'Rasmina' - Stories of Typhoid by the Coalition Against Typhoid

7 Jun 2016

Stories of Typhoid: Rasmina from Nepal

 

Read the latest blog originally posted by EWP member Coalition Against Typhoid at the end of May, 2016. 

Meet Rasmina, a 5 year old living in Banepa, Kavre District, Nepal. An excited kindergartener, Rasmina enjoys going to school, playing with her ball, and eating snacks like chow chow (a Nepali noodle dish), wafers and chocolates. Asked to describe her daughter, Sanchakumari Tamang, Rasmina’s mother, says, “She is very mischievous!”

Taking a break from playing, Rasmina Tamang, age 5, sits in her father's shop while a doctor takes her temperature during a follow up visit. Mathila Jariwala / Sabin Vaccine Institute

Taking a break from playing, Rasmina Tamang, age 5, sits in her father’s shop while a doctor takes her temperature during a follow up visit. Photo Credit: Mathila Jariwala

In March, Rasmina started feeling sick. She was nauseous, and had a high fever, diarrhea, and a burning stomach. Her parents assumed she had the flu and would recover in a few days. But a week went by and Rasmina did not get better. After seven days, Rasmina’s parents brought her to a neighboring town to seek care at Dhulikhel Hospital. After a blood culture test, Rasmina was diagnosed with typhoid fever, a bacterial infection transmitted through contaminated food and water.

 Mithila Jariwala

Rasmina’s mother, Sanchakumari Tamang, walks to her house after filling a jerry can with water at the nearby well. Photo Credit: Mithila Jariwala

Like Rasmina’s family, over 600 million people lack ready access to improved sources of drinking water and are at risk of contracting typhoid. Impacting over 21.5 million people a year, typhoid’s flu-like symptoms are often mistaken for malaria or pneumonia. If treatment is delayed or not sought, typhoid can result in severe complications and death. Typhoid can be easily prevented with a vaccine. Immunization not only protects those that receive the vaccine, it also reduces the spread of disease in the community, offering herd immunity to others, including children too young to be vaccinated.

Rasmina was lucky.  She was properly diagnosed a week after her symptoms began. And she recovered quickly once she received antibiotics at the hospital.

 Mithila Jariwala

Rasmina practices washing her hands with soap after being taught about hygiene and sanitation practices upon discharge  from Dhulikhel Hospital. Photo Credit: Mithila Jariwala

Before discharge, doctors spoke to Rasmina and her parents about how to prevent typhoid and other waterborne diseases in the future by carefully washing hands with soap and drinking boiled or filtered water. In addition, the doctors advised the family to eat cooked food, not the uncooked street food popular in Banepa like chat pat and pani puri which are often stored in unsanitary environments and are at-risk of contamination.

 Mithila Jariwala

Rasmina along with her parents and her 15 month old brother, Ganesh Lama, outside her house in Banepa. Photo Credit: Mithila Jariwala

Following the Nepalese cultural practise, Rasmina’s family eats with their hands.  “We have a habit of washing our hands before eating. But we use only water. We never use soap,” said Rasmina’s mother. Rasmina now practises her washing her hands with soap as instructed by the doctors and the family uses a newly purchased filter for their water to help keep Rasmina and her baby brother healthy.

Reporting and photos by Mithila Jariwala

The Coalition Against Typhoid (CaT) is a leader in the fight to control typhoid fever through increased access to life-saving vaccines. Typhoid vaccines have primarily been targeted for use in the private or traveller’s markets and have not been widely supported for use at the country level. This means that the most vulnerable populations, such as infants and young children, do not have access to the vaccine. CaT focuses on vaccine policy and raising awareness about the prevalence of typhoid and the need for vaccines. CaT aims to ensure that sufficient global typhoid immunisation and financing policies are in place to enable the widespread use of typhoid vaccines in endemic areas and that these policies are supported at the regional and national levels. Water, sanitation and hygiene (WASH) is a critical preventative measure in the fight against typhoid.