Child mortality
Race against time
Does it really matter if the Millennium Development Goals are not achieved? Of the eight goals set, there are a few that will be achieved (or have already been satisfied) before the 2015 time horizon. Others might not cut it.
Child mortality is one of those measures that is looking doubtful of meeting the 2/3 reduction of 1990 measurement of under-five death before 2015.
It is a race against time, and we as a global community as close to halving the 1990 level. Reduced from around 12 million deaths of under-five children in 1990 to an approximated 6.4 million deaths in 2013.
The stunt which frames the 10 City Bridge Run will illustrate this through running across two distances:
- 2.4 km. A participative run involving a large group running 2.4 km together across a bridge. There are 2.4 million children too many dying this year in 2013 above what is required to achieve the Millennium Development Goal 4 (reduce child mortality by 2/3 from 1990 levels before 2015).
- Half-Marathon. 10 half-marathons will be run in 10 cities across 10 countries as a stunt to show we have halved 1990 levels, and while that is good, it is now a race against time in this marathon journey to end child mortality.
This running is framing the conversation asking: “how can we use our networks to improve the delivery of child survival?”
There are a lot of people who have been working hard on this issue for more years than I have been aware of it. How can we find, learn about, then share best practice to make a difference in the lives of literally millions of people where the need is at its greatest?
This is a race we want to win. Together.
Reframe: Improving Child Survival
My last post was a month ago, but in that space of time I have covered a very large distance in many different respects. I wrote as I travelled from Sydney to London to attend the Commonwealth Study Conference, otherwise known as CSCLeaders. That trip proved to be a turn-key moment in gaining a new sense of clarity about this initiative.
It has taken me some time to process everything that has taken place. One month in fact. There is much to share, but here I just wanted to start with one brief comment.
I have reframed the 10 City Bridge Run following the input of many people and much reading over the last month. The emphasis, I believe, needs to be placed on child survival not child mortality.
Let me explain why:
- Child mortality is easy to explain, and is a very tangible and very troubling measure.
- The 10 City Bridge Run is an initiative about how we might use our networks for the better.
- I have come to the realisation that together we cannot actually reduce child mortality. Larger organisations and countries can through their effort, but even then the reduction of child mortality is a lagging indicator of their success in something else.
- Where we can have success is in improving child survival. Through increased child survival, the result is a reduction of child mortality.
This is a subtle shift, but an important one. It means the entire effort goes towards working out what we can do to save lives, rather than spending time recording facts about deaths. Yes, the two go hand-in-glove, but as for directing the efforts of a network, we are better focused on documenting what is best practice in child survival.
Already, there is good data. It is shared widely. But we are still falling short.
This is not about reinventing the wheel, but rather bringing the considerable resources of an extended network of bridge builders to bear on working out where we can best make change to improve child survival.
Just over ago in this blog, I wrote these words:
Changing the name doesn’t change the facts. We are still falling short, and there is more work to be done. But with a renewed focus, maybe at least we can have a clearer view on where our emphasis is best placed.
I didn’t recognise this insight at the time, but now can see that what I had instinctively observed. We are working towards compiling a sharable resource documenting best practice in child survival. This is our journey. Let’s go together!
This video, produced last year, explains this concept well:
An idea that changed the world
Global Zero seeks to mobilise people to join a movement with a seemingly impossible objective. The achievement of zero nuclear weapons held on earth by the year 2030.
Seriously? Yes, seriously. Impossible you say. But take note: aspirational goals are worth setting, even if the degree of stretch is well beyond our view and reach.
But is it impossible? It would be an idea that changed the world. Every change begins with an idea, with imagination.
This is where there is similarity with the 10 City Bridge Run. An initiative fuelled by the believing that a triumph of imagination is possible. The other similarity is that presently there are 17,000 nuclear equipped warheads in arsenals held on earth. There will also be 17,000 children who will die today, and tomorrow, and the next day. That number is decreasing, but it is an obscene amount.
There will never be a ‘zero’ count of child mortality. Death is part and parcel to being alive. But present levels are too high, and they shape a terrible over-populated future with health issues with a food and water security crisis if not addressed. We can’t see that problem now, but it awaits us if nothing changes.
Food for thought. Take a look at the short clip from Global Zero below. Impossible: what is in a word?
From child mortality to child survival: what’s in a name?
Ok, so there seems to be a new phrase entering the lexicon of child health.
‘Child mortality’ is being used less frequently in favour to the use of ‘child survival’.
What’s in a name? Does this really make a difference at all? I think it does. It is a more optimistically framed language, which sets our minds looking towards the solution, rather than the seemingly impossible wall of death to overcome.
Changing the name doesn’t change the facts. We are still falling short, and there is more work to be done. But with a renewed focus, maybe at least we can have a clearer view on where our emphasis is best placed.
Change your thinking: it is a matter of perspective
The avuncular Hans Rosling joins us again to explain where the focus on child mortality ought to be placed across the world’s 7 billion people, and whether tackling this issue will make a difference.
