More than 12.2 million children under 5 years of age died in the developing world in 1993. In parts of the developed world only 6 out of 1 000 liveborns die before reaching age 5, whereas in 16 of the least developing countries the rate is over 200 per 1000. The gap between the developed and the developing world in terms of infant and child survival is one of the most serious examples of health inequity.

The biggest problem in the developing world is malnutrition, I think. Micronutrient malnutrition is estimated to affect at least 2 billion people of all ages, but children are particularly vulnerable. For example, iodine deficiency and vitamin A deficiency cause babies and children serious health problems.

Another problem is poor sanitation. Diarrhoeal diseases, resulting from unsafe water and poor sanitation coupled with poor food-handling practices, are responsible for a further 3 million deaths a year among children. Many of the deaths from diarrhoea could be prevented by using oral rehydration salts, which cost just US $0.07 .

A third problem is that many children are dying from vaccine-preventable diseases. There have been improvements in child health, and 1993 saw the number of children dying from vaccine-preventable diseases such as measles, neonataltetanus, tuberculosis, pertussis, poliomyelitis and diphtheria reduced by 1.3 million compared to 1985. Nevertheless, around 2.4 million children under 5 years are still dying every year from such diseases.

What can we members of the Japanese medical community do for these problems? First, we can cooperate in education, not only medicalÅ@training but also all basic education, because I think basic education can develop their social power. Of such deaths in the developing world, the great majority could have been avoided if those countries enjoyed the same health and social conditions as the world's most developed nations.

Second, we must research to find the most useful ways to help children in the developing world. Indeed, we can give the developing countries material help such as medicine, vaccine, medical tools. This is a big help for children in the developing countries and we must do this, of course. But what we give the developing countries might be sometimes useless for people living there. because we don't know their own culture and ways to deal with social things. So I think researching is very important. For basic understanding , we have to take a sociological and cultural anthropological researching approach. But this researching approach will take time. What must we do right now ? I think a medical researching approach is the most important. We need to know the medical standards in each developing country and what kinds of medical tools or medicine are fit for their therapy. Then we can find the efficient assistance system for children's health care in developing countries.

In this point of view, medical students like us should be more useful. We have free time in spring and summer vacations. We can go to the developing countries, live with people having children there, talk with them and also work for medical camps or assist researching. Then we might understand the problems not only of the developing countries but also of people living there. And when we become doctors, we might be able to make ourselves useful for people in the developing countries. We can supply useful information to medical organizations or medical staffs relating to aid for the developing countries as well as our going to the developing countries as medical staff. We can also write some articles about the serious problems related to children's deaths in the developing world to attract people's attention in the developed countries to these problems .