Voices From the Field on Childhood Pneumonia

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  • 8/3/2019 Voices From the Field on Childhood Pneumonia

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    Wocna~gxoe tfa gcald o`

    nfcldfood z`aqeo`cm

    Mqtfox~2

    ^fohfm ^fqklm, ^oesm Mxoxm, ^fckfm ^xcwm~tmwm, Xmfql Kqemx Dycwadc, Xcta~f Mxsm,@aaxmbEmc`mlc,@mdaae^mlem`c,Bcta`dxmDycwadc,BcttcemBm`tm`memlmkm,HohhsXmemkm`t

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    8 | W o c n a ~ g x o e t f a g c a l d o ` n f c l d f o o d z ` a q e o ` c m

    Tfa~a mxtcnla~ fmwa haa` yxctta` m~ zmxt og m ~axca~ c` lamd qz to tfa YoxldZ`aqeo`cm Dms, =8 @owaehax 8:==.

    Tfa wcay~ avzxa~~ad c` tfa~a mxtcnla~ mxa tfo~a og tfa Nctcra` @ay~ ^axwcna&N@^# yxctax~ m`d tfa zax~o`~ c`taxwcayad hs tfae.

    @owaehax 8:==

    N@^2 Tfc~ no`ta`t c~ mwmclmhla q`dax tfa Nxamtcwa Noeeo`~ Lcna`naMttxchqtco` >.: Q`zoxtad &NN HS >.:# lcna`~a

    MQTFOX^2

    ^fohfm ^fqklm

    ^oesm Mxoxm^fckfm xcwm~tmwm

    Xmfql Kqemx DycwadcXcta~f Mxsm

    @aaxmb Emc`mlc@mdaae ^mlem`cBcta`dxm Dycwadc

    Bcttcem Bm`tm`memlmkmHohhs Xmemkm`t

    Zqhlc~fax2 Zqbm Zxmkm~fm`, N%88==, N%hlonk nxo~~c`i, C`dcxm @mimx, Lqnk`oy%887:=7.

    Zxcna2 X~ 1:

    Tfa yxctax~ og Nctcra` @ay~ ^axwcna &N@^# noea gxoe mggantad noeeq`ctca~yfo fmwa ~oeatfc`i to ~ms o` c~~qa~ tfas gaal gox, ox mxa mggantad hs, c`

    tfacx dmcls lcwa~, m`d icwa m wocna to tfa wocnala~~. N@^~s`dcnmta~ no`ta`t ia`axmtad c` goqx lm`iqmia~&A`ilc~f, Fc`dc, Qxdq m`d Tfmc# q`dax NxamtcwaNoeeo`~ &NN# mttxchqtco` lcna`~a m`d zxodqna~ 4foqx~ og xmdco zxoixmeea~ dmcls gox GE xmdco c``oxtfax` Tfmclm`d. N@^ c~ gmnclctmtad hs m Tfmclm`d%hm~ad noezm`s % BmsC`~zcxa No Ltd &BCNL# % Eadcm m`d Noeeq`cnmtco` ^axwcna~.

    Yfaxa Zaozla Noea Gcx~t- N@^2 yyy.nctcra`%`ay~.oxi

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    > | W o c n a ~ g x o e t f a g c a l d o ` n f c l d f o o d z ` a q e o ` c m

    TMHLA OG NO@TA@T^Mnk`oyladiaea`t~.4CXO@S2 Zxawa`tmhla z`aqeo`cm c~ hciia~t kcllax og nfcldxa` q`dax 1. 1Ymka qz nmll mgtax samx~ og `ailant o` nfcldfood z`aqeo`cm. 9Amxls xanoi`ctco` ' em`miaea`t og nfcldfood z`aqeo`cm =:Icgt soqx nfcld loy z`aqeo`cm xc~k hs }qcttc`i tohmnno.. =8

