PILOT project CCWW in collaboration with Medici con l’Africa CUAMM ChildCare WorldWide – CCWW Wolisso, Ethiopia: October – December 2011
16 pediatricians ,1 pharmacist and 1 Coordinator have participated to the program from October 2011 to December 2011. The pediatricians have visited 1544 children: 957 instead of the 506 initially planned of the Leban Elementary School and 587 from St.Gabriel School (Kinder and elementary).
All childen have been registered using the CCWW Electronic Medical Record and on Medical Cards which have then been left at the schools. Out of the 1544 visited children (810 females and 734 males) in 762 of them 1075 diagnosis have been registered (49.32%) and a consultation has been requested in 143 children (18.76% children) with a total of 169 requests (15.06% diagnosis). Of the 169 requested visits 80 have been taken to the hospital by the parents (in the first weeks there have been some problems in the organization of the follow up visits at the hospital counter).
• Ophthalmological 82 42
• OPD 41 13
• Audiological 15 10
• Dental 16 7
• MCH 12 7
• Surgical 2 –
• Orthopaedical 1 1
In all children seen by the ophtalmologist the refractive disorder detected by the pediatricians has been confirmed and the use of glasses has benn prescribed; unfortunatley for all the remianing visits no follow up report ws found or it was not readable.
All lenses and frames have been bought using a CCWW donation. Two of the children sent for an audiometry had a residual hearing capacity and a hearing aid coud be used. Anthoponometric Survey The data collection is not reliable due to the unknown date of birth of many children.
Public Health Department
The Public Health Department PHD staff has been a major help for the project. All have been trained to perform health promotion oriented supervision visits for preschool and school age children.
Most pediatricians have participated to the planned Outreach Visits in the Wolisso Rural area. Future interventions should be evaluated with the new Director of the PHD and the Medical Director.
Education Seminars and Tutorials
PBLS ,First Aid 4 seminars (hand out for all participants and posters for the schools) 3 seminars for Hospital Staff and students and 2 seminars for Teachers on common skin diseases in primary care setting in Developing countries (presentation left at the Medical Director)
2 Seminars on childhood immunisation and HIV prevention for Teachers
2 Seminars on Normal birth and essential neonatal care and 2 Seminars on newborn asphyxia and infections; care of low birth weight and preterm babies (CUAMM/ UNICEF program)
Report on Drugs usage,Storage and Accounting
Requested medicines; O2 Saturation device with neonatal probe; Frames and lenses.
Ethiopia, Ankober 2013
These initiatives involved in a personal individual members of our association in collaboration with other NGOs or non-profit Ankober 17 February to 22 March 2013 Vitalia Murgia , Roberto Bussi , Claudia Angeli
The work of the group of pediatricians CCWW ( Pediatricians family for the world’s children NPO ) February- March 2013 was included in the most extensive project coordinated by IPO ( Peoples Increasing Opportunities , Perugia), called ” Every child a vegetable garden “.
Also this year we got to the two groups and the local coordination of the project was entrusted to Anne Laure Cavin ( pharmacist ) with the support of Annachiara Vassallo (voluntary IPOs) .
From the database of views of the years 2011-2012 have been selected all children suffering from malnutrition and , together with their families , were included in the project that will develop into at least three years and aims to fill the needs of health, particular nutritional seen in children Ankober . Children and families will be followed through an integrated program of interventions aimed at promoting the development of local agricultural system and food education programs and health care. The families will be transmitted knowledge and tools to meet the food needs of the household ( with the resources available and those that are able to produce thanks to the support of IPOs ) , so that all the members , especially children and pregnant women and / or breast-feeding , receive a balanced nutritional intake.
The intervention of pediatricians and operators IPO aims to educate children and families the importance of a varied diet and a proper intake of nutrients , to disseminate correct sanitation practices also reduce the risk of infectious diseases ( parasites , skin diseases , …). The first group of pediatricians (Angela Roberto and Claudia ) was to Ankober from February 17 to March 1 , the second ( Franco, Stephen and Vitalia ) March 10 to 22 .
