Testimony by Pierre-Marie Metangmo, MD, MBA, MPH
Dean of Future Generations Graduate School of Community
Change and Conservation, Franklin, WV and
Village Chief in Ntsingbeu, Cameroon, Africa
House
Committee on Foreign Affairs
Africa
and Global Health Subcommittee Hearing
Rayburn House Office Building 2255
March 13, 2008
10:00 a.m.
Good morning Chairman
Payne, Ranking Member Smith, and distinguished members of the House Subcommittee on Africa and Global Health. Thank you for this opportunity and
honor to share with you a few reflections on my
20 years of experience working on child health programs to improve health
conditions in rural Africa, Asia, and Latin America.
My experiences represent just the tip of a
massive iceberg – that iceberg being 20 years of Child Survival programs funded
by the U.S. government through its Child Survival and Health Grant Program. This program gives support to U.S.-based
private voluntary organizations (PVOs) to work with millions of mothers and hundreds
of thousands of community health workers, midwives, and health professionals in
impoverished communities to provide simple interventions that save children's
lives.
The previous speakers
have provided a clear picture of where we stand today in our global effort to
reduce under-5 mortality by two-thirds by the year 2015. I would like to bring the perspective of an
African professional and community leader born and raised in Cameroon who has
led community-based child survival programs all over the world. After graduation from the medical school of
Lille in France, I first worked seven years with the Cameroonian government as
district medical officer in Dschang in the Western
Province.
I then joined Plan
International in the position of West Africa Regional Health Advisor, working
in Senegal for two years. Nine years
ago, I came to the United States as Plan global child survival specialist providing
leadership for child health programs in 46 countries. I most recently joined
Future Generations as Dean of its new Graduate School for Applied Community
Change and Conservation.
Today, I am
privileged to speak for the voiceless and the powerless mothers and children
from Africa – and indeed from impoverished communities all around the world –
to those of you who can make it possible for millions of such people to live
instead of die.
When I was a child
growing up in the village of Bafou, Cameroon, as the
first-born I had to accompany my mother twice a day to fetch water at the river
half a mile away. The question I had then was, “Why didn’t the leaders build
the village along the river side?” And, after I graduated from medical school
in France and went back home to work in the Hôpital de Dschang (10 Km from Bafou), I kept wondering why people couldn’t simply move to
live closer to a hospital or health center for easy access to quality health
services. It was not until much later
that I had to switch my focus to the essential services moving to the people rather
than the people moving to the services.
Indeed, during my
years at the Hôpital de Dschang,
one evening as my family and I were
having dinner, Ntuma, a young woman whom I had rescued two months previously from
an obstructed labor and who had left the
maternity ward with a healthy baby, pounded at our door crying, “Doctor, save my baby, please save my baby!” I quickly took the baby in my arms
only to discover that it was too late.
I learned that five
days earlier, the two-month-old baby had started coughing and had developed
difficulty breathing. The baby’s condition gradually worsened and no one realized
how serious the situation was. Ntuma’s husband decided to wait until the next morning to
seek advice from the elders. It was not until the following afternoon that Ntuma
and her mother-in-law gathered some money from their family members and walked
five hours down a path, wading through a big river, to finally reach me at my
house next to the hospital.
That was the turning
point in my life. I knew that, if Ntuma and her family had learned about the
danger signs of pneumonia in young children, they might have sought medical
care earlier and the child might not have died. I also knew that if a local
community health worker was trained to diagnose and treat pneumonia in children
in that village where mothers have no medical care available to them, he/she
might have provided care to save the baby’s life. The scientific research is
conclusive: the lives of millions of children like Ntuma’s baby can be saved
through readily affordable community-based programs that Ntuma’s community did
not have.
This experience opened my eyes to the
importance of community-based programs that seek synergy between simple, effective
health interventions and empowerment of local people. Through the grassroots work of non-governmental
organizations such as Plan, Future Generations, and thousands of similar NGO’s
working with governments and international donors, community-based primary
health care programs are saving the lives of millions of children who otherwise
would have died from pneumonia, diarrhea, measles, neonatal tetanus, and
malnutrition.
