Pakistan Earthquake Relief & Rehabilitation Communication 2005-06

1. Gastroenteritis (Acute Diarrheal Diseases)

They can be caused by a variety of bacterial, viral, parasitic and chemical agents.
The spread is usually "fecal-oral" i.e. ingestion of food and water contaminated by infected stools. Poor sanitation promotes the spread of infection.
The symptoms include frequent loose or watery stools, vomiting, abdominal cramps, fever, and dehydration. There may be dysentery with mucus and blood in stools. Children are most commonly affected. The disease is usually self-limiting in a few days. If not properly managed, the dehydration can prove fatal.
Most cases of acute diarrhea do not need any drugs.
Fluid and electrolyte replacement can be a life saving measure.
Use of ORS is necessary to save lives.
Frequent hand washing, especially before eating and after using the toilets, is important. There should be proper disposal of faecal discharges and soiled articles.
Water and food should be clean and safe for human consumption.
Breastfeeding saves infants from diarrhea by increasing their resistance and avoiding chances of contamination.
Proper nutrition during diarrhea is important.

2. Malaria

It is caused by different species of a parasite called plasmodium, which undergoes its development in man and mosquitoes. It is transmitted by the bite of an infected female anopheles mosquito.
It is considered to be a seasonal disease, with peak prevalence during July to November. Floods, rainfalls and earth quakes may give rise to epidemics if conditions are favorable for breeding of mosquitoes.
The disease is characterized by cycles of fever, chills, sweating and headache. Without treatment it may have relapses for years, or progress to serious diseases with involvement of other systems of the body.
The diagnosis is confirmed by presence of malarial parasite in blood film.
Preventive measures against the disease include:

Protective clothing
Bed nets
Screening of door and windows
Insect repellents
Sanitary improvements to prevent breeding of mosquitoes, e.g. draining, standing water, filling ditches, etc.
Use of Larvicides
Residual insecticidal spraying on inside walls of houses in endemic areas.
Prophylactic treatment in certain cases (e.g. travellers to infected areas).

Treatment of patients with anti-malarial drugs is important for cure and prevention from complications.
The Government of Pakistan, Ministry of Health has a Malaria Control Programme which aims to maintain a low level of malaria in the country, so that it does not become a major public health problem. In endemic rural areas house to house search for cases is conducted and the patients are provided treatment. Insecticidal spraying of houses is also done. All patients coming to health facilities are provided free diagnosis and treatment. Other measures to prevent breeding of mosquitoes are also carried out.

3. Tuberculosis

It is caused by a bacterium called mycobacterium tuberculosis. Overcrowding in camps can spread the disease.
The symptoms include fever, fatigue, and weight loss, cough, chest pain, and blood in sputum. Without treatment it can become chronic and progressive and can lead to death.
Its diagnosis is confirmed by presence of bacilli in sputum.
A person is infective when bacilli are present in the sputum. They can spread to others in the form of small droplets when a person coughs or sneezes. They can also mix with dust when a person spits and be inhaled by others, who can get the infection if their resistance is low. Malnourishment, overcrowding, and poor hygiene increase the risk of infection.
The disease can be prevented through proper education. People should be told to:-

Maintain good nourishment and proper hygiene. Get plenty of rest and relaxation, and avoid overcrowding.

Tuberculosis is completely curable with short-course multiple-drug therapy. The patient need not be confined to bed during treatment, which usually lasts 8 to 9 months. It is very important to adhere strictly to full treatment schedule, for complete cure.
The Government of Pakistan has a National TB Control Programme through DOTS, through which free diagnosis and treatment is offered to the patients, under supervision, and they are educated about the disease.

4. Immunization

Immunization saves lives of children and protects them from seven diseases. Start immunization of children as soon as they are born through local vaccinator or nearest fixed centre.
Remember to make 5 visits for vaccination before the first birth day of your child.
Measles is highly contagious and can spread rapidly among children who are not immunized.
Safe injection practices can help to decrease in HBV, HCV and HIV infections which would have implications on not only the incidence and prevalence indicators but also on the cost saving from the complex treatment of these infections and their complications.

5. Nutrition

Breast milk is the best nutrition for a child from birth to six months of age does not give any other food or drink just breast milk is enough.
Breastfeeding helps protect babies and young children from dangerous illnesses.
From six months to two years children need a variety of other foods 3 -5 times a day in addition to breastfeeding that should be continued up to two years.
Regular use of iodized salt is important for all family members and in children it prevents learning disabilities and delayed development.
First three years of a baby's life is the most important period for growth & learning. Children learn best when family gives them affection, attention, talk to them and encourage to play.
Vitamin A prevents night blindness and protects children from various diseases such as diarrhea and ARI.

6. Maternal Health

During pregnancy and breastfeeding, women should receive increased quantity and better quality of food.
Family members should help in reducing work load of pregnant women so that they can get more rest, especially during the last three months.
A doctor, nurse or trained mid-wife should check pregnant women at least 4 times during pregnancy to ensure mother’s health and proper growth of child.
Families should arrange funds and transport to rush the woman to the nearest hospital in case of emergency.
At the time of delivery, a doctor, nurse or trained mid-wife should be present to ensure safe\delivery and care of mother and newborn.
In case of heavy bleeding, fits or prolonged labor for more than 10 hours after delivery, the woman should be taken to a nearby hospital where emergency operation facilities are available.
Most maternal deaths and complications could be prevented through routine material care, emergency treatment and post partum family planning.