Alleviating Infant Mortality in Guinea-Bissau

The Milkman Cometh!

You ever wonder what ever happened to the baby in the bed next to you at the nursery? Did he go on to become a doctor? Is she a race-car driver? It wasnít until I landed here in Guinea-Bissau, a tiny impoverished nation in West Africa that I pondered this question. You see, Guinea-Bissau and I share a common bond, but I didnít discover this until I scoured the streets of the capitol city Bissau for an affordable hotel room. Since there are no tourists whatsoever in this undeveloped country of one and a half million people, the only hotels exist to cater to foreign development workers whose organizations pay their expensive hotel bills. After trudging through the dusty streets for an hour with my backpack getting heavier by the minute, I was told about a somewhat-affordable place on Avenida 12 de Setembro. Ecstatic to finally speak Portuguese in Africa, I asked the importance of this date, for I assumed it had not been named in honor of my birthday. I was told that September 12, 1974 is Guinea-Bissauís independence was recognized by Portugal.

But despite our common birthday, our destinies could not be more different. I was conceived out of the pure love of two wonderful parents. Sure, I had a bit of a tumultuous delivery; my mother still complains about my two-week late arrival, but in the midst of placental bliss, I must not have gotten the memo telling me my nine months were up. But upon my arrival, I received excellent medical care, nourishing breast milk and a happy home.

Guinea-Bissau, on the other hand, was born out of centuries of conflict. For two hundred years, this region was home to the torturous slave trade between the Portuguese empire and the African tribes that thrived from this shameful practice. This human commerce was so profitable that the region was coined ďThe Slave CoastĒ and colonized by the Portuguese in the eighteenth century. After hundreds of years under the yoke of colonialism, an independence movement was born in 1956, but nearly twenty years of armed conflict would take place before independence was granted. Shortly before its birth, its founding father Amilcar Cabral was assassinated. When Guinea-Bissau was officially born, the Portuguese left the country en masse, and what remained was a struggling economy beset with political instability and under-funded and inefficient health and educational systems.

Since our shared birthday, while I have received nourishing food, wonderful schooling and a healthy upbringing, Guinea-Bissau has been wracked by uprisings, coups and a crippling civil war in 1998. (As a sidenote: I visited a British organization that is still clearing undetonated ammunition from the countryside here that has remains from the civil war; farmers and children still lose limbs and lives to these unexploded weapons). While many countries have enjoyed economic expansion, Guinea-Bissau has been plagued by debt and a lack of social services; today, roughly a quarter of kids here complete the sixth grade and itís per capita income hovers around $600 a year. To make matters worse, this country has become a transit point for South American cocaine shipments to Europe, with many government officials involved in the trafficking, which generates ten times the countryís national income.

Arriving in complete darkness in the absence of streetlights while crammed into a station-wagon with nine other passengers, it was immediately obvious this country is beset with problems. Besides the fact there was a failed coup attempt six days before my arrival when a military faction invaded the presidential palace, there is virtually no running water in the entire country and only electricity in the capitol city of Bissau. Even here though, power is spotty at best, as I learned while trying in vain to sleep in a sweaty bed. While in the countryís second largest city, Bafata, I learned there is no internet available in town - anywhere. Imagine Los Angeles without a single internet connection.

But what is especially troubling about this country are the horrific health conditions. The male life expectancy in the US is 75 years, but only 45 here in Guinea-Bissau, so while I consider myself enjoying the prime of my life, that baby in the crib next to me, if he were from Guinea-Bissau, would be only ten years from his grave.

That got me thinking about the babies here in Bissau that are born into such a fragile existence. In fact, Guinea-Bissauís infant mortality rate ranks as one of the highest in the world. Over eleven percent of babies born here do not survive their first year of life and twenty percent of babies do not live to celebrate their 5th birthday. Just think about that a second; imagine if every child you gave birth to or knew had a 11% chance of dying before itís first birthday. Itís a startling statistic. As a result, many babies here are not even named until six months after their birth, so as to avoid an emotional attachment with a child with such a tenuous lease on life. While funerals for old members of the community are very somber events, the deaths of young babies do not warrant big ceremonies. The main causes of infant mortality are malaria, acute respiratory infections, malnutrition and water-borne diseases.

Another related health problem for babies and the entire population is AIDS. While the nationís HIV rate is much lower than many other African countries, what is especially troubling is the ďvertical transmissionĒ rate from HIV+ mothers to their babies, a figure that stands at about 25%. After researching this problem, I learned that by treating the mother with a drug called Retrovir during pregnancy and delivery and then administering the newborn with the same drug for the first six months of its life can reduce to rate of transmission to 2.5%!

In the process of searching out a local project that addresses this need, I visited with officials from international health organizations, the European Commission and the Maternity Ward at the government hospital (which was a very troubling experience). Several people I spoke with in Bissau raved about the same project: Clinica Ceu e Terra, which was founded in 2001 by a Cuban doctor who has been working here for twenty years. This clinic (which translates to Sky and Earth Clinic) offers free services to more than 2,000 HIV+ women in order to prevent the vertical transmission of the virus to their babies. Without this clinic, there is no chance these women would be able to afford the Retrovir or the powdered milk to feed their babies. 25% of these children (500 babies) would be sentenced to a life with HIV, but thanks to the wonderful work of Ceu e Terra, only 2.5% (50 of them) will inherit the virus. Thatís 450 prosperous lives spared. Those are the kind of results I look for before supporting a project!

Speaking with the director of the clinic, I offered to help on behalf of my donors, at which point she let out a huge sigh of relief as she explained that one of the clinicís foreign donors had recently re-allocated its resources, leaving her with a shortage of the fortified powdered milk the mothers feed their babies. I went directly to the supplier and purchased $600 worth of product, tossed it in the trunk of a taxi and returned an hour later as the Milkman Extraordinaire. I also sought out two mothers that are in especially dire straits and provided each with $60(over a monthís wages here) to spend on food for their babies, as they are currently facing malnutrition.

As I held baby Mamadou in my arms, it saddened me to reflect the uphill battle she faces. I thought back to my own days as a newborn and more than ever, I realize just how blessed I have been. I only hope that with the help of clinics like this and through the generous donations of people like you, Mamadou will live a happy, productive life in this challenging land of limited opportunity.

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