Asthma

A person with asthma has fits or attacks of difficult breathing. Listen for a hissing or wheezing sound, especially when breathing out. When he breathes in, the skin behind his collar bones and between his ribs may suck in as he tries to get air. If the person cannot get enough air, his nails and lips may turn blue, and his neck veins may swell. Usually there is no fever. Asthma often begins in childhood and may be a problem for life. It is not contagious, but is more common in children with...

Infectious Diseases

Infectious diseases are caused by bacteria and other organisms (living things) that harm the body. They are spread in many ways. Here are some of the most important kinds of organisms that cause infections and examples of sicknesses they cause different antibiotics for different bacterial infections colds, flu, measles, mumps, chickenpox, infantile paralysis, virus diarrhea from someone who is sick, through the air, by coughing, flies, etc. aspirin and other painkillers (There are no medicines...

Finding Out What Progress Has Been Made Evaluation

From time to time in your health work, it helps to take a careful look at what and how much you and your people have succeeded in doing. What changes, if any, have been made to improve health and well-being in your community You may want to record each month or year the health activities that can be measured. For example How many families have put in latrines How many farmers take part in activities to improve their land and crops How many mothers and children take part in an Under-Fives...

Antibiotics

The Penicillins Very Important Antibiotics Penicillin G or V 351 Short-acting penicillin crystalline penicillin, benzylpenicillin, penicillin G,aqueous penicillin, soluble penicillin, sodium penicillin, potassium penicillin 352 Intermediate-acting penicillin procaine penicillin, procaine penicillin aluminum monostearate (PAM) 352 Ampicillin and Amoxicillin Wide-Range (Broad-Spectrum) Penicillins 353 Penicillin with Streptomycin 354 Erythromycin An Alternative to Penicillin . . 355 Tetracyclines...

Minor Problems during Pregnancy

Nausea or vomiting Normally, this is worse in the morning, during the second or third month of pregnancy. It helps to eat something dry, like crackers or dry bread, before you go to bed at night and before you get out of bed in the morning. Do not eat large meals but rather smaller amounts of food several'times a day. Avoid greasy foods. Tea made from mint leaves also helps. In severe cases, take an antihistamine (see p. 386) when you go to bed and when you get up in the morning. 2. Burning or...

Sinus Trouble Sinusitis

Sinusitis is an acute or chronic (long-term) inflammation of the sinuses or hollows in the bone that open into the nose. It usually occurs after a person has had an infection of the ears or throat, or after a bad cold. Pain in the face above and below the eyes, here (It hurts more when you tap lightly just over the bones, or when the person bends over.) Thick mucus or pus in the nose, perhaps with a bad smell. The nose is often stuffy. Sniff a little salt water into the nose (see p. 164), or...

These Two Children Are Malnourished

Underweight (he n gain weight for a ' because of swellir dark spots, peeling skin, or open sores underweight (he n gain weight for a ' because of swellir dark spots, peeling skin, or open sores Malnutrition may cause many different problems in children, including In mild cases In more serious cases desire to eat dirt (anemia) frequent colds and other infections little or no weight gain swelling of feet (sometimes face also) dark spots, 'bruises', or open peeling sores thinness or loss of hair...

Other Important Illnesses Of Old Age Heart Trouble

Heart disease is more frequent in older people, especially in those who are fat, who smoke, or who have high blood pressure. Anxiety and difficulty in breathing after exercise asthma-like attacks that get worse when the person lies down (cardiac asthma). A rapid, weak, or irregular pulse. Swelling of the feet worse in the afternoons. Anxiety and difficulty in breathing after exercise asthma-like attacks that get worse when the person lies down (cardiac asthma). A rapid, weak, or irregular...

Sore throat and the danger of rheumatic fever

For the sore throat that often comes with the common cold or flu, antibiotics should usually not be used and will do no good. Treat with gargles and acetaminophen (or aspirin). However, one kind of sore throat called strep throat should be treated with penicillin. It is most common in children and young adults. It usually begins suddenly with severe sore throat and high fever, often without signs of a cold or cough. The back of the mouth and tonsils become very red, and the lymph nodes under...

Witchcraftblack Magicand The Evil

If a person believes strongly enough that someone has the power to harm him, he may actually become ill. Anyone who believes he is bewitched or has been given the evil eye is really the victim of his own fears (see Susto, p. 24). A 'witch' has no power over other people, except for her ability to make them believe that she has. For this reason It is impossible to bewitch a person who does not believe in witchcraft. Some people think that they are 'bewitched' when they have strange or...

The Limitations of Home Remedies

Some diseases are helped by home remedies. Others can be treated better with modern medicine. This is true for most serious infections. Sicknesses like pneumonia, tetanus, typhoid, tuberculosis, appendicitis, diseases caused by sexual contact, and fever after childbirth should be treated with modern medicines as soon as possible. For these diseases, do not lose time trying to treat them first with home remedies only. It is sometimes hard to be sure which home remedies work well and which do...

Words To The Village Health Worker

A village health worker is a person who helps lead family and neighbors toward better health. Often he or she has been selected by the other villagers as someone who is especially able and kind. Some village health workers receive training and help from an organized program, perhaps the Ministry of Health. Others have no official position, but are simply members of the community whom people respect as healers or leaders in matters of health. Often they learn by watching, helping, and studying...

