tv Inside Story 2018 Ep 51 Al Jazeera February 21, 2018 2:32pm-3:02pm +03
of congo thousands of people in tang and you could province have been forced from their homes because of fighting u.n.h.c.r. says poor security is hindering the thames to help those in need. israeli media are reporting that one of the prime minister benjamin netanyahu is closest confidantes is said to testify against him over allegations of corruption they say shlomo filbert will get a lighter sentence in return it's in relation to an investigation into government benefits offered to a telecom giant and it in yahoo denies all allegations a prominent rights activist has been jailed in bahrain for five years an appeal rajab was a leading figure in twenty eleven pro-democracy protests he's been sentenced for tweets criticizing bahrain's intervention in the yemen civil war and the prison authorities use of torture rajab was a ready seventy two year sentence for cues in the government of torturing political presence kind of his prime minister has reiterated that he supports
a one united india during his first visit to the country justin trudeau and his family are on an eight day. those are the headlines the news will continue on al-jazeera but first it's time to look at inside story. the world is failing its newborns that's the warning today from unicef in a report that says the death of babies globally is alarmingly high so can child mortality be reduced and if so how this is inside story.
hello again welcome to the program i'm peter dobby at least seven thousand infants die every day mostly from preventable causes that's according to a report by unicef the fund babies born in some of the poorest countries are significantly more likely to die countries such as pakistan somalia central african republic afghanistan and listen to have the highest rates of newborn deaths will examine the reasons without guests in a moment but first this report from. this is one of the busiest maternity wards in the pakistani capital islamabad several babies are born here every day but the odds of survival for infants across pakistan is some of the worst in the world according to u.n. children's charity unicef one hundred twenty two die within the first month of life the mothers don't have access to. the hospital they don't have access to look and
birth attendants the mothers are malnourished they are an american and it is the lack of awareness among us is cool big a mother build a hospital or a head get on their way to their time of their delivery the situation globally isn't much better every year more than two and a half million babies die before turning one month one million of them take their first and last breaths on the day they are born another two point six billion are still born central african republic afghanistan somalia and list so throw around out the top five nations were infants struggle to stay alive there has been some success in reducing child deaths the number of dying before their fifth birthday has halved over the past twenty five years but according to the u.n. millions more could be saved if mothers and babies have access to affordable quality health care good nutrition and clean water some of the governments actually that are worst off spend less than one percent of the gross domestic product on
health care in the national recommendation is to spend at least five percent if you couple that with training competent health workers giving them a chance to wash their hands as they were is stepping in to deliver babies having basic equipment drugs getting breast feeding going within an hour and sending girls to school i think it's within within reach of all governments to do that babies born in countries across sub-saharan africa often face the toughest odds that's mainly because pregnant women are less likely to receive assistance during delivery . al-jazeera. ok let's get going let's bring in our guests in karachi dr shah siyad founder of the pakistan national forum on women's health and in new york also on skype dr head of unicef global maternal and child health program welcome to inside story to see out first why is this figure in pakistan so very high
there unfortunately in buggiest on the video highlighted of polity illiteracy and the government's failure to provide basic health care is the mean reason that we have all these high end mortality never. would have been sick in new york how many of these deaths are actually preventable. yes i think that there is a quite a substantial number of deaths preventable among new born deaths and it is that simple interventions that can make it through friends although we have many newborns that might need sophisticated care but what we have estimated then our report globally every country would do the major effort that is needed that we could save sixteen million newborns but two thousand and. sure society in current shape this is not explicitly linked in pakistan to income level are there other
factors that we need to be aware of as well. well i mean if you know they're in pakistan and you have more than fifty percent of the population living below poverty level you're certain there was operating in one small hospital just sixty or sixty miles of there from karachi and get you been that. fourteen patient a operated all of them are having. less then about nih and they're all malnourished but we have to operate them because they're all having poor left eucharist because of the multiple pregnancies and they have this multiple pregnancies because of the very high nuna to the mortality rate you know so it's all interlinked but the main thing is that if you are poor girl going to have all this problem poverty is the biggest course we are suffering from and they specially the majority of the our our population and it's development who are the main sufferer and if the woman is poor
and she's not able to provide anything for her children then that that's the way it happened dr sacks if you're born in singapore iceland or japan chances are you'll do very well in those first crucial crucially important few days of life what is it those countries are doing right that other countries might learn from. it is absolutely true that there is more funding available and of course these are high and the friend budgets and the poverty level are lower but i think there are things in intervention that we can learn learn from first of all for sure that policy and political commitment that we have in those countries and then also on the very essential as district and hospital level japan has for instance introduced them up a new bone health book which is basically a record a track record of how the mother and the new borns you doing during pregnancy during childbirth and apos natal period and then off of course it is also the point
