Child-Friendly Healthcare Initiative

To the Editor. I was deeply moved by Fig 1 in the article by Southall et al entitled “The Child-Friendly Healthcare Initiative (CFHI): Healthcare Provision in Accordance With the UN Convention on the Rights of the Child” ( Pediatrics . 2000;106:1054–1064) that shows a child with neuroblastoma from an unnamed impoverished country. The small body is lying on a small metal cot. Even in the shadows, one can see that the sheets are threadbare, and the upper face is sheathed in some type of surgical bandage. The left arm appears to be splinted, perhaps to some sort of intravenous infusion. The legend mentions that some (palliative?) surgery had been undertaken, but there was inadequate chemotherapy and analgesia. I was reading this issue of Pediatrics in my usual fashion—skimming it at midnight. I wept out loud when I saw this bleak image. No child should have to suffer. No child should have to die in pain, unable to see or to be held. Although I experienced sorrow, I felt proud to be a member of a the American Academy of Pediatrics, whose journal published the photo. This is a specialty …