This essay investigates the grounds why Goma ( in DRC ) is more affected by infantile paralysis than Gisenyi ( in Rwanda ) . The two parts on which the probe is about are neighbors ; they have the same clime and the same geographical construction.
This probe was carried out utilizing field work. I started my probe by inquiring inquiries to physicians so that I would hold more thought of what infantile paralysis was. After that, I selected the factors I would look into on in order to cognize why Goma is more affected by Polio than Gisenyi. The factors selected are: the environmental factors, handiness of wellness attention and the cognition the population has about infantile paralysis.
For the environmental factors, the clime and the hygiene were considered and investigated on. In the instance of the handiness of the vaccinum, I asked inquiries to the people in charge of the inoculation plans in each part. For the cognition about infantile paralysis, inquiries were asked to 70 female parents in each part about their consciousness about infantile paralysis.
The decisions I drawn from this probe is that neither the handiness of the vaccinum nor the consciousness of the population contributes to the difference in infantile paralysis instances between the two parts. Amongst the environmental factors merely the hygiene contributes to the difference in infantile paralysis instances between the two parts. The chief ground why Goma is more affected by infantile paralysis is that the population there is populating without holding basic demands and in add-on to that, non all the kids are vaccinated. The poorness stops the parents from boiling the H2O before giving it to their kids and the war is doing the parents move from one topographic point to another and as a consequence, the kids do non acquire all the three doses of the vaccinum which makes them susceptible to acquire infantile paralysis.
Poliomyelitis or infantile paralysis is an infective disease caused by a virus that was foremost discovered in 1909 by Karl Landsteiner ( 1868 -1943 ) . Polio largely affects kids that are less than five old ages old. Polio is eradicated in Europe, in USA, and in Australia since the 1990 ‘s[ 1 ]. However there are still some instances of infantile paralysis in Asia and really many instances in Africa.
The virus that causes infantile paralysis is known as the poliovirus. The poliovirus is a really contagious virus that can distribute really easy and really rapidly from one individual to another.[ 2 ]The incubation period of infantile paralysis can be really short ( 4days ) or long ( 14 yearss ) .[ 3 ]
The poliovirus can merely infect worlds. It is really common in tropical climes and during summer in temperate clime ; it is rapidly inactivated by heat.[ 4 ]The poliovirus can populate in an environment that has a temperature between 18 A°C and 40 A° C
There are two chief types of infantile paralysis: the first type is caused by the wild infantile paralysis. This is the 1 in the environment, the one people get by imbibing contaminated H2O or by being in contact with contaminated fecal matters. The 2nd type is the vaccinum infantile paralysis. This is the infantile paralysis people get because of the vaccinum that contains weak poliovirus. This happens when for illustration a kid who was ill and has non recovered yet is vaccinated. In this instance the immune system of the kid is weak and ca n’t battle the weak polioviruses.
The difference between the two types of infantile paralysis is that the wild infantile paralysis causes a palsy that is non reversible while the palsy caused from the vaccinum infantile paralysis is reversible significance that the individual can go normal once more after few yearss.
Poliomyelitis can distribute in different ways. The most common manner is the fecal unwritten transmittal ; the other manner is the unwritten -oral infantile paralysis transmittal[ 5 ]. The fecal unwritten transmittal is when a individual is in contact with the fecal matters of an septic individual. It occurs in countries where the hygiene is hapless. In countries where the sanitation is better, the spreading will happen utilizing the oral- unwritten transmittal which occurs when an septic individual sneezes or coughs in the presence of non-infected people. In this instance the non- septic individual will be in contact with droplets or spit. Insects such as flies can besides be agents of transmittal of the virus.[ 6 ]The virus can besides distribute through contaminated nutrient and H2O.[ 7 ]Not all the people that are in contact with the poliovirus acquire ill. They will merely hold something that looks like a bad cold. Those people can move as bearers and can infect other people. Once a individual is paralysed, that individual ca n’t pollute the others. The individual is merely contagious during the incubation period of the poliovirus.
