Diarrhea and Water Loss – 10 minutes 4. Share the Meaning of Each Picture Ask the caregivers to describe what they see in the pictures on page 5. Read the captions on the flipchart out loud. Share the meaning of each picture using flipchart pages 4 and 5. A with diarrhea loses water and strength. Watery feces three times in one day is diarrhea. This child has lost too much water. His body is weak and thin. Like a tree without rain a child with diarrhea is at risk of sickness and death. The tree is unable to stand. It has lost all of its leaves and dried out. A child with diarrhea is at risk of death just like this tree. Besides diarrhea, what other sicknesses cause water loss? Vomiting Sweating from fever Additional Information for the Trainer Defined Diarrhea is defined as watery feces three or more times in one day. Exclusively breastfeeding infants have soft, loose feces. This is not diarrhea. However, if a breastfeeding has soft feces more than once after each feeding; this is diarrhea. Breastfeed more often to replenish all the liquids that are lost. Diarrhea is common in children especially between the ages of 6 months and 2 years. It is also common for children younger than six months who are eating or drinking liquids other than breast milk. Diarrhea Prevalence (DHS 2011) Fourteen percent of children in Amhara had diarrhea and 5% had diarrhea with blood. Of the children with diarrhea over half of them (58%) where children 1-2 years of age. Severity Worldwide, diarrhea is the second leading cause of death to children under five years of age. It kills more young children than AIDS, malaria and measles combined. In the year 2007, Ethiopia alone lost 73,700 children from diarrhea. A child can become dehydrated if fluids are not replaced at the first signs of diarrhea, and in turn die very quickly.
What do you think these pictures mean? Don’t let your child die from diarrhea! Give ORS every time a child has watery feces. After the child has watery feces three times, prepare ORS. Offer the child ORS to satisfy their thirst. Offer a half cup or more if the child is still thirsty. The next time the child has watery feces, offer ORS again. Offer a half cup or more if the child is still thirsty. If the child vomits, give the ORS again, more slowly. How do you prepare ORS? Prepare one of water purified with Aquatab or boiled and cooled. Mix one sack of oral rehydration compound into the purified Shake the bottle until the powder is mixed. Use the ORS as often as needed for one day. After one day, mix a new packet to give to the child. Where can a mother get ORS packets? Additional Information for the Trainer ORS in Amhara In Amhara, only 61% of women know about ORS (that leaves 39% who do not know)! two percent of children with diarrhea were not given any special treatment to help them recover. One in four children (25%) with diarrhea was taken to the health provider for advice or treatment. Of those receiving treatment, only 1 in 3 children received ORS (28%) although 9% received a rehydration formula made at home. Oral Rehydration Salts For a child of two years or older, give as much ORS as the child will drink (50-100 ml is recommended) after each watery feces. 24 hours, prepared ORS should be thrown away. New solution should be mixed if the diarrhea continues. Other Treatments Zinc is recommended for diarrhea treatment. See Lesson 2 for details on zinc treatment. Germs that cause diarrhea can be either bacteria or viruses. Diarrhea caused by bacteria can be treated with antibiotics. Bacteria caused by a virus cannot be treated with antibiotics.
2. Attendance and Troubleshooting ─ 15 minutes When teaching Volunteers: CHA fills out attendance sheets for each Volunteer and mother group. CHA fills out vital events mentioned by each Volunteer (new births, new pregnancies, and mother and child deaths). CHA asks if any of the Volunteers had problems meeting with their neighbors. The CHA helps to solve the problems mentioned. CHA asks Volunteers to review the key practices from the last lesson. The CHA asks the Volunteers about their commitments from the last meeting and follows up with those who had difficulty trying out new practices. What was your commitment at the last lesson? Have you kept that commitment? How – what did you do? Did anyone (spouse, grandmother or children) interfere or tell you not to follow your commitments? Tell the story of what happened? What factors (people, events or chores) in your life made it difficult to keep your commitments? How were you able to overcome these problems? CHA thanks all of the Volunteers for their hard work and encourages them to continue. CHA asks the group’s Activity Leader to discuss the needed items for next week’s activity and solicit volunteers. When Volunteers teach their Neighbors: Volunteers will take attendance. Volunteers will ask new births, pregnancies or illnesses in the families of the mothers attending and help refer those with severe illness to the local health facility. Volunteer will ask the mothers to review the key practices from the last lesson. Volunteers will ask the neighbor mothers about their commitments from the last meeting and follows up with those who had difficulty trying out new practices (see the questions above). Volunteer asks the group’s Activity Leader to discuss the needed items for next week’s activity and solicit volunteers.