Stopping the runs!

Winney went home on Monday. Sheba and our small dedicated team of nurses had made sure that she was well cared for. Her diarrhoea stopped. She has been loved, looked after and prayed for. In the process she just kept eating and gained an amazing 5 kgs in what seemed the blink of an eye.

Yesterday we had this month's "Health message" training for our home-based care team. The idea is to have a specific health topic each month. Our home-based staff then share this with our HIV positive friends during their home visits - in order to spur changes towards positive health behaviours.

Last month's topic was hand-washing. We now all wash our hands in a 6 step process that would do a surgeon proud (well - we should!).

This month we reinforced the hand-washing push with a 5 point health message about preventing diarrhoea.

The idea is to use each point to see how a family can change their actions and prevent a condition that so many people with HIV suffer from - and which causes serious illness and even death.

After going over our presentation with the staff we had a discussion where we revieved Winney's case - the lady who had just been discharged.

Before coming to Jeevan Sahara Winney had been admitted repeatedly to different hospitals. A small fortune had been spent on her by her on the treatments. Much of which she was unable to pay and so others like her brother helped out. Needless to say they are fed up of spending more.

One of the reasons for admitting her at Jeevan Sahara was to spend enough time with her. And Sheba took time to understand what the causes of her diarrhoeas were.

Winney rarely if ever washed her hands. We went about coaching her in this.

Winney never treated her drinking water. Whatever was there she drank. For people with 'battle hardened' stomaches and tip-top immunities this is one thing (still not clever - many people admitted to hospital with Hep A or Typhoid will vouch for that) - but for people whose immunities are virtually nil... Winney has been paying the price for the last two years. The cost of boiling water is nothing compared to thousands of rupees spent in hospital bills.

Winney did not store her water safely. Using narrow necked vessels, which had been cleaned and dried before use, and covering them makes a huge difference. A study in Pakistan found that 37% of water samples from 'boiled' stored water was contimated - mainly due to lack of hand-washing reintroducing the very pathogens that had been boiled to death before!

Winney did not eat safe food. Mumbai is a fast town and fast food - roadside wada-paos and other quick (and often dirty) delicacies abound. We had to help Winney realise that with her immunity she must stick to fresh, home-cooked food. This sounds great - but when you are a widow living alone... The daily monotony of cooking for yourself can be helped so much if a neighbour helps out with a tasty fresh meal every now and then. Love your neighbours as yourself...

Finally, Winney did not get the proper treatment as soon as she fell ill. Instead of drinking a glass of oral rehydration fluids (either the big pinch of sugar, small pinch of salt in boiled cooled water - or a commercial ORS packet) for each stool she passed - Winney just tried to ride out her illness - and ended up riding to the hospital more often than not.

The word is going out. Its nothing flashy. Nothing super hi-fi. But simple steps, conscientiously followed - can make huge differences in lives - especially those of people with HIV!

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An old 'pundit' joke:
"I hear diarrhoea is heriditary"
"Really?"
"Yes, it runs in the jeans"
fade to hilarious laughter....