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Putting a Face on Childhood Diarrhea

The rotavirus is a highly-infectious double stranded RNA virus that serves as one of the most common causes of diarrheal disease in children . The two most common symptoms are severe watery diarrhea and vomiting, both symptoms lasting for 3 to 8 days . Subsequent dehydration of the body causes dryness in the mouth and throat, dizziness, and decreased urination. Infected individuals can transmit the virus through their feces and contract the virus by coming into contact with infected fecal matter; thus, addressing improper hygiene practices that lead to fecal contamination of water sources should be of greatest concern when it comes to rotavirus alleviation in sub-Saharan Africa. In particular, the link between water, sanitation, and health becomes strikingly apparent when examining how children come into contact with infected fecal matter. Unwashed hands contaminated with viral strains of the rotavirus, drinking tainted water sources, or consuming food prepared with unsafe water are
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Water and Infants - Blue Baby Syndrome

Image 1: Infant suffering from methemoglobinemia You see a shallow well next to an agricultural plot of land.  You think, “hmmm, a shallow well - that’s probably susceptible to contamination and unprotected.” What we often cannot see, thus not think about, is the percolation of chemicals from pesticides, manure, and fertilizer from distant to nearby farming practices into the well’s groundwater. In many parts of Africa, households that surround high-intensity agricultural land may suffer from high nitrate levels in their water sources.  Normal levels of nitrate in water usually fall around 1-2 mg/liter but households near farmed land can see levels of up to 50 mg/l. For reference, the U.S. Public Health Services set the maximum nitrate level at 10 mg/l .   High levels of nitrate in water can cause methemoglobinemia, a condition that can best be described as oxygen starvation . In a healthy body, oxygen taken in from the lungs diffuse into the capillaries and are bound to

Water and Infants - Environmental Enteropathy

Image 1: Little girl waiting patiently for her mother to wrap up that day’s market goods (Kitoro, Kampala) Source: Personal photo Take a moment to look at the little girl in the image above and closely examine the environment around her! I had passed by her mother’s stand en route to by some passion fruit in a nearby kiosk and this girl had been sitting outside the plastic container, crawling around the dirt ground to her heart’s delight. Right behind her is a small ditch that is filled with garbage and rainwater from the storms that had rolled in that morning. I’m not exactly sure what particular pathogens are in the ditch but I reckon it’s not sanitary and this toddler's clothes and body are definitely not clean. Fortunately, her mother had placed her in the carton pictured above by the time I’d returned to buy some mangos. But kids at this age always have their hands in their mouths - can you imagine what she’s been putting into her mouth for the duration of market da

Water and Children

Image 1 :  Map showing the varying risks for childhood stunting across the globe Acute diarrheal infections are one of the most devastating diseases impacting children in resource poor nations.  Although direct impacts such as administering oral medication may be helpful in the short run, interventions in the non-health sector such as securing clean water may have a much more sustainable impact. The United Nations’ new objectives under the Sustainable Development Goals (SDG’s) have started to highlight the importance of a holistic approach to addressing public health issues in regions such as sub-Saharan Africa. Across the world, an estimated 2.4 billion people do not have access to safe water sources and over 800,000 children die from diseases related to poor sanitation conditions each year. I’ve mentioned that diarrheal diseases have the highest impact on young children but you may be wondering in what ways? Besides being one of the leading causes of morbidity, diarrheal d

Illusive Havens Part 3

Image 1: Gidan Bege Orphanage in Benue, Nigeria Source: https://www.facebook.com/Gidanbegehomemakurdi/photos/pcb.260105698111607/260105628111614/?type=3&theater Are orphanages the safe havens most people assume them to be? According to Atu & et al., it may be the case that orphanages have higher disease prevalence rates for protozoan infections compared to the global averages calculated for resource poor countries (Minetti & et al., 2016, Atu & et al., 2016). As a whole, diarrheal diseases are the second leading causes of death in children under the age of five, beating out AIDS, malaria, and measles. Unfortunately, these statistics aren’t well known by the international community and consequently, malaria ends up at the forefront of public health initiatives. Children ages five and under are the most susceptible age demographic and when compounded with poor hygiene conditions and malnutrition, can lead to devastating results. The disease burden of dia

Illusive Havens Part 2

Image 1: Memorial for villagers murdered by Fulani Herdsmen Source: http://dailypost.ng/2018/01/11/names-people-killed-fulani-herdsmen-benue-full-list / Since the early 2000’s, Nigeria’s Middle Belt has suffered from a series of violent attacks by the Fulani Herdsmen on the non-belligerent, indigenous peoples of Benue state, ultimately displacing villagers from ancestral lands and stripping them of their livelihoods (Ode, 2018). The Fulani Herdsmen are considered semi-pastoralists or nomads and are primarily Muslims, whereas most of the sedentary farmers in the region identify as Christians. As of January 2018, a suspected 170,000 displaced persons had entered the Internally Displaced Persons (IDP) camps set up by the Nigerian government across several states in Nigeria’s Middle Belt. These asylum seekers are not considered refugees by the international community, as they remain within Nigeria’s national borders and unfortunately, this means that the resources and services t

Illusive Havens Part 1

Image 1: Dadaab Refugee Complex Source: UNHCR, 2018 Dadaab, located in Kenya, is the world’s largest refugee camp (UNHCR, 2018). It houses over 235,269 Somalian refugees in informal settlements often lined with white, UNHCR tents. During the early 90’s, the first wave of Somalian refugees fleeing civil war established the first portion of the camp. A second influx of refugees took place in 2011 when drought and famine afflicted the southern region of Somalia. Around November 2015, a worrying cholera outbreak spread throughout Kenya and eventually reached the frontlines of Dadaab (CNN, 2015). By December 2015, seven people had died and hundreds were in the hospital seeking treatment. By June of 2016, fourteen deaths and almost 1,800 cases of cholera had been reported by the UNHCR to the CDC (Golicha, Qabale, & et al., 2018). Unfortunately, the demographic most ravished by the outbreak were children ages two to four, with an incidence rate of 16.9:1000 whereas adults saw an