Category Archives: Child Deaths

Maps of Malaria Hotspots to Save Lives

30 September 2014

Major Progress in Malaria Fight

Malaria is one of the world’s biggest killers. In 2010, an estimated 660,000 people lost their lives to the disease – most of them children in Africa, where a child dies from malaria every minute.

Until recently, however, it was difficult to access information about the locations of Africa’s malarial hotspots or how they are influenced by the weather there. Information about the continent’s malaria distribution was scattered across published and unpublished documents, often gathering dust in libraries.

But now, thanks to a digitised malaria mapping database that brings together all available malaria data, the disease no longer has the ‘blind killer’ status of past decades. MARA – Mapping Malaria Risk in Africa – was launched in 1996, with initial support of US$10,000 from the WHO’s Special Programme for Research and Training in Tropical Diseases to map information on malaria prevalence across Africa. The project’s first phase (1997-1998) aimed to produce an accurate atlas of malaria risk for Sub-Saharan Africa.

The project was set up as a pan-African enterprise, not owned by any specific organisation but coordinated by South Africa’s Medical Research Council, in the spirit of open collaboration.

A group of scientists, based at institutions across Africa and Europe, worked together on the project. Further funding came from donors including Canada’s International Development Research Centre, the Wellcome Trust, TDR and the Multilateral Initiative on Malaria (MIM), and the Roll Back Malaria Partnership. African institutions contributed through expertise, staff time and facilities.

Five regional centres – each using a standardised data collection system, were established across Africa. French-speaking West had an office in Bamako, Mali, while English-speaking West had a base in Navrongo, Ghana. Yaoundé, Cameroon hosted the Central Africa office; Nairobi, Kenya hosted the East Africa post and Durban in South Africa became home to the Southern Africa centre.

The project built expertise among local malaria control staff to enable them to reference the collected data, and it trained epidemiologists, medical doctors and researchers. In total it trained: 33 people to use GIS (geographic information systems) and databases, 23 to study climate change effects on the spread of the disease and 45 to interpret the results for people who might want to use them. Eight people got master’s degrees and PhDs on malaria.

The mapping project tracked down information on malaria prevalence from both published and unpublished sources to identify malarial mosquito hotspots, disease prevalence and the weather conditions that fuel transmission.

The MARA database contains more than 13,000 malaria prevalence surveys collected over 12,000 locations: with 37 per cent in Southern Africa, 33 per cent in West Africa, 25 per cent in East Africa and five per cent in Central Africa. The data remains live but no new material is being added.

The project then disseminated this information to national and international policymakers, distributing 3,000 poster-sized malaria distribution maps to malaria control programmes, health departments and research institutions in malaria endemic countries.

Whereas previously the absence of centralised records had made choosing appropriate solutions very difficult, the new data systems help countries identify transmission periods, implement control programmes and tailor control measures according to individual contexts – which also saves valuable resources. Rajendra Maharaj, director of the Malaria Research Unit at South Africa’s Medical Research Council, says the project has a strong legacy in the support it provides for the planning of malaria control programmes.

Konstantina Boutsika, an epidemiology and public health researcher from the Swiss Tropical and Public Health Institute (Swiss TPH), in Basel, Switzerland, where the database is now hosted, says the original maps are still available as downloads from the MARA website, as is a CD-rom developed by South Africa’s Medical Research Council to enable easy access to MARA project data.

Boutsika, who has been at MARA’s helm from 2006, says a project highlight is the first accurate assessment of the malaria burden in Africa, which has been made possible by advances in geographical modelling. “We can now give useful answers with regards to malaria,” she says.

MARA has made its results available through the technical reports published regularly on its website in both English and French.

The programme’s main beneficiaries have been identified as scientists, malaria control programme staff and local communities.

Maharaj says the scheme helps alleviate disease and death, especially in children and pregnant women, and has contributed to the efforts to reach the sixth Millennium Development Goal on combating HIV/AIDS, malaria and other diseases.

