Community Mmobilization Against a Predator

A COMMUNAL CHALLENGE TO A PREDATOR2.Background InformationIn September 2016, a cholera outbreak struck the quiet small town of Isashi. Isashi is one of the newly created Local Council Development Areas in Lagos State, Nigeria. The out break was traced to poor hygienic disposal of fecal matter and poor food hygiene. The victims of the out break were distributed evenly sparsemy among the populace.The report available for records indicated that affected individuals were taken to health centres, private hospitals, convalescent homes, maternity homes and traditional birth attendants. A significant by unaccounted were treated at homes.The statistics below represents a cross section of he victims   distribution.                                                                                                                                                                                                                                               NO  AGE(YRS) SEX TOTAL PROGNOSIS             
7      40+              M          -             +     
13   25 - 34          F          -              +  
15   23 - 27         M          -              + 
10    6  -   1          F           -              +     
9      6 - 17          M          -               +  
                                         
 >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>Gross-  54                                                                      >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>MEN-    7                                                                  >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>WOMEN-13                                                         >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> CHILDREN-19  
                               
Discussion: Cholera is caused by Gram negative comma-shaped bacteria. Portal of ingress is feco-oral route. An infected person deposits the germ in stools where flies pick them to deposit on uncovered food materials.  Incubation lasts from a few hours to 5 days after which the victim develops fever, purges profuse watery(rice-water stools) with subsequent dehydration shock, obtundation and if not treated could die.     The list above demonstrates that though no mortality resulted here were reports of near swaths due to shock and electrolyte depletion. This was accounted for by the children between the ages of 6 to 12 who were either males of females. Another age distribution with similar report were males between ages of 22 and 27. No causal link could be associated with this out come but a conservative relation might exist in nutrition and immune status.   A cursory look at the disease burden and distribution shows clearly, the fact that women and children remain the vulnerable segment of the population. They  seemingly are  often at risk during societal critical momenta.  The women and children as we all know are positioned linearly in the societal survival geometries and so one wonders why they remain the most endangered. We all must do everything possible to eliminate the root causes of these vulnerabilities. 

CHALLENGES IN REACHING VICTIMS.          Movement to and fro health centres, hospitals, maternity homes were free but many affected individuals could not be reached due to poor mentality and poverty. The unaccounted victim posed a challenge in the fact that we could not identify, qualify and quantify them. We have no record of mortality or success in these places but we are aware many people resorted to unorthodox treatments.
                                      
COMNUNITY MOBILIZATION/ACTION.           Redeem Community Health Consult has affiliate hospitals. We also work together with the health centre. We enjoy rapport with the CDA. Immediately we received the first report, we moved into action. We called the CDA chairman, Mr. Igwe who called an emergency meeting of his cabinet. The meeting was held at our Headquarters with our president. The CDA was briefed on what the community should do to avert further spread of the germs. To this effect, the town crier was deployed to alert the people on what to do. We equally contacted the Chief Surveillance Officer Mrs. Kowosi who immediately notified the state surveillance team that stormed Isashi within a period of 3 hours.                                                              Samples were despatched to laboratories were tests were conducted to authenticate the bacteriology or otherwise of the epidemic.                                                          
RESULTS. Our community mobilization yielded a resounding success on the sense that non of the victims reached suffered severe complications or mortality.                   
FOLLOW UP. Following our great effort, Lagos State was motivated to organize a training for all hospital representatives and health based NGOs within the state. We were also invited. The training involved collecting, identifying, isolating and diagnosing germs using limited resources. 

 RECOMMENDATIONS OF FURTHER COMMUNITY ENGAGEMENTS/FACILITATIONS. 
We are happy to report that our initiatives yielded appreciable results but it fell short of the desired goal in the sense that a significant population remained unreached. This population was unavoidably unavailable for the records. It is important that these people be reached because apart from certain untoward prognosis, improper treatment protocols might lead to the transformation of the bacillus into a more virulent strain that might pose a higher risk to the entire community. To this effect, we recommend that the following be adopted to reach them;                                                      
1 Identification of focal persons of influence: these could be traditional healers, Traditional Birth Attendants and other community leaders.                                                               
2 Training directed at these people and the community.                                                        
3 Provision of portable and clean water for the people.                                                         
4 Adequate housing for all to ensure proper disposal of fecal matter.                                  CONCLUSION.  Our community mobilization effort to combat cholera out break that ravaged Isashi community was successful due to the swiftness in response of both local and state health facilities. There is still room for improvement to ensure this singular effort benefited all and sundry.                                                                                                    
 SUBMITTED BY DR. IKECHUKWU ONYEKWELONWU  MBBCH                                                        
PRESIDENT, REDEEM COMMUNITY HEALTH CONSULT ON BEHALF OF REDEEM REDEEM COMMUNITY HEALTH CONSULT                                                                                                               
5, EZECHUKWU IGWE STREET, OKEMORO ISASHI, OJO, LAGOS, NIGERIA                           RCHC
                                                                                   

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