Five-year plans are nothing new in China, but the one called "Freedom of Breath, Fountain of Life" is different -- it's saving tiny lives.

Launched a year ago by a unique partnership of Chinese and American organizations, the program is rippling through the medical community of the world's most populous nation, spreading training techniques on neonatal resuscitation.

One hundred Chinese doctors, nurses and midwives attended the inaugural "Freedom of Breath, Fountain of Life" national training course in Beijing in July 2004. The thrust of this five-year plan is to have those trainees train others, who will train others, and so on until more than 60 thousand professionals in China will know what to do when newborns struggle for their first precious breaths of life.

"From the original 20 provinces included in July 2004, additional areas have been brought on board so that all provinces of China are now participating and have instructors for their regions," says Dr. William Keenan, director of the Division of Neonatal-Perinatal Medicine at St. Louis University School of Medicine and head of the U.S. based medical team that went to China to launch "Freedom of Breath, Fountain of Life."

In China, where there are 13 million live births annually, an estimated 125,000 infants die each year from birth asphyxia when, for reasons ranging from a simple mucous buildup in the throat to serious birth complications, they cannot breathe on their own.

The staggering numbers in China are part of a global problem, with birth asphyxia counting for nearly one million infant deaths a year worldwide. And the solution can be as simple as teaching professionals the various ways of clearing tiny airways.

"The goal of the program is really simple -- to make sure that there's one person trained at every hospital birth in China who knows how to do neonatal resuscitation," says Owen Rankin, president of the Johnson & Johnson Pediatric Institute, L.L.C., and a participant in the inaugural conference.

The Johnson & Johnson Pediatric Institute, L.L.C., the Chinese Ministry of Health and the American Academy of Pediatrics joined forces to develop, launch and implement "Freedom of Breath, Fountain of Life."

While it is difficult to quantify results of the program a year after its beginning, one measure of success that can be counted is the demand for a seat in training sessions throughout China.

"The national and provincial-level trainers report that the major difficulty they are facing is the tremendous demand to attend a course," says Dr. Susan Niermeyer of the University of Colorado School of Medicine and a member of the team.

Participants in the initial teaching sessions have no doubt that their lessons are being taught and re-taught throughout regions from cities such as Beijing and Shanghai with modern, sophisticated hospitals, to rural areas where hospitals often lack resuscitation tools.

"It was incredibly gratifying to learn that the grassroots providers are very eager to provide the best possible care for babies in China," says Maggie Vogt, a neonatal intensive care nurse from St. Louis and a trainer in the inaugural session.

"They were so proud to take the NRP (neonatal resuscitation program) back to their own hospitals to share it with their colleagues. They had a very elaborate graduation ceremony for the new trainers, complete with patriotic music and certificates."

Dr. Tony Duan, vice president of Shanghai First Maternity and Infant Hospital and a participant in "Freedom of Breath, Fountain of Life," says, "The ��'ipple effect' of training teachers to teach others is working in China.

"As a teacher, you can train a lot of other people, they can pass on the knowledge to hundreds of thousands of other doctors, so that every child could have the same advantage," he says.

While neonatal resuscitation training programs have been going on around the world, including parts of China, for years, "Freedom of Breath, Fountain of Life" stands as the first unified effort to spread the knowledge to all provinces of the vast country and all strata of the massive population.

The endeavor produced real results early on. During planning stages, it became clear that success of the program would hinge on training all health professionals -- not just doctors -- attending a birth. The Chinese Ministry of Health moved to change a long-time policy to allow hospital nurses to take action on their own.

"That was an incredibly important change in the scope of practices for nurses," says Rankin of the Johnson & Johnson Pediatric Institute, L.L.C. "That will make a difference for nurses, and will make a difference for the health of babies in China."

By Yong Tang, our Washington-based correspondent