Beliefs That Can Make People Well

Some home remedies have a direct effect on the body. Others seem to work only because people believe in them. The healing power of belief can be very strong. For example, I once saw a man who suffered from a very bad headache. To cure him, a woman gave him a small piece of yam, or sweet potato. She told him it was a strong painkiller. He believed her and the pain went away quickly. It was his faith in her treatment, and not the yam itself, that made him feel better. iij'tj Many home remedies...

Tapeworm

In the intestines tapeworms grow several meters long. But the small, flat, white pieces (segments) found in the feces are usually about 1 cm. long. Occasionally a segment may crawl out by itself and be found in the underclothing. People get tapeworms from eating pork (pig meat), beef (cow meat) or other meat or fish that is not well cooked. Prevention Be careful that all meat is well cooked, especially pork. Make sure no parts in the center of roasted meat or cooked fish are still raw. The worm...

A silent belly is like a silent dog Beware

These pictures show the areas of the belly that usually hurt when a person has the following problems low back pain often goes around the waist to the lower part of the belly Inflammation or tumor of the ovaries, or out-of-place pregnancy , etc. pain on one side or both, sometimes spreading to the back Note For different causes of back pain see d. 173.

Using Local Resources To Meet Needs

How you deal with a problem will depend upon what resources are available. Some activities require outside resources (materials, money, or people from somewhere else). For example, a vaccination program is possible only if vaccines are brought in often from another country. Other activities can be carried out completely with local resources. A family or a group of neighbors can fence off a water hole or build simple latrines using materials close at hand. Some outside resources, such as...

Correct Uses Of Laxatives And Purges

Laxatives are like purges but weaker. All the products listed above are laxatives when taken in small doses and purges when taken in large doses. Laxatives soften and hurry the bowel movement purges cause diarrhea. Purges The only time a person should use a strong dose of a purge is when he has taken a poison and must clean it out quickly (see p. 103). At any other time a purge is harmful. Laxatives One can use milk of magnesia or other magnesium salts in small doses, as laxatives, in some...

Anabolic steroids Nandrolone decanoate Durabolin Deca Durabolin Orabolin stanozolol Cetabon oxymetholone Anapolon

There are many other brand names.) Anabolic steroids are made from male hormones and are mistakenly used in tonics to help children gain weight and grow. At first the child may grow faster, but he will stop growing sooner and end up shorter than he would have if he had not taken the medicine. Anabolic steroids cause very dangerous side effects. Girls grow hair on their faces like boys, which does not go away, even when the child stops taking the medicine. Do not give growth tonics...

Men And Women Who Are Not Able To Have Children Infertility

Sometimes a man and woman try to have children but the woman does not become pregnant. Either the man or woman may be infertile (unable to bring about pregnancy). Often nothing can be done to make a person fertile, but sometimes something can be done, depending on the cause. 1. Sterility. The person's body is such that he or she can never have children. Some men and women are born sterile. 2. Weaknesses or a nutritional lack. In some women severe anemia, poor nutrition, or lack of iodine may...

High Blood Pressure Hypertension

High blood pressure can cause many problems, such as heart disease kidney disease, and stroke. Fat people are especially likely to have high blood pressure. Signs of dangerously high blood pressure v f* pounding of the heart and shortness of breath vVv (( with mild exercise occasional pain in the left shoulder and chest All these problems may also be caused by other diseases. Therefore, if a person suspects he has high blood pressure, he should see a health worker and have his blood pressure...

Rheumatic Fever

This is a disease of children and young adults. It usually begins 1 to 3 weeks after the person has had a strep throat (see above). Principal signs (usually only 3 or 4 of these signs are present) joint pain, especially in the wrists and ankles, later the knees and elbows. Joints become swollen, and often hot and red. curved red lines or lumps under the skin in more serious cases, weakness, shortness of breath, and perhaps heart pain If you suspect rheumatic fever, see a health worker. There is...

Appendicitis Peritonitis

These dangerous conditions often require surgery. Seek medical help fast. Appendicitis is an infection of the appendix, a finger-shaped sac attached to the large intestine in the lower right-hand part of the belly. An infected appendix sometimes bursts open, causing peritonitis. Peritonitis is an acute, serious infection of the lining of the cavity or bag that holds the gut. It results when the appendix or another part of the gut bursts or is torn. The main sign is a steady pain in the belly...

An Infection Of The Gums Pyorrhea

Inflamed (red and swollen), painful gums that bleed easily are caused by 1. Not cleaning the teeth and gums well or often enough. 2. Not eating enough nutritious foods (malnutrition). Brush teeth well after each meal, removing food that sticks between the teeth. Also, if possible, scrape off the dark yellow crust (tartar) that forms where the teeth meet the gums. It helps to clean under the gums regularly by passing a strong thin thread (or dental floss) between the teeth. At first this will...

And Other Skin Problems Due To Malnutrition

Pellagra is a form of malnutrition that affects the skin and sometimes the digestive and nervous systems. It is very common in places where people eat a lot of maize (corn) or other starchy foods and not enough beans, meat, fish, eggs, vegetables, and other body-building and protective foods (see p. 110). Skin signs in malnutrition (see the pictures on the following page) In adults with pellagra the skin is dry and cracked it peels like sunburn on the parts where the sun hits it, especially In...

Enlarged Prostate Gland

This condition is most common in men over 40 years old. It is caused by a swelling of the prostate gland, which is between the bladder and the urinary tube (urethra). The person has difficulty in passing urine and sometimes in having a bowel movement. The urine may only dribble or drip or become blocked completely. Sometimes the man is not able to urinate for days. If he has a fever, this is a sign that infection is also present. If the person cannot urinate, he should try sitting in a tub of...

