Botswana: country report on children's environmental health.

According to the World Health Organization (WHO), 5.9 million children under age 5 died in 2015, and globally, the main causes of child deaths are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria. In 2012, it was reported that one quarter of childhood deaths and disease burden could have been prevented by reducing environmental risks. Children are vulnerable to environmental risks such as air pollution, inadequate water, sanitation and hygiene, hazardous chemicals and waste, radiation, climate change, as well as emerging threats like e-waste. They are particularly vulnerable to these threats due to their developing organs and immune systems, smaller bodies and airways. In 2010, there were 132,989 in-patient morbidities. This number represents a 5.2% increase from the 126,381 registered in 2009. The major causes of infant morbidity and morbidity in children under 5 years old were diarrhoea and pneumonia. Although morbidity cases increased in 2010, there was a 6% decline in in-patient mortality from 6952 registered deaths in 2009 to 6535 deaths in 2010. Pneumonia and diarrhoea were the major causes of both infant and child mortalities. In Botswana, various environmental risk factors such as contaminated water, air and soil pollution and poor waste management have been associated with children's environmental health (CEH). The outbreaks of diarrhoea in the country have always been associated with contaminated water. In the recent outbreak of diarrhoea in August 2018, laboratory investigations attributed the outbreak of diarrhoea to rotavirus. Children (1-6 years) living in areas with high levels of traffic congestion (living near a busy road) had higher levels of lead in their blood than those who lived in areas with less traffic. Poor waste management may lead to contamination of air, soil and water. CEH has not been given the attention it deserves in Botswana. It is, therefore, time to raise awareness on the subject. Health care workers, for example, need to be trained on diseases affecting children that are due to environmental exposures. Communities as well need to be trained on environmental factors that are prevalent in their areas and the effects of those on children's health. It is important that research should be conducted on CEH in Botswana. At the time of compiling this report, the author was not aware of any CEH network in the country or networks in the region. To raise awareness and advocacy of CEH, there is a need for the establishment of a CEH network in the country or to participate in networks in the regions.