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Report by Past District Governor Emmanuel Adedolapo Lufadeju

CAIRO, February 6-7, 2009

PRESIDENTIAL CONFERENCE ON MEMBERSHIP AND CHILD MORTALITY

RI President D. K. Lee and many Rotarians including some Rotary International leaders participated in a Presidential membership conference in Cairo on 6-7 February 2009 to support his theme for the year, "Make Dreams Real". This conference featured a special half day program addressing how Rotarians can help reduce child mortality.

The main conclusion at the end of the conference is that Rotarians should actively encourage others in their club, district, and community to learn more about the issues that contribute to child mortality. One way to do this is by getting conversant with some of the major preventable causes of child mortality, as well as some of the solutions that Rotarians can help to support.

In order to expose Rotarians and Rotary leaders to this realities, and to learn more about specific interventions that can help save children's lives, experts from WHO, UNICEF as well as some members of President Lee's Resource Groups and leaders of the Rotarian Action Group for Population Growth and Sustainable Development were, on hand at the conference to provide lots of useful information and offer insightful suggestions and ideas on what Rotarians worldwide can do to alleviate the problem.

Rotarians were reminded by RI Director Orscelik Balkan on the need to enhance Rotary in Africa by working to achieve 10% net increase in membership and 2 new clubs per District. He provided statistics on the status of Rotary in Africa which has a population of 954,999,159 people, with Rotary clubs in 54 countries, 23,204 Rotarians, 959 Rotary clubs, 553 Rotaract clubs, 745 Interract clubs and 267 Rotary Community Corps. He noted that Rotary clubs and Rotarians are active in only 4 countries – South Africa, Nigeria, Egypt, and Uganda. He concluded that membership of 39,000 is practically achievable in Africa, and that the goal set at Johannesburg Membership Seminar for Zone 10A until 2010 was 30,000 members. He concluded that a big potential exists to expand Rotary in Africa and bring more members.

Past RI Director Carlo Monticelli spoke of the need to help enhance Rotary's image worldwide. He enjoined Rotarians to 1) listen and observe 2) be the Rotary spokesperson, 3) talk positively about Rotary's programs and achievements, 4)Use personal stories and 5) build long lasting relationships. He concluded that Rotarians should start a new PR/communication approach, and reiterated the need to bring many new and young people into Rotary.

RI Director Rudolf Horndler gave the status of the Global Polio Eradication Initiative, he explained the role of RI in the effort, and gave suggestions on what Rotarians can do to support the efforts. He noted that polio is now present in only 4 countries – Nigeria, India, Pakistan and Afghanistan. He also mentioned new commitments of Head of Government and Leadership, new commitments of WHO in proclaiming Polio as WHO's top operational priority, and new funding opportunities offered by Bill and Melinda Gates Foundation. The Bill and Melinda Gates Foundation gave a challenge grant of 355 million USD to be matched by Rotary with 200 million USD by 2012. This is the largest grant ever given to a volunteer service organization, and it is considered a tremendous validation of the approach and success of RI Polio program.

By far the issue that generated the most interest and concern was that of unrelenting child mortality in Africa. Speakers from WHO and UNICEF rightly noted that Children are among the most vulnerable people in the world and provided stunning statistics which showed that each year:

• Four million newborns die within 28 days of birth.1
• An estimated 10.1 million children die before reaching their fifth birthday.2
• One million children die from malnutrition.3
• 1.5 million children die from lack of access to safe water.4
• Preventable conditions like diarrhea, malaria, neonatal infection, pneumonia, preterm delivery, or lack of oxygen at birth account for 70% of all child deaths.5
• Child mortality rates are directly linked to a community's access to safe water, adequate food, decent sanitation, basic medical care, and education.

