The greatest causes of death amongst children remain a relatively small number of
preventable diseases and conditions. These are dehydration, pneumonia, tetanus,
measles, and whooping cough. These five conditions will account for two thirds of all
child deaths and over half of child malnutrition in the 1990's (UNICEF 1990:16). Low
cost vaccines, oral rehydration therapy, and antibiotics could prevent the majority of
these deaths. The technology to achieve this is widely available at reasonable cost
levels. The problems are those of political commitment, access to primary health care,
the provision of assistance to ease the flow of vaccines and drugs, and of education.
Ignorance of simple procedures is responsible for far too many preventable cases of
death and malnutrition. Oral rehydration requires no expensive ingredients, no
instruments to administer, and only basic knowledge of procedure - yet it has been
estimated that 2.5 million deaths occurred which could have been prevented by using
ORT in 1988. Similarly much malnutrition is preventable if basic health information is
widely disseminated and mothers are aware of the signs and causes. UNICEF (1990:30)
reports studies which estimate that the rate of child malnutrition could be more than
halved by the widespread use of simple procedures and knowledge of good practices
over the next decade. The impact of malnutrition of growth and achievement is
reviewed in Pollitt's (1990) recent book. The provision of basic health information,
which also encourages hygienic living conditions and awareness of nutritional
requirements, are central to educational development directed at poverty alleviation and
the relief of unnecessary suffering.
1.3.3 Increasing HIV infection
A growing but as yet unquantified threat to public health, which may have a substantial
impact on population growth, arises from the spread of the HIV virus and the
subsequent development of AIDS. The number of HIV seropositive cases identified
appears to be rising substantially in those countries worst affected. This presents a
major challenge for educational development. A brief summary of recent research is
available in the Institute of Development Studies research review Insights (Spring
1992).
If the worst prognostications prove well founded mortality rates will continue to rise
both amongst 1-5 year olds infected by their parents, and amongst the most at risk
groups - 15-40 year old adults. The latter is particularly critical since it is this
population that is the most economically active and it is from this population that the
majority of teachers in most countries are drawn. Significant increases in mortality in
this group will increase the school age dependence ratio, making it much more difficult
to finance educational services, will deplete the often inadequate teaching force
available, and reduce the working lifetime of teachers trained at considerable cost. The
Economist Intelligence Unit speculates in a Zambian study that AIDS will cause a