SIERRA LEONE, Wata Meresin (Oral Rehydration Salt)
He sat sad and brooding on his hospital bed with a cup of water and a loaf of dry bread. His small bones poked out of his almost translucent skin. He looked old and unhappy as if he carried all the burdens of the world on his small shoulders.
Mohammed is only two years old and severely malnourished from repeated episodes of diarrhea. He has been on admission for three weeks now at the Ola During Children's Hospital in the eastern end of Freetown, Sierra Leone's capital.
Mohammed is the youngest of his mother's three children. The others are a boy of eighteen-years in Grade Eight and a nine-year old girl in Grade Two.
His mother Josephine Thomas is a single mother who makes a living selling cold water and ginger beer- a local drink made from ginger and sugar packaged in little plastic bags - with the help of her two older children. On average she makes Le10,000 a day (US$3).
"Mohammed had diarrhea, vomiting and fever, His body was warm … for about a week. I took him at first to the Community Clinic in Wellington. There was no improvement after four days so I took him to the Arab Clinic and after a day I rushed him here because he was so weak" reports Josephine, Mohammed's mother. "Now the diarrhea is gone, only the weakness is left." Josephine reports that Mohammed gets diarrhea often, and she does not know why. "That is his sickness, but this one really had me worried. I thought he was dying" she confessed.
In Sierra Leone diarrhea is one of the most important causes of morbidity and mortality in children below five years of age. In addition to being a cause of child mortality, diarrheal diseases are also a major contributor to childhood malnutrition, which in turn increases the severity of other childhood diseases and the severity of malnutrition itself. "Mohammed looks much better now. You should have seen him when he first came to us" stated Mrs. Kamara, assistant to the Sister-In-Charge of Ward Two. "For a while it was touch and go."
The nurse informed the interviewer that most of the children who are brought to the ward have diarrhea, malaria and anemia. She reports that on average the ward has between sixteen to twenty children at a time. There are three wards similar to Ward Two in addition to the Therapeutic Feeding Centre which on average also has up to twenty children.
Low access to safe drinking water, limited use of sanitary means of excreta disposal, worm infestations and the effects of the war on social infrastructure and movement of populations contribute to the high impact of diarrheal diseases on the health and survival of children under five. Traditional practices and beliefs have also acted as barriers to appropriate and simple preventive actions such as hand washing with soap, before feeding children and after cleaning a child's bottom.
Mrs. Kanie Kamara, the assistant State Nurse in charge of the ward is confident that things are getting better. "We need to continue promoting how to take care of children.
Almost all the children brought here have diarrhea. Most of these mothers know about ORT, know how to use it and can mix it themselves or know where to get the packaged ORS but may not have the money to get clean water, so they always look for the easy way out. After an experience like this, they leave here with a better understanding of how to look after their children."
As for Josephine, she is happy that Mohammed is still alive. She says "I know now that the 'wata meresin' (Water Medicine, the local name for Oral Rehydration Therapy) works and I know that if he ever gets sick again, I'll be able to take better care of him."