MARA was also one of 700 projects – selected for their exemplification of practical solutions to challenges – presented at the EXPO2000 world fair in Hanover, Germany. The programme owes its success to its strong team of investigators from participating organisations, Maharaj says: “The big lesson was inter-country collaboration, which is essential for malaria control”.

It has not all been smooth sailing, however. The main challenge was the collection of non-digitised data, explains Maharaj.

“But this was overcome by teamwork, whereby malariologists from all walks of life worked within ministries, academic and scientific institutions to source data that was stored in archive boxes, university libraries and government storerooms,” he says. And Boutsika adds that obtaining funding to sustain the programme was difficult because harmonising various databases required a heavy investment.

When funding for research ran dry in 2006, the project was given a new lease of life by the Bill & Melinda Gates Foundation and Swiss TPH, and moved from Durban to Basel, where phase II was launched. In 2009, the software team at Swiss TPH merged the MARA databases from phases I and II and developed a new web interface.

Since then, the MARA database has been in the public domain accessible to registered users and can be downloaded in different formats. Boutsika says researchers individually continue to collect data in Africa and use the MARA database as a sounding board.

[Courtesy AllAfrica News]


Africa: Does Democracy Improve Your Health?

18 Nov 2013

Back in the 1990s, the Nobel-prize winning economist Amartya Sen famously wrote that “no famine has ever taken place in a functioning democracy”, coining an argument has shaped thinking across countless sectors – and none more so than healthcare.

If governments face open criticism and are under pressure to win elections, we assume, they are incentivised to improve the health of their populations. Dictators are not.

“Democracy is correlated with improved health and healthcare access … Democracies have lower infant mortality rates than non-democracies, and the same holds true for life expectancy and maternal mortality,” Karen Grépin, assistant professor of global health policy at New York University, wrote in a 2013 paper. “Dictatorship, on the other hand, depresses public health provision.”

She argues that democracies entrench longer-term reforms than their dictatorial counterparts – often involving universal healthcare or health insurance schemes.

“The effects of democracy are more than a short-term initiative, such as an immunisation programme, which don’t always have lasting effects,” she said in a telephone interview. “Democracy can bring larger-scale reforms that create new things or radically transform institutions.”

But does that theory hold water in Africa?

Ghana, one of the continent’s deepest democracies, is doing well. According to Gallup data, 75 percent of its population consider its elections to be honest, compared to a median of 41 percent over 19 sub-Saharan countries. Correspondingly, it was also one of the first countries in Africa to enact universal health coverage laws.

In 2003, roughly a decade after entering a multi-party democratic system, the west African country hiked VAT by 2.5 percent to fund a national health insurance programme.

Voters who had been overstretched by the previous ‘cash-and-carry’ system happily swallowed the tax increases, and the scheme was so popular that when the government unexpectedly changed in 2008, it survived the transition.

The country still has a way to go to attain universal coverage. According to the National Health Insurance Authority, by the end of 2010 34 percent of the Ghanaian population actively subscribed to the scheme. But the institutions are now in place, laying the foundations for the future.

Similar schemes are being rolled out in other democracies like South Africa. But this isn’t a simple equation. There are plenty more multi-party systems which have failed to enact meaningful reform – think of the pitiful performance in Kenya, where the government changed earlier this year – while some more autocratic regimes are performing well.

“Several of the countries that are seen as the big success stories in public health are not very democratic,” argued Peter Berman, a health economist at the Harvard School of Public Health.

Take Rwanda. Led by Paul-Kagame’s decidedly authoritarian Rwandan Patriotic Front, the country is considered “not free” by Freedom House. In the run up to 2010 presidential elections Human Rights Watch alleged political repression and intimidation of opposition party members against the leadership.

Yet the government has a strong developmental track record. “Rwanda started out with somebody who is autocratic, but who genuinely wants to see these indicators change,” Grépin said.

