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close this bookOral Rehydration Therapy and the Control of Diarrheal Diseases (Peace Corps, 1985, 566 pages)
close this folderModule Two: Diarrhea, dehydration and rehydration
close this folderSession 6 - Practicing ort in the village
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View the documentTrainer Attachment 6A: Problem situations - ORT in the home

Trainer Attachment 6A: Problem situations - ORT in the home

The following problem situations are exaggerations of ones that Volunteers may encounter when trying to prepare Oral Rehydration Solutions in their villages. Each situation should be adapted to be culturally appropriate and then read to the participants. Based on their knowledge and experience to date, the group should describe how they would handle each situation given the ingredients available and their ingenuity. Each situation contains ingredients either for:

- preparing homemade sugar-salts solutions,
- using ORS packets
- providing simple nutritious foods and/or
- replenishing the liquids and nutrients lost during diarrhea but not correcting the electrolyte imbalance.

Problem Situation Number 1:

Situation Description: The child who is one year old had four to six loose stools yesterday. The mother had only one packet of ORS and mixed half of it on the first day of her child's diarrhea. She gave the ORS solution from a cup but the baby coughed and choked, and refused to drink. The mother is trying to wean the child from the breast and so is nursing only once a day. The child only wants to sleep and when awake is always reaching for the mother's breast.

Problem: What would you do if in the household you only found the following:

- a fresh but half empty packet of ORS
- water from a clean source
- rice powder
- a dirty one liter container
- salt
- large bulk tea

Answer: Follow treatment Plan B of the WHO Treatment Chart and the information for mixing ORS. If the child continues to have diarrhea after finishing the half liter solution of ORS and if it is used in the local culture give the child the rice powder solution. If the diarrhea persists for longer than two days and or the child shows more signs of dehydration, take him or her to the health center.

Problem Situation Number 2:

Situation Description: The older daughter (ago 7) has told you that both her younger brother and sister have had a runny tummy several times today. The mother is at the market selling bread. The children have diarrhea and cry a lot but appear to be fine. When you check their pulse you find it to be normal. Their skin goes back immediately after you pinch it and they are constantly asking to drink.

Problem: What would you do if in this household you found the following foods and materials:

- potatoes
- salt and molasses (or appropriate country specific sugar substitute)
- large mixing spoon
- water
- large gourd

Answers Follow treatment under Treatment Plan A of the WHO chart and include relevant information from the sessions on nutrition and how to mix sugar-salts solutions.

Problem Situation Number 3:

Situation Description: it is the rainy season and there is little food available. The roads to the health center are washed out. The mother is in the fields most of the time. When you pass by her house you find the woman at home worried because her two year old son has had diarrhea since yesterday. She asks you for some Western medicine to treat her son. You have been told never to give out the medicine from your Peace Corps kit.

Problem: What would you do and say to this mother if, in this household, you look around and find the following:

- sugar cubes
- dirty water in a bucket
- several small tea cups
- carrots and other vegetables and tubers
- small mortar and pestle.

Answer: This scenario should lead to a discussion of the pros and cons of treating children with medicine that is not readily available in that culture or village. If the child is not in danger of dehydration all the materials are there for preparing the sugar-salt solution and providing some nutritious food in between drinking the solution. Review Session 5 for the discussion of the pros and cons of using dirty water to prepare the solution, and Session 9 for information on preventing malnutrition.