Cape Town's Red Cross Children's Hospital is admitting five to eight babies and young children with diarrhoea daily as health authorities swing into action with a fine-tuned programme designed to fight the annual scourge.
Dr Ralph Diedericks, head of acute medical emergency services at the hospital, says the hospital will be admitting up to 15 children to Red Cross every day at the height of the diarrhoea season.
That excludes children with diarrhoea who are treated successfully at home, primary healthcare clinics, or treated and then discharged from Red Cross's oral rehydration unit.
The head of health in the Western Cape, Dr Ivan Toms, said city and provincial health authorities had joined forces to address the diarrhoea problem, which occurs annually between mid-January and May.
Toms identified Khayelitsha as the worst-hit area of greater Cape Town.
But the joint intervention was already seeing results. Between 2004/05 and 2005/06, death rates from diarrhoea in Cape Town had dropped from 277 to 248. These included both adults and children.
In Khayelitsha, said Toms, death rates from diarrhoea were down from 85 to 68 last year.
The intervention strategy included personnel from environmental health practitioner level conducting water education, to special oral rehydration corners in every clinic.
At Red Cross Children's Hospital level, where the worst cases were admitted, Toms said staff had to be prepared for rising admission numbers, ensuring the appropriate number of available beds during the season.
Diedericks told the Cape Argus that admissions, currently between five and eight a day, were on the rise, but this was a "typical seasonal increase".
The hospital mainly admitted children who were dehydrated and who had "failed the oral rehydration programme" at home, a primary health care facility or in Red Cross's own oral rehydration unit.
"The intake starts annually from about the second or third week in January and we are already seeing an acute upswing in cases of infants presenting with diarrhoeal disease," he said.
Diedericks said seasonal diarrhoeal disease was a major socio-economic issue, closely linked to poverty and access to clean, running water.
"The children we see in the diarrhoeal disease wards are generally poorly nourished, along with those who are HIV positive," he said. This week, staff had also seen a pattern of admissions of somewhat older children.
"From early on this week, it became clear that some viruses are sweeping the Western Cape right now because we're definitely seeing an upswing in the numbers of bigger children with gastro and respiratory disease," he said.
Toms blamed the increase in diarrhoea on increasing heat, and the consequent increase in flies which transmitted viruses and bacteria through food.
Of the intervention programme, he said the city and the province had joined forces two years ago, but that "we really got into it in earnest" last season.
"The programme has just been relaunched for this season and we're confident that its components will help us to be more effective," Toms said.
Health authorities advise parents to mix the following easy solution, which Diedericks called a "brilliant public health solution", as soon as children start showing signs of diarrhoea:
- The sugar-salt solution: Wash all the utensils you need in clean water, then wash your hands with soap and water. Measure one litre of boiled water and add eight teaspoons of sugar and half a teaspoon of salt. Mix until the sugar and salt are dissolved.
Children younger than two should be given 50 to 100ml (about a quarter of a cup) of the solution, slowly, after each loose stool. For older children, give 100 to 200ml after each loose stool. If the child vomits, wait 10 minutes and then try again.