By Susan Anyangu
Last year, Merciline Akhwabi, a resident of Mathare North, lost her one-year-old daughter to a bout of diarrhoea.
"After I stopped breast-feeding Peninah, she suffered from diarrhoea frequently. I would take her to hospital for treatment but the last time she did not recover," says Akhwabi. The toddler died a week later.
One in every 14 babies die from diarrhoea before their first birthday. Diarrhoea contributes 20 per cent of under-five mortality yet the disease can easily be managed through oral rehydration therapy (ORT), which costs Sh10.
WHO statistics indicate that there is a 32 per cent decrease in the use of the therapy in Kenya. An intake of oral rehydration salts (ORS) coupled with continued intake of fluids, could control diarrhoea and significantly reduce the number of children who die each year.
A new survey in Asembo in Nyanza and Kibera in Nairobi, reveals that despite being a lifesaver, ORS was not being used for management of diarrhoea.
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The Unicef, Centre of Disease Control and US’ Buffalo University study reveals that despite knowledge and availability ORS, health workers are not prescribing the therapy.
A sachet of ORS, which is a single formulation of glucose-based rehydration, salts retails at Sh10. Caregiver are directed to use ORS coupled with increased intake of fluids and continued feeding to manage diarrhoea Wamae says.
Expected
However, the study shows that the situation on the ground is contrary to what is expected.
One of the researchers, Ms Pravin Ram of University of Buffalo, says interviews revealed that caregivers like Akhwabi had no or little information about ORS.
"They said they did not use ORS because it was not recommended by health workers. Many consumers believe antibiotic treatment, which does not deal with dehydration, is the only solution for diarrhoea managment," said Ram.
"When Peninah was ill all I got from the health centre were drugs but she could not eat and was unable to retain the medicatio," says Akhwabi.
Doctors say Antimicrobial and Antimotility drugs are not the most effective way to treat watery diarrhoea and prescription of ORS should be encouraged. "This will significantly reduce the number of deaths due to diarrhoea Dr Wamae says.
She says continued feeding and fluid intake is crucial to keep up the strength of the child and to avoid dehydration, which is often the cause of death.
According to Dr Wamae, Control of Diarrhoea Diseases Program (CDD) initiated by World Health Organisation in 1980 significantly reduced and prevented diarrhoea-related child mortality and morbidity.
Eight years after the launch, the 100 countries that adopted CDD registered drastic reduction of the disease. A reduction from five million deaths in 2000 to about two million globally was attributed to ORT.
The study showed that 78 per cent of people use surface water for drinking and cooking which is fertile ground for a variety of communicable diseases including diarrhoea.
The findings indicate that lack of ORT use was also due to insufficient ORS in remote clinics, conflicting information from local herbalists who advised mothers to give their children a solution of sugar and salt instead of ORS and lack of money.
Health experts warn that diarrhoea, the third leading killer of children under five after malaria and pneumonia, may soon become the foremost killer.
They are concerned that while this disease kills millions of children, the world’s attention is focused on HIV/Aids, malaria, tuberculosis and communicable diseases. Speaking during the release of the survey, Dr Annah Wamae, Assistant Director of Medical Services Division of Child and Adolescent Health, expressed concern at the increasing danger The experts have called for revitalised campaigns for ORS.