Advocating for Children
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Zeba Azizali Rasmussen ’76 |
More than two million children under the age of five die each year of pneumonia, which is more than all other single causes of death other than neonatal death, according to Zeba Azizali Rasmussen ’76, a physician and public health researcher who specializes in infectious disease, focusing on childhood diarrhea and pneumonia.
“The number is roughly the equivalent of a jumbo jet crashing every hour and a half,” Rasmussen says. “Who advocates for these children?”
Throughout her career, Rasmussen has done just that. After earning an M.D. from Harvard Medical School and a master’s in public health from Johns Hopkins School of Public Health and completing her residency in internal medicine at Massachusetts General Hospital (MGH), she was awarded a nine-month traveling fellowship by the Ella Lyman Cabot Trust in 1984. The fellowship supported her work at the Hospital for Tropical Diseases in London, U.K., the World Health Organization (WHO) in Geneva, Switzerland, the Marie Adelaide Leprosy Centre in Karachi, Pakistan, and the Aga Khan Central Health Board for Pakistan. She later specialized in infectious diseases, also at MGH.
Community-Based Interventions
In 1988, Zeba and her husband, Stephen Rasmussen, settled in Gilgit, where she helped to develop the health system in Pakistan’s remote Northern Areas for the Aga Khan Health Service. For almost 20 years, she also served as an assistant professor in the departments of medicine and community health sciences at the Aga Khan University in Karachi.
“When I moved to the Northern Areas, about 50 percent of the deaths in the population were in children under the age of five — about half of those due to diarrheal disease and the remainder due to pneumonia,” Rasmussen recalls. “During two major outbreaks of dysentery, we developed a surveillance program in one village and set up a microbiology lab in the district hospital. In addition to providing antibiotic treatment, we made a lot of progress helping children with diarrhea survive by teaching mothers how to prepare and administer a wheat-based oral rehydration solution at home.”
However, parents needed access to health-care professionals for diagnosis and antibiotic treatment of pneumonia, which occurs at annual rates of up to 80 episodes per 100 children per year in the region. “On a winter day, it took the average person as many as 12 to 18 hours to drive to the district’s only headquarters hospital,” Rasmussen says. “So we trained women in the community to recognize symptomatic fast breathing using a simple timer developed by UNICEF and WHO and to administer antibiotics.”
Most children began recovering after two to five days. “Using this approach, we were able to manage 95 percent of the pneumonia in the community, and there were great reductions in the mortality rate,” Rasmussen says.
Preventing pneumonia in the region is difficult due to crowded living conditions, the presence of wood smoke, and the absence of central heating. “But another major factor is that people in power don’t really care about the problem,” Rasmussen maintains. “Approximately 95 percent of the world’s funding for health research goes for diseases of the developed world and only five percent for those common in developing countries.
“What we need is prevention through the subsidized distribution of Haemophilus influenzae B and pneumococcal vaccines, coupled with prompt diagnosis and treatment,” Rasmussen continues. “People in power don’t feel the ‘pinch’ of what happens in these rural areas, so they don’t put into place the kind of interventions that are required.”
Children with Disabilities
In 1997, with the encouragement and financial support of her parents, Rasmussen started a small Montessori school in Gilgit. The school operates under the auspices of a nonprofit organization, the Mehnaz Fatima Educational and Welfare Organization, which is named for Rasmussen’s sister, who has Down syndrome. Since that time the school has trained 25 staff members, increased enrollment in early childhood education to more than 200 children, and is expanding into primary education.
Two years ago, the organization launched the Mehnaz Fatima Special Education Centre for children with disabilities. The school has nine staff members working with more than 40 children. “What is really exciting is that we are now extending this effort, particularly for children with disabilities, into the communities,” Rasmussen says.
Last year the organization obtained funding through the Development Marketplace, a program of the World Bank, to make adaptive equipment for children with disabilities, such as wheelchairs, beds and toilet seats, as well as toys in an area where children have none. Rasmussen is also starting an early-intervention program for detecting children with disabilities in the community.
As these new ventures ramped up, Rasmussen resigned from the Aga
Khan University, but she independently continues her research with a greater focus on childhood pneumonia. She also serves as vice-chair of the Mehnaz Fatima Educational and Welfare Organization, president of the board of the International School of Islamabad, and vice-president of the board of the Gilgit Eye Hospital and Gilgit Educational and Rehabilitation Centre.
Rasmussen has always derived inspiration from observing children grow and flourish. “I remember a time in Professor Jane Oppenheimer’s developmental biology class at Bryn Mawr,” she recalls. “We watched frog embryos grow from one cell to two to four to eight, and then moving tadpoles, and it was mind-blowing. I’ve had a lot of fancy medical training since then, but I’ll never forget that.”
Similarly, Rasmussen says, “We need to find ways to help all children live healthy lives and give them an optimal learning environment. If you give kids the right opportunities, they can do anything.”
Dorothy Wright contributes news and feature articles on science, technology, engineering and general-interest topics to a variety of publications, including Civil Engineering and Engineering News Record .
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