Our case spotlight this month comes from northern Haiti.
Children often present to their health care provider with abdominal complaints, and these are usually viral, treated with time, rest, and rehydration. However, for parents of children in Haiti, the causes behind vomiting and diarrhea can mean illnesses more difficult to address due to a lack of sanitation and clean drinking water.
A community health worker in Haiti reached out to The Addis Clinic with the case of a 10-year-old boy with a 1-week history of vomiting up to four times daily accompanied by a cough. No one else in his home complained of similar symptoms, and he had previously been treated for an infection of worms from which he had recovered. The health worker needed assistance with how to proceed, and we allocated the case to a volunteer family medicine physician practicing in New Zealand. Despite the large time difference between Haiti and New Zealand, our volunteer was quick to respond with detailed follow-up questions and recommendations.
The volunteer believed it most likely that the little boy was suffering from an infection of worms (a parasite living in the intestine), which can sometimes go to the lung and cause irritation leading to a cough. These are usually caught by children through water, food or soil and can be spread through feces. They can lead to poor nutrition and weight loss.
The volunteer detailed the appropriate course of treatment for worms and recommended his entire family take the treatment at the same time. This physician provided dosage adjustments based on age range, as well as the restriction of the treatment in the first trimester of pregnancy and in babies less than 1-year-old. This volunteer, by consulting on the case of this one child, addressed the health of his entire family.
While the boy had previously been treated in this way, this family medicine physician educated the health worker that it can be difficult to keep the infection from returning. Sometimes, taking the prescribed medication in a preventative manner is the only way. He recommended an interval of 6 months between treatments and even provided resources to the health worker for obtaining the medication from clean water initiatives working in Haiti. The volunteer emphasized the importance of regular hand washing with soap and water, keeping nails short, and how to best avoid contamination of food.
Finally, this volunteer provided the Haitian community health worker with a detailed list of warning signs that would signal the patient needed urgent care. The community health worker confirmed his understanding of the plan and will update the physician on the boy's status in a couple of weeks. The Addis Clinic is honored that we were included in the care of this boy and his entire family, and look forward to hearing about his clean bill of health soon!