you have here death is a very big. problem cerned it has been addressed in those countries and i think also here we can learn because we know that. if the quality is good up a certain health service then women will come back and also bring to a new one spec so if the quality is poor or if it is not the maps appliance in the hospital for instance because of stock outs then we may not come back and so this is it's a vicious cycle actually ok political commitment sons like shorthand for making sure the presidents and prime ministers that home secretaries who ministers do what they should be doing when it comes to health care how do you see that the role of those individual people changing because presumably it needs to be driven by an individual. i think it is not only on national level it's also very important that the political commitment is there on district level our net and on
a province level so it's really thought all throughout the whole system and i think the commitment is the area many countries and one of the also see is that some countries especially those who are stepping up into middle income status nowadays that there is more funding available but what we also see is that funding alone doesn't make the difference is not about the money only it's also to put them on the smart and also every as we heard just now before it is empowerment of women we know that. educated women or women who are educated and it were. have or face less lower mortality rates you know within their own population but also for newborns so it's a molecule a a problem but certainly poverty is the underlying issue port but it's also about how to put on the smart in a smart meaning invest in smart great political we understood dr science in karachi we could also turn these figures from unicef around and say they're actually good
news in as much as the mortality rate for newborns is done by forty nine percent but the mortality rate for newborns up to five years old there's been even more progress there are they caused by the same factors of the of the issues in the problems the same for newborns as for those little children up to being five years old. before i answer this question i just want to mention one more thing the countries you mention leg up on rice lynn who remember one thing all these countries has empowered women you know woman status is very important in our country especially pakistan women has no value in the society and if the woman has no value in the society then we don't want to see if the woman with the most to do when it is dying during pregnancy as a maternal death and then woman and a girl child doesn't matter then how in how you can put him a new name when
a woman is coming in there in the hospital with the mobility of four or five and six there's the routine so come back to be so figure in pakistan i mean compared to when im in a one thousand babies are dying in pakistan one in twenty to be. dying so this is too much and as in. as it is mentioned that it is the is the power the chair had the means reasons for the. for the death of the new new new needs doctor search some of the solutions to this particular huge problem quite old fashioned reassuringly old fashioned i guess it comes down to skin to skin contact between mother and baby within the first sixty minutes of life literally and also breastfeeding so that bond is made so the immunity system of the child is improved from the get go and that doesn't cost anything that's fast free medical care if you will at points of delivery. absolutely and that so it's really simple interventions
that are the first line not the magic silver bullet point. bullets but they are very important interventions that can help at least a big proportion of the newborns to survive it is about skin to skin which means the babies put on the tummy of the mother when they need the support and breast feeding is starting to clot should be a rep there on the baby so he's being kept warm what be seen some country see is there some nice believes are some misbehaviors if you want that newborns are being fed with coffee with water sometimes and there is this very important again and pa women and educate them what to do and how to deal with with those new parents and what to do with them and that's why we also believe that cost naval care which means the care up to delivery for the newborn even at home or at the hospital where but then you when you're staying with the mother's group so but the newborn can survive but we also have to see that we have sophisticated. very complicated cases
where it's very simply intervention who know it's work and we need simply more one example to bring in babies that are born with whom we call them the mature. dockside in karachi you talking about employing empowering women and educating women is it also about educating the whole family particularly the male figures the father figures literally within the family unit adopting a holistic captured because because to me some of these countries may be the men folk have a very distinct attitude towards women and childbirth and that's something that women and childbirth they do that on their own the men maybe don't get involved in that but if the men did get involved in the mall they would be that would include a healthier atmosphere surrounding the whole process. well of your hundred percent died that is it is important to educate every member of the family but. in our
experience we are in doing in a big media training midwives in pakistan and we feel that venue to venue when you educate a woman a girl in the in the in the house she will take care of all the younger brothers and sister but if you do get in men men is there is not going to give that kind of import what educated girl does so i think in pakistan or any country like pakistan is there any border to educate girl child and the woman it is more important to educate them then the then the why then in the in the in the in the family and we have seen in the family when like were published in like an order and. the ninety these places when you educate a girl child she is she is really good for the whole family so i think it is limited your source says and when he has to go somewhere i will go for the gut education of the girl child and the woman well we always talk about she has a darling important countries because of poverty and
