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Joy Marini, MS, PA-C Headshot

Speaking Up For A Baby Named Silence

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Her name was Silence.* She was given this name because she rarely made a sound as an infant. Silence was with her twin sister in a quiet room in the back of the Pediatric Ward at Debarq District Hospital. Her mother, Abeba, was nursing the two girls on a cot, as another child, a young girl sat next to her. They had made the 2-day trek to the hospital when Abeba realized that her twin daughters were in trouble.

I sat there, quietly admiring the mother as she breastfed her babies. I estimated them to be about ten months old. In reality they were nearly three - tiny, barely able to stand, and had "Kwashiorkor," a form of protein malnutrition. The name Kwashiorkor is from a Ghanaian word that translates to "the sickness the baby gets when the new baby comes" because often children succumb when they are weaned from breast milk. In this case, there simply was not enough milk for two babies when their mother was malnourished.

Abeba was barely thirty and a mother of ten. She never had prenatal care and had given birth to all ten babies at home, without a skilled attendant. One newborn died at birth and two others died from starvation. It was then she knew her babies were in trouble and needed medical intervention, fast.

I also spoke briefly with the young girl sitting with her mom and the twin babies. She was eleven years old but looked about six or seven. She had not been to school for two years, because she was needed to help care for her siblings. In truth, I could see what a savior she was to her mother.

When I wonder if this little girl's life will be the same as her mother's, I think about how different it could be. With education, she is likely to have fewer and healthier children. If she could get back to school and have nutrition, her life's path might look very different than it does today. But in the meantime, she needs help, as does her mom. While many improvements in maternal and child health have been made, this family serves as a reminder about how much we still have to do. Forty million women still give birth at home, without a skilled birth attendant. One million babies do not survive beyond the first day of life, and 34 million children suffer severe, acute malnutrition.

As a global community, we know what to do and how to improve the lives of mothers and children like Abeba and her family. We must come together to apply our strengths across the continuum of health and education to address this cycle of poverty and reduce the number of preventable deaths. Mothers must have prenatal care and a skilled attendant during childbirth. Children must have the healthcare and nutrition they need to not only survive, but to develop to their full potential. Girls must be educated and have the right to choose when to marry and have children. And families must have access to affordable and quality health care.

No single entity or organization can manage any one of these issues - let alone all of them - on their own. This is why partnerships have been so effective. Many partners come together to improve and increase services at Debarq District Hospital. The Health 4+, a joint effort of UNAIDS, UNFPA, UNICEF, UN Women, WHO, and the World Bank , in partnership with Johnson & Johnson, improved clinical services by supporting the training of an Integrated Emergency Obstetrics Surgeon. Other partners, such as Women's and Health Alliance International (WAHA) provide solutions to everything from medical waste management to local transport. Linking this work in Debarq with others who are contributing is critical to ensure that there are no gaps in the continuum of care.

We must raise our voice for children like Silence and her family. My wish is that the global community share expertise and resources, and move away from "siloed" approaches. We must work together across a range of maternal and child health issues to help women and families get the education and care they need to be healthy - and stay healthy - at all stages of their lives. We must use our collective voice to make a noise for children like Silence, and her mother, who deserve a healthy, bright future.

*Translated from Amharic