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    Saving young lives.

    Badzik S

    World Health. 1984 Nov; 24-6.

    The marked decline in the infant mortality rate since 1950 among Palestine refugees, cared for by the United States Relief and Works Agency (UNRWA), reflects the efforts of the UNRWA's medical personnel to provide maternal and child health (MCH) services for an increasing number of refugees and to develop innovative programs for the treatment of dehydration and diarrheal disease among infants. In some of the areas where the UNRWA's dehydration program operates the infant mortality rate declined from 140 to 40 during the past decade. The dehydration program was so successful that it is now used as a model for the development of similar programs in other countries. The agency initiated its work in 1950 and health services were gradually expanded. Currently the agency operates 98 health facilities for refugees in Jordan, Libya, Syria, and the Israeli occupied territories of the West Bank and the Gaza Strip. 86 of these centers provide MCH services. In 1984 alone, the agency provided MCH services for 30,000 women and 100,000 infants annually. Expectant mothers are encouraged to visit the clinic 5 times during the course of their pregnancy. In 1982 there were 30,478 deliveries among MCH clients. The proportion of hospital deliveries increased considerabliy in recent years. 41% of the deliveries occurred at home and were performed by UNRWA supervised and trained traditional midwives. The infant care program was improved considerably during the last 34 years. The focus is now on preventive care. Mothers are encouraged to bring their children to the clinics for regular checkups and for vaccinations. During these visits the mothers are provided with breastfeeding, weaning, nutrition, and infant care advice. Underweight children are referred to a nutrition and rehabilitation program. During the 1950s dehydration from diarrhea was a major problem among refugee infants. In 1961 an innovative program to treat dehydration was established at Maghazi Camp in the Gaza Strip. Infants were given intravenous rehydration therapy, medication to control diarrhea, and appropriate nutritional feedings. The mothers stayed at the hospital with their infants, participated in caring for the infants, and as a result also received nutritional education. The educational component of the program gradually improved infant nutrition in the camp. Serious cases of dehydration are now rare, and the proportion of underweight infants has also declined. The center now stresses nutrition rehabilitation rather than intravenous rehydration therapy. Mothers are taught how to administer oral rehydration salts to infants suffering from mild dehydration.
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