nextThe news of the attack on the Baghdad UN office rattled me
while reading the Lancet articles on child survival[1]. It crossed my
mind that Chris and the other UN staff would perhaps not have died if they would
have been busy explaining ORT to health officials.
The Lancet articles contain good food for thoughts. But I also found them
wanting in their causal analysis. Some of the countries with the largest number
of child deaths and highest mortality rates have thousands of doctors and
scientists, who of course know the illnesses and how to avoid the deaths, and
who themselves could have written the Lancet articles. But it is not necessarily
the absence of knowledge about child-saving technology that causes children to
die, but the often un-asked and un-answered question why such technology is not
put to use. And here lies the crux. Because it is not “we” or “us” who are going
to prevent 10 million child deaths, but the countries and their people.
UNICEF has not only pioneered and refined the country programme approach
including a country based Situation Analysis (something that the Lancet seems to
favour and which the UN system has adopted via CCA and UNDAF). UNICEF also
promotes a great model conceptual framework indicating the presence of
structural, political, and behavioural causes that are in the way of child
survival. And - through its human rights based approach to programming - UNICEF
is making giant steps to help countries identifying the accountabilities of
those responsible for putting life-saving technology to use[2].
Hence, I am not buying that child mortality can be fixed by doctors, engineers,
and technicians alone focusing on immediate causes. We need the analysts, the
planners, the advocates, the shrewd negotiators, and the visionaries identifying
and tackling structural, political, and organisational causes, to create a world
fit for children.
We knew that human rights based programming leads to more political involvement.
It is sad and shocking that some old or new extremists feel the need to kill
those that are there to help.
And, as we continue to seek and contribute to country-based consensus on the
basic causes for the violation of children’s rights, I am wondering: Are we
harmonizing and aligning too much, making it difficult for people to see our
positions, motives and intentions?
[1] Lancet 2003; Volume 362
Issue 9377, How many child deaths can we prevent this year?, plus four related
articles in the child survival series
[2] This is not to say that we have
collectively mastered the Situation Analysis or HRBAP.
(5 September 2003)
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