The US commission investigating STD research unwittingly conducted on Guatemalans in the 1940s has concluded that “at least 83 people died as a result of the “study” AFP reports We are still waiting for a comparable investigation of, and governmental apology for, similarly unethical CIA torture research.
Unethical U.S. research killed 83 in Guatemala: panel
WASHINGTON — At least 83 people died as human guinea pigs in macabre US research on sexually transmitted diseases in Guatemala in the 1940s, a commission ordered by President Barack Obama concluded Monday.
Nearly 5,500 people were subjected to diagnostic testing and more than 1,300 were exposed to venereal diseases by human contact or inoculations in research meant to test the drug penicillin, the presidential commission found.
Within that group, “we believe that there were 83 deaths,” said Stephen Hauser a member of the commission, which has pored over 125,000 documents linked to the shocking episode since being set up by Obama last November.
Among the 1,300 people exposed to STDs during research between 1946 and 1948, “under 700 received some form of treatment as best as could be documented,” Hauser said.
Obama personally apologized to Guatemalan President Alvaro Colom in October before ordering a thorough review of what happened. Secretary of State Hillary Clinton described the experiments as “clearly unethical.”
This sentiment was clearly expressed by the commission, which said US government researchers must have known they were contravening ethical standards by deliberately infecting mental patients with syphilis.
Commission president Amy Gutmann called it an “historic injustice,” and said the inquiry aimed to “honor the victims and make sure it never happens again.”
“It was not an accident that this happened in Guatemala,” Gutmann said. “Some of the people involved said we could not do this in our own country.”
The US researchers “systematically failed to act in accordance with minimal respect for human rights and morality in the conduct of research,” she said, citing “substantial evidence” of an attempted cover-up.
A Guatemalan study, which was never published, came to light in 2010 after Wellesley College professor Susan Reverby stumbled upon archived documents outlining the experiment led by controversial US doctor John Cutler.
Cutler and his fellow researchers enrolled 1,500 people in Guatemala, including mental patients, for the study, which aimed to find out if penicillin could be used to prevent sexually transmitted diseases.
Initially, the researchers infected female Guatemalan commercial sex workers with gonorrhea or syphilis, and then encouraged them to have unprotected sex with soldiers or prison inmates.
Neither were the subjects told what the purpose of the research was nor were they warned of its potentially fatal consequences.
Cutler, who died in 2003, was also involved in a highly controversial study known as the Tuskegee Experiment in which hundreds of African-American men with late-stage syphilis were observed but given no treatment between 1932 and 1972.
The Guatemalan president has called the 1946-1948 experiments conducted by the US National Institutes of Health “crimes against humanity” and ordered his own investigation.
August 30th, 2011
I have come across an important article from the British Medical Journal that discusses one of the major gaps in what has come to be called Evidence-Based Medicine. Such a gap is a major scandal for the field of medicine:
Parachute use to prevent death and major trauma related to gravitational challenge: Systematic review of randomised controlled trials
Gordon C S Smith, professor1, Jill P Pell, consultant2
1 Department of Obstetrics and Gynaecology, Cambridge University, Cambridge CB2 2QQ, 2 Department of Public Health, Greater Glasgow NHS Board, Glasgow G3 8YU
Correspondence to: G C S Smith gcss2@cam.ac.uk
Abstract
Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
Design Systematic review of randomised controlled trials.
Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.
Study selection: Studies showing the effects of using a parachute during free fall.
Main outcome measure Death or major trauma, defined as an injury severity score > 15.
Results We were unable to identify any randomised controlled trials of parachute intervention.
Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.
November 25th, 2009
A new study estimates that 45,000 Americans die yearly from lack of medical insurance. It’s a good thing we have the best healthcare system in the world:
45,000 excess deaths annually linked to lack of health insurance: study
A study published online today estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.
The new study, “Health Insurance and Mortality in U.S. Adults,” appears in today’s [Thursday's] online edition of the American Journal of Public Health.
The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.
Lead author Dr. Andrew Wilper, who worked at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, said, “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease – but only if patients can get into our offices and afford their medications.”
The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.
Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.
Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease.
An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths associated with lack of insurance. The uninsured are more likely to go without needed care.