Over the last decade, Rwanda has registered some of the world’s steepest healthcare improvements. After the 1994 genocide – when national health facilities were destroyed and disease was running rampant – life expectancy stood at 30 years.

Today, citizens live to an average of almost double that. Deaths from HIV, tuberculosis and malaria have each dropped by roughly 80 percent over the last 10 years, while maternal and child mortality rates have fallen by around 60 percent.

Part of its success stems from the fact that its healthcare services reach rural citizens. The leadership hands responsibility to local government and authorities and holds them accountable for their efficiency; and almost 50,000 community health workers have been trained to deploy services to marginal populations.

Like Ghana, Rwanda runs a universal health insurance scheme, though it has fared better in its roll out. Upwards of 90 percent of the population is covered by the community-based Mutuelles de Santé programme, which has more than halved average annual out-of-pocket health spending.

“By decreasing the impact of catastrophic expenditure for health care we increase the access,” explained Agnes Binagwaho, minister of health, from her Kigali office.

The benefits of that programme are clear to see at the bustling Kimironko Health Centre, which is a 20-minute drive from central Kigali and deals with most of the suburb’s non-life threatening medical complaints.

As dozens of men, women and children queue to hand over their health cards, a young nurse named Francine Nyiramugisha explains that “Ever since the Mutuelles de Santé was introduced, there has been a huge difference. You pay 3,000 RwF ($4.50) per year and then you get treatment.”

In the reception, thirty-year-old Margaret Yamuragiye, a slender sociology student who has been diagnosed with malaria, waits patiently for her prescription. “Before I got my Mutuelles card I would fear that I could not go to the clinic because it would be too expensive. Today if I have simple cough or flu, I come to the doctor, I don’t wait to see if it gets worse,” she said.

Nearby in Ethiopia, another autocratic regime registered by Freedom House as “not free” is also clocking significant health improvements. Like Rwanda, leaders in Addis Ababa have little time for political opposition, but are registering impressive developmental gains.

“They’re not very democratic but they have the power and authority to allocate resources towards population health needs,” Harvard’s Berman said.

There’s no universal coverage scheme in Ethiopia, but government has opted to focus on deploying basic healthcare services across hard-to-reach rural areas.

Starting from a pitifully low base, it has spent a decade training a network of around 40,000 extension workers to bring care to rural communities. Over ten years, the nation registered a more than 25 percent decline in HIV prevalence, according to a 2012 progress report. Under-five mortality has declined to 101 deaths per 1,000 live births in 2009/10, from 167 in 2001/2. Infant mortality halved in the same period.

Those examples should be evidence enough that the relationship between democracy and improved healthcare isn’t a simple one. “There are autocratic governments that care about the people and there are autocratic governments who don’t. There are democracies where politicians respond to a broad public demand, and then there are democracies where the politicians respond to narrower interest groups,” Berman said.

“There is no simple equation between democracy and caring about public health.”
[Courtesy of This is Africa]

Seattle: Global Effort Targets the Leading Killers of Children

25 May 2013:

PATH, a Seattle-based global health development organisation, is aiming to save two million lives by 2015 by jointly tackling diarrhoea and pneumonia, the leading killers of children globally.

Steve Davis, president and CEO of PATH, delivered the message at the ninth annual PATH Breakfast for Global Health held in Seattle on Tuesday.

“Today we placed a bold stake in the ground, with partners around the world, to save two million lives by the end of 2015,” Davis said.

PATH will begin its efforts in India, Cambodia and Ethiopia, where intervention is most urgently needed and PATH has resources. While all three countries have seen their child mortality rates from diarrhoea drop, India’s pneumonia death rate remains stagnant, accounting for 24 percent of deaths of children under five, the same as in 2000, according to 2013 World Health Organisation statistics.

“No parent should have to bury a child because of something we can help prevent or treat,” Davis said.

