Cape Town - Two thirds of child deaths in low and middle income countries could be prevented with the most basic of interventions.
This is according to Heather Zar who, when she stepped off the plane recently with an international award from an American health society, had one thing on her mind: disparities in global child health.
Zar, who is UCT’s head of paediatrics and child health at the Red Cross War Memorial Children’s Hospital, is the first person from Africa and the first child health specialist to receive the coveted World Lung Health Award from the American Thoracic Society.
In her acceptance speech in front of more than 17 000 people, Zar did not shy away from an issue that illuminates each milestone of her career.
“The disparities in global child health versus adult health are staggering,” she says. “And as professionals, we have a direct responsibility to address these issues and be socially responsive.”
Closer to home, she says that in South Africa, under-five mortality is closely aligned with one’s area of residence and socio-economic circumstances. “Racial groupings are proxies for disadvantages around housing, education, nutrition and stimulation. We are still one of the most unequal societies and it really plays out in child health,” she says.
But, speaking of South Africa and other low and middle income countries, “breastfeeding, immunisation and good nutrition alone could eradicate two thirds of child deaths. We also need effective management of illnesses like pneumonia (using antibiotics and oxygen) and diarrhoea (using remedial solutions)”.
She has called on all healthcare professionals to carefully consider the burden of disease.
“Pneumonia is a case in point,” she says. “Ninety percent of these cases are in low and middle income countries, and it is especially horrifying because more are preventable with access to proper treatment. The mortality rates should be lower.”
She does say, however, that “South Africa has seen good progress” with prevention of mother-to-child transmission, with strong immunisation programmes, and with good national guidelines.
She says national Health Minister Aaron Motsoaledi “has made much progress, but there is still potential to make a much bigger difference”.
She says that globally, researchers in the field of health also face the challenge of what happens to the findings once a research paper is out. “Policymakers and professionals have to use that research effectively for it to have an impact,” she says.
An example she cites is that of PCV (pneumococcal conjugate vaccine) which protects babies and infants from diseases which are caused by a bacteria known as streptococcus pneumoniae.
“We have overwhelming evidence that PCV is highly effective in reducing incidence and hospitalisation, and despite the fact that it is so cost effective, some countries still haven’t rolled it out,” she says.
Because child health is a “relatively under-resourced area of research, Zar hopes that her award will place it more firmly on the global agenda, and especially in Africa.
“We have to develop stronger capacity in child health, particularly in Africa. We have to be fierce advocates for child health,” she says.
Groundbreaking interventions spearheaded by Zar include the development of a homemade spacer for the treatment of asthma.
When commercially-produced spacers proved too expensive for hospital budgets, Zar and her team pioneered the use of empty 500ml plastic cooldrink bottles instead. These bottles now form part of the Global Initiative for Asthma and the World Health Organisation (WHO) guidelines. Also thanks to Zar and her team, it is now possible to diagnose and begin treatment of childhood TB far more rapidly than before, and the new methods are now also included in the WHO guidelines.
Most recently, Zar and her team set up a unique birth cohort study to investigate childhood pneumonia and the determinants of child health. - Cape Times