Another factor contributing to the widening gap in the risk of death between those who have insurance and those who don’t is the improved quality of care for those who can get it.The research, carried out at the Cambridge Health Alliance and Harvard Medical School, analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.
The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those that examining physicians said were in fair or poor health (222 percent increase).
Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”
Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, “The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate – now one dies every 12 minutes.”
More information: “Health Insurance and Mortality in U.S. Adults,” Andrew P. Wilper, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., Karen E. Lasser, M.D., M.P.H., Danny McCormick, M.D., M.P.H., David H. Bor, M.D., and David U. Himmelstein, M.D. American Journal of Public Health, Sept. 17, 2009 (online); print edition Vol. 99, Issue 12, December 2009.
September 18th, 2009
And now for some good news. A recent study finds major drops in mortality [dying] among those heart attack survivors who ate chocolate at least twice a week. Usually I caution about waiting for replication of research findings before acting on them. But in this case….
Chocolate ‘cuts death rate’ in heart attack survivors
By Marlowe Hood
PARIS (AFP) – Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold compared to those who never touch the stuff, scientists have reported.
Smaller quantities confer less protection, but are still better than none, according to the study, which appears in the September issue of the Journal of Internal Medicine.
Earlier research had established a strong link between cocoa-based confections and lowered blood pressure or improvement in blood flow.
It had also shown that chocolate cuts the rate of heart-related mortality in healthy older men, along with post-menopausal women.
But the new study, led by Imre Janszky of the Karolinska Institute in Stockholm, is the first to demonstrate that consuming chocolate can help ward off the grim reaper if one has suffered acute myocardial infarction — otherwise known as a heart attack.
“It was specific to chocolate — we found no benefit to sweets in general,” said Kenneth Mukamal, a researcher at Beth Israel Deaconess Medical Center in Boston and a co-author of the study.
“It seems that antioxidants in cocoa are a likely candidate” for explaining the live-saving properties, he told AFP in an exchange of e-mails.
Antioxidants are compounds that protect against so-called free radicals, molecules which accumulate in the body over time that can damage cells and are thought to play a role in heart disease, cancer and the aging process.
In the study, Janszky and colleagues tracked 1,169 non-diabetic men and women, 45-to-70 years old, in Stockholm County during the early 1990s from the time they were hospitalised with their first-ever heart attack.
The participants were queried before leaving hospital on their food consumption habits over the previous year, including how much chocolate they ate on a regular basis.
They underwent a health examination three months after discharge, and were monitored for eight years after that. The incidence of fatal heart attacks correlated inversely with the amount of chocolate consumed.
“Our findings support increasing evidence that chocolate is a rich source of beneficial bioactive compounds,” the researchers concluded.
The results held true for men and women, and across all the age groups included in the study.
Other factors that might have affected the outcome — alcohol consumption, obesity, smoking — were also taken into account.
So should we all be loading up on cocoa-rich sweets?
“To be frank, I’m pretty cautious about chocolate because we’re working on weight problems with so many individuals,” said Mukamal, who is also a practising physician.
“However, I do encourage those who are looking for healthier desserts to consider chocolate in small quantities,” he said.
“For individuals with no weight issues who have been able to eat chocolate in moderation and remain slim, I do not limit it,” he added.
The researchers caution that clinical trials are needed to back up the findings of their study.
In the meantime, however, a bit of chocolate may not be amiss, they suggest.
August 14th, 2009
Several readers of my post earlier today New Doubts Regarding the Lancet Iraq Mortality Study have raised the question as to why the lapse committed by Burnham et al. in this study warrants dismissing the entire study. After all, they argue, the lapse of recording names was an ethical lapse, perhaps, but recording extra information should not affect the results. Let me take this opportunity to clarify my reasoning.
The faith one has in the results of any study depends largely on the quality of the research design and on how carefully that design is followed. In the case of a population-based epidemiological survey like the 2006 Lancet study (Lancet II), even minor deviations from the survey design can have large effects on the results. (Survey research depends crucially on every person in the population having an equal chance of being selected.) As one example, if interviewers used discretion – beyond that mandated by safety considerations – in selecting households, it could introduce (probably unintentional and unconscious) bias that would make the findings unreliable. For this reason, survey researchers attempt to maintain strict control over the procedures actually used by those collecting data in the field.
