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newborns fell. In Papua New Guinea, where legislation whichaccords with the subsequent World Health Organisation code ofmarketing for breast-milk substitutes, was passed in 1977, thepercentage of bottle-fed infants fell from 35% to 12% and seriousundernourishment was reduced from’ 11% to 4%.The final weapon in the fight against malnutrition is the mass

distribution of simple cardboard weight charts. Mothers are taughtto enter the monthly weight of her child and compare it to anexpected rise in weight so that any failure to gain is clearly visible,and corrected, where possible, by extra food. A depressing exampleof an actual child’s development in Central America is included inthe report. The graph shows the continual interruptions in weightgain by diseases after the cessation of breastfeeding. At eighteenmonths, the child weighed the same as he had done at six months.As Grant emphasises, a substantial drop in the perinatal and child

mortality rate does not produce a population boom: "It is a conflictwhich is dissolved by time. For when people become more confident

that their existing children will survive, they tend to have fewerbirths. That is the principal reason why no nation has ever seen asignificant and sustained fall in its birth rate without first seeing afall in its child death rate". In addition, the report suggestseffectively targeted food subsidies (to the malnourished childrenindicated by growth charts, for example), and the fundamentalservices of clean water, sanitation, and basic literacy.The business of improving the chances of vulnerable children has

endless ramifications. UNICEF has concerned itself with just foursimple processes which depend for their efficacy on a network ofeducation to extend into the remotest areas of the world. Theenthusiasm and hard work of innumerable health and communityworkers is required to instil knowledge the simple remedies that cansave children’s lives.

1. UNICEF: The State of the World’s Children 1982-83. Oxford University Press, 1982.Pp. 128. £2.95.

Round the World

From our Correspondents

South Korea

A DEVELOPED DEVELOPING COUNTRY

South Korea is a mountainous country. Laced between the

highlands are broad valleys where paddy rice is grown. The word"developing" has real meaning in Korea. During the forty yearssince Korea passed from being a Japanese colony, through a periodof civil strife, it has become one of the newly industrialisedcountries. Just after the Korean war, the country had thecharacteristics of a developing country, with a high infant mortalityand severe stunting of growth in small children, still evident in thesmall stature of many adults today. The present health of most of thepeople is similar to that in European countries and they have thesame diseases of affluence. Seoul is a bustling city with broad streets,some with five lanes of traffic in both directions, and towering hotelsand office blocks. It has its slums, but they are much less of aproblem than in most other cities in Asia.Breastfeeding is declining and little has been done to curb the

activities of the milk companies. Korea was one of the few countriesthat abstained in the W.H.O. vote on breast-milk substitutes, butthe Government is expecting to accept the W.H.O. code beforelong. Children have few major nutritional setbacks, but when theycome off the breast or breastmilk substitute and go on to the bulkyrice diet there is some faltering in growth. Perhaps more serious isthat these children will be conserving their energy to sustaingrowth, and are therefore reducing their activity.So far, most of the Government’s involvement with health has

been in providing loans for groups to build district hospitals. Whereno hospitals were formerly available, they have been welcomed. Asfor primary health care, the Government has set up health centreswhich are hardly used-partly, perhaps, because of the attitude ofthose working in them, partly because logistic support for thesecentres has been poor. The Government of Korea, in common withGovernments in many other developing countries, is slow to realisethat a system of primary health care already exists, partly traditionaland partly western. Perhaps it would have been better to examinewhat existing forms of primary health care the people use, and thendevelop and expand them, rather than start an entirely new system.

United States

THE PRESIDENT AND UNEMPLOYMENT

The newly elected Congress meets on Jan. 3 in an atmospherereminiscent, in some respects, of the days of President HerbertHoover. Then, as now, massive unemployment and worldwideeconomic troubles were foremost in the minds of the politicians; anda Republican President was reassuring the citizens that the

economy was sound and prosperity was just around the corner. LikeMr Hoover fifty years ago, Mr Reagan seems puzzled when his

opponents interpret as callous and uncaring his refusal to takedrastic measures to relieve unemployment. He strongly opposes"make work" programmes, he says, because they do not createpermanent jobs on a large scale. Though he would never refuse toprovide Government help to feed hungry people while approving itfor starving cattle, as Mr Hoover did in 1930, Mr Reagan has MrHoover’s faith that only private enterprise can restore the nation’seconomic health. In view of his ideology, leaders of the new

Congress in the President’s Republican party must adjust their zealto do something about the highest level of unemployment since theGreat Depression-in excess of 10%. In persuading the President tohead off the Democrats and propose a five-year$32’9 9 billionprogramme for the repair of highways, bridges, and mass transitsystems, Congressional Republicans were careful to emphasise thatthe programme would provide 320 000 jobs. The President pointedto the need for the repairs and refused to call the legislation a "jobsbill".There are signs, in fact, that the President and his advisers believe

that some of the unemployed do not really want to work. He pointedout to a news conference that Sunday newspapers carried manypages of advertisements offering excellent jobs. The openings weremostly limited to highly trained professionals, engineers, andadministrators, far beyond the reach of jobless factory workers.More recently, the White House was contemplating a plan to tax theunemployment benefits of some workers on the expectation that itwould force them to find work. The President vetoed the plan afterunion leaders had called it cruel.The Democrats in Congress, their majority in the House of

Representatives strengthened in the recent election by 26 seats, willpropose jobs bills far more ambitious than anything Mr Reagan hasbeen willing to endorse. With a Federal deficit now running close to$200 billion, however, there can be no return to the large-scalespending programmes of the New Deal. "The main thing is to getrid of the image that we’re the big spenders," the leader of theOpposition, House Speaker Thomas P. O’Neill Jr, has declared.In military matters, Mr Reagan is the big spender. He may well

seek an 8-10% increase in money from this Congress for hismilitary build-up. The Democratic leadership will try to hold thisincrease to around 4%, saving$10-15 billion. A major spendingissue for both parties is the Social Security old-age pension andhealth-care programme, which is going broke. Congress, however,can at best strike compromises with the President. He alone canpropose measures to prevent the national recession from plunginginto a depression that would shake economies in other countries aswell.

ADDITION OF POISON TO DRUGS AND FOOD

The deliberate adulteration of over-the-counter drugs might turnout to be as difficult to control as plane hijackings. As Dr ArthurHull Hayes Jr, Commissioner of the Food and DrugAdministration, has pointed out, even the tamper-resistantpackaging the drug industry is now adopting cannot stop a

determined criminal. So long as the bottles and boxes are freelyaccessible on the shelves of drug stores and supermarkets, a way topoison an unsuspecting purchaser can be found. The addition of