The experts noted that child mortality is a complex issue that lacks a single solution. However, a number of international development organizations including UNICEF, the World Health Organization, and Save the Children have suggested the following strategies for reducing child mortality as stated in RI Fact Sheets on the subject:

• Invest in inexpensive solutions – Most child deaths could be prevented by solutions that cost as little as US$ 1.00 per child. These include immunizations, breastfeeding, oral rehydration therapy,
  antibiotics, trained birth attendants, nutritional supplements, and insecticide treated mosquito nets.
• Educate women and girls – Educated women and girls are a crucial component to reducing child
  mortality. As a whole, women and girls who are educated are healthier and better equipped to
  understand and address the health risks mothers and children face.
• Train health care providers – Many communities lack access to trained health care providers who can provide life saving care for children and mothers.
• Strengthen health systems – Health systems, particularly in local communities, should be strengthened and expanded to provide technical health interventions to children, mothers, and their
  families.
• Promote partnership – Partnership at local, regional, and national levels enhances the ability of the
  world community to reduce child mortality by increasing the effectiveness of interventions, minimizing
  costs, improving accountability, and avoiding the duplication of efforts.
• Involve governments – Increasing government support for proven solutions that save the lives of
  mothers, children and newborns has been an essential part of reducing child mortality rates in countries
  worldwide.

It was noted at the Conference that Rotary is a world leader in efforts to reduce child mortality. Among Rotary's best known child survival programs is PolioPlus, which has helped immunize millions of children around the world and is used as a model for other major international immunization programs.

Rotary's consistent emphasis on critical development issues like water, health and hunger, and literacy has increased the number of Rotary clubs and districts engaged in projects that help reduce the vulnerability of children worldwide.

At the beginning of the 2008, over 50% of all World Community Service health projects addressed issues that reduce child mortality. Common Rotary club child mortality prevention projects include programs to train healthcare providers, equip medical clinics, improve child nutrition, increase access to safe water and sanitation, and raise community awareness.

In the 2005-06 Rotary year, The Rotary Foundation awarded over US$ 30 million in grants for Rotary club and district projects, many of which sought to improve the health and wellbeing of children.

However many Rotarians expressed fears that these efforts may not be continued in the coming Rotary years, such fears were put to rest by President Lee who reiterated that a good foundation has been laid in this Rotary year to sustain the continuation of the child mortality initiative in coming years.

In his own contribution at the conference, the Chairman of the Rotarian Action Group for Population Growth and Sustainable Development PDG Salem Mashhour called attention to the enormous and well documented unmet need for family planning, especially among the two billion people who live on less than $2 a day. According to him, it is clear that achieving the Millennium Development Goals (MDG) are difficult or impossible to achieve without a renewed focus on, and investment, in family planning.

Family planning is wanted and it works. Whenever high-quality contraceptive services have been made available with supporting information, the birth rate has fallen, even among low-income populations. Evidence shows that when family planning is easy to obtain, and free of barriers, both educated and uneducated women use contraception at the same rate, opening the door to reduction in poverty.

Many women in Africa and South Asia have hesitated to use family planning because they believe contraception is medically more dangerous than having another child, or will cause infertility later in life. There is increasing evidence that when women find there is a safe way to have control over whether and when to have another child, they often express a desire for a smaller family.

He concluded that there is an obvious need to raise awareness and improve information and education about the benefits of family planning. Religious opposition to family planning or cultural practices, such as child marriage and the desire of large families, are prevalent and it is vital to gain support at all levels of society (from national government to community and religious leaders) to develop new strategies to improve maternal health and to support people's choice regarding the size of their families and the spacing of their children. In all countries adversely affected by high fertility rates it is urgently needed to press governments to develop a comprehensive national plan for providing universal access to voluntary family planning services, including relevant education services, especially educating women and girls.

Family planning is one of the most cost effective ways of reducing infant mortality, but governments in countries with high fertility – and thus significant population growth- find it difficult to keep up with the demand for health services that help save children's lives. For the most effective care, a continuum linking maternal, newborn and child health care through the lifecycle and between homes and health facilities is needed.

Half of African women and their babies do not receive skilled care during childbirth, and even fewer receive effective postnatal care. This is also the crucial time for other interventions, especially prevention of mother-to-child transmission of HIV and initiation of breastfeeding. Additionally, poor families who are more at risk are the least likely to have access to care, especially more complex hospital care for emergencies. To ensure that children thrive, all of us have an important part to play along the continuum of care.

Download speech by Salem Mashhour (PDF 16KB)

Page Updated: October 14, 2009