The virus can come in the being through the air ( nose, larynx, amygdales, ) but largely it enters the being through the digestive system.[ 8 ]When the virus is in the being, it develops and multiplies in the bowels and so goes to the nervous system where it causes a palsy in few hours.[ 9 ]
The poliovirus can impact three different parts of the organic structure. The first portion is the encephalon ; in this instance the individual affected dies. The 2nd portion is the respiratory system, cut downing the external respiration capacity of the septic individual. This largely consequences to decease if the individual does non hold aid from take a breathing machines. The 3rd portion is the legs. In this instance the virus amendss merely the nervousnesss that control motions. The palsy caused by the poliovirus is known as a floppy Paralysis. The individual will non be able to walk unless assisted with crutches or with prosthetics.
In Africa, the bulk of the instances of infantile paralysis are coming from hapless households. Those who have their respiratory system affected by infantile paralysis merely die because they ca n’t afford to purchase the setup assisting to breath. For those who have the legs paralysed they ca n’t purchase the prosthetics which cost around 350 $ ( this being the cheapest ) . Most of the paralysed people merely hope that person takes attention of them or in most instances they become mendicants on the street because their households think they are a charge and do n’t desire to take attention of them.
Poliomyelitiss can non be cured. Since infantile paralysis is caused by a virus, the antibiotics do n’t hold any consequence on it. In order to kill the poliovirus, the host cell has to be killed besides. The lone thing the physicians can make is to bring around the symptoms such as febrility. When a kid becomes paralysed the lone thing that can be done is the rehabilitation.
The fact that infantile paralysis can non be cured does non intend that it ca n’t be prevented. One of the bar methods used is inoculation. The vaccinum for infantile paralysis is unwritten. It contains weak polioviruses. Four doses have to be given for the vaccinum to be effectual. The first dosage is given at the birth ; the 2nd 1 is given when the babe has 6 hebdomads, the 3rd at 10 hebdomads and the 4th and last dosage at 14 hebdomads.
Another bar method that can be used is to imbibe poached H2O. In Africa, people in the small town acquire the H2O they need from the lakes and rivers near their houses. The H2O from the lakes can be really unsafe because it is the same H2O in which people wash their apparels and many people do their fecal matters near the H2O. If person is affected by infantile paralysis and realeases his/her fecal matters in the H2O, the poliovirus will travel in the H2O and will impact the kids who will imbibe that H2O. In order to avoid that, the parents should boil the H2O before giving it to their kids. In that manner non merely the poliovirus will be killed but besides all the other viruses and bacteriums that was in the H2O.
In this essay we are traveling to see what can do two parts have different infantile paralysis instances. To look into this, I have chosen the part of Goma ( in DRC ) and the part of Gisenyi ( in Rwanda ) .
This is deserving look intoing because infantile paralysis can be contaminated through the air and the fact is that there ‘s a batch of contact between the populations of the two parts. Since there ‘s a batch of contact between the two populations and that infantile paralysis can be transmitted in the air the inquiry is why one portion of the population is more affected than the other?
The part of Goma and the part of Gisenyi are neighbors. They are non in the same state ; Goma is in DRC while Gisenyi is in Rwanda. Both the parts have the same geographical construction. Both are hilly and portion the same lake: Lake Kivu.
Even though they have the same clime and geographical construction, the two parts are non affected in the same manner by infantile paralysis. The part of Goma is more affected by infantile paralysis than the part of Gisenyi. In fact most of the kids in Goma are affected by infantile paralysis while in Gisenyi the opportunity of holding a kid affected by infantile paralysis is approximative to 0 % .
What makes the part of Goma more affected by infantile paralysis than the part of Gisenyi?
Many things can do these two parts so different in the manner infantile paralysis affect them in this essay, three factors were used to look into why Goma is more affected by infantile paralysis than Gisenyi. Three factors are: The environmental factors, handiness of the vaccinum and wellness attention, and the consciousness amongst the people.
The environmental factors
For the environmental factors the clime and the hygiene will be considered.
The clime of the two parts is the same ; hence, the clime can non be among the grounds why the rate of infantile paralysis is different in the two parts. They both have the same temperatures and clime. Since Goma and Gisenyi have the same clime this can non be a ground why Goma has more infantile paralysis instances than Gisenyi.