Diarrhoea and pneumonia are two diseases that overwhelmingly affect children in African and Asian countries, Davis said, with diarrhoea claiming around 760,000 lives a year. And while the number of children dying in Africa before the age of five has decreased, it still vastly outnumbers all other parts of the world, according to the 2013 WHO statistics.

Melinda Gates, philanthropist and founder of the Bill and Melinda Gates Foundation, which helps fund health development and vaccines world wide, spoke at the breakfast of the importance of vaccinating children as well as “appropriate” science that meets the needs of communities in the developing countries.

“[The] developing world is littered with pilot programmes,” Gates said.

As he took to the stage, Davis pointed to a tool belt around his suit jacket. A visual aid, the belt allowed Davis to show and carry some of the tools that can prevent the deaths of so many children from diarrhoeal disease, tools that will be used to achieve PATH’s life-saving goal.

Clean water, soap, zinc tablets for oral rehydration therapy and the rotavirus vaccine, which stops some diarrhoeal diseases before they start, were all included.

But it’s not just science and vaccines that can improve the lives of communities ravaged by diarrhoea. Deeply held cultural traditions and ideas about the disease have to be altered as well.

Dr. Alfred Ochola, PATH’s Technical Advisor for Child Survival and Development in Kenya, spoke about educating Kenyans on how to reduce the risk of diarrhoea in their communities through hygiene practices like hand washing.

But Ochola, who lost a brother and sister to a diarrhoea outbreak in Kenya as a child, has found that at first, people are reluctant to embrace change.

“A big [challenge] is combating old beliefs that diarrhoea is a curse and not an infection, and that the death of a child is an inevitable part of life. ‘God will give you another one’ is a common saying in Kenya,” Ochola said.

Many people believe a child who has diarrhoea is cursed, Ochola said. Vomiting and diarrhoea are welcomed because it rids the body of the evil inside it, while it should be taken as a sign that something is seriously wrong.

Poverty is another challenge in combating the diseases. Although heart disease and diabetes are becoming the new illnesses of poverty, according to Davis, diarrhoea and pneumonia still adversely affect children of developing countries in Africa and Asia.

In Africa and Southeast Asia, the percentage of child deaths are higher than the global average and have not significantly decreased in 10 years.

Both regions have seen child mortality from diarrhoea fall from 13 percent to 11 percent of deaths from 2000 to 2010, but in Africa, the rate of death from pneumonia has actually increased, from 16 percent to 17 percent.

“Too many people lack the financial means to seek care when it’s most needed, like paying for transportation to get to a health facility far from home… We often reach women and their children too late,” Ochola said.

Ochola told the story of Jane Wamalwa, a Kenyan woman who came to understand the reasons behind making a change in long-held practices in treating and preventing diarrhoea. Wamalwa lost three children to the disease, and has now become a trusted source of information on good anti-diarrhoea practice in her community, Ochola said.

“It has become her calling,” he added.

[Courtesy AllAfrica News]

Uganda to Save Children’s Lives With Pneumonia Vaccine Drive

Pneumonia kills thousands of Ugandan children every year. A new vaccination programme aims to defeat the illness.

Uganda is rolling out the immunisation against pneumonia using a new vaccine called Pneumococcal Conjugate Vaccine (PCV 10). The vaccine has been introduced to mitigate the high infant and childhood death rate and illnesses due to lung infections.

Pneumococcal Conjugate Vaccine was first introduced in sub-Saharan Africa two years ago.

In Kenya and Ethiopia the vaccine was introduced in 2011.

Madagascar and Mozambique started using this vaccine in 2012.

Uganda and Zambia are introducing the vaccine in their routine immunisation programme this year.

Pneumonia is the second leading cause of infant mortality in Uganda after malaria with 18,000 children below the age of five dying of pneumonia every year.

Children under one year are most at risk of getting pneumonia. Factors that expose a child to the lung infection are lack of exclusive breastfeeding, indoor air pollution, poor nutrition and inadequate ventilation.