The activities of the visit there were always with the help of a very competent local nurses , salaried IPO , which acted as a liaison between the children and the pediatrician and is also busy and all counseling interventions (goiter , malnutrition, hygiene ) and explain to the children how to take the prescribed therapies .
The integrated program of 2013 has planned activities for :
– Interventions of the health education teachers, who in turn repeated them to students ( health and nutrition ) , the work of local experts and IPOs.
– Visits to general check- up for students of schools and outpatient , even a few adults ( spontaneous recourse to the pediatrician ) .
– Food Education ( iodized salt and malnutrition ) and health ( hygiene).
– Treatment of common diseases and “referral ” to the hospital for more serious cases .
– Counselling targeted to cases of malnutrition.
Having had the opportunity to observe in previous projects in Ankober , many drugs , vaccines , tests and Plumpy ¡ | nut ( special food for malnourished children ) were allowed to expire , we tried to intercede with the head of the district because of Ankober packs plumpy ¡ | nut close to maturity were used for children suffering from ” moderate malnutrition .”
A total of 695 children were examined and in all those in which it was a problem and was distributed free of charge the necessary therapy . They were also sent to the specialist ophthalmologist ( made available by an NGO for free every two months ) cases of severe vision impairment . During the visit there was an activity of the occasional presence of Comunity Health Workers with varying availability to collaborate and learn. It was possible to conduct , for a few days , an on the job training of local nurses and and 2 was conducted a training intervention on malnutrition , which involved 8 employees of the District of Ankober ( nurse and Health extension workers ) .
Pediatric visits were conducted in 4 schools devices: Dabdabo (60 ‘ downhill and 1 ‘ , 20 ‘ uphill) , Kundi accessible by car, new school construction, Tamke accessible by car, but Kulfe just 500 feet from the where you park your car.
In the afternoon , in general, were carried from house to house visits to some of the children included in the program. The visit to the homes and 9 was interesting though somewhat ” impressive.” Even in the homes of families in more affluent appearance promiscuity between man and animals and very intense. In the houses the poorer you have a unique space that serves as a kitchen – bedroom in which they live and even cows , goats, chickens and kids.
In some cases the cow and partially separated from the rest of the room by a partition consisting of sparse branches of eucalyptus , but in other promiscuity and absolute.
Free range chickens roost even on pallets . In some cases, the sanitary conditions are much better at least in the room destined for the rest, if the animals are not permitted. The hygienic conditions of the children are often very poor and the dresses are very dirty, messy sometimes so as to have lost all traces of the original color.
The parents seem to be completely unaware of what is the way to feed the children , especially those who often already malnourished , if you have more than eight years, are subjected to religious fasting (no proteins or fats of animal origin for 50 days!) .
The work of this year has been interesting and rewarding professionally and personally for all pediatricians and laid the foundation for a future project , attended by more pediatricians and CCWW with a greater partnership between CCWW and IPOs.
For two years I work with a non-profit Italian IPO ( Increasing Opportunities People ipoassociazione.org .
IPO is based in Italy ( Perugia ) , in Ethiopia and in this country carries out projects that aim to promote the development of potential for economic growth and for improving the health situation in favor of the Ethiopian population from local resources. IPO has favored the creation of pastoral cooperatives in southern Ethiopia for the collection of various types of frankincense and myrrh. These are then sold in the local market with an economic return redistributed among the members of the cooperatives themselves . In the capital , Addis Ababa, was created a cooperative whose members have learned to distill essential oils to obtain essences that can be used as a fragrance in soaps and other hygiene products . This activity provides a small source of income from local resources.
IPO also studied medicinal plants Ethiopians also to evaluate the therapeutic potential , a lot of my collaborative work takes place at a distance, and once or twice a year I go to Ethiopia for the ” field ” of the projects that follow. Since essential oils can be safely used mainly for topical use , the main interest was directed immediately on dermatological diseases .
