KARACHI: Participants in a consultative seminar were informed on Wednesday that deaths of 23 per cent of children who died within the first month of their life in the country were caused by ill treatment of umbilical cord and that rate was staggeringly higher in rural areas where medical facilities were scarcer and pregnancy was left with unqualified birth attendants.

“Some 23pc of the children among those who die within the first month of their life are those who are infected because of mistreatment in cutting of umbilical cord. In figures we can put this ratio as 13 out of every 1,000 children born in Pakistan,” said Shoaib Shahzad, a programme manager with the Mercy Corps, global aid agency in healthcare sector, at the seminar organised by his organisation at a local hotel.

He said Pakistan had the worst ratio of neonatal deaths in South Asia, which was 55 to 1,000 — worse than the war-torn Afghanistan, where the situation had been improved a great deal with 36 neonatal deaths in every 1,000.

Bangladesh and Nepal have the better ratio of 24/1,000 while it is 31/1,000 in India.

Mr Shahzad said some 75pc of children who died in first month of their birth did not survive more than a week.

Pakistan has worst figures in under-five-years deaths with 89/1,000 with Sri Lanka has the least (12/1,000). Pakistan is the only country, which has worst infant mortality rate currently than what it was in 1990. All the other nations in the region have improved, according to experts.

The participants, however, said Pakistan had a programme to prevent deaths of child who died because of uncared-for umbilical cord incision.

“The world has saved hundreds of thousands of newborns by using Chlorhexidine, which the World Health Organisation has approved to prevent sepsis because of mistreated umbilical cord cut,” said Mr Shahzad.

He said the common practice in Pakistan to apply kohl (surma), butter or anything else after cutting of umbilical cord caused sepsis among children and some of them could not survive the infection.

He said Sindh was the first province, which procured around 50,000 3-gram tubes of the new medicine from Nepal on experimental grounds, which were being used in its 15 districts.

However, another speaker, Dr Sajjad Ahmed Siddiqui, said Sindh needed much bigger quantity of the medicine for newborns in a year and quantified it at around 3.8 million.

He said all the provinces in Pakistan had sent their summaries to Islamabad for procurement of Chlorhexidine that could be applied after the umbilical cord was clamped and cut close to the baby’s body in a painless procedure.

He spelled out WHO recommendations, which asked for the medicine’s treatment at least for a week, which required at least a 20-gram tube for one child.

“So far this medicine is not being manufactured locally, but we have talked to some local pharmaceuticals which will soon start manufacturing it in 20-gram tubes,” said an expert.

The experts said the medicine had done wonders in Nepal, Bhutan and several other countries and helped those countries in reducing the infant mortality rate.

“The same could happen in Pakistan, if it is universally used here,” said Dr Siddiqui.

Published in Dawn, November 27th, 2014