Encephalitis affecting children

Iraqi doctors have recorded an increase in cases of encephalitis in the Iraqi capital, Baghdad, over the last two weeks, raising concerns about the state of children's healthcare in the country. This adds to a recent report by a leading health NGO which found that youngsters remained vulnerable to malnutrition. "We have diagnosed 10 cases of encephalitis over the last two weeks," Uday Abdel Rada, a senior doctor in the emergency ward of Baghdad's Central Teaching Hospital, told IRIN. He said there was little the doctors could due to contain "the outbreak" of encephalitis, a viral disease that causes swelling of the brain. "We have seen a significant increase in the number of cases since the war ended," Rada said. But he said it has been hard to treat the virus given the poor condition of Iraqi medical infrastructure after the US-led invasion of Iraq toppled Saddam Hussein's former regime on 9 April. "We need to isolate the virus and have a greater supply of oxygen," the health official said. "But it is very difficult to diagnose the outbreak at this point because we don't have the necessary material." Rada explained that the disease was causing long-term damage to children because it was going untreated. If left untreated, encephalitis causes long-term mental disorders. The virus is spread from droplets, such as saliva, or from blood. Of the 40 patients Rada provided care for over an eight hour working day most of them were suffering from bronchitis or illnesses related to malnutrition, which is still common among Iraqi children. According to a recent report from the International Medical Corporation (IMC) NGO's office in Baghdad, Iraqi children still remain vulnerable to the threat of malnutrition due to the combination of socio-economic and environmental factors. UNICEF estimated that around 400,000 children suffered from malnourishment at the close of the recent conflict. But there has been no in depth studies published on the full impact of sanctions and war on the mental and nutritional status of Iraqi children. "It is difficult to obtain figures on child malnutrition in Iraq," Tanya Habjouqa, an IMC communication's officer in Baghdad, told IRIN. But this doesn't mean there are no efforts to combat it. IMC Iraq implemented a Community Child Care Unit (CCCU) programme from 15 July to 30 September. Habjouqa said the IMC programme enabled the Iraqi community to actively participate in supporting the well being of their children. The programme was restarted in conjunction with the Iraqi Ministry of Health to improve the living conditions for children younger than five years of age and to encourage women to breast-feed their children. According to Habjouqa, the IMC had successfully revived 709 CCCU's in five governorates - Missan and Wassit in the southeast, Diyala in the centre east, and Mosul and Kirkuk in the north - and has trained over 1,718 volunteers in the areas of nutrition, malnutrition, communicable disease management, hygiene and vaccination assessment. Of the 193,798 children registered in the whole Missan and Wassit CCCU's, IMC found 55,593 children diagnosed as moderately malnourished and 1,115 children as severely malnourished between the months of July and September of 2003. Under the programme's mandate, the IMC distributed desks, chairs, calculators, growth charts, uniscales and educational material. This provided for the "rapid revitalisation of the programme as the CCCU's flourished and proved to be an integral part in the surveillance of child health," Habjouqa said. IMC efforts were needed to revitalise the programme and improve health awareness. The weak state of CCCU's at the end of the war, contaminated water supplies, abrupt disruption in public health and poor socio-economic factors left Iraqi children susceptible to malnutrition and communicable diseases. "There years ago, CCCU's completely collapsed and became merely distributors of high protein biscuits," IMC nutritionist Jean Luboya said. "IMC sought to build the capacity of the local communities, revitalising UNICEF's community approach to nutrition." Habjouqa explained that to help prevent malnutrition and catch it in the early stages, they had trained volunteers to diagnose children and coach parents in better health and nutrition practices. "CCCUs are teaching nutritional practices such as breast-feeding, to avoid the devastating combination of contaminated water and baby formulae," Luboya emphasised. "Such intervention can drastically improve the lives of children in Iraq," she added. The CCCU volunteers were also trained to take children to a primary health care centre if the malnutrition is more advanced for further assessment and the prescription of high protein biscuits. If the condition is severe, the CCCU volunteers were trained to take children to a general hospital. Habjouqa explained that IMC nutrition intervention in Iraq was rapid and effective. "Continued monitoring visits show that CCCU's are fully functioning and sustainable and community volunteers are eager and motivated," she said. She argued that as NGOs and international organisations carry out future interventions, CCCUs will prove to be an indispensable tool to gauge the health of children and as a mechanism for reliable statistics on the nutritional status of Iraqi children. But for Iraqi doctors like Rada at the Children's Teaching Hospital, there remains much work to be done to protect the health of children. "You can see the children here," Rada said. "There is much suffering among them. "No one seems to be helping them. We have been to the ministry of heath for assistance and to the Americans. We have received nothing so far," he maintained.