Basic services needed to save babies
5 October 2009, 13:45
By Esther Lewis and Lavern De Vries
Staff Reporters
Toddler Sanele Qaqa should have been running around his home by now. Instead, his family is grieving his death, which could have been prevented.
Sanele, the youngest of six children, died in March, just two weeks ahead of his second birthday.
There are no photo albums or toys as reminders of the toddler.
All the Qaqas have is an old hand-me-down bicycle he loved playing with ... and the grim image of his blue lips and limp body in bed at the Red Cross Children's Hospital.
A shocking 37 city children younger than five died of diarrhoea in February, March and April - deaths that could easily have been avoided.
In 2005, more than 100 children, most of them from poverty-stricken areas, died, statistics show.
But health officials are making headway in the war on this disease.
According to the Department of Health, the main contributors to the death rate are lack of access to potable water, and inadequate sanitation, sewerage services, and hygiene practices.
The deaths earlier this year were largely concentrated in informal settlements where access to clean water was limited.
The city has said that although it spends R10-million a year installing sanitation infrastructure, it is costing it R60m a year to repair infrastructure that has been damaged.
Broken toilets, stagnant pools of dirty water and human waste are common in informal settlements. These are the conditions in which disease thrives.
Children younger than five are especially vulnerable to diarrhoea.
Sanele lived with his parents and grandmother in a two-bedroomed house in Crossroads. Although the house has taps, the toilet does not flush. The bathroom does not have a bath or shower.
Opposite the house are several shacks with even worse sanitation. This is where he played daily with his siblings and friends.
On March 26, after playing outside, he said he felt very sleepy. Minkie Qaqa picked up her little boy and lay him down for an afternoon nap. It was only later that day that her husband noticed Sanele had become very weak.
Qaqa took her son to the KTC clinic, where staff administered a drip. She stayed at his side until midnight. She changed his nappy and realised his tiny body was stiff.
Qaqa slapped him lightly, but Sanele did not respond. His eyes were open, but not focused.
At about 2am, Sanele was rushed to the Red Cross Children's Hospital, where doctors told the Qaqas that Sanele was in a serious condition. He had stopped breathing by the time he reached the hospital - he was brain-dead.
Doctors told the family there was nothing they could do to save him.
Sanele died the following day, March 28.
One week earlier, on March 17, one-year-old Unabantu Mali died, tied to the back of his grandmother, as she made the two-hour walk home after allegedly being turned away from three health-care centres at which she had sought help for the boy, who had diarrhoea.
A probe later cleared the facilities of wrongdoing.
Sanele was one of 3 586 children admitted to hospital for diarrhoea in the past year.
Provincial health department spokeswoman Faiza Steyn said there was no accurate picture of deaths from diarrhoea that occurred outside hospitals.
Twelve children died in the Eastern District, which includes such areas as Mfuleni and Blue Downs, and eight in the Khayelitsha subdistricts.
Of the 37 children who died, four had malnutrition and 12 were HIV-positive. Dehydration was the direct cause of the deaths of 14 of the children, said Steyn.
The diarrhoea was caused by exposure to bacteria and viruses carried in impure water. Germs were transmitted to babies and children through bottles or cups prepared with contaminated water.
According to Jaco Muller, of the City of Cape Town's water and sanitation department, the capital expenditure for these services was R23m, while operating expenditure was R80m.
The city has 223 informal settlements. The number of toilets needed was 27 052. In May, there were 2 078.
The required number of standpipes providing potable water was 5 148, compared with the 4 402 that were in place.
"If all families were to have ready access to clean potable water, the risk of contamination would be considerably reduced," said Steyn.
"The risk would be further reduced if water was stored in clean containers that were cleaned regularly."
While 37 deaths in three months is high, the mortality rate has improved since 2005, when more than 100 children in the metropole died.
The provincial and city health departments have tried to curb the number of deaths through, among other things, awareness campaigns.
From April 1 next year, a new vaccine is to be introduced that can reduce the incidence and severity of diarrhoea.
