During a village checkup in February 2014 we found Mina lying neglected in her devastated hut. Two of her vertebral bodies were already destroyed by bone TB, thus she could not move anymore. Mina herself believed to have been bewitched by a neighbor thus she gave up and capitulated in the face of the disease. Her husband was totally overstrained with the care for the three children. He was addicted to alcohol and displaced reality. When we saw Mina she was already lying motionless for several weeks on the ground. After transportation to the health centre she was fed with five meals a day. Her youngest child Rupa was admitted as well. The two older children Sunil and Sima soon after visited the boarding school nearby having been made possible due to sponsorship.
The whole Shining Eyes team helped to bring Mina to the centre. In the next days Sunil, Sima and Rupa stayed together with their mother and received food. Silvia lovingly fed Mina. The medical treatment for diagnosed bone as well as lung TB started. One of the older children has got infected by Mina and received the life-saving treatment as well. Rupa the youngest child soon was the sweetheart of the hospital.
Left: Mina´s hut destroyed by the monsoon and neglected.
Right: Mina´s hut after reconstruction.
We felt the need to contribute to the restructuring of her home.
Jayanta -our social worker, was the driving force to renovate the hut. He made also neighbors to help rebuilding the home. Further he gave emotional support to the father who now understands the necessity to assume responsibility. With the new home the father himself had new confidence in his life and could draw sufficient strength from it.
Two months after we have brought Mina to our centre she could already sit in the wheel chair. Two weeks later she was blossoming, able to walk and presented her newly arisen life forces.
After one year of stay in our centre Mina was fully strengthened and had doubled her weight. She returns home. Our relation is manifested until today, always when she is in trouble she comes to us. Wonderful.
In July 2013 Maria -a 14-years old girl came to us with severe backpain and breathing problems. We referred her to a government hospital where she had to share one bed with three other patients however no further diagnostics were done. One doctor just referred to physiotherapy. We took her back and brought her to a private clinic to find out the cause of her pain. From there we were sent to Colkatta where we seeked for help from Dr. Swapan -a neurologist who is engaged there. Dr. Swapan arranged a MRT showing spine tuberculosis which already had infected several vertebral bodies and has led to stiffening of the spine.
Immediately a surgery was performed by a neurosurgeon. This surgery prevented Maria from becoming totally hampered and dying a painful death. In the beginning when Maria came to us she was already unable to walk or stand alone and had lost much weigth. After several weeks along with medical treatment she recovered and could move again.
In 2015 we met the three year old girl Minoti. She was not able to hold her head properly, which was powerless lying on her shoulders. We diagnosed spine TB. Several surgeries were indicated. In September 2015 Minoti had to wear a support system which was also connected to her bones. Regular cleaning of the open wounds was necessary.
Today Minoti can hold her head again by herself -only a neck ruffle is still needed. Soon she will be fully recovered.
He came with high fever fistula at the lymphnode at the neck, swelling of abdomen, diagnosed as LN- TB and abdomen TB.
Our Tb specialist from Kolkata treated him over one year and then he could return healthy home and started again with the school.
In 2015 a two year old girl came to our outpatient clinic with pus fistula at her lower leg. The X-ray image showed that her shinbone had almost disappeared with some bone splinters left behind. Bristi was found to be TB-positive which was the real cause of the chronic bone infection. Meanwhile several surgeries have been implemented in Kolkata to restructure the bone. Today Bristi is fully recovered.
Mono was found in the village Panchabanpur during routine medical checkup. She complained about weakness. Her paleness indicated an alarming low hemoglobin level which was confirmed (1.5g/dl) by the rapid test HemoCue 201+ system. Immediately we transferred her to a hospital for blood transfusion. However in India it is quite complicated to receive blood. It is common to bring your own blood donors along with you. Mono needed two donors due to the severity of anemia. Her relatives refused to give their blood. However neighbors were willing to help her -luckily both had the right blood group. The blood transfusion was successful but not strong enough to keep Mono alive, some days later she died.
Chobi came with severe anemia in our OPD. Hb 2.5g/dl. We guided the family to receive blood transfusion, because they couldn´t understand the threatening of Chobi´s life. After successful blood transfusion we visited their village and their house. Altogether we found poor life conditions: the father was engaged in daily labour with irregular income. They have three children and the mother and the father are mentally retarded. They receive some support from their parents in law to master day by day. However the house was broken down and the only food was rice, puffed rice, and potatoes during the rainy season as indoor there was no cooking facility. Moreover there was no awareness and no knowledge about health, hygiene and valuable food. The family lived socially isolated in the village. No preventive check up during pregnancy, delivery at home, no birth certificate, no immunisation, no acces to ICDS centre. no land, no kitchen garden. No BPL or MGNREGA card and thereby no acces to ration shop.