In his idiosyncratic way to craft a story that is as simple as it is engaging, he presents one of the most pressing and complex problems very clearly.
His message: Yes, there is hope for the future! We can make a difference in this lifetime to child mortality.
He does leave us with one request: change your thinking. Stop thinking about developed and developing countries, because it is unhelpful in focusing on those people where the real need is found.
Good message to reflect on next time you go to grab a coffee mug: we can make a difference.
Overcoming a dilemma: building a bridge
In my last post I wrote about a dilemma I faced. Come too far to stop, but not enough backing to start running on 12 December 2012. It was a real dilemma. I had been training hard to make this journey possible since early 2010. Many false starts, many injuries, but not yet enough of what I needed to begin the journey.
The journey involves a stunt. I will run 10 sub-marathons each of 24 km each in 10 cities across 10 countries all inside of one month. The stunt is to open a conversation about how might we use our networks to help reduce child mortality within the context of the Millennium Development Goals.
Every time I had delayed the start in the past was a difficult decision. I felt as though people who were supporting me would be disappointed, I felt the embarrassment of having to change plans from what I said I would achieve, I felt the difficulty of needing to refocus my mind to a new set of dates.
The good thing was that many people really did help me with some good advice when I shared this last dilemma. Their advice: take your time if you need it, get it right, find some space to rest your mind and get clear on what you are wanting to achieve.
So, to those people who have been a great support, I just want to say thank you.
The new start date for running is 24 February 2013. The dates I had earlier outlined will obviously need to be shifted, but that gives us an opportunity. Through the ‘Supporters Passport’ I have sent to those people who have helped me, we now have a straw man of the concept which we can build upon.
And there are some good opportunities emerging:
- ‘Conversation Partners’ have now been identified to help with the journey.
- A significant partner is likely to help to frame the experience. More on that opportunity shortly I hope!
- Just over three months from now until I start running, so much better time to build the conversation before running.
- Running outside of the Christmas break so can build a more focused conversation.
- Looking at a launch party on 31 January 2013, with a very good MC agreeing to help out on the night. More on that shortly!
- Some good performers also agreeing to help out at the launch event!
It is regrettable to delay, but in this case it helps to build a stronger conversation. Building a bridge over a dilemma. That is what is most beneficial to the outcome, and that is what is most important.
One of the outcomes is the definition of a Three Year Plan. The run will now take place at the beginning of that Three Year Plan. We will be living it out as the plan unfolds. Every decision we make has real consequences.
Thanks to everyone for joining the journey. We welcome many more to come with us if you are not already on board.
Over the coming months, I will be asking for your advice. Looking forward to hearing from you!
Take the Pledge: Slactivism or Game Changer?
UNICEF last month announced a breakthrough new initiative: they would ask everyone to visit ‘A Promise Renewed’ website and take the pledge to help reduce child mortality.
I was especially intrigued when I heard of this campaign. Intrigued because this is completely aligned with what I am seeking to achieve through the 10 City Bridge Run. Or maybe to rephrase that better, in light of their initiative, I am completely aligned with the campaign ‘A Promise Renewed’.
Let me tease this out a little first. Follow me here: I am being objective in my thinking. These initiatives must be able to stand up to scrutiny. It ought not to be a case of everyone just drinking the Kool-Aid.
So what is this pledge all about? Let’s start with that.
It works on the premise that governments can’t do it alone. Making change happen in not something that can be only left to the G20 or the G192. We are all in this together. My thoughts: No problem with that – I think everyone would agree with that assertion.
Here is what UNICEF Executive Director Anthony Lake said to explain the pledge:
Sign the pledge, which will mean you’re pledging to do what you can to change behavior in your communities — you’ll encourage local NGOs to sign the pledge and to work harder, you’ll pledge to advocate your governments to follow through on their pledges and make real progress. You can make a difference.
I think that too is sound. It is not saying that people have the power to make change themselves necessarily, but the corporate act of persuasion that leveraging your voice is not to be discounted.
There is some further wording in their release which gets a little wishful. That is where they hope that by posting videos, that some of them will go viral. My thoughts: The truth is that no one really knows what makes a video go viral. ‘Going viral’ is really mostly outside of our control. I think that Anthony Lake got it right when he placed emphasis on advocating for change.
His closing words are worth noting. They are worth reading twice, because they are easily to just read past the first time. I agree with him:
[We should all] start advocating with [our] governments to live up to their commitments to do everything we can to save children from what is a moral abomination. If we don’t do it, shame on us.
So will we? This is where the fine line between slactivism and game changing behaviour comes along. If it is just a few thousand people doing it along with their friends, there is a lot of feel-good value in that, but not enough force to change the game. If a significant amount of the global population are involved because people care enough, change will happen.
Moral abomination. Those are strong words. Will you just click off this page, or click onto this link APromiseRenewed.org and make the pledge? “If we don’t do it, shame on us.“
Photoessay: Committing to Child Survival
Here is a beautifully presented photo-essay by UNICEF that helps to tell the story about what work is going on around the world to combat child mortality. It doesn’t cost you to look a these photos, except for your time.
