Where The Millennium Development Goals Could Really make a Difference

from The Guardian Katine Blogs

Sarah Boseley

Lambert Etwaru, 13, gets up at sunrise with the rest of his family and all of them head for the fields, to dig out weeds and plant or harvest cassava, sweet potatoes, maize or beans, depending on the season. After a couple of hours, Lambert and three sisters head for school. They have had no breakfast. They will have no lunch either. Their first meal of the day, cooked from the crops they have helped grow, is when they arrive home at about 4pm.

In Katine, a rural area of northern Uganda, hunger is an inseparable part of childhood. This, among the mud and thatch houses which have no power, little sanitation and unsafe water supplies, is what the millennium development goals are all about.

Families such as Lambert's exist below the accepted UN poverty line of $1 a day. When they have finished cultivating their fields, which do not generate enough crops to sell, Lambert's father, Julius Elwangu (below), will head for the trading centre on the main road through Katine to try to earn some cash repairing bicycles. Mary Amulo, his mother (in Katine children are given grandparents' surnames) knits little woollen hats which occasionally a neighbour will come to buy for 1,300 shillings (37p). They need the money to pay for uniforms, exercise books, pens and exam fees so that their children can go to school.

Lambert and his sisters Betty, 15, Barbara, 12, and Angela, 10, all go to Tiriri primary school. They are lucky - the girls especially - because their parents believe in education. Their mother only made it to the third year of primary school. "My father brought me back home to look after a younger child," she said. "He said there is no need to send a girl to school."

Mary and Julius would like to see all their children reach secondary school, but money will be a big hurdle. The drop-out rate in Katine is 19% among boys and 22% among girls aged 6-12. Only a handful get beyond primary.

Mary's biggest concern at the moment is the state of the well, where she and the girls go twice a day to get water for drinking, cooking and washing. It is clearly polluted. Sometimes they see worms in the water and try to keep them from being washed into their yellow plastic jerrycans. The nearby swamp has invaded the well, thanks to heavy rains and broken stones that should have kept it out.

Bad water means disease. Small children like Mary's youngest, 18-month-old Jorrem, are especially vulnerable. Diarrhoeal diseases are responsible for 17% of the high death toll of under-fives in the developing world. But their undernourishment - the tell-tale pot bellies and stick legs are common in Katine - makes them more vulnerable to every kind of infection and particularly pneumonia (the biggest killer) and malaria. Katine's swamps provide a breeding ground for the mosquitoes that carry the malaria parasite. One of the best means of protecting children is to put them to sleep under bed nets, but few families have them - Mary and Julius do not - and where they do, often it is the head of the family who has its use.

Pregnant women are also highly vulnerable to malaria. In fact, pregnancy exacerbates the risk of many diseases, including HIV/Aids. Women in Uganda have a one in 25 lifetime chance of dying in pregnancy or childbirth. In Katine, many women cannot get to the health centre's maternity unit when they go into labour and deliver with the help of a traditional birth attendant. When there are serious complications, the absence of transport to get to hospital in Soroti, nearly 20 miles away, can be a death sentence.