The mother and her three children were admitted in our hospital. During admission they received a balanced nutrition and training, with 5 meals per day, rich in protein, viatamins and minerals. Every day they got teaching about hygiene with practicable use during the day, further how to recognize emergency signs of sickness in the child, valuable feeding to the children with daily care and affection. Our village health worker guided them how to find access to and register for the governmental Anganwadi Centers providing six meals a week to children. Further a kitchen garden was started on the small land available. One neighbour family was trained to cook for this family at the beginning. Slowly the mother learned to change the life habits for a better development. Chobi came up and started to walk and got open for social communication. The mother could overbear her depression. She could regain her own value and respect as a human being under God´s blessing.
All three children of the family now maintain an Hb over 10mg% and could reduce their severe infection rate (pneumonia). Still, the family regularly seeks help in our centre as now a trustful connection is created.
Duli was pregnant and suffered in November 2015 from symptoms of life-threatening preeclampsia. We found her during a village checkup with swollen feet and increased blood pressure. We brought her to our health care centre and in the night her amniotic sac broke -too early for the 30th week of gestation. Immediately we brought her in a government hospital.
The admission was successful and Duli got a beautiful baby girl in the night. We thank God that this child was not born in the village where her chances of survival would have been much lower.
We were glad and grateful to see Duli and her infant in February 2016 during a village checkup again. Unfortunately Duli´s family felt no need to agree to any further admission for supplementary food. Attempts of persuasion failed. On the picture her child is three months old.
Here we see a low birth weight baby with 1800g, suffering from a weak larynx, thereby inducing difficulties in swallowing. We started supplementary feeding, however the mother accused the vitamin drops to be the reason for the drinking problems of her newborn and she went back home. However the health condition of the newborn got soon worse. After some time we could convince her to come back to the health care centre. The baby soon gained weight by the help of a gastric tube.
One day a teacher came to the OPD and he layed down a newborn baby. Hopeful he told us: “if this boy had a chance, then in the care of this health care centre.” He told the baby was born not after the 30th week of pregnancy with merely 1500g. Luckily this baby was able to breathe itself. We wrapped the boy in warm blankets. With a syringe we could infuse small amounts of milk in his mouth. This we did successfully over some weeks until the baby was able to drink himself from mothers´ breasts. Some months later we met the boy again and he had regained strength and became a healthy boy.
In our OPD we welcomed a mother with a premature child of 1100g and mild infection. Our child specialist showed her kangaroo care and appropriate infant and young child feeding practices for protection of further infection. The mother followed his advice and came regulary for check up. The child developed nicely under our teaching and nutrition training.
Left: we see an infant suffering from severe wasting (having too low weight for height according growth reference standards)
Right: we see two boys in similar age (around 6 years old). The left one experiences healthy nutrition, the right one suffers from chronic malnutrition stunting (being too short for age according growth reference standards).The condition of stunting is hard to see without direct comparison as the child is normally-proportionated.
A malnourished pregnant woman will give birth to an already growth delayed child. This child continues to become weaker with inappropriate feeding methods like non-exclusive breastfeeding or inadequate complementary feeding. By lacking adequate nutrition and stimulation for cognitive and physical development later on this child grows to an adult with hampered work capacity, implying low average wages and continuance of low economic status of the household, again resulting in food insecurity. As a child is the beginning of a new generation the focus of concern should be on mothers and children.
Source adopted from UN ACC/SCN, 2004 in Jallow, 2006.
Frequently we find diverse signs of malnutrition in the villages:
vitamin A deficiency (pictures on top): Nightblindness, followed by Bitot´s spots and foam cells -a sign of severe vitamin A deficiency can result in irreversible blindness without supplementation. (Left picture from Unicef Ethiopia)
Iron deficiency anemia (left pictures in the middle): common signs are weakness, paleness of skin, tongue, sklera, nailbed.
vitB deficiencies: resulting in skin irritations, dry or cracked skin
Folic acid deficiency (pictures on the bottom) during pregnancy results in birth defects in the newborn like cleft palate or neural tube defects.
Neurological children visit the physiotherapy nearby. Most of these children suffer due to birth obstructions from their handicap.
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