Waging war against diarrhoea

It is impossible to eradicate Diarrhoea without the provision of safe drinking water. But records have shown that only 10 per cent of Lagos State residents have access to safe public water supply, while the 70 per cent residing in semi-urban and rural areas, is further excluded from safe public water services.

According to Lagos State government data, the average diarrhoea incidence is about 13 per cent or 520, 000 cases per annum. Under-five diarrhoea related episodes and deaths could be prevented through the application of simple, effective and low cost interventions, such as provision of safe drinking water in every household.

Towards an effective improvement in this regard, Save the Children, an international non-governmental organisation is working to inspire breakthroughs in the way the world treats children, by establishing the Stop Diarrhoea Initiative (SDI) in Shomolu and Bariga areas of Lagos. The programme will run from January 2015 to December 2018. The aim is to test the efficacy of the World Health Organisation (WHO), and United Nations International Children Education Fund (UNICEF) Seven Points Plan on the control of Diarrhoea. The plan also addresses the issue of making water available in good quality and quantity in every household.

Providing potable water for all requires an active involvement of all stakeholders, including government, developing partners, civil society organisations, organised private sector, and concerned communities. They need to demonstrate commitment through provision of funding, enabling environment and infrastructure to achieve desired result and end unnecessarily high childhood deaths.

Dr. Ijeoma Agbo, health adviser to Save the Children, said diarrhoea is the passage of three or more loose or liquid (watery) stools per day or more frequent passage than is normal for the individual.

She explained that diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faeces contaminated water.

“Infection is more common, when there is shortage of adequate sanitation and hygiene, as well as safe water for drinking, cooking and cleaning.”

Agbo noted that retrovirus vaccines introduced by Save the Children are the most common agents of diarrhoea in children, adding that children, who die from diarrhoea, often suffer from malnutrition, which makes them more vulnerable to diarrhoea.

She said: “Diarrhoea can also spread from person to person, aggravated by poor personal hygiene. Food is another major cause of diarrhea, when it is prepared or stored in unhygienic conditions. Water can contaminate food during irrigation. Fish and seafood from polluted water may also contribute to the disease. Symptoms of diarrhea include passage of frequent loose, watery stools, vomiting, abdominal pain/cramps, fever, and dizziness from dehydration among others. The most severe threat posed by diarrhoea is dehydration. This occurs during an episode of diarrhoea, when the loss of water and electrolytes sodium, chloride, potassium and bicarbonate is not replaced. The degree of dehydration is rated on a scale of three.”

“In early dehydration, no signs or symptoms are shown, while moderate dehydration causes thirst, restless or irritable behaviour, decreased skin elasticity and sunken eyes. Symptoms of severe dehydration include, severe shock, reduced consciousness, reduced urine passed, cool, moist extremities, a fast and feeble pulse, low or undetectable blood pressure. Death can follow severe dehydration, if body fluids and electrolytes are not replenished.

To combat the disease Agbo said: “Pursuing multi-sectoral efforts can prevent diarrhoea, including access to safe drinking water, improved sanitation and personal hygiene, hand washing with soap at critical points, especially before touching food, after using the toilet and after changing diapers. There is also need for exclusive breastfeeding for the first six months, as well as health education about how infections spread.

“Key measures to treating diarrhoea include rehydration, with low osmolarity oral rehydration salts (ORS), solution. ORS is a mixture of clean water, salt and sugar. Zinc supplements reduce the duration, volume and severity of a diarrhoea episode. It also reduces reoccurrence in the nearest short term continued feeding by continuing to give nutrient-rich foods, including breast milk during an episode. Consult a health professional for management of persistent diarrhoea, after 14 days, or when there is blood in stool or if there are signs of dehydration.”

David Atamewalen, Chief of project Stop Diarrhoea Initiative (SDI), said: “Since inception, the project has trained and fully mobilised 314 Community Oriented Resources Person’s (CORPs), who are responsible for daily services delivery in the community households. These services include: provision of zinc to families in need of regular distribution of water purifiers to improve access and quality of water, and ongoing education of mothers on proper nutrition, including the practice of exclusive breast feeding. They are also involved in a wide range of wash activities, such as hygiene and sanitation, as part of the broad-spectrum effort aimed at improving diarrhoea prevention and management within the context of the seven point-plan.

“In addition, the school health component of the project is currently running in 20 public primary schools. It is intended to enhance children’s participation in wash activities and motivate desired positive behaviour change at an early age. The project has improved routine immunisation in hard to reach communities, including health systems strengthening, the distribution of 4,095 co-packs and training of 214 health workers on the Integrated Management of childhood Illness in 2016. It has also constituted and trained 146 persons as water sanitation and hygiene committee (WASHCOM).