The health ministry’s director general of health services, Dr Jane Ruth Aceng, says the introduction of PCV 10 into the routine immunisation programme will prevent more than 94,071 new cases and save more than 10,796 lives per year.

“Children have been suffering from pneumonia without any measure of prevention, and we are happy that the government of Uganda in collaboration with GAVI [a coalition of children’s health NGOs] in introducing this new vaccine free of charge for all children under one year age” she says.

Children will get three doses. Infants will receive the first dose at six weeks, another at 10 weeks and the last dose at 14 weeks after birth.

Unicef’s Dr Irene Mwenyango says the drug is safe, free and effective against diseases caused by pneumococcus bacteria. It will offer immunity against infection of the brain covering (meningitis), infection of the lungs (pneumonia), bacteria in blood (bacteraemia), ear infections among others.

A total of 1,521,061 children are expected to be immunised this year across the country.

Administration of this vaccine was set to start on Saturday 27 April in the eastern district of Iganga and then rolled out throughout the country in all health centres

Uganda has low immunisation coverage with only 52 per cent of children fully immunised, so half the child population at a greater risk of being wiped out by preventable killer diseases.

This is attributed to inadequate community sensitisation and mobilisation.

And a sect calling itself 666 is reported to be campaigning against immunisation in rural areas, telling parents and guardians it is not safe. The government has vowed to deal with them since their message is confusing parents.

It is estimated that 17,216,000 euros will be spent on the new drug. Under the cost-sharing arrangement, the government of Uganda will contribute 919,000 euros while GAVI is contributing 16,296,000 euros.

According to the World Health Organisation (WHO) pneumonia is the world’s leading cause of child deaths, killing an estimated 1.2 million children under the age of five every year, more than Aids, malaria and tuberculosis combined.

[Courtesy of All Africa News]

Major price cut for five-in-one vaccine

NAIROBI, 18 April 2013 – The cost of vaccinating children with the pentavalent vaccine – a five-in-one formulation – is set to drop significantly following a deal between the GAVI Alliance and an Indian drug manufacturer that is reducing its price by 30 percent.

GAVI will now be able to purchase the pentavalent vaccine – which protects against diphtheria, tetanus, whooping cough, heptatitis B and Haemophilius influenzae type b – from Indian firm Biological E for US$1.19 per dose, down from its current price of $2.17 (and down from $3.56 per dose a decade ago). Millions of children in 73 GAVI-eligible countries are set to benefit from the price drop, which will free up an estimated $150 million for GAVI over the next four years.

“Working to secure price reductions means we are able to make our funding go further, reaching more children and protecting more lives,” a GAVI Alliance spokesman said.

Experts say reductions in the price of vaccines – and the price of transporting and storing them, which often requires expensive refrigeration – will be crucial to lowering child mortality and meeting the UN Millennium Development Goal on child survival.

Uganda’s midwives struggle to meet demands


8 April 2013  – Despite the significant role midwives play in Uganda’s maternal health programmes, they face numerous challenges, including lack of training, inadequate facilities and poor pay.

According to the Africa Medical Research Foundation (AMREF) just 38 percent of Uganda’s estimated 11,759 midwives are either registered or have a college education. Yet they attend to 80 percent of all births in the country’s urban areas and 37 percent of all births nationally.

Esther Madudu, a midwife in Uganda’s rural Soroti District, explained to IRIN that many go to great lengths to help women deliver.

“Health centres lack electricity, water and other essential medical commodities to assist in delivery. In the past, I used to [hold] my cell phone in my mouth [and use its] torch to [assist delivering] mothers at the health centre,” she said.

A 2009 analysis by the UN Population Fund (UNFPA) found Uganda’s health system “unsupportive to midwives, as characterized by poor remuneration, poor health service infrastructure, lack of essential equipment and supplies, eg, gloves, drugs – especially in public health facilities – inadequate protection from infections, high workload owing to few qualified staff” and lack of supervision or training opportunities.

