A Consultant Paediatrician at Gbagada General Hospital, Lagos, Dr. Emokpae Abieyuwa, says the inability to complain or express themselves is a major fueling diarrhoea-related death among under-five children.
He explained that unlike adults who can easily reach out for fluid, most under-five feel helpless when they are dehydrated or thirsty.
The World Health Organisation says diarrhoeal disease remains a leading cause of child mortality and morbidity across the world, and mostly results from contaminated food and water sources.
It further stated that although it is both preventable and treatable, diarrhoeal disease is the second leading cause of death in children under five years old.
“Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year. Each year diarrhoea kills around 525,000 children under five.
“The most severe threat posed by diarrhoea is dehydration. During a diarrhoeal episode, water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost through liquid stools, vomit, sweat, urine and breathing. Dehydration occurs when these losses are not replaced,” it stated.
Speaking in an exclusive interview with PUNCH HealthWise, Emokpae emphasised that diarrhoea is usually got through the faecal-oral route.
“It simply occurs when you put something, whether edible or fluid, that carries dirt into your mouth. Why diarrhoea-related death is so common and high among children under-5 is because they can’t talk or complain, especially when they are thirsty.
“But an adult can easily reach out for water once they feel thirsty or dehydrated. Unless, of course, he doesn’t desire to take it immediately. It is like seeing a man coming in from the scorching sun to take water. That is his body complaining or passing a message that he needs to take a drink.
“My hypothesis is that because of the environment we live, you can get it from contaminated food. You can even get it from somebody who has diarrhoea and stools. That is one way to look at it. The major cause is because we don’t have access to clean water to drink. You must have seen people in a poor sanitary condition. It is where they excrete that they also get their drinking water. It is common in our environment,” he said.
He noted that while some adults may be lucky to survive diarrhoea, it kills children, especially those under five years old.
The paediatrician identified diarrhoea, pneumonia, malaria and newborn diseases as the big four leading causes of death in under-five children and newborns.
“I agree that diarrhoea may not be looking so prominent again in our environment. Oral dehydration and zinc therapies seem to have reduced it. But it is still significant. Most people who died of diarrhoea don’t have enough fluid in their body.
“When I was growing up as a medical officer, there was no day I won’t admit up to five chronically dehydrated patients. But with the advent of Oral Rehydration Therapy and sachet or packaged water, it is no longer as common as it used to be in those days,” he said.
Emokpae stressed that access to potable water and good sanitary condition is the panacea.
“I think the government is working vigorously on improving the number of toilets in the community. Once these are achieved, diarrhoea would die naturally on its own. Did you remember what former United States president Jimmy Carter do to eradicate guinea worm? He understood that guinea worms are got through the same process as diarrhoea.
“The Carter Centre went about digging up boreholes in certain areas with a prevalence of guinea worms. Once people stopped going to the river to drink water, guinea worms naturally disappeared. The same method can be adopted. Let boreholes and potable water be sunk everywhere and the issue of diarrhoea would ease off,” he advised.
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