Take a look through this link here which opens the photoessay. Leave a comment below with what your favourite frame was and why.
The 10 City Bridge Run is funded through the pre-sale of a book called ‘Life Bridge’ which will feature 100 photographs of ‘human bridges’. Describing a human bridge in words is best achieved through drawing inspiration from a quote by Ophelia Dahl, cofounder of Partners in Health and daughter of renowned children’s book author Roald Dahl, quoted Adam Hochschild who wrote about the importance of “drawing connections between the near and the distant”:
Linking our own lives and fates with those we can’t see will, I believe, be the key to a decent and shared future… Imagination will allow you to make the link between the near of your lives with the distant others and will lead us to realise the plethora of connections between us and the rest of the world, between our lives and that of a Haitian peasant, between us and that of a homeless drug addict, between us and those living without access to clean water or vaccinations of education, and this will surely lead to ways in which you can influence others and perhaps improve theworld along the way.
You too can join this journey but supporting this effort, and receive a copy of the book Life Bridge when it is published early next year. Please visit www.pozible.com/lifebridge. Your support is important.
Tiffany Eyes Off Grace’s First Birthday Cake (…meanwhile, somewhere in Sierra Leone…)
My good friends Nick and Liz have a daughter. Her name is Grace, and last weekend we all gathered in their backyard to celebrate her First Birthday Party. It was a beautiful day, lovely weather, too much food to eat, and many friends (old and new) to mingle with.
You can see from the photo that her friend Tiffany perhaps enjoyed it more than anyone, while she eyed off the birthday cake. I imagine she was thinking: ‘If everyone is looking the other way, would anyone notice if I just had a little taste of this cake before it was cut?’
Most of us have been to this sort of party before. Many of you will be parents who have had the pleasure and privilege to celebrate this occasion for your own child or children.
Such a stark contrast with other countries that for one reason or another don’t make it onto the radar of what gets printed in our newspapers. It is a tragedy unfolding every day.
We live like royalty in comparison. Even with problems we all encounter: the boss is a jerk, coffee was too bitter, missed the 7.05 bus, caught in a traffic jam for 45 minutes this morning.
Here is some food for thought. I hope this brings some perspective as to why I am about to run 10 sub-marathons each of 24 km in 10 cities across 10 countries all inside of one month. To open a conversation asking how might we use our networks to alleviate child mortality. Consider these facts:
- About half of under-five deaths occur in only five countries:India, Nigeria, Democratic Republic of Congo, Pakistan, and China.
- India (24%) and Nigeria (11%) together account for more than a third of all under-five deaths.
- The highest rates of child mortality remain in sub-Saharan Africa where 1 in 9 children dies before the age of 5. That is more than 16 times the average for developed regional (1 in 152).
- By 2050, 1 in 3 children will be born in Sub-Saharan Africa, and almost 1 in 3 will live there, so the global number of under-five deaths may stagnate or even increase without more progress in the region.
- The proportion of under-five deaths that occur within the first month of life (called the ‘neonatal’ period) has increased 17% since 1990, from 36% to about 43%. This is because progress in reducing the neonatal mortality is slower than that in the mortality for older children.
- Almost 30% of neonatal deaths occur in India.
- Sub-Saharan Africa has the highest risk of death in the first month of life and is among the regions showing the least progress.
- Historical trends show that for most countries progress has been too slow and that only 15 of the 66 countries with a high under-five mortality rate (at least 40 deaths per 1,000 births) are on track to achieve Millennium Development Goal 4.
This information is taken from the 2012 Report Levels and Trends in Child Mortality developed by the UN Inter-agency Group for Child Mortality Estimation published in 2012.
There is some good news. Sub-Saharan Africa has in the last decade seen a faster decline in its under-five mortality rate, with the annual rate of reduction doubling since the decade before. We are making progress, much work attention is needed, and now.
Happy birthday, Grace.
12.12.12 Design Forum
The journey taken during the 10 City Bridge Run will culminate in a Design Forum held in Seoul on 12 December 2012 (12.12.12) to crowdsource good ideas, and to listen and learn from four key questions.
* Q1: What is best practice, and how is that is having an impact? Who is succeeding and why?
* Q2: Is best practice contextually specific? Can good ideas be shared into different and unpredictable environments?
* Q3: What is not working well? Can we map the negative factors that prevent innovative change?
* Q4: How might a human bridge be part of a solution? What might this look like?
An outcome from the Design Forum will be to determine a list of lessons from failure and success titled “10 Tangible Ways To Make A Difference.”
This is a framework to work from, and over the coming three months before the 12.12.12 Design Forum, there will be plenty of good ideas to improve this approach. The Design Forum will be picking up on a great idea from my good friend Kelley Joyce, and looking at ways of how this can be inclusive of other locations outside of Seoul using social media.
Plenty of good ideas. I’m sure you have some of your own. Care to share?
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