Maternal deaths

Uganda grapples with high rates of pregnancy-related complications and maternal deaths, consequences of poor healthcare investment by the government, low education levels and an unmet need for reproductive health services.

Uganda’s 2011 Demographic and Health Survey showed the maternal mortality rate at between 310 and 480 deaths per every 100,000 live births.

According to the Ministry of Health, 24 percent of these deaths are the result of severe bleeding, and many are due to infection, unsafe abortion, hypertensive disorders and obstructed labour.

Experts say much more must be done if Uganda is to meet Millennium Development Goals 4 and 5 – the goals on reducing child and maternal mortality and achieving universal access to reproductive healthcare – by the 2015 deadline.

“Death resulting from pregnancy-related [complications] is a big issue in Uganda that requires urgent attention,” health commissioner Anthony Mbonye said, noting that these deaths are preventable “with improved access to [quality] healthcare to the population and… positive attitudes towards… health workers.”

Too few health workers

Midwives say their small number has them struggling to meet demand. They have called on the government to recruit more midwives.

“We are only three midwives working day and night with [the] assistance of two nursing assistants,” said Lydia Tino, a health supervisor and midwife working at a centre with 20 maternity beds in the rural Gulu District.

In 2006, the government stopped midwifery trainings, arguing that nurses could be given additional skills to take up the roles played by midwives. This has not happened.

And the few who have midwifery skills often leave the country.

“Uganda has trained many midwives, but [the] majority opt to work in places outside the country where facilities and remuneration are better,” Mary Gorettie Musoke, senior midwife and trainer, told IRIN.

n a progress report by Uganda’s Ministry of Health, tabled before a parliamentary committee in February, the government indicated that it had employed an additional 5,707 health workers to help plug the gap.

But many rural health facilities are still unable to perform either basic or comprehensive emergency obstetric and newborn care.

Government obligation

Government officials told IRIN it plans to carry out a countrywide maternal health audit as part of its efforts to deal with the problem.

“We are under obligation to perform our duties, so the government doing everything possible to address problem,” said Sarah Kataike, the health minister.

While government health facilities in Uganda are supposed to provide free services, they are understaffed and lack essential medical supplies. At times, patients are forced to pay extra fees before they can receive services.

Florence Akio, 34, had to be transported to a private facility some 45km away after failing to receive any assistance at a nearby government facility.

“My labour started in the middle of the night, but I couldn’t make to Atiak Health Center III. I waited until morning, when my husband borrowed a bicycle and carried me to the health centre. But, reaching the health centre, there was no sight of any staff to attend to me,” she told IRIN.

In a landmark 2011 case, civil society organizations sued the government over the high maternal mortality rate, but the case was dismissed. The organizations had argued the government had failed to provide essential medical commodities and services to pregnant women.

[Courtesy of IRIN]

Tied to a rope because she is disabled

Tied to a rope because she is disabled

Although she is 14 years of age, *Lisa cannot eat by herself or talk. She does not play with other children either, and needs help with basic activities. Therefore, her parents tie her to a tree because they feel it is the only way to keep her safe.

Lisa, 14, spends her day tied to a tree near her parents’ home in Nateete, Uganda with a rope. The rope is fastened onto her right leg. When she is not tied there, the rope remains. The tree is now known as Lisa’s tree.

This is not another case of the nodding disease. Lisa is deaf and mute. Her parents think tying her to the tree is the best way to manage her. While there, she keeps on moving around it. From time to time, she picks anything on the ground and puts it in her mouth. Her sisters keep on removing leaves and sticks so she has nothing to put in her mouth. But that doesn’t deter her from searching for something else. She tries to go as far as her rope allows her and when she finds nothing, she continues moving around the tree and sits down when tired.

All this she does while making sounds similar to that of a goat bleating.

Perhaps the saddest part in this story is that this slender and tall teenager was not born with any abnormality.

