{"id":1072,"date":"2017-11-03T02:37:27","date_gmt":"2017-11-03T02:37:27","guid":{"rendered":"http:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/?p=1072"},"modified":"2017-11-03T02:37:27","modified_gmt":"2017-11-03T02:37:27","slug":"gasping-for-breath-pneumonias-deadly-toll-among-the-hungry-children-of-kenya","status":"publish","type":"post","link":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/2017\/11\/03\/gasping-for-breath-pneumonias-deadly-toll-among-the-hungry-children-of-kenya\/","title":{"rendered":"Gasping for breath: pneumonia’s deadly toll among the hungry children of Kenya"},"content":{"rendered":"

T<\/span><\/span>he baby lying under a red printed blanket is gasping for air. Her tiny chest is convulsed with the effort of drawing oxygen into her lungs and,as her mother looks on helplessly, her pupils roll back under half-closed eyelids.<\/p>\n

Sumea, six months old, from Lodwar, Kenya, is suffering from the disease parents here fear the most: pneumonia. Without treatment, she could be dead in a day or two. In Kenya<\/a>, one of the worst countries affected by the disease, it claimed the lives of 22,473 people in 2015, almost all under the age of two.<\/p>\n

But Sumea, the daughter of a businessman, is one of the lucky ones. Her mother, Fatuma Abdi, brought her to hospital when she began breathing very rapidly, a telltale sign that pneumonia has become life-threatening. In Turkana, a rural county where awareness of the symptoms is poor, her mother\u2019s quick thinking helped save her. Only half of children in sub-Saharan Africa<\/a> with such symptoms are brought to a healthcare facility.<\/p>\n

Pneumonia kills two children under five every minute, or almost 1 million a year worldwide: more than malaria, diarrhoea and measles combined, according to research published by Save the Children on Thursday<\/a>. Yet it can be treated with antibiotics, such as amoxicillin, costing as little as 30p. The report, Fighting for Breath, shows that fewer than 60% of health facilities in Kenya, Tanzania, the Democratic Republic of the Congo and Mauritania have amoxicillin available. In Uganda and Nepal, the figure falls to a quarter of facilities. The charity is calling for cheaper vaccines and action plans by governments to ensure universal access to healthcare.<\/p>\n

In the acute ward of Lodwar hospital\u2019s paediatric unit, Abdi sits cross-legged on a rubber mattress beneath a jaunty mural of Donald Duck. She gathers her exhausted infant in her arms. A nurse places a face mask over Sumea\u2019s nose and mouth; it is attached to a portable nebuliser to help open her airways, before she is given antibiotics.<\/p>\n

The effect is immediate and dramatic. Moments later, Sumea opens her eyes. Her breathing quietens and she looks up at her mother, whose face breaks into a wide smile of relief.<\/p>\n

\u201cI was so stressed, I was in a panic\u201d says Abdi, 38. \u201cBut now, look, the child is happy. She is even looking at me.\u201d<\/p>\n

In Turkana, an arid region in northern Kenya, close to the border with South Sudan and Uganda, the acute respiratory disease is common among pastoralists who use charcoal and wood fuel for cooking. Here, most children are offered vaccinations for pneumonia. But a severe and ongoing drought affecting the Horn of Africa has led to widespread hunger and malnutrition, which weakens the immune systems of the vulnerable, including babies. The nutrition situation in parts of Turkana remains classified as \u201cextremely critical\u201d, and, in total, 3.4 million people<\/a> are expected to be in need of emergency food aid by the end of 2017.<\/p>\n

Already, one child in every four in the country is malnourished, making them more susceptible to disease: a severely malnourished child is nine times more likely to die from pneumonia than one who is well-fed. Worse still, malnutrition makes it more difficult to treat.<\/p>\n

\u201cPneumonia is the highest cause of morbidity and mortality here,\u201d says Adrian Kituma, the paediatrician in Lodwar hospital, a 132-bed institution that serves the entire county. \u201cMost are likely to have malnutrition and sometimes rickets and other diseases. But it is pneumonia that brings them to the ward.\u201d<\/p>\n

Kituma is frustrated by the number of very serious cases of pneumonia he sees. Antibiotics are not given often and early enough at the county dispensary health centres, he says. Neither are Turkana\u2019s 1.2 million people, mostly pastoralists, educated in looking out for signs of the disease.<\/p>\n

\u201cI would say 90% of people are not aware,\u201d Kituma says.<\/p>\n

A pilot project run by local Save the Children<\/a> staff in Turkana hopes to address some of these issues. It trains villagers as community health volunteers, diagnosing the symptoms of pneumonia and other diseases as well as encouraging breastfeeding and practices that reduce disease, such as handwashing. The volunteers use a simple but ingenious diagnostic tool already proven in other countries: a set of green and red beads, like a giant necklace, along with a timer, to count a child\u2019s breaths. If they finish up with a red bead in their hand, they know the child is breathing too fast and make a referral to the nearest health facility, where antibiotics can be administered. More serious cases are referred to the hospital. The \u00a3250,000 project, which began in 2016 in Loima sub-county, has trained 93 volunteers, who have referred 1,000 cases so far.\u00a0<\/span><\/p>\n