Staff Reporters
Toddler Sanele Qaqa should have been running around his home by now. Instead, his family is grieving his death, which could have been prevented.
Sanele, the youngest of six children, died in March, just two weeks ahead of his second birthday.
There are no photo albums or toys as reminders of the toddler.
All the Qaqas have is an old hand-me-down bicycle he loved playing with ... and the grim image of his blue lips and limp body in bed at the Red Cross Children's Hospital.
A shocking 37 city children younger than five died of diarrhoea in February, March and April - deaths that could easily have been avoided.
In 2005, more than 100 children, most of them from poverty-stricken areas, died, statistics show.
But health officials are making headway in the war on this disease.
According to the Department of Health, the main contributors to the death rate are lack of access to potable water, and inadequate sanitation, sewerage services, and hygiene practices.
The deaths earlier this year were largely concentrated in informal settlements where access to clean water was limited.
The city has said that although it spends R10-million a year installing sanitation infrastructure, it is costing it R60m a year to repair infrastructure that has been damaged.
Broken toilets, stagnant pools of dirty water and human waste are common in informal settlements. These are the conditions in which disease thrives.
Children younger than five are especially vulnerable to diarrhoea.
Sanele lived with his parents and grandmother in a two-bedroomed house in Crossroads. Although the house has taps, the toilet does not flush. The bathroom does not have a bath or shower.
Opposite the house are several shacks with even worse sanitation. This is where he played daily with his siblings and friends.
On March 26, after playing outside, he said he felt very sleepy. Minkie Qaqa picked up her little boy and lay him down for an afternoon nap. It was only later that day that her husband noticed Sanele had become very weak.
Qaqa took her son to the KTC clinic, where staff administered a drip. She stayed at his side until midnight. She changed his nappy and realised his tiny body was stiff.
Qaqa slapped him lightly, but Sanele did not respond. His eyes were open, but not focused.
At about 2am, Sanele was rushed to the Red Cross Children's Hospital, where doctors told the Qaqas that Sanele was in a serious condition. He had stopped breathing by the time he reached the hospital - he was brain-dead.
Doctors told the family there was nothing they could do to save him.
Sanele died the following day, March 28.
One week earlier, on March 17, one-year-old Unabantu Mali died, tied to the back of his grandmother, as she made the two-hour walk home after allegedly being turned away from three health-care centres at which she had sought help for the boy, who had diarrhoea.
A probe later cleared the facilities of wrongdoing.
Sanele was one of 3 586 children admitted to hospital for diarrhoea in the past year.
Provincial health department spokeswoman Faiza Steyn said there was no accurate picture of deaths from diarrhoea that occurred outside hospitals.
Twelve children died in the Eastern District, which includes such areas as Mfuleni and Blue Downs, and eight in the Khayelitsha subdistricts.
Of the 37 children who died, four had malnutrition and 12 were HIV-positive. Dehydration was the direct cause of the deaths of 14 of the children, said Steyn.
The diarrhoea was caused by exposure to bacteria and viruses carried in impure water. Germs were transmitted to babies and children through bottles or cups prepared with contaminated water.
According to Jaco Muller, of the City of Cape Town's water and sanitation department, the capital expenditure for these services was R23m, while operating expenditure was R80m.
The city has 223 informal settlements. The number of toilets needed was 27 052. In May, there were 2 078.
The required number of standpipes providing potable water was 5 148, compared with the 4 402 that were in place.
"If all families were to have ready access to clean potable water, the risk of contamination would be considerably reduced," said Steyn.
"The risk would be further reduced if water was stored in clean containers that were cleaned regularly."
While 37 deaths in three months is high, the mortality rate has improved since 2005, when more than 100 children in the metropole died.
The provincial and city health departments have tried to curb the number of deaths through, among other things, awareness campaigns.
From April 1 next year, a new vaccine is to be introduced that can reduce the incidence and severity of diarrhoea.
- This article was originally published on page 8 of The Cape Argus on October 05, 2009
Durban
