Every year, more than 5 million children ages 0 to 14, mainly in the developing world, die from diseases directly related to their environments.  In Southeast Asia alone, more than 1.6 million children die before they reach the age of five. Children here and elsewhere die of diarrhea, respiratory illnesses, malaria and other vector-borne diseases, injuries, and other environmental threats in and around their homes.

Children, health and the environment are three of the greatest assets that must be protected if we want to ensure sustainable development. In her speech commemorating World Health Day, April 7, 2003, the World Health Organization (WHO) Director-General Dr. Gro Harlem Brundtland called for the international community to reaffirm the commitment to protect the three, which are inter-linked.

“Ensuring Healthy Environments for Children - the theme of this year's World Health Day - is vital to our efforts to help shape the future of life,” explained Brundtland.

Asia’s Safe Havens Threat to Children

Most often, children in Asian countries die of chronic undernourishment, gastro-intestinal and acute respiratory diseases, malaria and measles, according to the World Health Organization.  A high mortality rate in the Asian region is resultant of poverty, uncontrolled urbanization, a low level of education, insufficient efforts of the authorities, cruel treatment of children and their exploitation, poor housing conditions, anti-sanitary conditions and environmental pollution.

WHO data shows that about 100 million children have no access to safe drinking water in the region that encompasses 37 countries and territories of East Asia and the Western Pacific.

It’s quite ironic that, according to WHO, that the biggest threats to children's health are found in the very places that should be safest - their homes, their schools and their communities - the places where they live, learn and play.

The United Nations (UN) Secretary General Kofi A. Annan, in a call to protect children all over the world, stated that, “Children are our future; and a future of sustainable development begins with safeguarding the health of every child.”

Annan further said that children are more vulnerable than adults to environmental hazards. Their capacity to absorb health hazards is still developing, and thus they are more susceptible to the effects of toxic chemicals and to germs as well as other pollutants. They are also more exposed to such risks because they consume more food, air and water than adults do in proportion to their body weight, and because they possess more natural curiosity but less knowledge and experience.

The only sustainable response is to make sure that children can live, learn and play in safe environments. This will not only save many lives; it will have positive consequences for economic development. It will prevent many children from being taken out of school due to chronic disease, and thus help society as a whole build the skill-base it needs for economic growth, Annan stressed.

Schools Close Doors in Face of SARS

Taking children out of school, at least temporarily, is now what the deadly Severe Acute Respiratory Syndrome (SARS) is doing in several Asian countries, such as Singapore and Hong Kong. In Indonesia’s capital city Jakarta, a Catholic school has requested its students to use medical masks during day-to-day learning activities in order to prevent possible SARS virus from spreading.

Singapore shut all its schools on March 26, affecting nearly 600,000 children from kindergarten to junior college, in order to contain the SARS virus that has killed 119 people and infected over 2,960 people in some 21 countries. Secondary schools for students between the ages of 13 and 16 will stay closed until April 14, and primary school children will be kept out of classes until April 16. The large-scale school closures are the first in Singapore since its former British colonial rulers gave children time off during a poliomyelitis outbreak in 1958.

In Hong Kong, which now has the largest number of reported daily cases of SARS, the government said more children and school staff had been diagnosed with the disease and that schools would remain shut.

Panic set in throughout much of the rest of Asia, as governments continued to urge citizens to stay away from infected areas, and in the rest of the world as the virus reached newer shores. SARS has hit tourism in Asia really hard, since more and more people now tend to avoid traveling in anticipation of being infected by flu-like disease.

The Indonesian government, for instance, has issued a regulation asking Indonesians, especially children, to stay away from China, which is suspected to be the epicenter of SARS, Hong Kong, Taiwan, Vietnam and Canada, where SARS is rampant.

Indonesia's Health Minister, Achmad Sujudi, has called on the people to help protect the country's children, aged 0 to 18 years, from the disease. He warned that schools, especially the international ones, must be alert of SARS and students suspected of having it should immediately have themselves examined at a nearby hospital.

A team from the World Health Organization, which first warned against travel to southern China and Hong Kong because of the disease, is hunting for clues to the source of the virus in Guangdong. Hong Kong's cable television reported recently that the Guangdong Disease Control Center now had data showing patients in the early stage of the outbreak were cooks and bird vendors, and that it suspected the virus was linked to animals.

However, WHO officials said it was also too soon to say exactly where SARS originated even though the first reported case was in Guangdong's Foshan city, nor could they say whether the virus originated in animals.

Experts thought the virus was passed only by droplets through sneezing or coughing, but the outbreak in Amoy Gardens suggested another mode of transmission, possibly by water or sewage. "It will take more than a few days just to find the virus in the environment in Amoy Gardens. We still don't know what virus it is supposed to be," said microbiologist John Tam, from the Chinese University.

Pledge to Protect Asian Children

A group of people, including scientists, doctors and public health professionals, educators, representatives of governmental and NGOs in South East Asian and Western Pacific countries, made a pledge to promote the protection of Children's Environmental Health in their meeting in Bangkok, Thailand, on March 7, 2002.

