A day in the darkness

Children are a gift – an amzing blessing from God. Every single day we may find ourselves doing a lot for our kids, loving and caring for them, nurturing, teaching, training, helping, leading, equipping, encouraging, protecting and so much more. It would not be wrong to say that for the parents every day is children’s day.
Universal children’s day takes place annually on 20th November. It was established to encourage all countries to institute a day, firstly to promote mutual exchange and understanding among children and secondly to initiate action to benefit and promote the welfare of the world’s children.
In many countries, children celebrate the day with full of joy and happiness and make it “well memorable” of their lives, but yesterday when children’s day came in Pakistan the poor innocents were really unaware about what to do and how to celebrate, as they are far away from pleasures and enjoyments.
24.3% of the country’s population lives below the national poverty line. The Economic Survey 2019-20 estimates that at least another 10 million people are expected to slip below the poverty line as a consequence of the coronavirus pandemic. The COVID-19 is expected to have a negative impact on the Pakistan’s economy, and the number of people living below the poverty line may rise from the existing figure of 50 million to 60 million.
The first victims of poverty are children, the weakest and most vulnerable, who face a complete deprivation of their rights in the country. Research and reports sadly convey the figures that an estimated 22.8 million children aged 5-16 are out-of-school, approximately 19 million children below 14 years of age are working as child labourers, millions are on the streets and often sleep hungry, thousands of children in Pakistan die every year from preventable diseases, and there is a troubling increase in the cases of abuse, kidnapping, and violence. The reports also show that children are sold, rented, or even kidnapped in order to force them to beg, serve, and even to prostitute.
Health issues are the worst among all the problems; innocents are facing in the country. Especially, rural healthcare lacks in quality, affordability, and accessibility for several reasons. The main reason at the back of mounting child mortality in Pakistan is lack of child healthcare facilities especially in the remote regions, where the majority of the population lives.
In 2019, the infant mortality rate in Pakistan was at about 55.7 deaths per 1,000 live births. From birth to the age of five the figures of children’s death are available and these figures have become a serious question to be answered. The child mortality rates for Pakistan are amongst the highest in the world. Although there is a consistent decrease in child mortality rate since last two decades still Pakistan has the lowest reduction rate of child mortality in Asia.
Asphyxia, preterm delivery, sepsis, and tetanus are chief causes of deaths among infants and newborns. Similarly, diarrhoea, pneumonia, measles, malaria, HIV/AIDS, and the underlying cause of malnutrition. It is believed that malnutrition alone causes 50% of infant deaths.
Girls who are malnourished as children grow up and become pregnant, not having received any dietary rehabilitation to correct this deficit. This then leads to adverse consequences for the pregnant mother, newborn baby as well as a household’s overall well-being. Limited resources due to widespread poverty, combined with a lack of understanding that pregnant women need nutritious diets along with micronutrients leads to poor weight gain of pregnant women. Thus, malnourished women give birth to babies who are small and weak – increasing their likelihood of dying in the face of otherwise minor illnesses.
Routine immunization coverage rates in Pakistan remain significantly below desired rates of 90% fully immunized children. Medical reports reveal that one child dies every minute from the diseases and acute respiratory tract infection. Illnesses related to diarrhoea are the fourth biggest cause of child deaths in Pakistan.
Poor social conditions and lack of interest of the responsible authorities is causing the increased spread of these diseases. Many of these illnesses spread due to pollution and mismanagement of administrative services for instance diarrhea spreads due to drinking of contaminated water and malaria occurs due to mosquito bite that is born at stagnant water. Low state spending on healthcare, abject poverty, low literacy, lack of skilled birth attendants, widespread communicable diseases, insufficient emergency child health services in government-run district and rural hospitals are amongst other major reasons behind growing diseases in children. Due to unavailability of transportation facilities in remote regions, a number of pregnant women lose their child before reaching the hospital.
The situation of child related issues in the country is abysmal and among the most important national issues that needs serious attention and efforts that are needed by the government and civil society to save the lives of thousands of children who are out of school, homeless, malnourished and most importantly, those who die every year from preventable diseases. Major factors which are playing role in death of children should be improved like education of mother, gender inequality and proper secondary as well as tertiary care.
A holistic approach is needed to improve children and newborn health, mainly by improving and upgrading facilities at district hospitals. In order to save the lives of children, paediatric institutes should be opened in all districts of Pakistan where emergency services along with trained child-disease experts should be made available all the time. There should be a nationwide training program for doctors of Pakistan to make them aware of how to handle pregnancy cases in order to reduce infant mortality rate. Since Neonatal Mortality Rate (NMR) constitutes about half of under five deaths in the country, any initiative to reduce NMR would in turn help in decreasing under five mortality rate and improve child health status.
A well-managed water and sewerage system can be helpful in reducing the amplification of such diseases. There should be proper awareness among people in rural areas about save and healthy life, importance of approaching the hospitals for the treatment. Sufficient public transport facilities are also mandatory to connect them to the health facilities to avoid losses.
We all can strive to play a role for the betterment of the deserving children without considering the volume of the struggles. Small efforts can bring giant changes. Indeed, there are examples that can motivate our moral towards sincerely serving the humanity such as Abdul Sattar Edhi and Dr Ruth Pfao.

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