Bitter Pills:Medicines & The Third World Poor | Page 13

15.1 million are from developing countries, and of these, 12 million deaths could probably be avoided. l7> The under-fives are especially at risk because they have little resistance to disease, and their vulnerability becomes acute when they are malnourished. Repeated bouts of diarrhoea and other common infections reduce a child's ability to absorb food. The child becomes weak and stops growing and may become severely malnourished. This precipitates a vicious circle of malnutrition and disease that is often only broken with the child's death. A large-scale.study of child deaths in the impoverished north-east of Brazil found that measles was the probable cause of half of all child deaths. But three-quarters of these children also showed obvious signs of malnutriton. '*' The problem of malnutrition is not of course confined to those who die. Many are saved from death but are left severely physically and mentally disabled. Poor nutrition undermines the health of other vulnerable groups in the community, such as pregnant and lactating mothers who can become severely anaemic from the effects of repeated pregnancies. A recent nutritional study carried out in North Yemen found that in one region almost three-quarters of mothers were suffering from anaemia. (91 In most developing countries the basic food intake of a large section of the population is totally inadequate for their health needs. It was estimated in 1980 that at least a third of the people in Mozambique get less calories than they require. (l0) In the very poorest countries, such as Bangladesh, where there is tremendous pressure on the land and rapid population growth, there is likely to be a much higher percentage of people undernourished and consequently vulnerable to infectious disease. COMMUNICABLE DISEASES People in the Third World today suffer from the same communicable diseases that were widespread in developed countries in the nineteenth century. Many of these illnesses are transmitted by food and water contaminated by disease organisms from human and animal excreta. They include diarrhoeal disease, amoebic and bacterial dysentery, typhoid, cholera, polio and infectious hepatitis, which are all major problems in the Third World. (ll) One Bangladeshi expert on diarrhoeal disease describes it as the major health scourge of Asia, responsible for at least half and possibly as much as three- quarters of infectious disease. (l2) In Bangladesh itself, an estimated 60% of children who die under the age of five, die as a result of diarrhoea, and in India it is thought that acute diarhoeal diseases alone take 1.5 million lives each year. "" Respiratory infections are major problems throughout the Third World. During the 1970s pneumonia and bronchitis were the main causes of death recorded in Tanzania and Nepal.