How to read the thermometer using one marked in degrees centigradeC

Turn the thermometer until High Fever The point where the silver line stops marks the temperature. This thermometer marks 40 degrees C. The point where the silver line stops marks the temperature. This thermometer marks 40 degrees C. 1. Clean the thermometer well with soap and water or alcohol. Shake it hard, with a snap of the wrist, until it reads less than 36 degrees. under the tongue (keeping the mouth shut) under the tongue (keeping the mouth shut) in the armpit if there is danger of...

Poisoning

Many children die from swallowing things that are poisonous. To protect your children, take the following precautions Never keep kerosene, gasoline, or other poisons in cola or soft drink bottles, because children may try to drink them. DDT, lindane, sheep dip, and other insecticides or plant poisons medicine (any kind when much is swallowed take special care with iron pills) rubbing or wood alcohol Treatment poisonous leaves, seeds, berries, or mushrooms kerosene, paint thinner, gasoline,...

White Spots On The Face And Body

Tinea versicolor is a mild fungus infection that causes small dark or light spots with a distinct and irregular border that are often seen on the neck, chest, and back. The spots may be slightly scaly but usually do not itch. They are of little medical importance. Make a cream with sulfur and lard (1 part sulfur to 10 parts lard) and apply it to the whoie body every day until they disappear. Or use an anti-fungal cream (p. 372). Sodium thiosulfate works better. This is the 'hypo' photographers...

Hemorrhaging Heavy Bleeding

When the placenta comes out, there is always a brief flow of blood. It normally lasts only a few minutes and not more than a quarter of a liter (1 cup) of blood is lost. (A little bleeding may continue for several days and is usually not serious.) WARNING Sometimes a woman may be bleeding severely inside without much blood coming out. Feel her belly from time to time. If it seems to be getting bigger, it may be filling with blood. Check her pulse often and watch for signs of shock (p. 77). To...

Umbilical Hernia Belly Button that Sticks

A belly button that sticks out like this is no problem. No medicine or treatment is needed. Tying a tight cloth or 'belly band' around the_ belly will not help. Even a big umbilical hernia like this one is not dangerous and will often go away by itself. If it is still there after age 5, an operation may be needed. Get medical advice. A 'Swollen Testicle' (Hydrocele or Hernia) If a baby's scrotum, or bag that holds his testicles, is swollen on one side, this is usually because it is filled with...

Signs of Special Risk that Make It Important that a Doctor or Skilled Midwife Attend the Birthif Possible in a Hospital

If regular labor pains begin more than 3 weeks before the baby is expected. If the woman begins to bleed before labor. If there are signs of toxemia of pregnancy (see p. 249). If the woman is suffering from a chronic or acute illness. If the woman is very anemic, or if her blood does not clot normally (when she cuts herself). If she is under 15, over 40, or over 35 at her first pregnancy. If she has had more than 5 or 6 babies. If she is especially short or has narrow hips (p. 267). If she has...

Examples Of Local Names For Sicknesses

Spanish Name EMPACHO (STOPPED-UP GUT) Name in Your Area _ In medical terms empacho (impaction) means that the gut is stopped up or obstructed (see p. 94). But in Mexican villages any illness causing stomach-ache or diarrhea may be called empacho. It is said that a ball of hair or something else blocks a part of the gut. People put the blame on witches or evil spirits, and treat with magic cures and cupping (see picture). Sometimes folk healers pretend to take a ball of hair and thorns out of...

Home Methods For Preventing Pregnancy

Every community has traditional methods to prevent or stop pregnancy. Some of these can help limit the number of children a couple has, but they are usually not as effective as modern methods. Some traditional methods can be harmful, and some do not work at all. For example, washing out the vagina or urinating after sex will not prevent pregnancy. WITHDRAWAL OR PULLING OUT (coitus interruptus). The man pulls his penis out of the woman and away from her genitals before the sperm comes. This...

Is it dangerous to take oral contraceptives

Like all medicines, birth control pills may cause serious problems in certain persons (see next pages), The most serious problems related to the pill are blood clots in the heart, lungs, or brain (see stroke, p. 327). This occurs most often in women over 35 who smoke tobacco. However, the chance of getting dangerous clots is higher when women get pregnant than when they take the pill. But for some women, both pregnancy and taking birth control pills have a higher risk. These women should use...

Other Methods Of Family Planning

THE CONDOM is a thin rubber sheath that covers the man's penis. It prevents the man's sperm from entering the woman's vagina and womb during sex. Condoms made of latex are also the best protection against STDs and HIV AIDS. The condom' should be put on when the man's penis is hard but before it touches the woman's genitals. After he ejaculates (comes), the man should hold the condom and withdraw from the woman's vagina while the penis is still hard. Then take off the condom without spilling the...

Vomiting

Many people, especially children, have an occasional 'stomach upset' with vomiting. Often no cause can be found. There may be mild stomach or gut ache or fever. This kind of simple vomiting usually is not serious and clears up by itself. Vomiting is one of the signs of many different problems, some minor and some quite serious, so it is important to examine the person carefully. Vomiting often comes from a problem in the stomach or guts, such as an infection (see diarrhea, p. 153), poisoning...

Better

The healthiest and most gentle way to have softer, more frequent stools is to drink a lot of water and to eat more foods with lots of natural fiber, or 'roughage' like cassava, yam, or bran (wheat husks) and other whole grain cereals (see p. 126). Eating plenty of fruits and vegetables also helps. People who traditionally eat lots of food with natural fiber suffer much less from piles, constipation, and cancer of the gut than do people who eat a lot of refined 'modern' foods....