We have been assured for years that the design of Lancet II was carefully followed. Now we hear that the specified design was not followed in a crucial way that may have put participants at risk. Furthermore, the Lancet researchers have for years pointed to those very risks as reasons to deny access to raw data and to withhold crucial methodological information when questioned. The fact that the protocol wasn’t followed in a central aspect severely reduces the confidence we can have that the study procedures were carefully monitored.
The Baltimore Sun reported:
“Because of the difficulty of carrying out research in Iraq during the war, Burnham and his team partnered with Iraqi doctors at a university in Iraq. Burnham, working out of Jordan, said he made it clear to the doctors that they could collect the first names of children and adults, to help keep the information straight, but that last names could not be collected.
“When the surveys came back to him in Jordan, it appeared that some had last names. Many were in Arabic. Burnham said he asked his Iraqi partners and was told that the names were not complete, which he accepted. But Hopkins, in its investigation, found that the data form used in the surveys was different from what was originally proposed, and included space for names of respondents. Hopkins found that full names were collected.”
This description, if true, supports the assumption that Burham was in no position to carefully monitor the details of data collection for the study. Further, at its most charitable, it indicates severe communication difficulties with the Iraqi staff that may easily have left him unaware of other possible deviations in procedures. If one is not so charitable, one may wonder why Burham was told a falsehood, that the names were only first names, and thus what else was distorted. In any case, in the absence of this confidence in the study procedures, we cannot maintain confidence in the study’s results.
There is yet another troubling aspect of this incident. The lapse that occurred, recording of full names of respondents reporting deaths from violence in a country undergoing civil war after the Johns Hopkins ethics committee and the respondents were told no names or unique identifiers would be collected, is no trifling error. As Johns Hopkins Magazine reported in its February 2007 issue:
“Concern for the safety of interviewers and respondents alike produced two more decisions. First, they would not record identifiers like the names and addresses of people interviewed. Burnham feared retribution if a hostile militia at a checkpoint found a record of households visited by the Iraqi survey teams.”
Thus, the researchers were well aware that collecting names of respondents could put them at grave risk. Burnham owed it to the people in his study to have enquired further when he noticed names on the forms and not so easily accepted false reassurances. That he did not suggests that he may have (perhaps unconsciously) looked the other way at other possible deviations from protocol.
Since the study was released over two years ago, it has been subjected to severe criticism. While much of this criticism was likely motivated by concern for the political implications of the study, and some of the criticism was clearly unwarranted, that does not give the study a free pass on criticism. And we shouldn’t look the other way to its potential problems just because its findings support our antiwar position.
In response to the criticism, the Lancet study authors have been less than forthcoming with key details, such as their exact sampling procedure for selecting streets, which, under criticism, they admitted was not accurately described in the published paper. That we now know that another crucial detail, the collection of identifiable information, deviated from the published record, and that the authors failed to correct the public record on the matter until forced to, raises questions about what other aspects of the study may not have been conducted as described. As long as these questions remain, the study cannot be considered reliable.
March 16th, 2009
SEE UPDATE BELOW:
Since the Iraq war began, an important question for those closely following the conflict has been the number of excess Iraqi casualties resulting from the war and occupation. Various researchers have attempted to estimate this number. Iraq Body Count has kept a running tab of civilian deaths reported in the Western media and, more recently, by certain Iraqi government sources., but their figure, now at around 95,000, is undoubtedly low due to its reliance on media reports and Iraqi government figures. During times of intense conflict, many deaths likely go unreported in the media, while there have been numerous inconsistencies in and reports of political manipulation of government figures as it may not be in the government’s interest to admit the extent of deaths from the conflict.
