Securing children's health in the face of pandemic

A nurse at Fumagila Health Centre records weight of a child

My fixer and I arrive at Kilima Hewa in Mwanza to meet Scholastica Kitula, 32, at her home fanning a charcoal stove ready to prepare lunch for her three children aged four, two and the youngest who is only ten-months-old. I inquire if the child visited clinic this month.
“I had gone to the market yesterday and I heard some women saying that herbal concoction boosts immunity. So it will keep sickness at bay since am scared of going to the clinic for fear of contracting the coronavirus. We have been taking a concoction of neem leaves, lemon grass and ginger for two months, in case of fever we buy over the counter medicine.” This means the younger one has missed routine clinic attendance for two months and the rest are treated at home with a cocktail of concoctions and over the counter drugs.
Scholastica says she resorted to herbal remedies for her children since they are cheap and readily available. Scholastica’s baby is just like many across the country and the globe whose mothers can no longer take them for routine clinics for vaccinations fearing the pandemic. From, Kilima Hewa, we walk over to Fumagila Health Centre in Kishiri Ward in Mwanza Region, we meet Alistidia Vedasto, 27. She also tells us she is visiting the facility after missing for two months.” I did not take my child to the clinic until the government announced a reduction of Covid-19 cases, “she said. From there, we visit Nyegezi dispensary and here there are many women seen carrying their babies to the clinic. So some good news here for children.
In Bunju, Dar es salaam, Halima Temba, 29, says though she is six months pregnant, she missed two clinics for fear of contracting Coronavirus. She also self-quarantined herself and her three-year-old daughter during this time only occasionally stepping out to get basic necessities and also resorted to home remedy of taking ginger and lemon most of the times with a belief that it would help boost her immunity and that of her unborn baby. Some parents are now resorting to either home based remedies or over the counter medicine with the belief that hospitals are red zones for Covid-19. Though there is still no data available to indicate how many children missed clinic between March and June in Tanzania, missing clinic and using home based concoctions come with some consequences at the end of the day. And for pregnant mothers missing ante-natal clinic comes with negative health impacts.
According to Dr Mariam Noorani, pediatrician and lactation consultant who heads the department of pediatrics at the Aga Khan Hospital Dar es Salaam, vaccines are life-saving interventions for children. “The World Health Organisation recommends that children should continue to get their routine vaccinations during the time of the pandemic while maintaining the necessary precautions. Missing vaccinations can result in outbreaks of preventable diseases like measles. For children who may have missed their vaccines, it is important to take them so that they can be given their missed shots and they can catch-up with the schedule,” she states categorically.
On home-based remedies she says, “Home treatments which are items that are regularly used in the kitchen and in food are safe and are recommended as remedies for simple viral illnesses. Herbal medicines and supplements are NOT recommended for children. They can have serious side effects including damage to the liver and kidneys. If a child is unwell and is not getting better in 3 days, it is important to go to a health care provider for evaluation.”
On his part, Dr Kaguta Munawar, the head of obstetrics and gynecology at Aga Khan Hospital (AKH), the problem of herbal remedies lies in the doses. “It is not easy to estimate safe dosage,” he says adding that, “Pregnancy is a progressive development of the fetus and changes of the women body. It needs to be followed up in all its stages, missing clinic will result into failure to detect any undesired changes.”
“Pregnant period ends six weeks after delivery. During this time still there are chances of developing complications related to pregnancy. It is important to attend,” emphasizes Dr Kaguta who is also Assistant Clinical Professor at Aga Khan University.
According to Mwanza Regional Chief Nursing Officer Claudia Kaluli, due to fear of getting corona infection some pregnant women stopped coming for ante-natal clinic and even younger ones were not brought for routine clinic.
"This means some babies were delayed in getting timely vaccinations and for pregnant women, missing clinic means risk factors are not detected early," she said.
"A pregnant woman with risk factors who arrives late for the clinic may lose her baby or die," she said adding that immunizations help protect children from disease and should not be missed as well.
Chief Physician at Buzuruga Health Centre located in Ilemela District in Mwanza Region Dr Eugen Rutaisire says it is a serious mistake to treat children at home without seeking doctor’s advice.
“First, you do not know what you are treating, as not every fever is malaria, Also drugs have many side effects on the body especially when you treat a disease that has not been confirmed by diagnostic tests,” Dr Rutaisire points out.
"But also, taking medication without testing is among the reasons why children are brought to the hospital already overwhelmed, dehydrated, where if the service is not available quickly even a child may lose his/her life or take a long time to recover, the home medication or remedies might also leave children with long-term effects on the body,“ he said.
"Parents should stop the practice of treating children at home, but when they see unusual symptoms in children such as fever, severe vomiting, frequent diarrhea, weight loss, convulsions, inability to breastfeed, or eating they should go to nearby government facilities and the good thing is that the current President John Magufuli has really facilitated access to the health services nationwide.”
According to the Coordinator of Reproductive Health Services in Mwanza Region, Sesilia Mrema due to the coronavirus being a new disease and no one was prepared, it created fear in the community and some health workers.
She says the fear caused even the services to drop, even pregnant women did not dare to go to the service centers again.
"Maternal attendance at our maternity and child clinics decreased because they were not coming," said Mrema.
She said a large number of people being treated at the dispensaries and health centres are mostly mothers and children under the age of five.
 “Due to overcrowding and congestion, guidance from the Ministry of Health came and we effected a social distance of one metre and wearing of mask.” she said.
She said in collaboration with various stakeholders they continue to provide education to health workers on how to care for pregnant mothers and babies during emergencies or pandemics.
She calls for awareness campaigns on the mass media to ensure children do not miss vaccinations even during pandemics. She says this is where the media should play its role in educating the masses to ensure children’s health is prioritized.
On ensuring that pregnant women do not miss their ante-natal visits and protect themselves and unborn babies, Dr Kaguta suggests that the appointment system of health facilities that the expectant mothers would be seen need to be set at a particular time to avoid massive gathering.

This article is part of Women in News Siri Program