The handiness of public lavatories for the people who do n’t hold modern houses with lavatories in them and a good hygiene can be included as an environmental factor. The usage of public lavatories is one of the preventative methods used to avoid infantile paralysis. The public lavatories are suggested because most of the people do n’t hold the capacity to construct houses with lavatories. In Gisenyi and Goma the public lavatories are available but they are in really bad conditions ; due to that people do n’t utilize them. Most of the kids and the parents let go of their fecal matters near the Lake Kivu, in which they go to bring H2O. This increases the rate of spreading of infantile paralysis particularly if the non-vaccinated kids drink the H2O from the lake straight without boiling it and that the H2O contains the infantile paralysis virus.
The image below shows kids from Goma bringing soiled H2O.
Picture nA° 1 ( From my camera )
The fact is that in Goma most of the people live either in a refugee cantonment or in really hapless conditions. Those who live in refugee cantonments do non hold good sanitation installations. There are many people populating in a little country ( eg: two households in one collapsible shelter ) which facilitates the spreading of diseases such as cholera and infantile paralysis among the kids. The other 1s who do n’t populate in refugee cantonments live in really bad conditions because of the war and the insecurity.
Refering the hygiene there ‘s a large difference between the two parts in the sense that in one ( Gisenyi ) people have reasonably acceptable life conditions which enables them to hold a good hygiene while in the other ( Goma ) people are populating in bad conditions which makes them non able to hold a good hygiene.
The handiness of the vaccinum and wellness attention
The handiness of the vaccinum and wellness attention are finding factor in the sense that if the vaccinum for infantile paralysis is available, fewer kids will be affected by infantile paralysis. This besides include whether people can afford to pay for the vaccinum or non. In Rwanda, the vaccinum is available and free for everyone. Therefore in Gisenyi, which is one of the parts of Rwanda, the vaccinum is available and free.
In Goma the vaccinum is besides free. In fact people from the public wellness section are sent to near the parents to immunize their kids.
In both the parts the medical Centres are near to the people. One difference is that in Gisenyi the population has an insurance provided by the authorities in order to ease the entree to medical attention while in Goma the people have to pay for themselves.
The fact that the vaccinum is available in Gisenyi explains why there are few instances of infantile paralysis. The inquiry now is to cognize why there are more instances of infantile paralysis in Goma when the vaccinum is besides available and free at that place. The 2008 statistics by Unicef showed that in Rwanda, 95 % of the kids where immunized against infantile paralysis while 89 % merely were immunized in Congo.[ 10 ]
Public consciousness about infantile paralysis
If the vaccinum is available the figure of kids affected by infantile paralysis will depend on the figure of kids who were vaccinated. The figure of kids Vaccinated will depend on how cognizant parents are that their kids have to be vaccinated. There is no point of doing the vaccinum available if the parents do n’t take their kids for inoculation. This can be a ground why Goma has more kids affected by infantile paralysis than Gisenyi. If the parents in Gisenyi are more cognizant about infantile paralysis than the 1s in Goma this can explicate why the kids in Gisenyi are less affected by infantile paralysis than the kids in Goma.
In order to look into that, few inquiries were asked to parents holding kids less than five old ages old in the two parts.
70 parents from each part were asked the undermentioned inquiries:
Make you cognize what infantile paralysis is?
What do you cognize about infantile paralysis?
Are your kids vaccinated against infantile paralysis?
What do you make when your kid is ill?
Make you boil or set chemicals in the H2O before giving it to your kids?[ 11 ]
The following tabular array shows the consequences got in the different parts
Number of parents cognizing about infantile paralysis
Number of parents that have some thought about infantile paralysis
Number of parents that have no thought about infantile paralysis
Number of parents that take their kids for inoculation
Number of parents that do n’t take their kids for inoculation
Number of parents that take their kids to the physician when they are ill
Number of parent that leave their kids place when they are ill
Number of parents that take their kids to witchdoctors when they are ill
Number of parents who boil or put chemicals in the H2O before giving it to their kids
The undermentioned graph shows us the consequences got
From the graph above we can see that refering the cognition about infantile paralysis the parents in Goma are more cognizant about that disease than the parents in Gisenyi. We can see from the graph that there are more parents in Goma who really know what infantile paralysis is than in Gisenyi. Most of the parents in Gisenyi have no thought of what infantile paralysis is. Some parents even thought that it was a disease caused by malnutrition.
