The three primary killers of children under 5 years of age -- pneumonia, diarrhea and malaria -- are both preventable and treatable with simple and cost-effective interventions. Efforts to end these preventable child deaths will only be successful when integrated packages of interventions are available to the population most at risk.
A few years ago in Nairobi, Kenya, I met Helene Gayle, President and CEO of CARE. Helene's vision and passion for improving the lives of women and girls were evident. Each woman that we encountered told a personal story of creating a better life for her family as a result of CARE's work. It was clear that Helene is leading the charge of "Defending Dignity. Fighting Poverty."
As a child growing up in the rural outskirts of Hong Kong, "wash your hands" was a frequent -- and wise -- admonition. The simple act of eating a piece of fruit or a chocolate bar with soiled fingers and licking those delicious flavors off already dirty hands may have resulted in a stomachache, or so much worse. I was lucky. Even today, intestinal worms caused by lack of access to water for handwashing affects nearly a quarter of the people on this planet.
Millions of people in impoverished countries are alive today because a midwife was by their side when they gave birth, or they were vaccinated as infants by a nurse, or because their families learned from a community health worker to adopt healthy behaviors like breastfeeding, hand washing, birth spacing, and sleeping under a mosquito net.
Yes, improved sanitation has improved the lives of billions of people all over the world, and it's important to note that success. But we need to make some course corrections. The stakes are just too high. Leaving billions of people to live with "improved sanitation" that includes untreated sewage--that's an economic, environmental, and humanitarian catastrophe.
In an ideal world, the issues of poverty would never play a central factor on a child's right to a loving home. Until that day happens, what about the children now? As the call to deinstitutionalize grows louder and spreads faster than alternative solutions, we risk losing a generation of children who for now don't have an alternative to living in an orphanage.
Once trained, a single midwife can provide care for 500 women every year, including safe delivery of 100 babies. An estimated that 350,000 more midwives are needed around the world to help reduce maternal and child deaths -- but training is prohibitively expensive for most women in the developing world.