War on Disease

( By Radhika Ramasubban, Bhanwar Singh & Nigel Crook )

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Sushma Saves Her Baby

When Medicine Is In Your Hands Is As Important As Visiting The Doctor

Smita was surprised to see Sushma at her door clutching her three month old baby. She looked agitated. " Smita, do you know of any doctor who would be available now ?" she asked.

"In the middle of the afternoon ? Can’t it wail till the evening ? Dr. Khan comes in early, by 4.30 or so. What’s the matter, you look so upset. "

"It is the baby ." said Sushma. "She has had almost eight loose motions -- watery ones -- in the last hour. It doesn’t seem to stop. Look, the clothes are soiled again." "It is a serious matter," said Smita, quickly putting away the chappati dough she had been kneading, and washing her hands. "We can’t wait for a doctor. WE must act fast. "

"ORS ( Oral Rehydration Solution ) -- that’s what we need now," she exclaimed. " I remember well that at the mahila mandal we were shown how simple remedies can make the difference between life and death for small children. You sit down, Sushma, clean the baby and wash out the clothes and cover her with this sari. I’ll get the water ready."

Smita measured one empty milk bottle ( the type one gets at the government milk booth ) of water and put it to boil. "Look , Sushma, this is how we make ORA. For half a litre of boiled and cooled water (one milk bottle = half a litre) , take a small closed fistful of sugar, three big pinches of salt , and stir these into the water. Keep the solution in a clean vessel and keep it well covered with a clean lid like this. Give it to the baby a spoonful at a time at first, then half a cup at a time every half an hour or so. Within the next 24 hours you must finish this amount I have made and give her another half litre of the solution as well. "

"But why must the water be boiled first ?" asked Sushma. "What is wrong with using water from the tap or stored water from the pot ?"

"Because, by boiling the water, you are making sure that it is made completely pure and free of germs, " explained Smita. "And remember , never put the prepared solution on the fire. "

"But what if the watery stools continue ?" What’s the point in putting in water which is coming out anyway ?" asked Sushma. "That is precisely the point." Smita said emphatically. "To put back the water that is leaving the body along with the essential salts. In small babies the rapid loss of precious body fluids can cause them to die, if this loss is not checked. And this is not a substitute for going to the doctor. It is something you must do until you are able to reach a doctor and which you must continue doing on your own until the watery stools stop completely, in addition to any medicines the doctor may give to kill the germs that have entered the baby’s body. If for some reason you are just not able to reach a doctor, this ORS alone can save your baby’s life. The watery stools will keep washing the germs out and if you keep putting fluid back into the body, balance can get restored. But, of course, " she added, " this time don’t rely on this alone. Go and see Dr. Khan and tell me what he says."

That evening Sushma had a long wait in the doctor’s clinic. But the doctor had been called away on an emergency and those patients who could not wait any more started leaving. Sushma had brought along the solution with her in a bottle that she had boiled and sterilised and had been giving it to the baby as she waited. The frequency of the stools had gone but she fervently followed Smita’s advice. How lucky she had been to get this advice; at least she didn’t panic when there was no doctor.

On her way home, Sushma dropped in to see Smita.

"Dr. Khan did not come today. I waited all evening. What should I do now ?" she asked.

Smita taught for a moment. "Don’t worry. We’ll go to Sion Hospital tomorrow morning. Be ready at 8. I’ll come to you. "

HOW TO PREPARE ORAL REHYDRATION SOLUTION (ORS) : A REMINDER

Take boiled and cooled water. For half a litre of this water ( one milk bottle = half a litre ), take a small closed fistful of sugar ( or gur), three big pinches of salt and stir these into the water.

This solution can be easily made at home. ORS packets are also available in the market and with health centres.

There are also other ways of putting fluids back into the body both as an emergency measure and to give strength to the recovering baby or child.

These are :
Rice water with salt and some lemon juice.
Water in which dal has been boiled with salt and lemon juice added.
Lemon juice with sugar and salt .
Weak tea, lassi.
Green coconut water.
If the baby is being breast fed it is important to continue breastfeeds in addition to the above fluids.

Khichdi, rice kanji and ripe babana are also easy to feed and easy to digest for a baby or child recovering from diarrhoea.

Sushma thanked Smita gratefully. "Don’t forget to continue the ORS until the baby goes to sleep and again after she wakes in the morning, " reminded Smita.

The next morning the two women went to Sion Hospital with the baby. When the doctor had examined the baby, Sushma hesitatingly told her about the ORS she had been administering since the day before." You saved your saved by your timely action. " said the doctor.

Pinching the skin of a baby in its mother’s arm as the nurse was leading them away to put the baby on a glucose drip, the doctor said to Sushma, " This baby had the same diarrhoea as yours. But because no fluids were put back into its body, its condition has worsened.

Here are some medicines to kill the germs which have caused the diarrhoea. Give it to the baby regularly in the quantities I have written down. She should be well and active soon Don’t hesitate to come back to me if the diarrhoea recurs. And don’t ever forget the ORS recipe. "

WHAT IS DIARRHOEA ?

Diarrhoea --- large watery stools --- can cause death fairly quickly, and particularly among children under five years old. It is a major cause of mortality. In Bombay city, inspite of the presence of medical facilities, diarrhoea kills a large proportion of the children who die every year. The main cause of diarrhoea is poor sanitation, and infant deaths due to diarrhoea occur all over the city, wherever poor people live. While protection of food and water from contamination and maintaining general cleanliness in and around the house are the only the ways to prevent infant diarrhoea, prompt recourse to oral rehydration therapy (ORT ) is the only known method of saving the lives of children between the time that they are attacked by the germs and medicines begin to act on the body.

Learn how to prepare the ORS and teach others. Even if you have no little child of your own you might be able to save a life as Smita did.
Organise collective action to improve cleanliness in your area. A common cause of contamination are flies which sit on garbage / faecal matter and then come and sit on food stuffs and water in your house.

FOR TEACHERS :

Get the children in your class to investigate how many children in their area have had diarrhoea in the last month and what measures their mothers resorted to. How many died ? How many mothers used ORT ?
Teach the children how to identify early signs of diarrhoea in their siblings. Teaching them about Oral Rehydration Therapy (ORT) might be one way of getting through to their households.

FOR YOUTH VOLUNTEERS :

Encourage the children to organise cleanliness campaigns along their line of houses.

Give badges to the group which does the maximum to clear its area of garbage and whose drains flow smoothly.

Sushma came away filled with a sense of satisfaction and a new understanding. She would help people in future, the way Smita had helped her.

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