Vitamin A pills in the dock
HEALTH for the children is a part of overall public health care system. Three major institutions -- the bureaucracy, NGOs and private entrepreneurs are involved in implementation of health related policies and programs. Besides, a score of international agencies operate health care programs for mothers and children under family welfare. All such concerned agencies are fully committed to the UN convention on the rights of the child.
This convention is a universally agreed standard for the care and protection of the child. All ratifying countries, including Bangladesh, are committed to reducing infant and child mortality and combating disease and malnutrition. All the nations of the world are supposed to make sure that all children have access to health care facilities.
Despite global concerns about reducing child mortality, as reflected in one of the objectives of the Millennium Development Goals (MDG), children in developing countries, including Bangladesh, continue to be malnourished and plagued by preventable diseases, and are even denied health security and safety. Poor governance on the part of the bureaucracy is responsible for the poor state of child health. More terrible is the lack of efficient monitoring and evaluation of the child related health policies under implementation.
Preventive health related shocks arising out of vitamin A and anti-worm medicine campaign are an eye opener. In the 1980's, medical scientists ignored evidence that vitamin A could reduce child deaths by between a quarter and a third in many developing countries. This scepticism has been swept away by "an avalanche of data." Most countries in the developing world are now moving to make this most cost effective health intervention available to their children.
Lately, the reaction to vitamin A capsules and de-worming tablets has taken a heavy toll. About 400 children who were provided with vitamin A capsules and de-worming tablets were taken to different hospitals and clinics because of diarrhoea. Two children -- a six year old and an eleven year old -- succumbed to such diseases after taking vitamin A capsules and de-worming tablets, their parents claimed. This a fearful situation, going to such an extent that parents do not want their infants to take vitamin A capsules and de-worming pills. The vitamin A campaign as such has become undone, and the worried mothers have become sceptical and seized by panic.
This disaster has opened a Pandora's Box of questions about the commitment of the dispensing authorities and international agencies sponsoring vitamin A policy advocacy campaigning across the country. A child or an infant needs vitamin A because severe vitamin A deficiency causes blindness, even paralysis and death. It also impairs immunity. Many infants suffer a lot from worms that cause pain, ulcer, fever and deformities.
Brushing aside mass phobia and scepticism, international agencies like WHO and Unicef advocated vitamin A campaign along with de-worming programs. The Unicef communication chief seems to uphold the quality of the capsules and tablets, which are rigorously controlled and supplied by this agency. The concerned authorities in Bangladesh claimed that there were no incidents of deaths as there were no side effects of vitamin A capsules and de-worming tablets. Many medical practitioners thought that several thousand children suffering from diarrhoea in the summer was a mere coincidence.
Notwithstanding all such declamation in self-defense, the campaign for vitamin A is in jeopardy. Only forming a probe body as a conventional institutional response is eyewash. The government, NGOS and international agencies cannot afford to disclaim their respective obligations and commitments. They ought to review their child health interventions. An enquiry committee should investigate the matter properly to bring the culprits to book and to see whether there was any sabotage to undo the supply line. It should try to see if there was any inefficiency and corruption in the distribution process.
The international agencies sponsoring the vitamin A campaign may well be advised to review intervention considering the time and suitability to a tropical climate. The news that many primary school going children are falling sick after eating biscuits distributed by international agencies is mind boggling. All the actions of the concerned agencies must be aimed at confidence building among the masses, dispelling all doubts and scepticism.
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