WAR ON DISEASE

( By Radhika Ramasubban, Bhanwar Singh & Nigel Crook )

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Seems And Her Baby

Why Children Must Be Given A Full Course Of Immunization

Adam and his wife Sakhu, lived in a hut on the pavement on Tulsi Pipe Road. Kadam was president of the pavement dwellers colony there ; hence visitors to his hut were frequent. Seema, one of his neighbours, had returned from Sholapur with her baby, and called in to see Kadam with the baby in her arms.

"Ah, Seema, welcome back !" exclaimed Kadam and Sakhu. Sakhu eagerly took the infant in her arms.

"Oh, sheís so sweet !" exclaimed Sakhu.

"Sheís very good," said Seema, " she sleeps well and she feeds well. "

"Ah, you are blessed to have a healthy baby, " said Kadam.

"I know, " replied Seema. " it seems so sad to have to bring her from the village to this pavement. But what else can we do ? There is no work in the village. At least here in Bombay we have a job and sufficient income for food. But brother, there is one problem here, " she went on, " I do not know where to go to get her injections to prevent her from getting all these diseases. IN the village I could take her to the Primary Health Centre - itís two miles up the road at the taluk headquarters. But here, I do not know where to go."

By now several other neighbours had gathered to look at the new baby.

"That is true, " said Kadam, " newcomers to this settlement like yourself, donít know where to go for services such as these. I will tell you where the municipal clinic is. But it is good that you remembered how important it is to get the vaccination. "

"I think they call it DPT," she said.

"Thatís right, " said Kadam, " it is also called triple vaccine, because it protects the child against three disease, diphtheria, whopping cough and tetanus. And there is an additional one you take orally for polio. You see there is no cure for some of the diseases. That is why itís so important to give these vaccines, and to give all the doses required to complete the course."

"We gave the full course to our daughter, " Sakhu added. "You have to give boosters from time to time until the child is eight years old. You see, you have to keep up the immunity in the growing body, otherwise it will disappear and she may fall sick after all.

You must think of the future. We are glad to know that our girl can never get these diseases now. "

" We only went for one dose, " said one of the neighbours, " it was too much of a problem going to the clinic all the time - how can you take a day off work every month to take the child ? The first we gave because someone from the hospital came around and told us. But after that we didnít bother. "

"But you must complete the course, " insisted Kadam, " otherwise it will not give protection for your child."

Another neighbour, an old man, had something to say ; " So many injections, -- we never had them in the old days. "

"Thatís why people used to get those crippling diseases like polio," said Kadam. "You donít see so many crippled children in Bombay nowadays do you ? Thatís because they have taken the vaccine. "






THE IMPORTANCE OF PROPHYLACTICS


Preventive medicines ( technically known as Prophylactics) are very important to protect children from diseases against which they have little or no natural immunity. For some of these there is no curative medicine either.

Children are protected against diptheria, whooping cough ( pertussis), and tetanus if they take a full course of triple vaccine injections (DPT). They are protected against polio by taking a full course of polio vaccine which is taken orally. They have some protection against tuberculosis and possibly leprosy if they are given the BCG injection at birth. ( If this is missed it is wise to ask for a Heufís test or Mantoux test to be done at the municipal clinic when you go for the other injections - this will check whether the child has immunity against TB) .

If the child is currently suffering from cold or cough accompanied by fever and is being cranky and rejecting milk, or has a sickness in the stomach, the taking of these prophylactics should be delayed until the child is better. You should inform the doctor about the current health of the child before he gives the prophylactic. Otherwise it may have to be taken again. Also if the child has an accident or needs treatment the doctor should be told what injections the child has received. Medicines interact with many of the bodyís functions l so it is important to let the doctor know the patientís full medical history when medicines of prevention or cure are being prescribed.

Furthermore, problems affecting the ability of the person to follow through a prescribed course of preventive ( or curative) medicine should also be shared with the doctor.


"Thatís true, " said the old man thoughtfully, " but as she says, itís very difficult to go back so often to the clinic. My son and daughter are working all day, so I was supposed to take my little grandson to the clinic - but I remember I myself was ill at the time, so how could I take him ? Then the monsoons came and the child got sick. "

" I can understand your problem as you fell ill, " said Kadam, "but he persisted, " it is important to take the child for the later doses also. If necessary your son or daughter should be ready to lose a dayís wages and take him. "






THE FULL COURSE OF PROPHYLACTICS

Below we show the full course of treatment to protect the child against life-threatening diseases. Immunity will only be maintained if the boosters are given as well. We suggest parents should keep a card with the dates ( as in the example below ) ; if documents are kept in another place the parents should make a copy and keep it with them in the hut or chawl.

AT BIRTH: BCG ( injection to protect against tuberculosis).

3 MONTHS OLD: DPT first dose ( injection to protect against diphtheria, pertussis ( whooping cough ) and tetanus ; ( also called Ďtriple vaccine Ď). Polio first dose ( taken orally).

4 MONTHS OLD DPT second dose. Polio second dose.

5 MONTHS OLD DPT third dose. Polio third dose.

7 MONTHS OLD Heuf or Mantoux test ( a check for freedom from tuberculosis ) to be taken if BCG was not given at birth.

9-12 MONTHS Measles injection

TWO TO TWO AND A HALF YEARS First DPT booster. First Polio booster.

AROUND THREE YEARS Measles booster

FOUR AND A HALF TO FIVE YEARS Second DPT booster. Second polio booster.

FIVE YEARS BCG booster

FIVE TO SIX YEARS Tetanus Toxoid. Subsequently Tetanus Toxoid every 3 years.


"The worst thing is when the children themselves fall ill around the time when they need to be given the doses -- thatís what happened to our daughter on two occasions, " said Sakhu

" You are not supposed to take the children for these vaccines if they are sick, because if you do they wonít work properly, and youíll have to repeat the dose, " said Kadam.

"But you must take them as soon as they get well again, like we did, " concluded Sakhu.

A few days later there was considerable agitation in the colony. People could be seen standing in groups and talking to each other in excited voices. The Municipal Corporation had sent some officers round to warn the people at one end of the colony that the road was going to be widened. It would be necessary for the huts affected to be moved elsewhere. Kadam came to see Seema. She had managed to visit the municipal clinic and they had given the injections. They had also given her instructions on future visits and told her how important it was to follow the full course.

"They tell us to protect our children and come to the clinic " she complained, " at the same time they keep moving us from one place to the next. How can we remember these things if we are always having to think about where we are going to stay, what work we can get, and how to keep the rain out of our huts ? Without security we cannot use the services provided properly. "

"Thatís a big problem, " said Kadam.

"At the clinic, " she went on, " They gave me so many instructions on what age I should bring my child for this and that ; it was quite confusing and easy to forget even for some one like me who has studied upto 7th, when so much else is happening. But I had an idea. Could be, it will help everyone of us. "

"What was that ?" asked Kadam.

" We should keep a card giving the dates when all these injections are due. Then we could keep it along with our ration cards. "

" It should like a good idea," said Kadam. " But one needs to be reminded all the time of these dates. Many people living in footpath colonies keep their ration cards elsewhere with their relatives in case their huts get demolished and they get relocated elsewhere. So they will not have the cards close at hand. "

"Then we should make copies of the card, " suggested Seema, and keep the copy here with us in our home where we can see it all the time. "

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