Nairobi, Kenya – Medical experts have warned that malaria and HIV have monopolised interventions geared towards curbing child mortality in Kenya, thus ignoring the equally deadly killer, diarrhoea. This disease has silently claimed the lives of hundreds of children every year. Cecilia Njambi, a mother of two, lost her first-born son to diarrhoea. “He hadn’t slept well the previous night and had complained that his tummy hurt. His stool was loose but we weren’t alarmed as no one takes diarrhoea seriously anyway. We just assumed that he must have eaten something that didn’t go down well with him.”
“We gave him a solution of water and salt, as is common practice, and in the morning I left for work. That’s the last I saw of my five-year- old alive.”
Recent statistics show that although child mortality has decreased from 120 per thousand deaths to an all-time low of 74 per thousand deaths over the last five years; there are no clear strategies to the killer disease.
Many children – particularly those in rural areas and urban slums – continue to succumb to the condition every year, even as the country strives to realize the Millennium Development Goal 4 of reducing child mortality.
Healthcare providers emphasise that diarrhoea is a key factor in child mortality, explains Evelyn Mutio, a nurse and member of the National Nurses Association of Kenya (NNAK).
She adds, “Many preventable deaths from diarrhoea among children arise from what is referred to as ‘the three delays’ in the medical fraternity.” The mother or guardian delays taking the child to the hospital for one reason or another usually it’s because many people think this condition can be easily controlled and treated by self medication.”
Then when they finally decide to take the child to the hospital, there’s usually the factor of the distance to the dispensary which further delays contact between the child and the necessary healthcare provider. When the child finally reaches the health facility, diagnosis takes precedence over First Aid.
Mutio further explains that there are various types of diarrhoea depending on the cause. The healthcare provider also has to ensure that while diagnosis is made the child is kept hydrated.
“They want to find the cause first and then treat. Meanwhile the child has lost a lot of liquid. You can imagine how dehydrated a child can be if every one hour they have four motions” (expelling through loose stool, which at times is accompanied by vomiting).
Jackline Ngatha says that often these fatalities arise from ignorance on the side of the parent or guardian. “Although we are taught the importance of dealing with illnesses such as diarrhoea immediately during our child immunisation clinic visits, information is not packaged in a manner that will drive the point home regarding the seriousness of the matter.” “Often we are given reading material on hygiene but most of us are more concerned with putting food on the table than reading.”
Mutio explains that a lack of money is another contributing factor and that diarrhoea is more rampant among the poor. At the very basic level, we are looking at diarrhoea caused by poor hygiene.
Clean water costs money, boiling costs money and even using chemicals to purify it costs money.” She says that delaying a trip to the hospital is often due to a lack of money. Even though the government has established dispensaries where people can be treated for free, it is never completely free.
“Dispensaries are usually far and one needs transport. At the dispensary one needs to buy a medical card. Often it costs way below a dollar but we live on under a dollar a day so that is still much. Then the healthcare provider will write down some prescription (for you) to buy from a chemist,”Njambi explains.
“Nothing is free. When a child has diarrhoea we make concoctions in the house to try and stop it in order to save money”. James Otieno, a resident of Kibera Slums – one of the largest slums in Africa – says that the situation is particularly bleak in the slums, as NGOs interested in the plight of the poor have put all their resources and energies into curbing HIV.
“There are no drainage facilities in the slum and no clean water. The little water that is available costs too much. When a child has been treated for diarrhoea and goes back to the same dirty environment, the problem has only been postponed,” he explains.
Otieno, together with friends, have formed a self-empowerment group to help keep their neighbourhood clean, and in the process help to control diseases brought about by what he refers to as ‘a lack of garbage management’.
It is a small initiative but for the neighbours, it is a welcome solution towards creating an environment fit for raising healthy children, saving them from diarrhoea and ultimately from deaths that are preventable.
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