The fact that more kids in Gisenyi are vaccinated than in Goma can explicate why there are more instances of infantile paralysis in Goma than in Gisenyi. However that is non all. From the consequences we can see that there are more parents who take their kids to the physician when they are ill in Gisenyi than in Goma. This is because in Gisenyi the parents have insurance and can afford to take their kids to the infirmary when they are ill. In the instance of Goma, the parents do n’t hold any insurance and have to pay for themselves. When the parents in Goma were asked why they do n’t take their kids to the physician when they are ill, most of them said that they ca n’t afford to take their kids to the infirmary. The fact that there are more childs vaccinated in Gisenyi than in Goma can be explained by the fact that less parents in Goma go to the infirmary. Because they have to pay for themselves, they do n’t take their kids to the infirmaries believing that they ‘ll hold to pay for the vaccinum.
We can see from the statistitics that about 16 % of the female parents do n’t take their kids to the infirmary. The fact is that some female parents do n’t even give birth in the infirmaries. If they did, the kid would automatically have the first dosage of the vaccinum and the female parent would be told that the vaccinum is free. The households in Goma do n’t hold a beginning of gross. Some were husbandmans but can no longer cultivate their farms because they live in refugee cantonments. In fact they ca n’t cultivate even if they leaved outside the refugee cantonments because Goma is a part of high volcanic activity. The bulk of the land is covered with larva, there ‘s no manner to works anything at that place.
In add-on to that, there are more parents in Gisenyi who boil the H2O or put chemicals in it before giving it to their kids. To the parents who do n’t boil H2O or put chemicals in it were asked why they do n’t make that. Most of the female parents in Gisenyi answered that “ since I was immature I ne’er drunk poached H2O and I ‘m healthy, why should my kid acquire ill if I did n’t. ” those in Goma explained that they ca n’t afford to make that but if they could, they would boil the H2O before giving it to their kids.
The kids in Goma drink H2O that is non purified and are non vaccinated. This is why they get infantile paralysiss while for the kids of Gisenyi, they drink poached H2O and even for those who drink H2O that is non boiled have the insurance that they are vaccinated and that they wo n’t acquire polio. There are no instances of infantile paralysis in Gisenyi, so, there ‘s no 1 to convey the disease.
The consequence got from my research can be supported by the unicef statistics about the sanitation, and improved imbibing H2O in Rwanda and in Congo
The tabular array below shows the studies from unicef about the sanitation installations and imbibing H2O. This besides includes the % of kids vaccinated against infantile paralysis.[ 12 ]
% of population utilizing improved sanitation installations in the rural countries
% of population utilizing improved imbibing H2O installations in rural countries
% of kids immunized against infantile paralysis in entire
The fact that the parents in Goma have some thought about infantile paralysis is supposed to do Goma less affected by it than Gisenyi where the parents are non cognizant which is non the instance.
This can be explained by the fact that in Goma, even though the parents have some thought about what infantile paralysis is they do n’t take their kids for inoculation. The parents in Gisenyi take their kids for inoculation. Most of the parents in Gisenyi do n’t cognize why they have to immunize their kids they do it because they were told to make so and that since the vaccinum is free, they do n’t free anything by taking their kids for inoculation. For the parents in Goma their job is that they are non stable ( i.e. : they move from one topographic point to another ) . Because of the war and the insecurity in Goma, the population keeps traveling. My theory is that due to the instability of the population in Goma, parents do n’t take their kids for inoculation. That would explicate the fact that even thought the parents are cognizant about infantile paralysis, they do n’t take their kids for inoculation doing them vulnerable to that disease.
To verify whether my theory is true, I asked 50 parents from each part some inquiries about their manner of life.
The inquiries asked are:
Where make you populate? Make you populate in a refugee cantonment or in your ain house?
How frequently do you travel ( go forth your house or refugee cantonment ) ?
