UKRAINE'S INDEPENDENCE: THE SIXTH ANNIVERSARY
NEWS AND VIEWS: UNICEF reports on childhood and motherhood in Ukraine
by Olga Stawnychy
PART I
In a 1997 report titled "Children at Risk in Central and Eastern Europe: Perils and Promises," UNICEF, the United Nation's Children's Fund, states that millions of children from this region have been forgotten in the race toward economic reform. The report, which covers some 18 countries, is the fourth in a series of monitoring reports issued by this U.N. agency.
Particularly tragic are the report's statistics and conclusions regarding the future generations of Ukraine, which are taken from a separate report called "Childhood and Motherhood in Ukraine." A detailed and comprehensive analysis of the situation of children in Ukraine until 1996, it is divided into seven chapters: economic and socio-demographic situation, maternal and child health, education and upbringing of children, children living in especially difficult circumstances, children and the Chornobyl nuclear disaster, legal and organizational aspects of children's protection, and strategies for improving the situation.
The national report examines the well-being of children and mothers during this transitional period of socio-economic change (many live below the poverty line), as well as the legacy of environmental neglect and the consequences of the Chornobyl disaster of 1986.
Ukraine, having signed the Convention on the Rights of the Child in 1991, the same year as it declared its independence, recognizes the priority of children's interests and is developing programs to resolve their problems. Unfortunately very little has been done to better the lives of these children both in families and in institutions. Due to financial restrictions, programs cannot be implemented as planned, no matter how honorable their intentions. At the same time, international and private aid has substantially decreased.
In the chapter on maternal and child health, the statistics show that only 27 percent of children under age 7 can be classified as healthy (with no chronic diseases); and 3 percent of all children display psychiatric disorders. The report states that "If the current situation continues, in 50 to 60 years (one or two generations) this could lead to a situation where the majority of youth in Ukraine would be mentally or physically disabled."
There is an increase in the number of children with genetic anomalies - this greatly influenced by unfavorable environmental conditions. Air pollution in some cities has reached a critical level, where the frequency of birth defects is three to four times higher than in other cities where pollution is lower. In many areas there is an unsafe drinking water supply and well as polluted and contaminated soil and ground water due to the radioactive contamination of Chornobyl's fallout.
Infant mortality increased steadily from 1990 to 1993, but recently has stabilized. The increase in many cases was due to external factors such as infectious diseases. This is considered a step backwards for Ukraine. The most common causes of death in the first year were conditions that arose during the perinatal period, developmental disorders and respiratory system disorders.
During the perinatal period, the quality of medical assistance provided during birth and the infant's first days of life have a significant impact on the survival of the babies. Of the women who lost babies during this period, 25 percent had unfavorable conditions of pregnancy due to hard and hazardous work conditions, unhealthy lifestyles, such as smoking and drinking, and consequences of the Chornobyl disaster.
The report states that there are many shortcomings in the health protection system for mothers and newborns, but that there will not be a significant change without a radical improvement in socio-economic conditions in general. The quality of health care in Ukraine is sub-standard and not in line with European standards. There is currently a need for the establishment of first-aid facilities and outpatient rehabilitation. The poor state of public health and the underdeveloped system of health protection have caused the mortality rate in Ukraine to be considerably higher than that of the majority of developed countries.
Since 1991, the number of deaths in Ukraine has surpassed the number of births. The incredible thing is that this is happening during peacetime. Marriage rates are declining, and divorce rates are among the highest in Eastern Europe (second to Russia). Today the country's median age is 37 years, making Ukraine one of the most aged countries of the world. There is a significant gender imbalance with women outnumbering men 117 to 100. Death rates are increasing, particularly among men of working age. These high mortality rates, coupled with the high incidence of divorce, add to the number of families in which the mother has to bring up the children alone.
The mother's health plays a crucial role in the health of her children. Her health is the result of conditions experienced throughout her life, especially in her childhood and youth. This has recently become an important health issue, since Ukraine realizes that this affects further generations of child-bearers. Prior to this change, the emphasis was on boys' health since they were to serve in the army. An analysis of the health of girls and young women shows an increase in cases of anemia, cardio-vascular disease, genital diseases and nephritis. In 1995 over a quarter of pregnant women had anemia, a condition that has effected premature births and maternal mortality. Data on the health status of pregnant women and measures for its improvement are very poor.
The abortion rate in Ukraine is the highest in the world, especially among women in their teens. Using abortion as the main birth control method has resulted in serious health problems, such as inflammation, hemorrhaging during childbirth and sterility.
There is an alarming growth in the incidence of sexually transmitted diseases. The increase has come from intravenous drug users who pass the infection on to the their sexual partners. In 1994, newly detected HIV infections were 8.6 per 100,000; by 1995 this figure increased to 2,025.3. During the first six weeks in 1996, 65 percent of new infections were acquired via intravenous drug injection. At this rate, the spread of HIV among the general population is alarming.
Nutrition also plays a very important role in early physical development and influences the functioning of the physiological system throughout life. UNICEF and the World Health Organization (WHO) promote breastfeeding as an integral part of a child's development, as ideal for nourishment and both biological and emotional development. Breastfeeding is connected with the child's immunity and has a positive effect on the nervous system, intellectual capabilities and emotional well-being. Most importantly it provides self-sufficiency and is a modern approach to raising children with a positive impact on the health and prosperity of the family. Although breastfeeding is a tradition in Ukraine, during the 1970s the higher employment rate among women and the availability of easy-to-use artificial formulas led to a decrease in breastfeeding.
The study found that most school-age children do not have a balanced diet. There has been an increase in the consumption of bread and potatoes, and a decrease in meat, fish and eggs. Children are not receiving enough main nutritional substances, especially vitamins and minerals. This situation leads to stunted development and causes problems in vision, reduced immunity, anemia and lowered fertility.
The radical decrease in the standard of living of the majority of Ukraine's families - many of whom live below the poverty level - has greatly affected the health and nutrition of children and their mothers. The family and society can barely satisfy children's basic needs or provide adequate living conditions.
In reading this report, I have come to the conclusion that many of the conditions and problems can be solved only with a better economy - and an active commitment to immediate action by the government and public officials, the international community, and social and educational institutions. Other factors can be solved by the people themselves, such as changing one's lifestyle (e.g., cutting out smoking, drinking and drug use), breastfeeding and birth control.
Members of society need to take control over their own lives and take an active and responsible attitude in promoting change. The government, the people and organizations need to work together during this crucial time. Greater coordination and cooperation are needed among the many organizations sending humanitarian aid and technical assistance, so that the greatest needs are meet.
As well, one can point to the fact that are communities and institutions that have been totally forgotten or ignored. On this sixth anniversary of the independence of Ukraine, the Ukrainian medical, professional, religious, business, political educational, cultural and humanitarian community in the diaspora needs to more effectively coordinate efforts in not only sending humanitarian aid but in promoting better health and lifestyles through the media (radio and TV ads, printed matter in communities and schools, newspaper articles and advertising), by educating teachers on how promote good health in schools, and by promoting preventive measures to arrest and reverse the catastrophic effects on future generations of Ukrainian children.
Olga Stawnychy is NGO representative to the United Nations and UNICEF for the World Federation of Ukrainian Women's Organizations.
Copyright © The Ukrainian Weekly, August 24, 1997, No. 34, Vol. LXV
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