A woman who has heavy bleeding after she has missed one or more periods probably is having a miscarriage

A miscarriage is like a birth in that the embryo (the beginning of the baby) and the placenta (afterbirth) must both come out. Heavy bleeding with big blood clots and painful cramps often continues until both are completely out. The woman should rest and take aspirin (p. 379), ibuprofen (p. 380), or codeine (p. 384) for pain. If heavy bleeding continues for many days Get medical help. A simple operation may be needed to clean out the womb (dilatation and curettage, or D and C, or suction). Stay...

Accepting Death

Old people are often more ready to accept their own approaching death than are those who love them Persons who have lived fully are not usually afraid to die. Death is, after all, the natural end of life. We often make the mistake of trying to keep a dying person alive as long as possible, no matter what the cost. Sometimes this adds to the suffering and strain for both the person and his family. There are many occasions when the kindest thing to do is not to hunt for 'better medicine' or a...

Allergic Reactions

An allergy is a disturbance or reaction that affects only certain persons when things they are sensitive or allergic to are . . . Allergic reactions, which can be mild or very serious, include itching rashes, lumpy patches or hives (p. 203) runny nose and itching or burning eyes (hay fever, p. 165) irritation in the throat, difficulty breathing, or asthma (see next page) diarrhea (in children allergic to milk a rare cause of diarrhea, p. 156) An allergy is not an infection and cannot be passed...

Amount See recommended page

Iron (ferrous sulfate), 200 mg. pills (best if pills also contain vitamin C 8. Lindane (gamma benzene hexachloride) and or sulfur powder FOR ITCHING AND VOMITING 9. Promethazine, FOR MILD SKIN INFECTIONS 10. Gentian violet, antibiotic ointment 1 tube 371

And Other Parts Of The Body

Swelling of the feet may be caused by a number of different problems, some minor and others serious. But if the face or other parts of the body are also swollen, this is usually a sign of serious illness. Women's feet sometimes swell during the last three months of pregnancy. This is usually not serious. It is caused by the weight of the child that presses on the veins coming from the legs in a way that limits the flow of blood. However, if the woman's hands and face also swell, she feels...

Antibiotics combined with antidiarrhea medicine

antacids to treat stomach ulcers together with medicine to prevent stomach cramps 2 or more pain medicines (aspirin with acetaminophen sometimes also with caffeine) Injecting calcium into a vein can be extremely dangerous. It can quickly kill someone if not injected very slowly. Injecting calcium into the buttocks sometimes causes very serious abscesses or infections. Never inject calcium without first seeking medical advice Note In Mexico and other countries where people eat a lot of corn...

Balance Between S

A balance between treatment and prevention often comes down to a balance between immediate needs and long-term needs. As a health worker you must go to your people, work with them on their terms, and help them find answers to the needs they feel most. People's first concern is often to find relief for the sick and suffering. Therefore, one of your first concerns must be to help with healing. But also look ahead. While caring for people's immediate felt needs, also help them look to the future....

Basic Guidelines Of Cleanliness

Always wash your hands with soap when you get up in the morning, after having a bowel movement, and before eating. 2. Bathe often every day when the weather is hot. Bathe after working hard or sweating. Frequent bathing helps prevent skin infections, dandruff, pimples, itching, and rashes. Sick persons, including babies, should be bathed daily. 3. In areas where hookworm is common, do not go barefoot or allow children to do so. Hookworm infection causes severe anemia. These worms enter the body...

Bed Sores Pressure Sores

These chronic open sores appear in persons so ill they cannot roll over in bed, especially in sick old persons who are very thin and weak. The sores form over bony parts of the body where the skin is pressed against the bedding. They are most often seen on the buttocks, back, shoulders, elbows, or feet. For a more complete discussion of pressure sores, see Disabled Village Children, Chapter 24. Turn the sick person over every hour face up, face down, side to side. Bathe him every day and rub...

Beliefs That Can Make People Sick

The power of belief can help heal people. But it can also harm them. If a person believes strongly enough that something will hurt him, his own fear can make him sick. For example Actually, the juice did not harm her. What harmed her was her belief that it would make her sick. And what made her well was her faith in injections In this same way, many persons go on believing false ideas about witchcraft, injections, diet, and many other things. Much needless suffering is the result. Perhaps, in a...

Black Widow And Other Spider Bites

The majority of spider bites, including that of the tarantula, are painful but not dangerous. The bite of a few kinds of spiders such as the 'black widow' and related species can make an adult quite ill. They can be dangerous for a small child. A black widow bite often causes painful muscle cramps all over the body, and extreme pain in the stomach muscles which become rigid. (Sometimes this is confused with appendicitis ) Give acetaminophen or aspirin and look for medical help. The most useful...

Bleeding Behind The Cornea Hyphema

Blood behind the cornea is a danger sign. It usually results from an injury to the eye with a blunt object, like a fist. If there is pain and loss of sight, refer the person to an eye specialist immediately. If the pain is mild and there is not loss of sight, patch both eyes and keep the person at rest in bed for several days. If after a few days the pain becomes much worse, there is probably hardening of the eye (glaucoma, p. 222). Take the person to an eye doctor at once.

Bleeding In The White Of The

A painless, blood-red patch in the white part of the eye occasionally appears after lifting something heavy, coughing hard (as with whooping cough), or being hit on the eye. The condition results from the bursting of a small vessel. It is harmless, like a bruise, and will slowly disappear without treatment in about 2 weeks. Small red patches are common on the eyes of newborn babies. No treatment is needed.