Indicators suggest pneumonia cases have fallen countywide since the scheme began, although it is unclear what is responsible for the drop. In June 2016, there were 4,152 pneumonia cases in Turkana county; this June, the number fell to 2,555.<\/p>\n

But fighting the disease, in the face of the drought<\/a> and the political upheaval following the country\u2019s election troubles<\/a>, remains an uphill struggle. A nurses\u2019 strike in June<\/a>, which followed a doctors\u2019 strike<\/a>, has crippled Kenya\u2019s heath service in recent months.<\/p>\n

The strike, caused by a dispute over poor pay and working conditions, has doubled the maternity death rate<\/a>. Doctors who spoke to the Guardian estimate deaths from pneumonia have also doubled since the strike began in June. Immunisation rates have fallen and babies are not being vaccinated against TB or pneumonia, they say. Hospital staff expect to see a rise in numbers of cases of both. \u201cI would say mortality of the children admitted with pneumonia has doubled since June,\u201d says Kituma.<\/p>\n

On the day the Guardian visits the hospital, there are two paediatric nurses on duty, for 50 to 60 patients. The nurse who treats Sumea does not want to be named, but says she has volunteered to work because she cares about the children and hopes to be paid when the strike is over, \u201cperhaps after the election\u201d.<\/p>\n

<\/div>\n

The other is Peris Nyakundi, one of two nurses funded by Save the Children.<\/p>\n

\u201cThis month has been hard,\u201d says Nyakundi. \u201cMalnutrition rates are still high. That happens when there is no food.\u201d<\/p>\n

Four of the eight children in the stabilisation unit have severe or moderate acute malnutrition. Their mothers, whose brightly coloured kangas and high, beaded collars mark them out as members of the nomadic Turkana tribe, talk of eating just one meal a day; if two, the amounts are very small. Seline Kebo, 24, whose daughter, Akalapatan, is being treated for acute malnutrition and pneumonia, has two other children at home, both of whom are also malnourished.<\/p>\n

\u201cWe used to have goats, but they died in the drought\u201d says Kebo. \u201cWhat worries me most is getting food for the children.\u201d<\/p>\n

The effects of the crisis are starkly apparent in the village of Kachiemeri, an hour\u2019s drive from Lodwar along a dusty, bumpy road, criss-crossed by dry river beds. Sitting on a low-lying trunk of an Acacai tree, Akuwom Atiir, who is not sure of her age, holds her second daughter, Adekei Akokote, in her arms as she talks about how she lost her firstborn to pneumonia. She was determined that her second child, who also developed the disease, would not suffer the same fate. So she took her to be treated at a health centre and, from there, she was referred to Lodwar, where she received antibiotics.<\/p>\n

\u201cShe is now doing well,\u201d Atiir says. Asked what she eats, Atiir gestures at an Eeng\u2019ol, a wild fruit, lying on the sandy ground, which is chewed for its juice.Beyond that she relies on food aid, provided locally by donors, though she and her husband often go to bed hungry.<\/p>\n

\u201cThe drought has affected us severely,\u201d she says. \u201cEven the livestock is dying because there is no pasture and no water.\u201d<\/p>\n

Dave Kihianyu, the area programme manager for Save the Children in Lodwar, says that while a massive aid-funding effort by donors, governments and aid organisations averted a famine in drought-affected areas of Kenya, Ethiopia and Somalia back in March, preventing a lot of deaths and saving many families from dangerous levels of food insecurity, the effects remain evident.<\/p>\n

\u201cThe community here are pastoralists,\u201d he says. \u201cDuring the drought they lost many animals, so restocking them takes a long time. We are in the season of short rains, and if the rains don\u2019t last till December, the restocking won\u2019t happen and the community will be at risk. We are not out of the woods.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The baby lying under a red printed blanket is gasping for air. Her tiny chest is convulsed with the effort of drawing oxygen into her lungs and,as her mother looks on helplessly, her pupils roll back under half-closed eyelids. Sumea, six months old, from Lodwar, Kenya, is suffering from the disease parents here fear the most: pneumonia. Without treatment, she… Read more »<\/a><\/p>\n","protected":false},"author":48,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1072","post","type-post","status-publish","format-standard","hentry","category-article"],"_links":{"self":[{"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/posts\/1072","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/users\/48"}],"replies":[{"embeddable":true,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/comments?post=1072"}],"version-history":[{"count":1,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/posts\/1072\/revisions"}],"predecessor-version":[{"id":1073,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/posts\/1072\/revisions\/1073"}],"wp:attachment":[{"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/media?parent=1072"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/categories?post=1072"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/baileyonlineclassroom.com\/subsaharanafricablog\/wp-json\/wp\/v2\/tags?post=1072"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}