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Central African Republic

Renowned photographer Jan Grarup documents UNICEF child survival efforts in Central African Republic

© UNICEF CAR/2011/Stark-Merklein
Jan Grarup photographs a mother and her two children in Sibut, outside the emergency unit of one of the few hospitals in Central African Republic. Many parents cannot afford medical fees to get treatment for their children.

By Brigitte Stark-Merklein

BANGUI, Central African Republic, 17 June 2011 – Renowned Danish photographer Jan Grarup recently visited Central African Republic (CAR) to document the challenges facing young children in the country, and how UNICEF responds.

Mr. Grarup’s photographs will support UNICEF Denmark’s ‘Give Me Five’ advocacy campaign that draws attention to the interventions children need to survive their crucial first five years of life.

Costs of disease

A seasoned war photographer who is not easily daunted, Mr. Grarup was surprised by the difficulties young children have to overcome in CAR.

“I just had a daughter myself and her first weeks of life have been so sheltered compared to what babies here are facing,” he says, commenting on his visits to health centres and hospitals where he saw infants struggling with malaria, malnutrition and a range of other diseases.

Christelle Abou, 22, knows from experience how difficult it is for her country’s children to survive. She lost her three-year old daughter Leslie a month ago to cerebral malaria that could no longer be treated when she arrived at the hospital.

“Leslie was often sick and then she developed anaemia in addition to malaria,” says Christelle. She looks down at the floor as she explains that her family subsists on her husband’s income from badly paid odd jobs and could not always afford the costs for doctor visits.

When her second daughter Deborah, 2, had a fever, Christelle did not want to take any risks. She immediately rushed her to the children’s hospital in Bangui where the girl was diagnosed with intestinal infection and malaria and is expected to recover.

Christelle’s struggle to keep her children alive is similar to that of thousands of Central African mothers and families. CAR’s infant and under-five mortality rates are among the highest in the world. Out of 1,000 children born in the country, 112 will die before reaching their first birthday and 171 out of 1,000 before reaching the age of five.

© UNICEF CAR/2011/Stark-Merklein
Christelle Abou, left, sits on her daughter Deborah's bed in Bangui children’s hospital emergency unit in Central African Republic. The two-year old girl is being treated for an infection.

Child survival strategy

Most of these deaths are due to malaria, diarrhoea, respiratory infections, malnutrition and measles – all preventable diseases.

But CAR is a poor country – two thirds of the population live on less than $1.25 a day – with an extremely weak healthcare system. At Bangui paediatric hospital, the only public facility allocated to the care of infants and children, there is one paediatrician per 4,592 children and one medical doctor per 6,888 children. Much of the medical equipment is outdated and medicines are in short supply.

To respond to these challenges, UNICEF recently launched an accelerated child survival strategy that provides health centres throughout the country, including the paediatric hospital, with essential drugs, anti-malaria medication, bed nets, micro-nutrients, medical equipment and other supplies.

The strategy is designed to reach newborns in every part of the country, including the most remote areas, if necessary with home visits. The package offered consists of integrated services such as prevention and treatment of malaria, infant and young child feeding, and immunization of children and mothers.

Other services include elimination of new HIV infections in infants and children, and management and care of HIV-exposed and infected children. Medical staff and health workers are being trained in the management of childhood illnesses at community-level.

Hope for the future

According to evidence from other countries, UNICEF’s accelerated child survival and development strategy can help reduce childhood mortality rates by over 60 per cent, if fully implemented.

Mr. Grarup is hoping that his work will help to raise awareness on the plight of Central African children, and funds for UNICEF to scale up child survival efforts. “I trust that people back home will be touched by the images of these children and their difficult situation,” he says.

Click here for a link to Jan Grarup’s photographs from Central African Republic on UNICEF Denmark’s website.



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