Treating Malnutrition at the JSMK15 October, 2015 Karen State, Burma
One rainy Thursday afternoon in May, arrived with his pregnant mother and worried father to the JSMK hospital. He is a 19 month old male who came to our hospital with watery diarrhea. Though he was not very dehydrated, he seemed tired and uninterested. He had no appetite. Further questions and examination revealed that his diarrhea had lasted months, and that he was very underweight. We diagnosed chronic diarrhea and malnutrition, and over the next 20 days, treated him with vitamins, minerals, worm medication, amoxicillin, and ‘High Energy Milk’ (milk powder, rice flour, sugar, and oil). He passed many worms, and his diarrhea slowed down and stopped. Slowly, his weight improved. It requires love and patience to feed a malnourished child every 2-3 hours through the day and night.
After 8 days, his appetite returned, and we were able to restore a healthy diet of rice, beans, pumpkins, eggs, papaya, bananas and moringa leaves. He began to play with an empty plastic bottle and respond normally to the coaxing of staff and family. During his stay at JSMK’s hospital, we were able to treat the entire family for intestinal parasites, and start prenatal care on his mother. Our staff and students enhanced their own management of severe malnutrition and learned another important lesson: although acute diarrhea is one of our most common childhood illnesses, a few of these children actually have the chronic form of diarrhea (lasting more than 2 weeks) which is often associated with underlying malnutrition. Mothers may not volunteer the longer story of diarrhea or difficulty finding food. We can discover these sicker children among the crowd, by patient and careful questioning and examination, and by calculating the ‘Z-score’ after measuring their height and weight. Eventually, Saw BMS was able to return home well, on iron and vitamins and his family have a new view on the foods that growing children need.
The number of children and adults attending JSMK with malnutrition has risen this year (2015), and these patients require special attention and love to recover, both in the hospital and afterwards.