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Political winds shifting on immigration policy

BARISAL, Bangladesh ó When Mahmuda Akhter arrives at the guesthouse in one of the tiny villages in this cyclone-damaged region of Bangladesh, she knows sheíll find a gaggle of babies and toddlers waiting for her. One day a month, the house turns into a community health clinic where Mahmuda can perform some very simple tasks that will allow her to save hundreds of lives.
First customer: a 17-month-old baby girl clutching a plastic turtle against her fancy green dress. Her mother, wrapped in an emerald silk sari on this 110-degree day, proudly hands over the little girl to Mahmuda, who busily unpacks her satchel. Out comes a scale attached to a sling that can hang from anything nearby ó a hammock hook, a tree limb. Next comes a record book tracking the progress of all of her young patients, comparing their weights with those recommended by the World Health Organization.
This baby weighs in right where she should ó a sign of good health in Bangladesh, where almost half of the young children are underweight ó and her mother explains she is still breastfeeding, as her health worker had advised. In a country where the water can be dangerously contaminated, breast milk makes for the safest food until the baby is 2 years old.
While Mahmuda holds her clinic, Afia Afroze makes a home visit to an 8-month-old boy with a cold and cough. She pulls out her respirator counter to measure his breaths and determines that he doesnít have pneumonia, the leading cause of illness and death for the under-5 population in Bangladesh.
Mahmuda and Afia are two of thousands of community health workers in Bangladesh who walk hundreds of miles a year to reach remote villages in an effort to slash the countryís startling statistics ó more than 12,000 mothers and 120,000 newborns die every year, almost entirely from bad care during childbirth. Though shocking, those numbers represent a remarkable 64 percent decline in the mortality rates of children under 5 over the past 20 years.
That story is repeated all over the world as local health workers provide the basic care and nutritional education that make it possible to save a child every four seconds. But that impressive achievement is overshadowed by the fact that every three seconds a child under 5 dies ó 24,000 children a day, almost 9 million a year ó mostly from easily preventable and treatable conditions. The developing world needs millions more Mahmudas and Afias.
To train and equip those workers requires a commitment on the part of governments, and the developed world has pledged those commitments through programs like the Global Health Initiative and the Millennium Development Goals. Still, itís always a struggle to get countries to put up the money to back up the rhetoric.
For example, Save the Children, where Cokie is a trustee, trained Mahmuda and Afia, using money from USAID ó the American agency that doles out foreign aid. But keeping funding at a level where more childrenís lives can be saved is a challenge, especially with the federal deficit at a record high. In a recent poll, The Economist magazine found that foreign aid was the only government program a majority of Americans, fully 71 percent, said they wanted to see cut in order to save money. Since foreign aid makes up less than 1 percent of the federal budget, totally eliminating it wouldnít do much to blot out the red ink, but it would mean millions more children would die.
Thatís the message Save the Children is trying to get across in an advertising campaign designed to bring Mahmuda and Afia into your living room and onto your computer. In seeing their stories and those of other community health workers around the world and learning how many children survive because of them, foreign aid is no longer a program but a person. The sometimes mind-numbing numbers ó that under-5 mortality rates decreased by one-third over 10 years in countries receiving USAID ó now have faces attached.
The hope is that those faces will spur action, causing people to contact their representatives in support of President Obamaís budget requests for $700 million for maternal and child health and $200 million for nutrition. If it works, it will surely surprise members of Congress used to hearing only negative things about foreign aid. But it would mean more Mahmudas and Afias could start their treks to save the worldís children.

Steve Robertsí new book, ěFrom Every End of This Earthî (HarperCollins), was published this fall. Email: stevecokie@gmail.com.
AP-NY-06-23-10 1652EDT

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