An alternate way to estimate conflict-associated mortality is through the conduct of carefully sampled household surveys counting the number of deaths in selected households and using statistical techniques to extrapolate to the overall population. Much attention has been focused especially, by myself and others, on the Lancet mortality studies of 2004 and 2006.The first of these studies estimated that there had been approximately 100,000 excess deaths from the war by September 2004. The second study estimated that there were around 650,000 excess deaths through summer 2006. They further found that the vast majority of these excess casualties — around 600,000 — were from violence, a stark contrast from most other such conflicts studied where large numbers die from poor health and the breakdown of social organization associated with conflict. “Excess casualties” here means the number who died above that number that would have been expected to die had prewar trends continued and the war and occupation not occurred.
We have recently learned that Gilbert Burham, the lead author of second Lancet study, has been sanctioned by Johns Hopkins for deviating from the approved IRB protocol and collecting the names of many survey respondents, a fact that was implicitly denied in numerous public pronouncements. The school does assert that, as far as they can determine, no one was harmed by this ethical lapse. As a result of this sanction, Burnham has been barred by Johns Hopkins from serving as the principal investigator (lead researcher) on studies involving “human subjects” (live people) for five years. He was also ordered to publish a correction in the Lancet, which has now appeared:
“The Methods section of this Article (Oct 21, 2006) stated that ‘Participants were assured that no unique identifiers would be gathered.’ Upon review, it was determined that a significant number of the surveys contained names of respondents and household inhabitants. This was a lapse in the authors’ obligations to protect participants. However, to the authors’ knowledge, the completed surveys remained in possession of the research team at all times and there were no known breaches in confidentiality.”
This error, and its possible coverup in subsequent public statements means that, in my opinion, we can no longer rely upon the Lancet II mortality estimates. If one major methodological detail was distorted, we simply cannot know whether other aspects of the study were carried out as stated. Until and unless there is far greater detail on these methods, I do not feel that their estimate of 650,000 post-invasion surplus deaths can be trusted.
Burnham had early last month been censured by the American Association for Public Opinion Research for refusing to reveal details of the study methodology. I must say I find this censure highly unusual at best as Burnham is not a member of AAPOR. I have never previously heard of a professional association investigating, much less censuring, a non-member. However, as the Hopkins investigation shows, the non-cooperation may have been to cover up the methodological discrepancy, rather than for more understandable reasons.
I find this episode deeply disturbing. The issue of the magnitude of civilian deaths in Iraq is a profoundly important one. Given the known political sensitivity of the issue, the researchers should have been especially careful in the controllable aspects of their methodology. They were not. Rather, they gave ammunition to those who would inevitably attack their conclusions for political or ideological reasons. The result is that we are less knowledgeable about this important question than many of us believed as an important data source is no longer reliable.
While I find David Kane’s self-satisfied tone to be disturbing, I must admit that he was more right than I had believed regarding the weaknesses in the Lancet II study. As Kane points out, Burnham’s public statements were, in spirit if not in legalistic wording, not accurate.
We are left with several other studies estimating Iraqi casualties. The British ORB polling company estimated as of August 2007
that over 1,000,000 Iraqi citizens have died as a result of the conflict which started in 2003
While ORB is a reputable polling company, the faith we can place in these results is weakened due to their failure to publish a detailed methodology; such information is typically included in papers published in peer-reviewed journals, which is one reason researchers typically place greater credence on studies published in such journals. When the Lancet II findings were credible, the ORB study appeared to be a replication of the general order of magnitude of casualties found in that study. With the increased doubts about the Lancet II study, the ORB stands as an outlier. I wish the firm would publish a detailed methodology that would allow better evaluation of their findings.
At the low end, a study conducted by the Iraq Ministry of Health and other Iraq government entities in collaboration with the World Health Organization, estimated 151,000 violent between January 2002 and June 2006. While the authors did not estimate the total number of excess deaths — nonviolent as well as violent — presumably because these estimates would be less precise, dependent as they would be on estimates of prewar mortality rates, those estimates would be considerably higher by several hundred thousand. Critiques of this study have questioned whether many Iraqi citizens might be reluctant to admit to Iraqi government-associated researchers that a family member was killed by violence. Thus, it is not implausible to assume that this study is an undercount and constitutes a lower bound. As the Ministry of Health study period ended while some of the most severe violence was still occurring, there have likely been many more violent deaths since then.
