It's 2018 but SA's kids are still dying of diarrhoea. Why? And what to do?

SA’s cities and a stretch of the Eastern Cape and KwaZulu-Natal coast are shaded brown in a new study depicting child deaths from diarrhoea.
The colour indicates mortality hot spots and, even though SA is far from the worst-affected country on the continent, the study highlights the toll of a preventable disease that is responsible for an estimated 20% of deaths among under-fives.
A website that maps child deaths from diarrhoea throughout Africa allows health officials and activists to examine the problem in 5km by 5km squares.
“The uneven distribution of diarrhoea within countries means national strategies will be much less effective than focused, local interventions,” said Bobby Reiner, lead author of the study published in The New England Journal of Medicine.
Results from SA prove his point, with large swathes of the country reporting hardly any child diarrhoea deaths and others facing a serious problem.
A Medical Research Council study in 2016 said there was a paucity of reliable data about the prevalence of diarrhoea, a problem the new study aims to tackle.
The Institute for Health Metrics and Evaluation at the University of Washington in the US looked at the period 2000 to 2015 in a study funded by the Bill & Melinda Gates Foundation as part of a global project to map health metrics in 5km by 5km squares.
The aim is to help doctors and policymakers to identify local health threats and intervene appropriately.
Reiner said: “Diarrhoea is highly preventable, and tens of thousands of child deaths from diarrhoea could be averted each year if interventions targeted mortality hot spots across Africa.”
In the case of diarrhoea, which killed more than 330,000 African children in 2015, interventions could include rotavirus immunisation, providing safe drinking water, sanitation and hygiene programmes and minimising exposure to contaminated food.
The Washington researchers found that half of diarrhoea-related deaths among African children were concentrated in just 55 of the continent’s 782 states, provinces or regions.
The mortality rate fell across the continent over the 15 years but there were increases at local level in parts of Zimbabwe, Nigeria, Ivory Coast, Gabon and the Central African Republic, sparking a warning from Reiner that these areas risked falling even further behind.
“Our precision public health maps are critical tools for calling attention to areas where diarrhoea-related child mortality is stagnating or worsening, despite proven interventions,” he said.