Pakistani Pediatrician Wins $1M to Save Children's Lives

January 14, 2014

In the poverty-stricken fishing village of Rehri Goth on the outskirts of Karachi, Pakistan, 11% of children die before turning 5 years of age, most of them right after birth. That compares with less than 1% in the United States.

Pakistani pediatrician Anita Zaidi, MD, aims to save at least 165 Rehri Goth children from that fate as the first winner of a $1 million prize awarded for the best plan to quickly and directly reduce child mortality. Dr. Zaidi, who trained in the United States, will spend the money on basics that no country, developed or otherwise, can take for granted: improved nutrition for pregnant women, transportation to birthing facilities, trained midwives for home deliveries, and follow-up neonatal care.

Dr. Anita Zaidi

In all, her plan budgets $6060 for each rescued life, just the kind of nuts-and-bolts thinking envisioned by environmental engineer, entrepreneur, and philanthropist Ted Caplow, PhD, who created the $1 million Children's Prize. Inspired by the experience of watching his newborn triplets endure a month in intensive care, Dr. Caplow solicits applications via the Internet from anyone with a good idea to save children's lives. Finalists in the inaugural 2013 competition included Doctors Without Borders, the University of Malawi College of Medicine, and American Medical Overseas Relief. The selection of Dr. Zaidi as the winner was announced last month.

Judges for the competition included 3 US pediatricians: Emmalee Bandstra, MD, and Jeffrey P. Brosco, MD, both on the faculty at the University of Miami Miller School of Medicine in Florida, and Barbara Stoll, MD, who chairs the Pediatrics Department at Emory University School of Medicine in Atlanta, Georgia. Another US physician who served as a judge was Barry Bloom, MD, a professor of immunology at Harvard Medical School and a former dean of the Harvard School of Public Health in Boston, Massachusetts.

Dr. Zaidi brought impressive credentials of her own to the competition. A graduate of Aga Khan University Medical College in Karachi, she completed a pediatric residency and a medical microbiology fellowship at Duke University in Durham, North Carolina; trained in pediatric infectious disease at Boston Children's Hospital; and earned a masters from the Harvard School of Public Health. That kind of resume has resulted in numerous job offers in other countries, but Dr. Zaidi told Medscape Medical News in an email interview that saying "no" has not been difficult.

"I enjoy my work in Pakistan," said Dr. Zaidi, who is chair of the pediatric department at the Aga Kahn University Medical College.

"Wonderful" US Mentors

Dr. Zaidi said she has worked for 10 years in the fishing village of Rehri Goth, which hugs a mangrove swamp off the Arabian Sea. One reason for the high child mortality rate there, she said, is inadequate public transportation.

"If there is an emergency at night, poor women cannot afford the expensive private transport to get to the city's main maternity hospital," she said. A portion of the $1 million prize will pay for rides to the nearest pick-up spot for a professional ambulance service.

Some village women choose to give birth at home, said Dr. Zaidi. For their sake, her project will train 5 midwives at Aga Khan University. They will use prepackaged delivery kits to make home births as clean as possible.

An additional 8 individuals will be trained as community health workers. They will provide antenatal care and counseling as well as make home visits to help mothers with newborn and infant care and promote childhood immunization. If need be, they will treat newborn sepsis.

"We have just completed a large trial on simplified antibiotic therapy for newborn sepsis in communities where referral is not possible, which will be published soon," said Dr. Zaidi. "This trial shows that there are very good outcomes with primary care clinic–based management combining antibiotics such as oral amoxicillin and once-daily gentamicin by injection."

Almost 30% of the prize money will go toward nutritional supplements and vitamins for pregnant women and their children. Seven in 10 villagers are malnourished.

Dr. Zaidi is quick to point out the US connection in her work in Rehri Goth.

"I have been mentored by many wonderful US doctors and work closely with many great pediatricians in the United States," she said. What unites pediatricians everywhere, she noted, is appreciating the need "to take time to listen to families and be holistic in their approach toward children."

When asked what American physicians can learn from her project to save 165 young lives in Rehri Goth, she replied, "There are many problems in the world, looking for interested people to solve them."


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