Blood Flukes Schistosomiasis Bilharzia

This infection is caused by a kind of worm that gets into the bloodstream. Different types of blood flukes are found in different parts of the world. One kind, common in Africa and the Middle East, causes blood in the urine. Other types, which cause bloody diarrhea, occur in Africa, South America, and Asia. In areas where these diseases are known to occur, any person who has blood in his urine or stools should have a sample of it tested for fluke eggs. * The most common sign is blood in the...

Boils And Abscesses

A boil, or abscess, is an infection that forms a sac of pus under the skin. This can happen when the root of a hair gets infected. Or it can result from v a puncture wound or an injection given with a dirty J . needle. A boil is painful and the skin around it sj r becomes red and hot. It can cause swollen lymph y_ '' Put hot compresses over the boil several times a day (see p. 195). Let the boil break open by itself. After it opens, keep using hot compresses. Allow the pus to drain, but never...

Bones That Have Come Out Of Place At A Joint

Three important points of treatment Try to put the bone back into place. The sooner the better Keep it bandaged firmly in place so it does not slip out again (about a month). Avoid forceful use of the limb long enough for the joint to heal completely (2 or 3 months). Have the injured person lie face down on a table or other firm surface with his arm hanging over the side. Pull down on the arm toward the floor, using a strong, steady force, for 15 to 20 minutes. Then gently let go. The shoulder...

Breast Infection Mastitis and Abscess

Painful breasts and sore or cracked nipples can lead to an infection or abscess (pocket of pus). Part of the breast becomes hot, red, swollen, and very painful. Lymph nodes in the armpit are often sore and swollen. A severe abscess sometimes bursts and drains pus. Keep breast feeding frequently, giving the baby the infected breast first, or milk the breast by hand, whichever is less painful. Rest and drink lots of liquids. Use hot compresses on the sore breast for 15 minutes before each...

Broken Bones Fractures

When a bone is broken, the most important thing to do is keep the bone in a fixed position. This prevents further damage and lets it mend. Before trying to move or carry a person with a broken bone, keep the bones from moving with splints, strips of bark, or a sleeve of cardboard. Later a plaster cast can be put on the limb at a health center, or perhaps you can make a 'cast' according to local tradition (see p. 14). Setting broken bones If the bones seem more or less in the right position, it...

Brucellosis undulant fever Malta fever see p 188

Rises in the afternoon and falls at night. Begins slowly with tiredness, headache, and pains in the bones. Fever and sweating most common at night. Fever disappears for a few days only to come back again. This may go on for months or years. childbirth fever-typical fever pattern

Bullet Wounds in the Arms or Legs

If the wound is bleeding a lot, control the bleeding as shown on page 82. If the bleeding is not serious, let the wound bleed for a short while. This will help clean it out. Wash the wound with cool, boiled water and apply a clean bandage. In the case of a gunshot wound, wash the surface (outside) only. It is usually better not to poke anything into the hole. If there is any possibility that the bullet has hit a bone, the bone may be broken. Using or putting weight on the wounded limb...

Buying Supplies For The Medicine

Most of the medicines recommended in this book can be bought in the pharmacies of larger towns. If several families or the village get together to buy what they need at once, often the pharmacist may sell them supplies at lower cost. Or if medicines and supplies can be bought from a wholesaler, prices will be cheaper still. If the pharmacy does not supply a brand of medicine you want, buy another brand, but be sure that it is the same medicine and check the dosage. When buying medicines,...

Cancer Of The Skin

Skin cancer is most frequent in light-skinned persons who spend a lot of time in the sun. It usually appears in places where the sun hits with most force, especially Skin cancer may take many forms. It usually begins as a little ring the color of pearl with a hole in the center. It grows little by little. Most cancers of the skin are not dangerous if treated in time. Surgery is needed to remove them. If you have a chronic sore that might be skin cancer, see a health worker. To prevent skin...

Cataract

The lens of the eye, behind the pupil, becomes cloudy, making the pupil look gray or white when you shine a light into it. Cataract is common in older persons, but also occurs, rarely, in babies. If a blind person with cataracts can still tell light from dark and notice movement, surgery may let him see again. However, he will need strong glasses afterward, which take time to get used to. Medicines do not help cataracts. (Now sometimes during surgery an artificial lens is put inside the eye so...

Checking if the Baby Is in a Good Position

To make sure the baby is head down, in the normal position for birth, feel for his head, like this 1. Have the mother breathe out all the way. With the thumb and 2 fingers, push in here, just above the pelvic bone. With the other hand, feel the top of the womb. The baby's butt is larger and wider. The baby's butt is larger and wider. 2. Push gently from side to side, first with one hand, then the other. If the baby's butt is pushed gently sideways, the baby's whole body will move too. But if...

Checkups During Pregnancy Prenatal Care

Many health centers and midwives encourage pregnant women to come for regular prenatal before birth) check-ups and to talk about their health needs. If you are pregnant and have the chance to go for these check-ups, you will learn many things to help you prevent problems and have a healthier baby. If you are a midwife, you can provide an important service to mothers-to-be (and babies-to-be) by inviting them to come for prenatal check-ups or by going to see them. It is a good idea to see them...