These problems certainly are not lacking in all African countries , are particularly common in Ethiopia. Last year we carried out an epidemiological study on dermatological diseases in two schools in a district of Debre Markos , rural area in the central- western Ethiopia. We visited in 1102 and of these 816 children had at least one dermatological disease including fungal infections ( 36.1% ) , lice, bacterial infections , warts, three cases of cutaneous tuberculosis , and much more.
We also distributed creams and lotions based on essential oils for the treatment of tinea corporis and tinea capitis results are really flattering . This year in April I went back to make a new trial on creams containing extracts of medicinal plants and to collaborate on a Mobile dermatologic clinic .
In the days when I was present has been viewed about 100 patients per day 112 tips in one day . In Ethiopia, everything is much more complicated than here, dilapidated structures , equipment to almost zero , drugs only if purchased and distributed by the Association.
The mobile clinic is organized usually in only two days per month , we have concentrated 4 in one go because I was there and we had to distribute the herbal creams (to check their effectiveness ) and medications .
People are being warned of the arrival of doctors from a passing car with a megaphone in the villages (such as ” on Bandidori ” when I was a child ) .
And so they come in droves doing many hours of walking distance ( or stretcher ) to take advantage of the opportunity . You see everything from leprosy (30 cases of which some new-onset and young subjects ) , the Leishmania , many ulcers infected wounds, venous stasis , many fungal diseases , eczema of all kinds , so many warts on the soles of feet.
This last problem may seem trivial but it is not whether to go from home to the field to work the land, to graze the goats , to fetch water or to the market to sell the products of the earth you have to walk for many miles and often climbs that only the goats you think might go.
The pain becomes intense and makes the effort even harder. The dermatologist was very sensitive to the problem of pain and did his best to remove the warts with a razor blade , among other things, with excellent results, you would have seen that gratitude by patients , smiles, bows , and even someone trying to kiss walk to the doctor. Unfortunately, everything happens without disinfect either before or after .
Fortunately , in our small laboratory , the days prior to the visits we had prepared an antiseptic ointment with eucalyptus oil and thyme, at least what we gave him . I guarantee that it works, I ‘ve used for the usual painful flea bites and I calm the intense burning for at least 4-5 hours.
A lady grateful we kissed the arm at all.
For leprosy problem is devastating , in addition to disfigurement and mutilation are the pain from neurological damage . Suffering is a lot ! We even saw a woman of 25 years. No medicinal product for them! Why the government , although we note the cases , argues that leprosy is now under control, that there are no new cases and no longer needed medication for that problem. In four days we saw 12 cases , including 2 new -onset and young people.
Without medication the pain is terrible to endure while medicines slow down the disease and pain by neurological disorders ! For this problem are drugs from Italy, I hope to raise funds and bring at least a certain amount for this area in the fall. For almost all the diseases we have distributed local medicines ( at sustainable costs paid by IPOassociation ) and for eczema and ringworm of the body cream with chamomile and thyme that prepared by me and the pharmacist who works with the IPO .
Check if they work at the end of the month, because all patients treated with the herbal cream will be revisited twice at 15 and 30 days from the dermatologist.
We did not pay for the drugs bir 1 ticket (equivalent to 1/15 EUR ) per piece , IPO paid them 7 to 50 bir also a piece depending on the product . It is a symbolic ticket to us may seem insignificant , but for them it is so . She made this choice because everyone thinks that the absolute gratuity would be harmful. The herbal creams and ointment have them distributed free of charge and also why so much gratitude !
It ‘ a drop in the ocean but most are unable to do. Meanwhile, here became active laboratory for preparing medicinal herbal extracts local nursery for the selection and growth of medicinal plants and the dermatological clinic has funds for another 3 months. In short, the results of a certain weight after a year of hard work and thanks to dear friends as ” friends of the park” Mogliano that helped us a lot.
The pictures show only some of the aspects worthy of attention from my experience , I’ve taken so many and I will need to never forget .
Vitalia April 2009