Oral Rehydration Salts: A simple Solution to reduce cholera deaths

The annual cycle of cholera outbreaks in Ghana continues unabated. Health officials estimate close to 70 deaths this year from cholera with hospitals overwhelmed by many cases. This current outbreak has reached epidemic proportions. According to Dr. Van-Otoo, the Greater Accra Regional Director of Health, some 200 to 300 cholera cases are recorded each day in the region alone.

 

There have been several commentaries on how embarrassing it is for Ghana to be battling with Cholera in the 21st century (no cholera outbreak for the past 100years in the UK) whilst others rehash the causes of Cholera. Missing in the narrative is the need for prompt use of Oral rehydration salts(ORS) to reduce deaths . According to WHO ORS can successfully treat 80% of cholera patients, both adults and children.

ORS can dramatically reduce the number of death, particularly during an epidemic and when given early when symptoms arise.

 

Indeed, in the last 30 years, O.R.S. has saved an estimated 50 million lives worldwide, particularly children who are most vulnerable to diarrhea-related dehydration. In 1978 the British medical journal The Lancet called the humble solution “potentially the most important medical advance of the 20th century.”

 

ORS is a solution we must thus promote in this Cholera outbreak.

 

Cholera is characterized by a sudden onset of acute watery diarrhoea that can rapidly lead to death by severe dehydration. The disease is acquired by ingestion of water or food contaminated by Vibrio cholerae and has a short incubation period of two hours to five days. Cholera is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. All cases of cholera should be treated immediately. If treatment is delayed or inadequate, death from dehydration and circulatory collapse may follow very shortly. Individuals with lower immunity, such as malnourished children or people living with AIDS, are at greater risk of death if infected by cholera. Among people developing symptoms, 80% present with mild to moderate acute watery diarrhoea, while the other 20% develop rapidly severe dehydration leading to deaths

 

Effective and timely case management contributes to reducing mortality to less than 1%. It consists of prompt rehydration of patients. Mild and moderate cases can be successfully treated with oral rehydration salts (ORS) only. The remaining 20% of severe cases will need rehydration with intravenous fluids. Antibiotics are not paramount to successfully treat patients, but they can reduce the duration of disease, diminish the volume of rehydration fluids needed, as well as shorten duration of shedding of the germ.

 

In these times that our facilities are overwhelmed, patients should be encouraged to early and liberally take the ORS whilst waiting to be seen by health professionals.

ORS is a sodium and glucose solution which is prepared by diluting 1 sachet of ORS in 1 litre of safe water. In case ORS packets are not available, homemade solutions consisting of either half a small spoon of salt and six level small spoons of sugar dissolved in one litre of safe water, or lightly salted rice water or even plain water may be given to PREVENT or DELAY the onset of dehydration on the way to the health facility. However, these solutions are inadequate for TREATING dehydration caused by acute diarrhoea, particularly cholera, in which the stool loss and risk of shock are often high. To avoid dehydration, intravenous fluids should be given as soon as possible. All oral fluids, including ORS solution, should be prepared with the best available drinking water and stored safely. Continuous provision of nutritious food is essential and breastfeeding of infants and young children should continue.

 

Promoting ORS must go hand in hand with promoting good hand washing practices, eating our foods hot and been mindful of the water we drink.

 

Cholera remains a disease of poor countries, cholera deaths are largely preventable. We need to take water and sanitation seriously. In the medium to long term Government policy on the provision of safe water and sanitation must be one of priority to help reduce the impact of cholera and other waterborne diseases.

EBOLA: THREE FACTORS WORSENING ITS SPREAD

EBOLA: THREE FACTORS WORSENING ITS SPREAD

Ebola virus disease has been rightly called a devastating killer as it sends up to 90 per cent of its victims to their graves. This recent outbreak is the largest recorded in history.

The first outbreak in 1976 occurred in Zaire where 318 were infected and 280 died. According to WHO, there are 2615suspected and confirmed cases of Ebola out of which 1427have died. Though in 1976 little was known of the disease, fewer numbers got infected and fewer died. The reason may be because of little mobility among rural and urban dwellersthen, compared to today with very active movements across porous borders.

But there are more factors implicated in this devastation. Three very significant factors that have contributed in worsening the spread of Ebola is the denial of the existence of the disease, gross misinformation even by some health workers and a dysfunctional healthcare system.

Denial
Even in this day of technology and advances in scientific knowledge, many in the epidemic zones deny the existence of the virus. For instance a recent survey of 1000 respondents conducted by Samaritan’s purse in the bustling Duala market, Monrovia—Liberia found that 92% of Liberians don’t believe Ebola exists. They believe it is a hoax created by their government to “eat money” from aid donors. Such denials have resulted in the ‘business as usual’ approach to handling of animals both sick and dead, handling of corpses and eating of wild animals. Report confirms how Guineans and Liberians still enjoy their bat meat even in the face of Ebola.