Thus, the best guess we can make at present is that at least 200,000 people died through violence since the US-led invasion, and that the true figure may be far higher. Moreover, an additional number that could be in the hundreds of thousands may have died from nonviolent causes — e.g., lack of clean water and healthcare — associated with the conflict, but this figure is uncertain. No matter what the correct figures turn out to be, it is clear that far too many have died as a result of this war of choice and subsequent occupation which may have deposed a dictator but which also disrupted an entire society.
UPDATE:
Postscript:
Several readers have raised the question as to why the lapse committed by Burnham et al. in this study warrants dismissing the entire study. After all, they argue, the lapse of recording names was an ethical lapse, perhaps, but recording extra information should not affect the results. Let me take this opportunity to clarify my reasoning.
The faith one has in the results of any study depends largely on the quality of the research design and on how carefully that design is followed. In the case of a population-based epidemiological survey like the 2006 Lancet study (Lancet II), even minor deviations from the survey design can have large effects on the results. (Survey research depends crucially on every person in the population having an equal chance of being selected.) As one example, if interviewers used discretion – beyond that mandated by safety considerations – in selecting households, it could introduce (probably unintentional and unconscious) bias that would make the findings unreliable. For this reason, survey researchers attempt to maintain strict control over the procedures actually used by those collecting data in the field.
We have been assured for years that the design of Lancet II was carefully followed. Now we hear that the specified design was not followed in a crucial way that may have put participants at risk. Furthermore, the Lancet researchers have for years pointed to those very risks as reasons to deny access to raw data and to withhold crucial methodological information when questioned. The fact that the protocol wasn’t followed in a central aspect severely reduces the confidence we can have that the study procedures were carefully monitored.
The Baltimore Sun reported:
“Because of the difficulty of carrying out research in Iraq during the war, Burnham and his team partnered with Iraqi doctors at a university in Iraq. Burnham, working out of Jordan, said he made it clear to the doctors that they could collect the first names of children and adults, to help keep the information straight, but that last names could not be collected.
“When the surveys came back to him in Jordan, it appeared that some had last names. Many were in Arabic. Burnham said he asked his Iraqi partners and was told that the names were not complete, which he accepted. But Hopkins, in its investigation, found that the data form used in the surveys was different from what was originally proposed, and included space for names of respondents. Hopkins found that full names were collected.”
This description, if true, supports the assumption that Burham was in no position to carefully monitor the details of data collection for the study. Further, at its most charitable, it indicates severe communication difficulties with the Iraqi staff that may easily have left him unaware of other possible deviations in procedures. If one is not so charitable, one may wonder why Burham was told a falsehood, that the names were only first names, and thus what else was distorted. In any case, in the absence of this confidence in the study procedures, we cannot maintain confidence in the study’s results.
There is yet another troubling aspect of this incident. The lapse that occurred, recording of full names of respondents reporting deaths from violence in a country undergoing civil war after the Johns Hopkins ethics committee and the respondents were told no names or unique identifiers would be collected, is no trifling error. As Johns Hopkins Magazine reported in its February 2007 issue:
“Concern for the safety of interviewers and respondents alike produced two more decisions. First, they would not record identifiers like the names and addresses of people interviewed. Burnham feared retribution if a hostile militia at a checkpoint found a record of households visited by the Iraqi survey teams.”
Thus, the researchers were well aware that collecting names of respondents could put them at grave risk. Burnham owed it to the people in his study to have enquired further when he noticed names on the forms and not so easily accepted false reassurances. That he did not suggests that he may have (perhaps unconsciously) looked the other way at other possible deviations from protocol.
Since the study was released over two years ago, it has been subjected to severe criticism. While much of this criticism was likely motivated by concern for the political implications of the study, and some of the criticism was clearly unwarranted, that does not give the study a free pass on criticism. And we shouldn’t look the other way to its potential problems just because its findings support our antiwar position.
In response to the criticism, the Lancet study authors have been less than forthcoming with key details, such as their exact sampling procedure for selecting streets, which, under criticism, they admitted was not accurately described in the published paper. That we now know that another crucial detail, the collection of identifiable information, deviated from the published record, and that the authors failed to correct the public record on the matter until forced to, raises questions about what other aspects of the study may not have been conducted as described. As long as these questions remain, the study cannot be considered reliable.