a lack of well trained health workers but what's the situation like in the developed world well take norway for example where for every six hundred sixty seven children who are born one of them will die while in low income countries that figure is nearly ten times higher in cyprus the situation is even better with just one death to seven hundred fourteen infants being born but in japan as we've been hearing newborns are the best chance of survival any place in the world is just one death for nearly twelve hundred births let's take it back to dr will abound in new york just looking at the bigger picture for us one would assume say an incredibly prosperous country like the united states would be in the top ten it comes in at forty first so it's not doing very well so that's questions of health care at points of delivery health insurance i guess might be an issue there and also. income inequality across the country and yet if we go to another country say rwanda they've done very well despite being associated with with conflicts and policy over
the past what fifteen or twenty years but how is rwanda done it and managed to cut its figures so dramatically yes we saw what we see in the report is that very big countries like the u.s. can feature very huge equity gaps and if they have to act with the gaps that means that you have populations that are that have nots are not the best access to health services and this pockets off the neck with the will then you know prompt tribute to the overall picture and that's why we see a locked up and on a higher numbers in big things i think rwanda is the very good example of smaller force compared to united states throughout the country it has really achieved a lot and i think one of the major achievements is as the us health health insurance and also universal health coverage. that has really committed to that and
it's also politically and i think that is showing in rwanda that you know you can you can make efforts that everyone has access to health care but as i said it's a molecule in their. system it's about poverty it's about empowerment of women the cultural background and also whether enough funding it's available and in some countries we see also in african countries that they are growing our grass stepping up to middle income status and then we have more funding available and if it's put in a smart way we can really help to reduce that read some. book to cite in karachi how easy would it be to take say the model of rwanda where you've got strong institutions and graft that model on to other countries. well a gal give you just one example in simple ovens and during the plea previous chief minister militia there is
a stent m d p p h r program probably but i would health initiative this is the program which is initiated to. to provide a healthy basic health care in basic health unit and you see in the program was not functioning in karachi an option and now you can see the difference in option and karate an option at this basic facility is not available for the for the for the. young woman with pregnancy and in the unit will care and the other other district these units are working functioning very well because the twenty four hours a midwife midwife the services are available and this i mean this is just simple simple simple comparison you can see and the difference what happened so this is this is the point if the government emphasize and and you have the priority to provide the basic health care the things will change but in other countries most of the other budgets they are spending in buying of very very expensive equipment
robotic system m.r.i. and big buildings and these buildings and these machines are good for the in name plate but that these are not good for the patient patient needs basic and emergency obstacle care bisignani it will care when you need basic health you need a center a hospital this kind of thing and we can see the difference in scene as far as b.p.h. eye is concerned and that is the very good model which should be a doctor in the whole country then there is a there is a chance that we can improve election next five or six years dr circle come on to the time scale issue towards the end of our discussion but this comes down to we can situations conflict either within the country or in countries bordering the country and also poverty out of those three main contributor e factors which one is the easiest fix. i would let's put it that way at the most difficult six i would say it's on. conflict is really
associated we have research and evidence around that conflict insecurity is really the main driver from up there high mortality rates amongst mothers newborns and also the population itself because the population doesn't have access to the health care system as it would normally have and also health workers are scared to go to work if there is insecurity in their area they would not go to the hospital for work every day so i think conflict is the main driver and i think we really have to acknowledge also that insecurity in those countries who are ranked. you know in the low and low up part of this report are the part of the. security issues and we have to acknowledge that this is certainly a major problem. in terms of other factors i have experiences and all that you should think on the card in africa and even if there's no insecurities for women in on the african continent and pigs days and also in lower health care center and
once they arrive big boss that then they are forced. don't something and not perceive the best care because of poverty and because the house took up the plan so i think you know what i want to say is that in normal situations not means here is that the situation is already quite alarming or difficult for mothers and newborn don't society cannot see with a particular point the doctor who is making the is this just about access to health care you were using the word basic a lot in your last on it's not expensive health care it's not m.r.i. machines it's not state of the art operating theatre it's the most basic health care but it's caused by not getting access to that health care. yeah i mean one hundred of what i'm saying basic means clean water access to the hand washing you know very basic basic health you need there is a clean midwife can provide the basic engine it'll clear and then be all know that