Childbirth Fever Infection after Giving Birth

Sometimes a mother develops fever and infection after childbirth, often because the midwife was not careful enough to keep everything very clean or because she put her hand inside the mother. The signs of childbirth fever are Chills or fever, headache or low back pain, sometimes pain in the belly, and a foul-smelling or bloody discharge from the vagina. Give penicillin injections of 500,000 units of procaine penicillin twice a day, or 2 pills of 400,000 units 4 times a day for a week (see p....

Childbirth fever see p 276

Begins a day or more after giving birth. Starts with a slight fever, which often rises later. Foul-smelling vaginal discharge. Pain and sometimes bleeding. All of these illnesses can be dangerous. In addition to those shown here, there are many other diseases that may cause similar signs and fever. For example, fevers that last for more than 1 month, or night sweats, may be caused by the HIV AIDS virus (see p. 399). When possible, seek medical help.

Cleanliness

Children are more likely to be healthy if their village, their homes, and they themselves are kept clean. Follow the Guidelines of Cleanliness explained in Chapter 12. Teach children to follow them and to understand their importance. Here the most important guidelines are repeated Bathe children and change their clothes often. Teach children always to wash their hands when they get up in the morning, after they have a bowel movement, and before they eat or handle food. Make latrines or...

Colds and the Flu see p 163

The common cold, with runny nose, mild fever, cough, often sore throat, and sometimes diarrhea is a frequent but not a serious problem in children. Treat with lots of liquids. Give acetaminophen or perhaps aspirin (see p. 379). Let children who want to stay in bed do so. Good food and lots of fruit help children avoid colds and get well quickly. Penicillin, tetracycline, and other antibiotics do no good for the common cold or 'flu'. Injections are not needed for colds. If a child with a cold...

Combined Methods

If you want to be more certain not to become pregnant, it often helps to use 2 methods at the same time. The rhythm or mucus method combined with the use of a condom, diaphragm, foam, or sponge is surer than any of these methods alone. Likewise, if a man uses condoms and the woman a diaphragm or foam, the chance of pregnancy is very low. INJECTIONS. In this family planning method, a woman is given injections of hormones every 1 to 3 months, usually at a health center or family planning clinic,...

Continue breast feeding and also give sips of Rehydration Drink

If vomiting is a problem, give breast milk often, but only a little at a time. Also give Rehydration Drink in small sips every 5 to 10 minutes (see Vomiting, p. 161). If there is no breast milk, try giving frequent small feedings of some other milk or milk substitute (like milk made from soybeans) mixed to half normal strength with boiled water. If milk seems to make the diarrhea worse, give some other protein (mashed chicken, eggs, lean meat, or skinned mashed beans, mixed with sugar or...

Cough

Coughing is not a sickness in itself, but is a sign of many different sicknesses that affect the throat, lungs, or bronchi (the network of air tubes going into the lungs). Below are some of the problems that cause different kinds of .coughs COUGH WITH A WHEEZE OR WHOOP AND TROUBLE BREATHING cold or flu (p. 163) worms when passing through the lungs (p. 140) measles (p. 311) smoker's cough (smoking, p. 149) bronchitis (p. 170) pneumonia (p. 171) asthma (p. 167) smoker's cough, especially when...

Cradle Cap Seborrhea Dandruff

Cradle cap is an oily, yellow crust that forms on a baby's scalp. The skin is often red and irritated. Cradle cap usually results from not washing the baby's head often enough, or from keeping the head covered. Wash the head daily. If possible use a medicated soap (see p. 371). Gently clean off all the dandruff and crust. To loosen the scales and crust, first wrap the head with towels soaked in lukewarm water. Keep the baby's head uncovered, open to the air and sunlight. DO NOT COVER A BABY'S...

Crosseyes And A Wandering Or Lazy Eye Strabismus Squint

If the eye sometimes wanders like this, but at other times looks ahead normally, usually you need not worry. The eye will grow straighter in time. But if the eye is always turned the wrong way, and if the child is not treated at a very early age, she may never see well with that eye. See an eye doctor as soon as possible to find out if patching of the good eye, surgery, or special glasses might help. Surgery done at a later age can usually straighten the eye and improve the child's appearance,...

Danger Signs

The eyes are delicate and need good care. Get medical help fast when any of the following danger signs occurs 1. Any injury that cuts or ruptures (goes through) the eyeball. 2. Painful, grayish spot on the cornea, with redness around the cornea (corneal ulcer). 3. Great pain inside the eye (possibly iritis or glaucoma). 4. A big difference in the size of the pupils when there is pain in the eye or the head. A big difference in the size of the pupils may come from brain damage, stroke, injury to...

Deafness With Ringing Of The Ears And Dizziness

If an older person loses hearing in one or both ears occasionally with severe dizziness and hears a loud 'ringing' or buzzing, he probably has M ni re's disease. He may also feel nauseous, or vomit, and may sweat a lot. He should take an antihistamine, such as dimenhydrinate (Dramamine, p. 387) and go to bed until the signs go away. He should have no salt in his food. If he does not get better soon, or if the problem returns, he should seek medical advice.

Deciding What To Do And Where To Begin

After taking a careful look at needs and resources, you and your people must decide which things are more important and which to do first. You can do many different things to help people be healthy. Some are important immediately. Others will help determine the future well-being of individuals or the whole community. In a lot of villages, poor nutrition plays a part in other health problems. People cannot be healthy unless there is enough to eat. Whatever other problems you decide to work with,...

Deep Chest Wounds

Seek medical help at once. If the wound has reached the lungs and air is being sucked through the hole when the person breathes, cover the wound at once so that no more air enters. Spread Vaseline or vegetable fat on a gauze pad or clean bandage and wrap it tightly over the hole like this (CAUTION If this tight bandage makes breathing more difficult, try loosening or removing it.) Put the injured person in the position in which he feels most comfortable. If...