What is the ground of your instability? *
When you move do you believe about taking your kid for inoculation? *[ 13 ]
The tabular array below shows us the consequences got
Number of parents populating in a refugee cantonment
Number of parents populating in their ain house
Number of parents who stay in the same topographic point during the whole twelvemonth
figure of parents traveling one time in twelvemonth
figure of parents traveling twice a twelvemonth
figure of parents traveling more than twice a twelvemonth
Number of parents taking their kids to inoculation after traveling
The tabular array below shows the consequences in %
% of parents tliving in a refugee cantonment
% of parents populating in a house
Overall % of parents traveling at least one time in a twelvemonth
% of parents taking their kids for inoculation after traveling
The graph below shows us the consequences got:
The consequences got support my theory that the parents in Goma do non take their kids for inoculation due to the instability. We can clearly see that in Gisenyi all the parents live in their ain house which is non the instance for Goma. My consequences besides show that there are more parents in Goma who leave their places compared to Gisenyi. The instability of the parents is caused by different grounds in the two parts. In Goma the instability is non merely due to the war, it is besides caused by the volcanic activity while in Gisenyi, the instability of the parents is due to their work ( ie: move from one topographic point to another harmonizing to seasons ) .
More parents in Gisenyi think about taking their kids to inoculation compared to Goma. This could explicate the fact that more kids are affected by infantile paralysis in Goma in the sense that more kids in Gisenyi receive all the doses of the vaccinum compared to Goma. In Goma, when the parents are obliged to go forth the country because of the war, they do n’t hold the clip to take the kid for the 2nd dosage because they are busy seeking to last in hard conditions, and since the vaccinum is non effectual if all the four doses are non given, their kids are susceptible of holding infantile paralysis if they are in contact with the poliovirus.
With all this we can reason that Goma is more affected by infantile paralysis than Gisenyi because most of the kids in Gisenyi are vaccinated which is non the instance in Goma. The fact that more kids are vaccinated in Gisenyi than in Goma is non due to the handiness of the vaccinum and the consciousness of the parents, it is because in Goma, the parents are more bemused by lasting than by taking their kids for the inoculation. The war is doing the population in Goma live in really hapless conditions. Their kids do n’t have all the four doses of the infantile paralysis vaccinum which makes them vulnerable to polio.
The deficiency of hygiene in Goma particularly in the refugee cantonments explains the fact that there ‘s more infantile paralysis in Goma than in Gisenyi. The fact that the kids lack hygiene and unrecorded together increases the rate of spreading of the disease.
Apart from the fact that there is war in Goma, the people are besides hapless. They do n’t hold the clip to take attention of their kids. Most of the parents have many kids and ca n’t take attention of them. They are busy the whole twenty-four hours seeking to acquire some money to feed their kids. When their kid is ill, they either leave the kid place or pray he will be all right shortly or if the disease is grave, they take the kid to the traditional physicians who are less expensive than the modern physicians. Harmonizing to many parents the traditional physicians are more effectual than the modern physicians because they are inexpensive and that they use herbs to bring around, which are better than the pills given by the modern physicians.
Most of the parents in Goma cognize how their kids can acquire polio and they know how to avoid it but they merely do n’t hold any pick. They ca n’t afford to boil the H2O or to set chemicals in it.
The ground why Goma has more polio instances is largely due to the war and to the instability of the population. We can see that clearly from the fact that the parents in Gisenyi are less cognizant about infantile paralysis, but since they are stable and that they were told to take their kids for inoculation they take them. They besides have the ability to purchase wood to boil the H2O.
The hazard now is that since Goma and Gisenyi are neighbors and that there are refugees from Goma in Gisenyi, infantile paralysis will distribute and impact kids from Gisenyi besides. That ‘s why the female parents in Gisenyi are sensitised to immunize their kids. Some of them do n’t see the intent of inoculation and do n’t cognize the hazard they are taking. Because of that, infantile paralysis which was eradicated in Rwanda might come back if all the kids are non vaccinated. Since the two parts portion the same lake and that kids do their faces in near the lake, there ‘s a opportunity that the infantile paralysis virus might distribute through the H2O if the kids drink the H2O without boiling it.