ninety percent deliveries will be normal deliveries the anyway and a good excuse me to five can deliver a good baby with a basic community health care with this. with this traditional of you know as you mentioned touching your skin and there being with the skin i mean these are the basic care and these these things work i mean m.r.i. and the big huge buildings and this this thing doesn't work you know in our country we have robotic surgical system without without clean water and without a trained person it is train technician what demographic machine will do if the female technicians don't have a little so what i am seeing the billy basically in activation of the basic health unit who are provision of the school midwife ford in ninety percent of the woman who are going to have number delivery and the treasury and the to local hospital and to suggest a last resort for doing simple simple intervention like to the infection that will
save more that you know i mean this big machine than big buildings and bigger ords they don't save mother it is the it it is the right politician with the heart on the right side they will they will take care of the woman and the and the new unit unfortunately we don't have the right politician and that i doctors who have the right. who have their heart on the right side so this is the problem dr if we go back to the bigger countries for a second like the united states or indeed the continent say like the european union is there a sense in which if they don't have a quotes national health service i.e. health care that's provided and paid for by some sort of insurance system that is kind of a zip code law saree as to whether the baby will survive or not when you've got that coming together of different factors that influence the delivery of the health care. yes i mean traditionally we have several systems in those
continents as you mentioned we have the system of central asia and eastern europe where we have run a centralized tell systems they have traditionally you know where they come from from from their history they're very centralized some of the other systems and your very decentralized in india us of course we have a not a system where we have a lot of private sector involvement but overall i think there's no we cannot say one system is better than the other i mean each system has its pros and cons what i think is what we think is important to emphasize is that there should we should keep the inequities as low as possible for the system that we keep doing that which is no might be the best because then we can really talk about universal health coverage mean everyone should have access to health care if possible for free or at least for low cost and with a low out of pocket expenditure this is what we mean by you know when someone comes
to the hospital has a additionally don't decide in karachi last point to you if i may you've already been talking about a time scale here of five years obviously the best scenario would be no infant baby mortality at all but at what point over the five years can you turn around and say yes we are making genuine progress in this area. well i mean it's very simple if you put away again emphasize if you provide the basic health care and in the in the basic health units and rural health center with the is killing me device and the train to staff to deal with the maternal death and the new new needs you will see the difference things will change very fast i can tell you the exact time because i don't know haha much other government is interested in they're doing the living dead but we have seen in the districts where there's intervention and which is there's intervention we see the difference you know i
mean and if you want to learn from the countries like japan and sudan and denmark and now when england you see what they have done i mean they're there doing it started doing big things that big building and highways and water with what they did we gain totally in the small villages and the counties to the units where the basic health care is available ok gentlemen we will have to leave it there but for your time we are very grateful thanks to both our guests stocks and dr whelan second thank you too for your company over the past hour you can see the show again any time by the web site al jazeera dot com and for the discussions to check out our facebook page that's facebook dot com forward slash a.j. inside story you can also join the conversation on twitter at a.j. inside story for me peter toby and everyone on the team here in doha thanks for watching.
travel often. by tranquil board tubes and purple forests may provide white wool. rocks of on. my icons landmarks valleys and scott lights. live for adventure. discovery jobs because faraway places closer to going places together with cats i always. i really felt liberated as a journalist while. getting to the truth as an eyewitness that's what this job.
five countries. four days. three thousand kilometer ends. two generations. one for. syrian refugees on assume real jannie to sweden. on the bright side. a witness documentary at this time on how does it. hello again adrian sitting in here in doha the top stories on al-jazeera the rebel held on klav of eastern syria is under more heavy bombardment by russian and syrian forces hundreds of people have been killed there in the past four days including twenty seven on wednesday it's the highest casualty figure in the area since
a chemical attack in twenty thirteen al-jazeera say the harder reports now from beirut in just a warning you may find some of the images and say in his report distressing. there is no front line in eastern. residential neighborhoods have become battlegrounds the syrian government and its allies are bombing the besieged rebel enclave into submission. the suburb of damascus is under attack. i. heard a plane overhead the myside landed people were torn into pieces i was with my nephew and we were both injured what i heard was the sound of an ambulance and i found myself here hundreds killed hundreds more injured the united nations says makeshift hospitals are being hit some are now out of service there is a humanitarian crisis.