money for them through some organizations or some enterprises. As for me, I'm a Christian and belong to a Church and we, the members of the Church, devote some money or things which are needed in other countries; now (October 1999), we plan to send to people to Turkey and Taiwan. With this money, we can improve some problems. we could treat underlying bacterial infections with low-cost antibiotics for a few days. Also, use of oral rehydration salts could prevent the deaths from diarrhoea by just US $0.07 on average. We can prevent it by a more simply way; improvement of the environment and unsafe water, poor sanitation and poor food-handling practices.

Secondly, we can send people to the developing countries for medical treatment. For instance, there is Asian Medical Students' Association (AMSA), which is the origin of Asian Medical Doctors' Association (AMDA). When the quake occurred in Taiwan in last September, news of the medical situation in Taiwan percolated through to members of AMSA. Some people called for doctors and medical students who could go to Taichung, the epicenter of the destroyed area, and to help the people there.

Moreover, medical education is important because it will help people recognize their health in the developing countries. If many effective drugs and high technological medicines are brought to the developing world, the best way of health improvement should be made by each daily life-style. Especially in child health, parents should think more critically about their children's lives. And then, what kind of medical-education do we need? For instance, it's necessary to educate females about the dangers of smoking, drinking, and taking drugs during early pregnancy. Second, we must offer people the correct knowledge about HIV, tuberculosis, and other infectious diseases, why these diseases are dangerous, how to prevent such diseases, and how to care for patients suffering from them.

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