In Africa our children die less from diseases and more from poverty, ignorance and belief systems. Not their own but those of their parents and societies.
A few days ago, a young mother brought her child to hospital who was gasping for dear life and taking her last breaths. We tried to help her but she was gone before anything could be done. Her pet name was Kuku, she was 8 months old, had achieved her milestones appropriately and was healthy until 3 days prior. she was her mother’s first and only child.
On the first day of her illness she had developed a bout of diarrhoea and vomiting. In the 3 days that followed, before she came to us, she went through the following:
Day 1: She was taken to her paternal grandmother. At this point she was diagnosed as having diarrhoea caused by teething and the remedy was rubbing salt on the palate and on the scalp. This was done several times but the illness only worsened. Now she was refusing food and struggling to breathe.
Day 2: She was taken to the family church where she spent the whole day being prayed for, “holy” mixtures being forced down her throat. She continued to deteriorate until they went back home at night. At this point I should mention that members of this particular church are not allowed to seek help from the formal health system, it is against their beliefs.
Day 3: Under the guise of the night Kuku was finally brought to us by her mum and her sister. She had decided to defy her church to save her child, unfortunately it was too late.
Kuku died from a combination of severe dehydration, metabolic acidosis, electrolyte imbalances and hypoglycemia. All of these should never kill a child, but in Africa this in not uncommon. According to WHO, diarrhoea is the leading cause of death in children between 1 month and 5 years old and 70% of these deaths are preventable.
Oral Rehydration Solution (ORS)
ORS is all that Kuku needed to survive, a mixture of water, salt and sugar. This simple solution was discovered in 1968 by researchers in Bangladesh and India and has saved millions of lives since then. UNICEF has called it the medical discovery of the century. It can be made at home by mixing a litre of clean water, 6 level teaspoons of sugar and a half level teaspoon of salt. These are available in every household and cost less than 20 cents. The Ministry of Health in Zimbabwe has gone a step further to print the instructions on how to make ORS on the child health card that is given to every mother after giving birth, whether the mothers are aware of this is another issue. UNICEF also provides ready made ORS sachets which are available in clinics and hospitals for free.
Around 8,000 children worldwide still die each day from diarrhoeal dehydration, a toll the world can and must reduce with ORS.
What needs to be done?
- Parents need to know that ORS is the recommended treatment for diarrhoea. The earlier it is started the better. The same enthusiasm we have shown in educating the public about HIV should apply here.
- Doctors and nurses should become more responsible. Parents now expect us to prescribe antibiotics and anti-diarrhoeals because that has become our routine practice when in fact this practice is wrong and even dangerous according to research. ORS is cheap, safe and effective, let’s stick to it.
- Africa needs more public health professionals if progress is to be made. The top 5 causes of death in Africa are preventable and clearly our priorities are misplaced.
Diarrhoeal disease is a leading cause of death in children under 5 years in Africa, It is preventable and treatable. Let us empower our societies with the knowledge that can save their families, after all it is those families that make up Africa. An Africa without Kuku is an Africa at a great loss, she had a part to play but because she was denied water mixed with sugar and salt, that part will never be played.