Sunday, September 8, 2013

Control of Diarrheal Diseases Program

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The Control of Diarrheal Diseases (CDD) Program by the Department of Health is an old program that follows also an old protocol of the World Health Organization (WHO). The protocol is still printed and distributed throughout the Philippines but is found only as a reference in the WHO. It is understood as a duty and responsibility of local city health offices and the program is hardly changed for more than a decade.

Historical Importance of the CDD program

Diarrheal diseases were once known as the top cause of mortality in the known world. Cholera was and still is a pandemic affecting millions. Deaths were also in the millions then and targeted the poor population. Sanitation was a luxury for industrialized nations and poor countries have very little resources to control diarrheal diseases.
The World Health Organization with the help of the International Center for Diarrheal Disease Research created oral rehydration salt formulas to deal with the effects of dehydration, the complication that resulted in death especially in children under five years of age. The Control of Diarrheal Diseases program sought to use these formulas for quick and easy treatment as intravenous fluid solutions are more costly and require more dollars for hospitalization. The very formula being used today is the result of incredible research and has reduced the deaths to these diseases substantially. Millions of children under five were saved.

Why are children still dying?

Diarrheal diseases dropped one spot to be the number 2 killer disease worldwide. The success of Oral Rehydration salts has led to this decline but children are still dying. This report from the WHO sought to answer this question and has found that treating the dehydration was only the tip of the iceberg. Sanitation is still the number one problem with war-torn areas and refugee centers reporting the most number of outbreaks. Soap remains a luxury and potable water is scarce even in areas in the world surrounded by water.

Using the Oral rehydration Solution

Various programs are being taught and barangay health workers are trained to use oral rehydration solutions according to the guidelines. But the guidelines are not applicable in areas where the WHO rehydration solution is no longer available.

You see when a country has the capability to produce its own supply of the oral rehydration solution in commercial packets, the WHO withdraws its 1 liter packet to give way to the nation's own produce. The available packets in the Philippines are not 1 liter packets but rather smaller, 200 ml packets. The packet contents should be mixed with 1 glass of water to have the same consistency as the WHO formula. This is something to be borne into mind when handling non-WHO packets and is something that is not taught in some centers. This leads to misconceptions to some constituents who think that the small packets are for 1 liter concoctions. 

Improving Sanitation

Open defecation is still a problem and a public information campaign is sufficient. The main goal is to provide insight to the problem and make the constituents themselves come up with a long lasting solution. Latrines provide temporary measure but sewage control can be provided by the government as long as rural areas continue to be educated about this need.

Garbage and pest problems, as well as flood control programs also help diminish the diarrheal problem. Coordinating evacuation centers and maintaining sanitation in refugee camps are very important. Local government units should implement guidelines even before events like war and natural calamities happen.

Promoting Good Handwashing

Handwashing remains the number one method of prevention for any disease. Also cooking food and protecting it from flies are another. Global subsidy for soap is called for. A simple hypoallergenic non-bacteriostatic cheap soap can do. 

What you can do to help?

Whether you have a small following of 10 friends or a large fan base of 10,000, your voice is very important in public health measures. A simple tweet about pointers from this blog or sharing videos related to it goes a long way to show you care. Also, a majority of people have no idea that small health centers or health offices cater these services to its constituents. If you can spread the word, more people needing help can get help... for free.