Combination treatment reduces diarrheal deaths in India
Diana Coulter, UNICEF
© UNICEF/2010/Crouch
Community health worker Rita Kumari administers diluted zinc tablets and oral rehydration salts in Pakauli village, India.
PAKAULI, India (August 30, 2010) — Health worker Rita Kumari eases a teaspoon of liquid into 2-year-old Kajal's mouth.
"There now, little one, you will be safe and feel better," says Kumari. The toddler swallows the last drops of the diluted zinc tablet, a supplement that will help her fight a potentially deadly case of diarrhea.
Frightening illness
Kumari is an "anganwadi," or health and nutrition worker, in India's Bihar state. She provides zinc supplements to local children on a daily basis, along with other sweet "treats." One is a cup of oral rehydration solution, which is prepared before a crowd of villagers so they can learn the treatment process themselves.
Baby Kajal's father, Amod Paswan, looks on with concern, remembering another girl who died just a few years ago after a serious bout of diarrhea. He and his wife, Sita Devi, immediately sought Kumari's help at the anganwadi center when their daughter started vomiting and having loose stools.
"We were very scared and worried," said Paswan. "We know children can die like this."
Thousands of children in India die each year from diarrhea and its complications. But an estimated 88% of global deaths from diarrhea are entirely preventable if simple treatment and basic health information can be offered. In Bihar, that lifesaving assistance is now being provided through the generous support of the IKEA Social Initiative, the international furniture company's philanthropic wing.
IKEA partnership
© UNICEF/2010/Crouch
A local health worker, meets with villagers to explain the benefits of ORS and zinc tablets in Bihar, India.
In partnership with UNICEF, and India's state and national governments, the IKEA funding is helping to mobilize people at every level of the health care system across three Bihar districts, offering zinc tablets and oral rehydration salts (ORS) to children with diarrhea.
The treatment is already saving lives—it is estimated at least 15,000 children have received the treatment to date.
Most often, diarrhea kills children because of the severe dehydration that it causes. Many deaths are also linked to under-nutrition, as repeat episodes of diarrhea cause the loss of essential nutrients—particularly zinc. Eventually, zinc deficiency leaves a child's immune system depleted and vulnerable to attacks of pneumonia, malaria and other diseases.
High cure rate
It's this vicious cycle of poverty, under-nutrition and lack of adequate care that Anita Chourasia, another anganwadi worker in Bihar, is also tackling.
"The cure rate has been very high," said Chourasia, referring to the progress made since the IKEA Social Initiative program began. "Zinc treatment gives such good protection that there has not been a repeated attack [of diarrhea] for many months."
Today Chourasia is advising one mother, Puja Devi, on how to treat her eight-month-old son Priyanshu's diarrhea and vomiting.
Swaddled in a bright yellow and gold-trimmed cloth, Priyanshu shakes the tiny silver bangles on his wrists furiously as he fusses and cries. His mother suspects that tainted cow's milk or bad water is to blame for his illness. To treat the child, Chourasia shows his mother how to dissolve one zinc tablet in a teaspoon of safe water or breast milk. She will give it daily for 14 days, along with regular drinks of the oral rehydration solution.
The new method, used in conjunction with breastfeeding, continued feeding and selective use of antibiotics, reduces the severity of diarrhea and the chance of repeat episodes.
Expanding assistance
© UNICEF/2010/Crouch
A health worker with an eight-month-old baby and packets of oral rehydration salts and zinc tablets Rajasan village, India.
Since the initial implementation of the zinc and rehyration program in three districts of Bihar, the initiative has also been extended free-of-cost to patients across a quarter of the state. The project was expanded under a partnership effort between the government of Bihar, the international health network known as the Micronutrient Initiative and UNICEF. The Bihar government hopes to one day offer the program to all of its regions.
The unique partnership is a project that could contribute significantly to helping India reach the United Nations Millennium Development Goals target on reducing child mortality. The MDGs, a set of internationally recognized targets for reducing poverty worldwide, call for reducing global under-five mortality by two-thirds by the year 2015.
Minhaj Alam, the magistrate of Bihar's Vaishali district, supports the expansion of the program. He understands a parent's terrible fear for a sick child—Alam's own child suffered from diarrhea just a few months ago.
"They can get sick so quickly and seriously," he said. "They don't eat anything or drink much, and can get dehydrated. It is very frightening."
But with the arrival of the new zinc-ORS program, he added, things are changing in the region. "We want all parents and children to know they are safe here," he said.
