PEDIATRICS Vol. 91 No. 4 April 1993, pp. 703-705
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Beyond Pediatrics: The Health and Survival of Disadvantaged Children E. H. Christopherson Lectureship on International Child Health

David Werner 1

1 From The Hesperian Foundation, Palo Alto, CA.

As an uncertified "village health worker," for me it is a great honor to speak at the annual meeting of the American Academy of Pediatrics. Yet I feel uneasy. Today as we convene, 60 000 children will die unnecessarily, of undernutrition and the disease of poverty.

As pediatricians living in today's "new world order," you are faced with a daunting and in some ways paradoxical challenge. This is partly because the health and well-being of children is to such a large extent determined by factors outside the realm of medicine and pediatrics. It is also because pediatricians, along with so many other resources, are unequally and unfairly distributed. Ninety percent of all pediatricians are in North America and Western Europe, which claim only 15% of the world's children. This means that the vast majority of children—and certainly those in greatest need—live in places where there is no pediatrician.

Please don't get me wrong! I'm not suggesting you catch the next plane to Calcutta to play "great white doctor" in the City of Joy. In the long run, you can probably do much more for children of poor countries by standing up for their health and rights here at home.

If I were asked what American pediatrician in recent times has made the biggest contribution to the future health and well-being of the world's children, I would suggest Dr Benjamin Spock. Not because of his famous books on baby care, but because of his infamous protests and civil disobedience in opposition to militarism, nuclear arms, environmental destruction, social injustice, and the institutionalized inequities that compromise the health, survival, and prospects for the future of so many of our planet's children.

Submitted on October 29, 1992
Accepted on November 12, 1992




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