“She was born normal and could talk and hear. But when she was two years old, she got malaria and got a seizure. Since then she lost her sense of hearing, talking and she sees only partially,” her mother *May Nakato, says.

She says that even when Lisa was older, she couldn’t sit like other children of her age. Someone advised them to take her to a traditional doctor who advised that a hole is dug and Lisa sit in it for a couple of hours a day with a blanket wrapped around her to keep her straight so as to strengthen her back. After three months, she could sit and even started walking. However, she still couldn’t see well, and when she walked, she kept on bumping and knocking whatever was in her way. That is when her parents started tying her onto a rope.

Nakato says, “I don’t know how the idea came to me. I was helpless when it occurred to me. It was a better solution because we couldn’t afford to take her to a school for the deaf and dumb which is the ideal and best solution.”

An attempt at getting medical help
The seizure 12 years ago was the start of the family’s trips to hospital. Lisa has since been in and out of the hospital. Sometimes she is put on drip. One time she needed a blood transfusion and once, had to be put on oxygen. Usually, she is discharged after staying in hospital for about a week.

The doctors recommended that she is taken to hospital every month for medication saying it would stop her from eating dirty things which the mother says was done for six months. But the parents say there was no change so the teenager continued to spend the day tied on to the tree which is dangerously near an electric pole.

One day a lady saw the child and told Nakato that what she was doing could get her arrested. Nakato acknowledged that and asked her to help them because they had run out of affordable options.

The lady advised her to take the child to Butabika Mental Health Hospital where other children like Lisa stay.

“When we reached there, I found that the children there are not in the same state as my daughter. Though deaf and dumb, they can play with balls, go for short and long calls without help. They also feed themselves and walk with a sense of direction,” says Nakato.

Unlike them, when Lisa is left to walk, she wanders around like a zombie, moving aimlessly and she usually gets lost. Even when she sees other children playing with objects like a ball, she doesn’t seem to have any interest. She doesn’t join in when urged to or even kick or touch the ball when it is given to her.

She urinates and passes stool on herself. When she is given food, she ends up throwing it all over the place because to feed, she scratches it like chicken wasting the food. So she has to be physically fed. But she drinks by herself without taking the cup off her mouth till it is empty and then she throws the cup.

Lisa was taken to Butabika for three days and was given medication. But she got a seizure one day so her father, decided to take her to Mulago Hospital where they were told to take her whenever she got a seizure.

Necessary evil
Though strange at first, the sight of a child tied on the rope is something the neighbours have gotten used to. Her parents have also made their peace with it. It is like a necessary evil. Nakato, a mother of four explains that she has to work to help her husband with financing the home so she can’t stay at home looking after Lisa.

In fact, when her siblings are at school, her mother locks her up inside the house because there is no one to watch over her. “Thankfully, I work nearby so when I leave in the morning, I go back at 10am to give her breakfast and bathe her. I return at 2pm to feed her and at 4pm Lisa is taken to her tree because then, her siblings are around to watch her.”

Though the family says they don’t have relatives with the disability and the rest of the children are normal, before Lisa, they had a child who was in the same state as their daughter. But unlike Lisa he could play, recognised things and when he walked he seemed to know where he was going. He too was tied to a tree during the day because, according to them, it was an easier way to manage him. Unfortunately, he got a seizure and passed on. When Nakato talks about him, it is with a pain in her voice. It explains the emptiness and helplessness with which she talks about Lisa’s state. “I wish we could afford to take her to a school for the deaf and dumb. I am sure it would help.”

Irene Nenduta, a neighbour tried to get help from African Network for Prevention and Protection of Children against Child Neglect and Abuse (ANPPCAN) but wasn’t able to go far. The officials say they think Lisa needs to be taken to a home for children like her but unfortunately ANPPCAN doesn’t know one such. The established ones require that some money is paid, so they are trying to find sponsorship for her.

Courtesy Saturday Monitor