"We don't expect children to die in the United States," explained Donna Denno, a pediatrician and recent 2006 MPH graduate from the UW, "but it's a daily occurrence in the developing world." This is why Donna went into the field of child health, children represent a vulnerable population in society and bear the burden of morbidity and mortality, especially in developing countries. In fact, 21 children under the age of five die each minute, most from preventable disease and most in the developing world. Despite these tragic statistics, for Donna, all hope is not lost.
She says there is an exciting renewed focus on children due to new advances in technologies that some think might be like silver bullets to save lives. And fortunately, this renewed focus also helps bring attention to the importance of how interventions are delivered. Donna believes that knowing how to deliver interventions (future and existing) is just as important as new technological advances. For example, nearly two-thirds of childhood deaths worldwide can be averted with simple, low-cost methods that we already know to be effective: insecticide treated nets to prevent malaria; access to water and sanitation to prevent diarrhea and other diseases; access to care and appropriate treatment for leading killers like malaria and pneumonia; and basic immunizations. All these solutions are known to reduce childhood mortality and improve the health and lives of children.
Donna first encountered the striking problem of childhood morbidity and mortality when working in Ghana. She returned several times, teaching medical students and residents, working with patients, and conducting research. She continues to mentor UW medical students doing elective rotations in Ghana and is working to develop programs to provide global health training opportunities. Donna believes that understanding international contexts/global issues are necessary and should be a central component of training programs to prevent common cultural misunderstandings, avoid unnecessary roadblocks to success, and expand the global community. Donna refers to her colleagues in Ghana as an "inspiration". "I feel so lucky to be able to work with them," she says, emphasizing how many could have left and made more money elsewhere but rather chose to stay and help their fellow citizens.
For Donna, it is this bigger picture that matters the most. The world is an increasingly smaller place which requires that we as global citizens be more aware of how national and international policies impact one another. "We know that within a country and within a community, including the US, poor children are more likely to die and less likely to have access to preventative and curative services compared to better off kids. The challenge is to ensure that workable interventions are delivered to those that need them the most." As such, entities such as the World Bank, the IMF, and powerful Western countries such as the United States have critically important political and economic influence on developing countries. Perhaps the most important thing we can do is to influence these entities to make their policies positive rather than harmful.
This point has been especially poignant for Donna over the last 15 years as she has watched how US and international policy have lost sight of the 'big picture' in Iraq. Donna, an Iraqi-American, describes her increasing sadness and frustration at watching how a formerly highly developed nation (with the best health care and education systems in the Arab Middle East) has been destroyed because of policy and reduced to a developing country now in need of "fixing." Despite her commitment to improving child health globally, her relatives have urged her not to be involved in re-building Iraq because of extreme security risks to her and her family.
In the face of these difficulties, Donna remains hopeful. She urges us all to influence and change the policies of banks and government so that life-saving interventions get to those who really need them. And even better, she urges us all to "work towards mitigating the underlying determinants of disease – poverty, inequity, and war – to improve the health and lives of children around the world."