Plan is one of the
world’s largest community development organizations, working at present in 46
countries, and dedicated to improving the lives of destitute children around
the world.
Plan currently has
three U.S. government-funded child survival grants in Cameroon, Kenya and Nepal
that benefit 613,285 children and 875,000 women of reproductive age. Through these grants, the women and children
benefit from interventions which promote nutrition, immunizations and family
planning. The children are treated for childhood
pneumonia, and death by malaria is prevented through insecticide-treated bed nets
and access to early and proper treatment.
In Plan’s USAID-funded Child Survival project in
Nepal, the percentage of children in our project area whose mothers gave them
oral rehydration solution when they had diarrhea increased from 34% to 67% in
three years. The Pregnant Women’s Group
initiative which brings together 10 to 15 pregnant women for weekly self-help
activities with counseling from community health workers has reduced the
under-5 child mortality by 50 percent as compared with control groups.
Future Generations is
another non-governmental organization committed to communities. Based in Franklin, WV, Future Generations works
in Afghanistan, China, India and Peru to empower communities and women to
improve their health and quality of life.
In 2002, Future Generations also founded an international graduate
school, offering a master’s degree in Applied Community Change and
Conservation. This school teaches
processes for equitable social change, community empowerment, and its
application to maternal and child health.
In Afghanistan, which
has the third-highest under-5 mortality rate in the world, Future Generations
work has transformed numerous communities and countless mothers by the
knowledge of simple and practical approaches. These approaches include the
promotion of exclusive breastfeeding during the first six months of life, handwashing,
the use of oral rehydration solution for childhood diarrhea, and other simple
and readily affordable activities. As a
result, lives are saved.
In my village in
Cameroon, the number of child deaths has drastically decreased as a result of community-based
health activities. Safe water is now provided by hand pumps from wells. Through the efforts of the local health
center, children are regularly immunized and diseases such as malaria and
pneumonia are detected and treated earlier. Community health education has resulted in
better sanitation and hygiene as well as more informed breast-feeding practices
among women.
For these village
improvements impacting child health to occur, a three-way partnership has been
essential involving the community, the local government administration, and external
funding support. Another important
element has been the training and support of local health workers.
Child survival
programs played an important role in reducing the number of children dying
around the world each year from 20 million in 1960 to less than 10 million now
in spite of the fact that the number of children born annually has risen from
96 million in 1960 to 135 million currently. However, in order to reach the
global goal of reducing under-5 mortality by two-thirds by the year 2015, we
will need to achieve the following:
Achieving this will
require a sustained and higher level of funding from the U.S. government and
from other donor countries around the world than has been available to date.
Achieving this will also require a stronger engagement of communities and their
creativity and resources. It will require new partnerships and alliances. And
it will require a higher level of commitment to first-class operations’
research to ensure the effectiveness of large-scale programs. Only these partnerships will ensure that more
children in Africa, Asia, and Latin America live to their fifth birthdays and
beyond.
The world has the
resources and the technical “know how” to ensure that fewer and fewer children
in the poorest countries of the world die from readily preventable or treatable
conditions. Now is the time for the American people and the United States
government to expand their support and contribute their fair share to make this
possible. Because of the generosity of the
American people, much has been achieved for the world’s children. But much more
is still left to do.
In conclusion, Chairman Payne, Ranking Member Smith, and distinguished members of the Subcommittee on Africa and Global
Health, I appreciate your interest in and attention to this critical matter of
saving children’s lives throughout the world. All of us who work on behalf of
mothers and children around the world look forward to your continued strong
support.
Your leadership is crucial to ensure
adequate resources for this great and historic global effort to combat child
mortality in the poorest countries of the world. Just
as Ntuma’s baby could have been saved with more
resources and community-based health education, millions of other babies will
be saved when we act now!