In no other industrialized country do as many babies die post-birth as in the US. A lack of medical access and education are primary causes. However there's a sliver of hope in one of the capital's poorest areas.
Bus stop, Anacostia. In the poorest part of Washington, D.C, even a bus can be converted into the waiting room of a pediatric clinic. When mothers, their children in tow, reach the bus on the street lined with cookie-cutter, low-income housing units, they've reached their destination.
"I'm here because of my daughter," says one mother. The woman is all skin and bone, with few remaining teeth. Her five-month-old baby, Julia, is the 22-year-old's third. "I have two other daughters, who are three and five," she says.
She was 17 when she had her first child. Each of her three daughters is from a different father. The mother herself is attending school once more. She'll make it work somehow, she says. She's one of many young single mothers in this district, where 90 percent of the population is African-American. In this forgotten corner of the capital city of the world's richest country, one in two has no job. Most never finished high school. The AIDS rate is higher than in some areas of Africa: Three in 100 carry the virus. For young black women between the ages of 25 and 34, it's the number one killer. Here, on the far side of the murky Anacostia River, a physician who's both good and affordable is a luxury.
That's what Georgetown University's cutting-edge mobile clinic offers them. It regularly checks up on seven problem regions. The white vehicle, covered with the logos colorful corporate sponsors, stands out like a UFO amongst the drab facades and boarded-up, broken-out windows. Deaths by handgun in the capital dropped from 500 to 90 last year. The large majority of those deaths, however, continue to come from Anacostia.
After a while, the waiting room in the small entry of the bus becomes increasingly full. From behind a sliding door, a young doctor examines Julia. In the hall, a small boy is vaccinated. At treatment table two, a mother uses the opportunity to get her own check-up.
A tour through poverty
For 20 years now, the Ronald McDonald Care Mobile program - with the help of loyal sponsors - has been cruising through Anacostia. Over that time, 50,000 patients have profited from Washington's oldest mobile clinic, says its founder, pediatrician Matthew Levy.
"We started out because there was tremendous health disparity between the underserved families and the wealthier communities," says the pediatrician. "The idea behind mobile health is to improve access to care."
President Barack Obama's hotly-contested health care reform, which has gotten off to a slow start, will hopefully guarantee insurance for the poor sometime soon. When that happens, a huge hurdle will have been removed, Levy says. Yet many economic barriers remain, he adds, with too many extremely poor and extremely rich, with too few in the middle. In Anacostia, "some of those infant mortality rates rival developing nations," he told DW.
In no other industrialized country do so many babies in the first year after birth as in the United States. Roughly 11,300 do not make it past the first day - 50 percent more than in other industrialized countries. Illness, a lack of medical care as well as poor education are among the causes Levy and his team are trying to fight back against.
"The health disparities that we see are in part due to access. And they're also in part due to understanding of health. So we act on both of those," Levy said. AIDS, diabetes and asthma are the predominant medical issues facing his patients. Many have other problems as well. "We make a lot of referrals to our social worker and mental health provider for anxiety, depression and for attention deficit disorder."
Sick of poverty
Studies conducted by epidemiologist Sanjay Basu of Stanford University and economist David Stuckler at the University of Oxford have verified that poverty induces illness. Were politicians to address the crisis correctly, it could contribute to societal recovery, the experts write in "The Body Economic - Why Austerity Kills".
"With the recession, suicide rates also went up. Other countries, like Sweden, prevented that through targeted social policies," Basu wrote.
New diseases even sprouted up on the foundations of economic ruin. On America's West Coast, standing water in foreclosed buildings and homes led to the appearance of pathogens such as the mosquito-borne West Nile Virus.
For pediatrician Levy, it's a clear-cut case. "They need some counselling. They need some support. The families need support to get through this."
His country's social welfare net has many holes. Health insurance for everyone, as it's implemented, repairs some of them. But his pediatric bus has many more miles to travel.