Acute Respiratory Infection (ARI) kills too many Himalayan children. It is a painful way to die: infection, either bacterial or viral, fills the lungs with puss and the child literally suffocates to death. Unfortunately, ARI is the poor person's disease, so it has not been studied till very recently. Caused by poor housing, indoor smoke, lack of protection from the cold, poor hygiene and malnutrition, most deaths occur due to delayed diagnosis and treatment.
Severe cases of ARI, manifested as pneumonia kill as many as 720,000 children in India. In Nepal, about 25 percent of the approximately 135,000 under five children who die every year succumb to ARI. How have these cruel statistics persisted? According to Dr. Mrigendra Raj Pandey, even as medical care became more organised, health planners left ARI alone because of its complexity. They concentrated instead on communicable diseases, immunisations and diarrhea. "It is difficult to imagine a primary health care programme that does not include an organised approach to counteract the leading causes of ARI related deaths," he said a few years ago.
GOALS FOR 2000
In Nepal, the official myopia regarding ARI has now been corrected, due in part to the pioneering work by the Mrigendra Medical Trust, which established that domestic smoke pollution is an important cause of chronic bronchitis and ARI. A National ARI Task Force which began work in 1987 in one of Nepal's districts has expanded its 'activity to 14 districts. Combatting ARI has now been incorporated into the nation's Basic Needs Programme and the official goal is to reduce infant mortality due to ARI by 50 percent by the turn of the century. Meanwhile, ARI control was also been given high priority at scientific meetings held under the aegis of the South Asian Association for Regional Cooperation (SAARC).