Deep Wounds in the Abdomen

Any wound that goes into the belly or gut is dangerous. Seek medical help immediately. But in the meantime Cover the wound with a clean bandage. If the guts are partly outside the wound, cover them with a clean cloth soaked in lightly salted, cool, boiled water. Do not try to push the guts back in. Make sure the cloth stays wet. If the wounded person is in shock, raise his feet higher than his head. Give absolutely nothing by mouth no food, no drink, not even water unless it will take more than...

Dehydration

Most children who die from diarrhea die because they do not have enough water left in their bodies. This lack of water is called dehydration. Dehydration results when the body loses more liquid than it takes in. This can happen with severe diarrhea, especially when there is vomiting too. It can also happen in very serious illness, when a person is too sick to take much food or liquid. People of any age can become dehydrated, but dehydration develops more quickly and is most dangerous in small...

Diarrhea and Dysentery

(For more complete information see p. 153 to 160.) The greatest danger to children with diarrhea is dehydration, or losing too much liquid from the body. The danger is even greater if the child is also vomiting. Give Rehydration Drink (p. 152). If the child is breast feeding, continue giving breast milk, but give Rehydration Drink also The second big danger to children with diarrhea is malnutrition. Give the child nutritious food as soon as he will eat. In small children, high fever (over 39 )...

Diarrhea like rice water Cholera

'Rice water' stools in very large quantities may be a sign of cholera. In countries where this dangerous disease occurs, cholera often comes in epidemics (striking many people at once) and is usually worse in older children and adults. Severe dehydration can develop quickly, especially if there is vomiting also. Treat the dehydration continuously (see p. 152), and give tetracycline (p. 356), co-trimoxazole (p. 358), or chloramphenicol (p. 357). Cholera should be reported to th authorities....

Diet and Cleanliness

As was explained in Chapter 11, after she gives birth to a baby, the mother can and should eat every kind of nutritious food she can get. She does not need to avoid any kind of food. Foods that are especially good for her are milk, cheese, chicken, eggs, meat, fish, fruits, vegetables, grains, beans, groundnuts, etc. If all she has is corn and beans, she should eat them both together at each meal. Milk and other dairy products help the mother make plenty of milk for her baby. The mother can and...

Diphtheria

This begins like a cold with fever, headache, and sore throat. A yellow-gray coating or membrane may form in the back of the throat, and sometimes in the nose and on the lips. The child's neck may become swollen. His breath smells very bad. If you suspect that a child has diphtheria Put him to bed in a room separate from other persons. Get medical help quickly. There is special antitoxin for diphtheria. Give penicillin, 1 tablet of 400,000 units, 3 times a day for older children. Have him...

Dosage Information

1 4 tablet one quarter or one fourth of a tablet 1 8 tablet one eighth of a tablet (dividing it into 8 equal pieces and taking 1 piece) DECIDING DOSAGE BY HOW MUCH A PERSON WEIGHS In these pages most instructions for dosage are given according to the age of a person so that children get smaller doses than adults. However, it is more exact to determine dosage according to a person's weight. Information for doing this is sometimes included briefly in parentheses ( ), for use of health workers who...

Double Vision

If double vision comes suddenly, is chronic, or gradually gets worse, it is probably a sign of a serious problem. Seek medical help. If double vision occurs only from time to time, it may be a sign of weakness or exhaustion, perhaps from malnutrition. Read Chapter 11 on good nutrition and try to eat as well as possible. If sight does not improve, get medical help. This disease is common in many parts of Africa and certain areas of southern Mexico, Central America, and northern South America....

Ears Throat And Nose

Ears Always check for signs of pain and infection in the ears especially in a child with fever or a cold. A baby who cries a lot or pulls at his ear often has an ear infection (p. 309). Pull the ear gently. If this increases pain, the infection is probably in the tube of the ear (ear canal). Also look for redness or pus inside the ear. A small flashlight or penlight will help. But never put a stick, wire, or other hard object inside the ear. Find out if the person hears well, or if one side is...

Eating right helps the body resist sickness

Not eating well may be the direct cause of the health problems just listed. But most important, poor nutrition weakens the body's ability to resist all kinds of diseases, especially infections Poorly nourished children are much more likely to get severe diarrhea, and to die from it, than are children who are well nourished. Measles is especially dangerous where many children are malnourished. Tuberculosis is more common, and gets worse more rapidly, in those who are malnourished. Cirrhosis of...

Eczema Red Patches With Little Blisters

In small children a red patch or rash forms on the cheeks or sometimes on the arms and hands. The rash consists of small sores or blisters that ooze or weep (burst and leak fluid). In older children and grown-ups eczema is usually drier and is most common behind the knees and on the inside of the elbows. It does not start as an infection but is more like an allergic reaction. Put cold compresses on the rash. If signs of infection develop (p. 88), treat as for impetigo (p. 202). Let the...

Erysipelas And Cellulitis

Anthony's fire) is a very painful acute (sudden) infection in the skin. It forms a hot, bright red, swollen patch with a sharp border. The patch spreads rapidly over the skin. It often begins on the face, at the edge of the nose. This usually causes swollen lymph nodes, fever, and chills. Cellulitis is also a very painful, acute infection of the skin that can appear anywhere on the body. It usually occurs after a break in the skin. The infection is deeper and the borders of...