March 15th, 2009
Parts of the world medical community are starting to protest the deatj-creating conditions in Gaza. The Lancet has release an editorial criticizing the Israeli attacks on civilian. Here is an AFP story [I can't find the editorial online yet.]:
Lancet blasts Israeli ‘atrocities’ in Gaza
PARIS (AFP) – Israel is responsible for “large and indiscriminate human atrocities” in Gaza, and the world medical establishment is a silent accomplice in the bloodshed, The Lancet charged on Wednesday.
In an editorial released ahead of publication next Saturday, the British health journal said Israel, by hitting civilians and wrecking medical infrastructure, had carried out attacks that were “unjustified and disproportional.”
“We find it hard to believe that an otherwise internationally respected, democratic nation can sanction such large and indiscriminate human atrocities in a territory already under land and sea blockade,” The Lancet said.
“… The collective punishment of Gazans is placing horrific and immediate burdens of injury and trauma on innocent civilians. These actions contravene the fourth Geneva convention.”
The editorial also blasted “national medical associations and professional bodies worldwide,” accusing them of keeping silent as the destruction unfolded.
“Their leaders, through their inaction, are complicit in a preventable tragedy that may have long-lasting public-health consequences not only for Gaza for also for the entire region,” it said.
More than 1,000 Palestinians have been killed, and at least 4,580 injured, since Israel launched Operation Cast Lead on December 27, the head of emergency services in the territory, Muawiya Hassanein, told AFP on Wednesday.
Israel says the operation aims at quelling rocket attacks by Hamas militants that threaten civilians living in an arc of southern Israeli towns.
The Lancet focusses on publishing medical research, but it also has a tradition of outspokenness on political issues that touch on health, such as the Iraq War and government policies on AIDS.
January 15th, 2009
The International Save the Children Alliance warns of the danger posed by Gaza conditions to newborns and young children:
Newborns and Babies in Gaza Face Increasing Health Threats
JERUSALEM (January 11, 2009) - Save the Children warns that Gazan babies’ lives are increasingly threatened by deteriorating living conditions and two weeks of conflict, with Gaza’s biggest pediatric hospital reporting that parents have been unable to bring ill children to the hospital. The World Health Organization reports that 34 out of 56 primary health care centers are open, but are seeing a 90 percent reduction in visits.
In addition, doctors and Save the Children staff in Gaza say that women are giving birth at home because they cannot reach a health facility. In many cases, they are being assisted by relatives or neighbors.
“Babies in the first month of life face the greatest risk of dying among all children globally,” said Annie Foster, Save the Children’s team leader for the Gaza emergency. “The threats to them are greater in a war zone, where danger in the streets prevents parents from accessing critical health services. Timely treatment of a complication during delivery can mean the difference between the survival of a mother and her new baby or not.”
Research shows that most newborn deaths could be prevented if women had access to basic health measures such as having a skilled attendant during childbirth who can identify and refer or complications, counseling on newborn care during the first critical hours and days after birth, and pre- and antenatal care.
“Save the Children knows from decades of experience working to improve infant and child heath that simple measures – among them keeping newborns warm, and ensuring treatment for pneumonia and diarrhea – can save babies’ lives,” said Foster. “Gaza’s youngest and most vulnerable should be able to receive the care and attention they need.”
According to UNICEF, approximately 320,000 children in Gaza are under 5 years of age, including about 40,000 infants under 6 months of age.
Even before the latest outbreak of violence, 50,000 Gazan children were malnourished, more than two-thirds of all children suffered from vitamin A deficiency and almost half of children under age 2 were anemic. Lack of access to food, clean water and medical supplies exacerbates threats to children’s health and well-being.
Save the Children is calling for a peaceful solution to the current crisis that endangers the lives of nearly every child in Gaza, and the lives of Israeli children in areas subject to attacks. Save the Children is calling for a cessation of hostilities by all parties including air and ground assaults from Israel and rocket attacks from Gaza. The agency is also seeking free access for humanitarian assistance to allow aid agencies to provide much-needed relief to vulnerable children and so that children and their families can access essential services.
January 11th, 2009