Care for All: Build a Mobile Clinic for Rural Gulu

With the availability of good services, Karin Medical Services, has had a tremendous improvement in health services delivery and an influx of patients especially young children. Among the common health problems identified in the clinic is the concept of false tooth, its presentation and the management practices.

False teeth among children are a Public Health problem which has not received adequate attention in Uganda. False teeth are a common problem among children mainly affecting children of two years old with no sex differences. It is believed to be caused by witchcraft and at times it comes on its own. This disease causes diarrhea, Acute Respiratory infection (ARI), fever and loss of appetite, restlessness and vomiting which are also believed to be key signs and symptoms for the disease. It seems there are no home remedies for the treatment of false teeth. “Oral/dental surgery” is mostly used as the common form of treatment of “false teeth and rubbing of teeth. 

For Apio, this was the case with her 8 months old baby. She was told that her child was suffering from false teeth. Her baby had been suffering from diarrhoea for the last one week, she had lost weight and was no longer taking breast milk. She spent sleepless nights worrying about her child, until one day her neighbour told her to visit the local herbalist. The local herbalist rubbed some herbs on the baby’s gum and using a sharp instrument removed something which looked white, and she was told that this was the cause of the baby pain. He assured her that the baby will be well. With a bit of relief, Apio left for home, however, her child was in such great pain and cried all day. Unable to bear this Apio, decided to visit the Karin Medical Centre, she explained to the clinical officer the condition of her child and her visit to the local herbalist.   

“In this community the knowledge about “false teeth” treatment is quite rife, with many mothers resorting to home remedies for the treatment of false teeth and rubbing of teeth. One of the greatest challenges of this practice is that the herbalist do not sterilise their instruments and no anesthesia of any kind is given to the children”, noted the Clinical officer of the Karin Medical Centre. The clinical officer, noticed the bleeding in the child and provided the necessary treatment. 

False teeth are still a community Oral Health problem among children which needs emergency action especially in this era of AIDS/HIV. The community needs more understanding on the issue of false teeth. 

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As we celebrate World Malaria Day I reflect on what we have done to prevent malaria and the challenges parents go through.

I met her in the clinic when she brought her five weeks old baby. Neatly wrapped in a yellow sheet. Her first baby, it broke her heart to see the baby in pain. "He not breastfeeding well," she said, in a low tone. I could see the pain in her face. As we got talking she shared with me how much she loved her baby and that when it came to naming him. She searched for the best names until she settled for Lagum, meaning "the lucky one". 

I have had the honour to lead this organisation, and as a public health specialist, part of my work involves training volunteers and staff to reduce the disease burden- to fight malaria in the communities.  As I watched the staff working with the patients, I am proud to see the impact we have contributed in fighting this disease.

Last year's malaria epidemic in the region has made me think less and less about the children saved and more and more about the children that still need to be saved. Last year 162 people died of malaria in various health facilities in Northern Uganda and 22,873 case were registered. Sadly, most of those were children under 5 years old. To me, these numbers are so disturbing. However, I am still grateful that we manage to reduce the malaria mortality. 

Over the years we have spent much time working in preventing malaria, however, to me the most painful part is witnessing death in children.  The memories of one particularly has remained etched in my mind till this day.  

As a mother these memories have remained row. I keep thinking of the mother whose child had severe malaria, he was convulsing when they brought him in the clinic. With her hands over her head, her face was full of fear. She could hardly explain the child's' condition. I know the trouble she is going through as I have also nursed my own children. 

In the years we have worked in this community, we have touched the lives of thousands with malaria prevention efforts.  In our small ways we have lent a small but humble hand to the national scale bed net distribution campaigns. We have walked in the villages and tied up the bed nets for those that could not do it themselves. We go back and check that they are still using these bed nets or they need new ones.

We touch the communities everyday in ways big and small. In the villages we converse with the ladies and share with them simple ideas of how to reduce the breeding of mosquitos around their homes. We advice them on what to do once they feel sick. Its these simple conversations that make a difference in people lives.

For now I will continue working at teaching on the prevention of this disease. I will continue talking about what they should do to prevent from being bitten by the mosquitoes. I am thankful that with the tools we have managed to keep children safe under the bed nets at night with the insect treated mosquito nets, that the staff providing good and coordinated treatment that involves all the line health workers.

Malaria is real and yet its preventable. I thank you for what you have done so far in ensuring that we have the medicines to test and treat for malaria. The struggle is not yet over untit we eradicate malaria completely. It is possible.

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