Kwashiorkor

Remember this rotted of heal that came about 1 week before the flood?  I was so stressed out about it and worried I had made the wrong decision about trying to take care of her here.  I wrote Lori and sent her pictures of it.  She then sent it to several doctors to get suggestion. Many gave me some good advice.  They were all about split equal whether to amputate it or try to save it.  That day seems like so long ago.  The flood came, bridges and road were washed out.  So I had no choice but to continue to do what I was doing.  It so far has worked out well.  I laughed today thinking that this heal was my biggest stress a little over a month ago.  If I only had know what was coming!

Here it is today…healing nicely.

We admitted three new children today.  This boy came down yesterday afternoon. He arrived at our gate around 5 pm.  They had been walking since 6am.  The sister of Helande, one of our MV children, walked  the family down to the clinic.  The family has never been to our village before so she showed them the way.   They slept at a friends house last night and came today.  He is 5 years old and weighs 36 pounds.  His legs are so heavy and full of water.  This makes the third time her has had Kwashiorkor.  He has one sister at home.  He has one sibling that has died.  He is suffering and it is difficult for him to breath.

 

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This is Maudline.  Check out these stats.  She came to the clinic for her first visit at 10 days and and weighed 6.6 pounds.  Her second visit visit was at 14 months and she weighed 16 pounds.  Third visit at 15 month-still 16 pounds.  Fourth visit today at 22 months and weighs 14 pounds.  She also has Kwashiorkor.  She will loose a few more pounds of her weight when her water retention begins to go down.

22 months and 14 pounds.  Not normal.  Her parents know that she is in critical condition.  They have lost 4 other children to kwashiorkor.  They have 4 other living children at home.

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This is Assemene.  She is five years old and weighs 22 pounds.  She is malnourished has diar, vomiting fever and is losing her eye sight.  She has lost 3 siblings to Kwashiorkor.  There are 4 other living at home. 

So with the three children that were admitted today, they have a total of 8 siblings, brother and sisters that have died.  Seven of those died of kwashiorkor.

Here is some good info for Kwashiorkor.

Kwashiorkor is a form of malnutrition caused by inadequate protein intake in the presence of fair to good energy (total calories) intake.

Causes

Kwashiorkor occurs most commonly in areas of famine, limited food supply, and low levels of education, which can lead to inadequate knowledge of proper diet.

Early symptoms of any type of malnutrition are very general and include fatigue, irritability, and lethargy. As protein deprivation continues, growth failure, loss of muscle mass, generalized swelling (edema), and decreased immunity occur.

A large, protuberant belly is common. Skin conditions (such as dermatitis, changes in pigmentation, thinning of hair, and vitiligo) are seen frequently. Shock and coma precede death.

The incidence of kwashiorkor in children in the U.S. is extremely low and only rare, isolated cases are seen.

This is typically a disease of impoverished countries, and is often seen in the midst of drought or political turmoil. Improving calorie and protein intake will correct kwashiorkor, provided that treatment is not started too late. However, full height and growth potential will never be achieved in children who have had this condition.

Severe kwashiorkor may leave a child with permanent mental and physical disabilities. There is good statistical evidence that malnutrition early in life permanently decreases IQ.

Risk factors include living in impoverished countries, countries in political unrest, and countries affected by frequent natural disasters (such as drought). These conditions are directly or indirectly responsible for scarcity of food which leads to malnutrition.

Symptoms

  • Failure to gain weight and failure of linear growth
  • Irritability
  • Lethargy or apathy
  • Decreased muscle mass
  • Swelling (edema)
  • Large belly that stick out (protrudes)
  • Diarrhea
  • Dermatitis
  • Changes in skin pigment; may lose pigment where the skin has peeled away (desquamated) and the skin may darken where it has been irritated or traumatized
  • Hair changes — hair color may change, often lightening or becoming reddish, thin, or brittle
  • Iincreased and more severe infections due to damaged immune system
  • Shock (late stage)
  • Coma (late stage)
 

Treatment

Treatment varies depending on the severity of the condition. Shock requires immediate treatment with restoration of blood volume and maintenance of blood pressure.

Calories are given first in the form of carbohydrates, simple sugars, and fats. Proteins are started after other caloric sources have already provided increased energy. Vitamin and mineral supplements are essential.

Since the person will have been without much food for a long period of time, starting oral feedings can present problems, especially if the caloric density is too high at first. Food must be reintroduced slowly, carbohydrates first to supply energy, followed by protein foods.

Many malnourished children will have developed intolerance to milk sugar (lactose intolerance) and will need to be given supplements with the enzyme lactase, if they are to benefit from milk products.

Expectations (prognosis)

Treatment early in the course of kwashiorkor generally produces good results. Treatment of kwashiorkor in its late stages will improve the child’s general health, but he or she may be left with permanent physical problems and intellectual disabilities. Without treatment or if treatment comes too late, this condition is fatal.

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2 Responses to Kwashiorkor

  1. Jen says:

    praying praying…. I don’t even know what else to say. just, praying.

  2. JWIII says:

    I’m doing a report on Malnutrtion and as I do my reaseach and I stumble upon pictures like the one above my heart goes out to these poor little children. I pray and hope they all come out ok. I never knew what real hunger was until I read up on malnutrtion, living in America makes you very jaded to these things.

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