During our stay at Grace Orphanage, one of the little girls was quite ill with Malaria, earning her a trip to the local clinic, about a 2km walk away. The doctor at the clinic agreed to take us on a tour through the clinic, and also elaborated on the health challenges prevalent to the area. The doctor asserted that malaria is endemic to this area, and is responsible for scores of deaths in young children.
Just one month prior to our arrival, another girl at the orphanage was so gravely ill with malaria, that the orphanage staff had to carry her for 14km to the closest hospital, for intravenous treatment. Without prompt and appropriate treatment, this parasite that is injected in to the blood stream by infected mosquitoes progresses to severe anemia, then coma and death once it attacks the brain. Medical treatment is costly; considering the frequency at which the children are ill with this endemic disease in combination with all the other urgent needs at this Orphanage, it is not always possible to pay for treatment.
Firstly, educating the children regarding what malaria is, where it comes from, and how to prevent it is key. Preventative measures are as simple as insecticide-soaked mosquito nets over sleeping areas, mosquito sprays, and wearing clothes that cover as much of the body as possible. We noticed that some of the mosquito nets currently covering the children’s beds have holes in them, and they do not have any mosquito spray. Support to enable the implementation of such simple preventative measures would be critical, and quite effective.
Food and Water Borne Diseases
The Doctor at the clinic went on to describe that typhoid fever, cholera, and intestinal parasites are hugely problematic food and water borne diseases in this area. Some of the parasites even exist in the soil, and set up shop in the children’s intestines for lack of washing. Intestinal parasites (some of which can be transmitted from child to child via hand contact) were certainly evidenced in many of the children at the Orphanage by their bloated bellies, as well as Auntie Charlotte’s (housemother to the children) description of frequent bouts of lethargy, nausea, and diarrhea amongst the children.
Crowded living and Poor Sanitation
Food and water borne illnesses point to the massive problem of the limited ability to sanitize food and water in the first place. Given the resources currently available to the Orphanage, as well as their list of urgent needs, this problem seems overwhelming. It seems almost impractical to suggest that the children be educated regarding diseases and prevention such as hand hygiene in the context of limited sanitized food and water, and crowded living; three to four children share a bed, 38 of them share one toilet, and food is prepared over a charcoal fire in the absence of running water or a refrigerator. Water for drinking, cooking, and bathing is hauled by the older children from Lake Tanganyika back to the Orphanage. While water for drinking is purified with tablets, dishes, clothes, and the children themselves are washed in un-sanitized water.
Skin and Eye Infections
Two children at the Orphanage had a bacterial eye infection called Trachoma; untreated or repeated infections will lead to painful, permanent blindness. Spread of this bacterial infection is not only caused by direct contact with secretions from the eyes, nose, and throat of the infected children, but also indirectly through contact with towels or clothes that have contacted secretions. As you can imagine, the crowded living quarters and limited sanitation as previously described will aggravate the spread of this nasty bug, and of many others. As already mentioned, the children often swim and bathe (a dual mission!) in unpurified water, reducing sanitation. We also noted that the children frequently touch each other’s faces, as well as their own, with no hand washing in between. Thankfully, through the provision of a donor, we were able to treat the two children with a large, one time dose of oral Azithromycin (a broad spectrum antibiotic).
Ringworm (a fungal infection) was evident on the skin, nails, and scalp of nearly all the children. This infection is transmitted easily in crowded living conditions with limited sanitation and the sharing of bed sheets. Recall how the children frequently touch each other without hand washing before or after; education for the children about hand washing, and how bugs are passed along would be helpful). Left untreated, the affected areas can blister, and bacteria enter, worsening the situation. Again, with the generous provision of a donor, we were able to initiate a six week course of an oral antifungal to treat seven of the children with the most severe cases. It felt awful to “choose” some children and not others when they all would have benefited from this medicine, but you do what you can with what it available to you.
Hosea, one of the full time volunteer staff members at the Orphanage has recently cultivated a few small spinach beds in the front yard of the property, adding much needed, wonderful nutrition to the children’s diet. Space on this rented property is limited, however it is possible that perhaps with support, more vegetable gardens could be cultivated.
Auntie Sofia (in charge of food services) prepares meals for 38 children using a charcoal fire in the back yard; ugali (an inexpensive staple starch effective in filling the belly, but is devoid of nutrients) is prepared here and often served with red beans and spinach, or dried fish. It seems inconceivable that meals for 38 children are prepared daily in the absence of a fully equipped kitchen and refrigerator. It is only recently that each child has had breakfast available to them for eighteen days of each month; the rest of the month, they eat only lunch and dinner.
The Doctor at the local clinic described that chronic undernourishment is pervasive amongst children in this area (and in Congo at large). Weakening the immune system, malnutrition increases the already enormous risk of infection and disease. The means to incorporate more nutrition in to their diet, as well as ensuring three nutritious meals a day for each child would go a long way in strengthening their bodies to hold ailments at bay. Additionally, I believe that a more equipped kitchen with a refrigerator might enable more sanitary preparation and storage of food and water. Given that electricity is only available a few hours a day, a generator would be necessary to warrant the efficacy of a refrigerator.
Please visit www.grace-orphanage.org to see how you can get involved and really make a difference!
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