Anganwadi health worker Rita Kumari administers some zinc tablets and oral rehydration salts to Kajal Kumari to demonstrate to villagers the process and benefits of oral rehydration salts (ORS) and zinc tablets in Pakauli Village. in Bihar.
By Diana Coulter
PAKAULI, India , 19 August 2010 – With promises of “sweet, sweet,” the smiling health worker easily tips a teaspoon of white liquid into two-year-old Kajal Kumari’s mouth.
“There now little one, you will be safe and feel better,” coos Rita Kumari, as the toddler swallows the last drops of zinc tablet diluted in a teaspoon of water, which will help her fight a potentially deadly case of diarrhoea.
Next, Rita hands the girl a second “treat.” It’s a cup of oral rehydration solution prepared moments earlier before a crowd of villagers who are closely watching the treatment.
Eagerly, the little girl drinks again, peering over the metal tumbler with large dark eyes heavily lined in black to ward off evil in the traditional way. She can see people still pouring in from the mango orchards, banana groves, and chicken sheds nearby to watch the demonstration given by Rita, the local “anganwadi” or village health and nutrition worker.
In the distance, drumming and devotional music comes from other brick and mud-plastered homes in Pakauli, a village of 1,100 in an isolated corner of Bihar, one of India’s poorest states.
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The toddler’s father, Amod Paswan, 30, looks on with concern, remembering another local girl who died just a few years ago after a serious bout with diarrhoea. That’s why he and his wife, Sita Devi, 25, immediately sought Rita’s help at the anganwadi centre when their daughter started vomiting and having loose stools.
“We were very scared and worried,” says Paswan. “We know children can die like this,” he adds, clutching his tiny daughter to his chest while she still holds Rita’s shiny spoon.
In India, about half a million children die each year from diarrhoea and its complications. But about 88 per cent of these deaths are completely preventable if basic information and a simple treatment can be offered. In Bihar, that life-saving assistance is now being given through the generous support of the IKEA Social Initiative.
In partnership with UNICEF, state and national governments, IKEA’s funding is helping mobilize people at every level of the health-care system across three Bihar districts to offer zinc tablets and oral rehydration salts (ORS) to children with diarrhoea. The treatment is already saving lives. It’s estimated at least 15,000 children have received the treatment here to date.
Most often, diarrhoea kills children because of the severe dehydration that it causes. Many deaths are also linked to malnutrition since repeat episodes of diarrhoea cause the loss of essential nutrients, particularly zinc, from the body. Eventually, zinc deficiency leaves the child’s immune system so depleted that they fall prey to increasingly debilitating attacks of diarrhoea, pneumonia, malaria and other diseases.
It’s a vicious cycle of poverty, malnutrition and lack of adequate care that Anita Chourasia, another anganwadi worker in the Bihar village of Rajasan, is also tackling.
“The cure rate has been very high and the zinc treatment gives such good protection that there is not a repeat attack for many months,” Chourasia says with flashing brown eyes that clearly reflect her conviction.
Today she is advising Puja Devi, 27, on how to treat her eight-month-old son Priyanshu’s diarrhoea and vomiting, which started one night ago.
Swaddled in a bright yellow and gold-trimmed cloth, Priyanshu, whose name means “very lovely dearest” shakes the tiny silver bangles on his wrists furiously as he fusses and cries. His mother suspects tainted cow’s milk or water is the culprit. Contamination is frequent here, either by animal waste or humans who don’t have proper toilet facilities.
Chourasia shows the mother how to dissolve one zinc tablet in a teaspoon of water or breast milk, and give it daily for 14 days, as well as regular drinks of the ORS.
The new method used in addition to breastfeeding, continued feeding and selective use of antibiotics reduces the duration and severity of diarrhoea, as well as lowering the chance of repeat episodes.
In the past, some parents relied on amulets and rituals, while others went to local “doctors” who prescribed costly and often ineffective injections of antibiotics or anti-vomiting medication.
Now, after the implementation of zinc and ORS program in three Bihar districts with IKEA’s ongoing support, this initiative has been extended free-of-cost to patients across one-quarter of the state under a partnership effort between the Government of Bihar, Micronutrient Initiative and UNICEF. The Bihar government hopes to offer it to all regions eventually.
Certainly, Vaishali District Magistrate, Minhaj Alam, supports this idea. He understands a parent’s terrible fear for a sick child. Alam somberly recalls one of his children suffering from diarrhoea just a few months ago.
“They can get sick so quickly and seriously,” he says. “They don’t eat anything or drink much and can get dehydrated. This is very frightening.”
Alam says the zinc-ORS program is “now very important in this region.” He hopes others will soon benefit from it as well.
“We want all parents and children to know they are safe here.”