Some Asian countries are still rampant to health problems affecting children. The United Nations Children’s Fund (UNICEF) is especially drawing attention to the continuing chronic malnutrition and other health problems faced by millions of children and women in war-torn Afghanistan.

According to UNICEF, Afghanistan ranks as the fourth worst country in the world in terms of under-five mortality, with one in four children not surviving beyond their fifth birthday. The infant mortality rate in Afghanistan is amongst the highest in the world, at 165 per 1,000 live births, while Afghanistan's maternal mortality ratio is equally alarming at 1,600 maternal deaths per 100,000 live births.

In Indonesia, the health condition of children is also not encouraging particularly due to the prolonged economic crisis that has been affecting the country since 1998. The infant mortality rate in Indonesia is still the highest in the Southeast Asian region. Before the economic crisis, the country managed to reduce the infant mortality rate from 60 to 49 per 1,000 live births in 1998. But within three years, it increased again to 51 per 1,000 live births in 2001.

In India, the world’s second most populous country, WHO launched a massive polio immunization campaign in the epicenter of the polio epidemic. To stem the epidemic and help eradicate polio, over 80 million children are to be vaccinated in six Indian states over the next six days, said WHO Director-General Dr. Gro Harlem Brundtland when launching the campaign in Lucknow, Uttar Pradesh, on April 7.

"Eighty-three per cent of all new polio cases are now found in India. This country, and Uttar Pradesh in particular, are the number one priorities for stopping transmission of the polio virus around the world," she said.

The poliovirus is now circulating in only seven countries around the world, reduced from over 125 when the Global Polio Eradication Initiative was launched in 1988. The seven countries with indigenous wild poliovirus are (from highest to lowest risk): India, Nigeria, Egypt, Pakistan, Afghanistan, Niger and Somalia. Successful immunization campaigns are crucial to ensuring the eradication of this crippling disease.

In the late 1990’s, according to the World Health Organization, China lost up to a staggering 7.7% of its potential economic output because of ill health caused by pollution. Two conditions linked to air pollution – chronic obstructive pulmonary disease and lower respiratory tract infections – accounted for 1.9 million annual deaths for all ages – over 21% of all deaths in China.

China also has an estimated 2.7 million people suffering from skeletal fluorosis, an irreversible crippling condition that is caused by the consumption of fluoride-rich drinking water.

The Silent Dangers

However, in addition to a healthy environment, according to UNICEF, a "protective environment" for children is just as crucial to their health and development. "Children have the right to an environment that safeguards them not only against disease, but against ill-treatment," said Carol Bellamy, executive director of UNICEF. Violence, abuse and exploitation are "the silent dangers" that lurk in every society in the world, she added.

UNICEF pointed out that tens of millions of children suffer from severe abuse and violence each year. In the last decade, millions of children have died as a result of conflicts, and over the same period, 6 million have been injured or disabled in wars. UNICEF advocates integrated approaches that combine interventions in health care and nutrition for children and mothers; clean water and proper sanitation; psychosocial care and early learning; and protection from violence, abuse and neglect.  

Bellamy stressed that, "Children must have every chance to survive and thrive. The risks that jeopardize the health and well being of children must not be limited to diseases and infections. Children must live in a protective environment that fortifies them against exploitation in the same way that good health and nutrition fortify them against disease."

Sources:

• Sustainable Development – A Gateway, 2000:ASIA: UNICEF Official Addresses Child Development

• Sui, Cindy, 2003: Too Early to Say SARS Under Control in China, Worldwide: WHO. – Agence France Presse.

• Antara, 2003: Save Indonesian Children from SARS, Health Minister says.

• Reuters, 2003: Singapore Extends School Closures to Fight SARS.

• Tan, Ee Lyn, 2003: WHO Reaches Virus Epicenter as Cases Grow. – Reuters.

• Antara, 2003: Indonesia to Impose Anti-Epidemic Law to Contain SARS.

• WHO, 2003: World Health Day 2003 urges "Healthy Environments for Children".

• WHO, 2003: Messages on World Health Day 2003 from the United Nations Secretary General Kofi A. Annan and Director-General of World Health Organization Dr. Gro Harlem Brundtland.

• WHO, 2002: A pledge to promote the protection of Children's Environmental Health in South East Asian and Western Pacific countries.

• UNICEF, 2003: Protecting Children is Key to Their Health.

• UNICEF, 2003: Abuse and Exploitation Do Lasting Damage to Healthy Development.

• UNICEF, 2003: On World Health Day, plight of Afghanistan's children remains cause for concern.

• KBI Gemari, 2003: Health Level of Indonesian Children still Low.

• WHO, 2003: WHO Director-General Calls India 'Number 1' Polio Eradication Priority.

• WHO, 2003: World Health Day Kit 2003: Healthy Environments for Children

Ms. Hani Mumtazah is an environmental journalist based in Jakarta, Indonesia. She graduated from a three-year English language non-decree program at the University of Indonesia, Jakarta. She attended the Non-Aligned News Agencies Journalism Course in New Delhi, India, in 1987.  Comments and suggestions may be forwarded to her by contacting the editor at ScienceTech@islam-online.net   

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