Family Planning

Having the number of children you want, when you want them, is called family planning. If you decide to wait to have children, you can choose one of several methods to prevent pregnancy. These methods are called family planning methods, child spacing methods, or contraception. Every year, half a million women die of problems from pregnancy, childbirth, and unsafe abortion. Most of these deaths could be prevented by family planning. For example, family planning can prevent dangers from...

Finding Out the Needs

As a health worker, you will first want to find out your people's most important health problems and their biggest concerns. To gather the information necessary to decide what the greatest needs and concerns really are, it may help to make up a list of questions. On the next 2 pages are samples of the kinds of things you may want to ask. But think of questions that are important in your area. Ask questions that not only help you get information, but that get others asking important questions...

Fits Convulsions see p 178

Common causes of fits or convulsions in children are high fever, dehydration, epilepsy, and meningitis. If fever is high, lower it rapidly (see p. 76). Check for signs of -dehydration (p. 151) and meningitis (p. 185). Fits that come suddenly without fever or other signs are probably epilepsy (p. 178), especially if the child seems well between them. Fits or spasms in which first the jaw and then the whole body become stiff may be tetanus (p. 182). This dangerous disease may come as a...

Fits Convulsions

We say a person has a fit when he suddenly loses consciousness and makes strange, jerking movements (convulsions). Fits come from a problem in the brain. In small children common causes of fits are high fever and severe dehydration. In very ill persons, the cause may be meningitis, malaria of the brain, or poisoning. A person who often has fits may have epilepsy. Try to figure out the cause of a fit and treat it, if possible. If the child has a high fever, lower it at once with cool water (see...

For the Well Prepared Midwife or Birth Attendant

Suction bulb for sucking mucus out of the baby's nose and mouth. Fetoscope or fetal stethoscope for listening to the baby's heartbeat through the mother's belly. Blunt-tipped scissors for cutting the cord before the baby is all the way bom (extreme emergency only). Blunt-tipped scissors for cutting the cord before the baby is all the way bom (extreme emergency only). Two clamps (hemostats) for clamping the umbilical cord or clamping bleeding veins from tears of the birth opening. Two clamps...

Gangrene Gas Gangrene

This is a very dangerous infection of a wound, in which a foul-smelling gray or brown liquid forms. The skin near the wound may have dark blisters and the flesh may have air bubbles in it. The infection begins between 6 hours and 3 days after the injury. It quickly gets worse and spreads fast. Without treatment it causes death in a few days. Open up the wound as wide as possible. Wash it out with cool, boiled water and soap. Clean out the dead and damaged flesh. If possible, flood the wound...

General Condition Of Health

Before touching the sick person, look at him carefully. Observe how ill or weak he looks, the way he moves, how he breathes, and how clear his mind seems. Look for signs of dehydration (see p. 151) and of shock (p. 77). Notice whether the person looks well nourished or poorly nourished. Has he been losing weight When a person has lost weight slowly over a long period of time, he may have a chronic illness (one that lasts a long time). Also note the color of the skin and eyes. These sometimes...

Goiter A Swelling Or Lump On The Throat

A goiter is a swelling or big lump on the throat that results from abnormal growth of a gland called the thyroid. Most goiters are caused by a lack of iodine in the diet. Also, a lack of iodine in a pregnant woman's diet sometimes causes babies to die or to be born mentally slow and or deaf (cretinism, p. 318). This can happen even though the mother does not have a goiter. Goiter and cretinism are most common in mountain areas where there is little natural iodine in the soil, water, or food. In...

Guidelines for the use of medicine

Use medicines only when necessary. 2. Know the correct use and precautions for any medicine you use (see the GREEN PAGES). 3. Be sure to use the right dose. 4. If the medicine does not help, or causes problems, stop using it. 5. When in doubt, seek the advice of a health worker. Note Some health workers and many doctors give medicines when none is needed, often because they think patients expect medicine and will not be satisfied until they get some. Tell your doctor or health worker you only...

Habits that Affect Health

Some of the habits that people have not only damage their own health but in one way or another harm those around them. Many of these habits can be broken or avoided but the first step is to understand why breaking these habits is so important. If alcohol has brought much joy to man, it has also brought much suffering especially to the families of those who drink. A little alcohol now and then may do no harm. But too often a little leads to a lot. In much of the world, heavy or excessive...

Have antivenoms for snakes in your area ready and know how to use thembefore someone is bitten

Send for medical help but always do the things explained above at once. Most folk remedies for snakebite do little if any good (see p. 3). Some treatments can cause infection or make the effects of the venom worse. Do not cut the skin or the flesh around the bite tie anything tight around the bite or the person's body put ice on or around the bite shock the person with electricity try to suck the blood or the venom out of the bite Never drink alcohol after a...

Having the Number of Children You Want

BOTH THESE FAMILIES LIVE IN POOR COMMUNITIES This family lives where resources are distributed This family lives where resources are distributed Some mothers and fathers want a lot of children especially in countries where poor people are denied a fair share of land, resources, and social benefits. This is because children help with work and provide care for their parents in old age. In such areas, having just a few children may be a privilege only wealthier people can afford. The situation is...

How A Mother Can Produce More Breast Milk

eat as well as possible, especially milk, milk products, and body-building foods (see p. 110), get plenty of sleep and avoid getting very tired or upset, nurse her baby more often at least every 2 hours. BOTTLE-FED BABIES ARE MORE LIKELY TO GET SICK AND DIE. BOTTLE-FED BABIES ARE MORE LIKELY TO GET SICK AND DIE.