Misinformation 
Ebola, like many other deadly diseases have suffered in the hands of conspiracy theorists.  In Freetown, capital of Sierra Leone, thousand marched at an Ebola treatment centre following allegations by a former nurse that the deadly virus was invented to conceal “cannibalistic rituals” at the facility. There have been similar attacks on health facilities in Guinea and Liberia. 
There are many others, who are spreading false information on the mode of spread and fuelling public fear. Though the strain of Ebola in this outbreak appears to kill 56% of the people it infects, to become infected in the first place, a person’s mucous membranes, or an area of a broken skin must come into contact with the bodily fluids of an infected person such as blood, urine, saliva, semen or stool or materials contaminated with these fluids such as soiled clothing or bed linen. Ebola is not airborne. Dr Peter Piot and many other scientists have consistently spoken against the hysteria we approach Ebola with. The largest outbreak of Ebola before this recent one was in Uganda between 2000 and 2001 in which 425 people were infected and 224 died. Since Ebola first appeared, a total of about 2000 have died from the disease. By comparison, Malaria kills 3,200 people a day and diarrheal diseases some 4,000.

 

 

Dysfunctional healthcare systems

This outbreak has exposed the weak healthcare system we have in West Africa. It is a system that hasn’t treated infection prevention and control seriously. Many healthcare workers risk their lives without adequate protection to treat highly infectious people daily. Health facilities are starved of infrastructure, equipment, personnel to run effective disease control.  In Liberia, the largest hospital, John Fitzgerald Kennedy Memorial Medical Centre or JFK is seen as a death trap. Locals have nicknamed it “Just For Killing”, because even simple malaria is poorly managed at the facility leading to many avoidable deaths. The hospitals Ebola ward had to be closed down because proper procedures for dealing with the disease were not followed.
People faced with the choice of going to the hospital to die and staying at home then choose the latter. Our health care systems because of such gross inadequacies face stiff competition with traditional and other unorthodox medical practices and in such epidemics; this state of dysfunctional healthcare makes the situation precarious.

The way forward
Ghana has been constantly awakened by these multiple scares. The morbid fear that has engulfed us must be well managed with accurate information on the disease. The need to seek early treatment, the proper handling of dead humans and animals, proper hand washing must be clearly communicated. Healthcare workers must be adequately protected and properly trained on prevention and control of this lethal virus.

Nestor Ndayimirije, WHO representative in Liberia says building trust in communities, including with elders and traditional leaders is the key on the fight against Ebola. Making populations understand the disease in scientific terms according to him is urgent.

The virus gets closer to our borders by day, beyond the assurances by Government; we need to see a readiness at the facility level, and a well-informed populace on Ebola.

 

 

Dr Nathanael Adjei-Kyeremeh

Medical Officer

St John of God Hospital, Duayaw Nkwanta

 

 

 

 

IT TAKES TWO TO BE HEALTHY

In fact, it takes more than 2 people or more...lol
have you ever considered why you form a group for studying during school exams, investment group, religious groups and more frequently social groups and clubs?

Synergy and discipline

Synergy and discipline are the 2 main reasons why we all form these respective groups.
Once you are in this group its like all your individual and limiting wishes are drawn together.
Its about time you find someone or a group of people to be with who are motivated enough to help u realize your health goals.

A local gym isnt a bad start at all.

Even though current trends show membership subscriptions are quite expensive, it gives a mental bond to a regular need to exercise. Depending on your local gym, you might meet very much motivated people to urge you on. Initially the very experienced might be intimidating but remember they were once like you

An already existing social group? That's versatility

Do you have an already existing group for an investment, a religious meeting, a study group? Suggest moderately to them another very important agenda to pursue... a health program. It will all depend on your ability to adequately convince them for the shift in focus as well.

Family members; "Charity begins at home"

This is the most simple way of starting a health plan. Your family, if they are like mine, are easy to bond together. This is very less cumbersome and readily accessible but mind you, you might need a lot of motivation to achieve your goals.....

WATCH OUT FOR THE 2ND PART OF THIS ARTICLE....THANKS

Vitamin C in pictures

Vitamin C; the magic elexir..

Follow my series of picture messages on Facebook, Twitter and Instagram giving more fascinating reasons to take a fruit meal a day

From the Consulting Room

Hello my good friends, it is with good pleasure that I start this, hopefully, long lasting relationship of health and good lifestyle with you.
Do not think for a minute you are alone in this struggle to live well, to live long, to stay strong by having total control over what you eat, what you drink or what exercise you want to embark upon.
People of all ages racial and educational backgrounds struggle with this all important fact of life. So the very first step is up there in your thinking faculties.
Known for the fact that you are not alone whilst you are at it, step-up a gear and remember that, that golden dream is achievable.
This series seeks to carefully unravel the secrets of good health and lifestyle and completely dissect the truth and myths surrounding it.
This is not going to be a place for long boring ‘lecture’. It is a revolution which is going to be set running by a brand meticulously structured with immense experience and by your help and crucial interaction.
The main challenge with healthy lifestyle is not the lack of information but the appropriate management of it and its relevance to ones peculiar status. 

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