    Tfaea =2 Cezoxtm`na og avnlq~cwa hxam~tgaadc`i dqxc`i tfa =~t ~cv eo`tf~ og lcgac` zxotantc`i nfcldxa` gxoe z`aqeo`cm m`d em`s otfax dc~am~a~

    @o Nonktmcl Gaadc`i Zlam~a Hxam~tgaad C~ Ha~t Gox Tfa Hmhs=7 Eotfax~ Eclk C~ Tfa Ha~t Eclk =3 Hxam~tgaadc`i2 M Nfcld~ Gcx~t Ceeq`crmtco`.8= Hxam~t eclk c`nxam~a~ ceeq`cts c` nfcldxa`....84 Eotfax~ eclk aggantcwals zxawa`t~ nfcldfood z`aqeo`cm..87 Eotfax~ eclk zxotant~ tfa nfcld mimc`~t z`aqeo`cm.86 Avnlq~cwa hxam~tgaadc`i wctml gox gcx~t ~cv eo`tf~. >:

    Tfaea 82 Cezoxtm`na og iood `qtxctco` m`d fsica`a &c`nlqdc`i fm`d%ym~fc`i# c`

    zxawa`tc`i z`aqeo`cm m`d otfax dc~am~a~ Gaad soqx nfcld yall2 Zxawa`t z`aqeo`cm. >> Gcift z`aqeo`cm yctf iood qtxctco`. >7 Nlam`lc`a~~ c~ `avt to iodlc`a~~ c` zxawa`tc`i nfcldfood z`aqeo`cm >3 Gaad xcift to gcift nfcldfood z`aqeo`cm. 48 @qtxctco` m`d nlam`lc`a~~ wctml to zxotant nfcldxa` gxoe z`aqeo`cm.41 Zxawa`t nfcldfood z`aqeo`cm hs iood `qtxctco`49 @qtxctco` m`d fsica`a falz~ zxotant nfcldxa` gxoe z`aqeo`cm.43 Iood `qtxctco` zxotant~ nfcldxa` gxoe z`aqeo`cm..1=

    Tfaea >2 Cezoxtm`na og c`doox mcx zollqtco` &nook ~towa, tohmnno ~eoka# c`zxawa`tc`i z`aqeo`cm m`d otfax dc~am~a~

    ^eoka%gxaa C`doox~ Gox Z`aqeo`cm Gxaa Lq`i~.14 A`wcxo`ea`tml Hqxda` Nm` Yacif Doy` Soqx Nfcld)~ Famltf..19 Zm~~cwa ~eokc`i m`d lmnk og fsica`a hxaad~ nfcldfood z`aqeo`cm..7: C`doox mcx zollqtco` m`d nfcldfood z`aqeo`cm..7> ^ano`dfm`d tohmnno ~eoka c`nxam~a~ xc~k gox nfcldfood z`aqeo`cm..71 C`doox Mcx Zollqtco` c`nxam~a~ tfa xc~k og Nfcldfood Z`aqeo`cm.. 79

    Tfaea 42 Mnna~~ to mggoxdmhla wmnnc`a~ c` oqx noeeq`ctca~ to zxawa`tnfcldfoodz`aqeo`cm

    Wmnnc`a ^fot~ Nm` Noehmt Tfa Damtf ^fot Og Z`aqeo`cm9: Lcga ^mwc`i ^fot~ Gox Kcllax Z`aqeo`cm.9> M ^fot C` Mxe Zxawa`t~ Nfcldxa` Gxoe Z`aqeo`cm. 97 Z`aqeo`cm wmnnc`mtco` `ot xamnfc`i nfcldxa` yfo `aad ct eo~t93

    Iat soqx nfcld wmnnc`mtad mimc`~t z`aqeo`cm6= Z`aqeo`cm wmnnc`mtco`2 Haso`d xamnf gox eo~t nfcldxa`.6> Lmnk og mymxa`a~~ mhoqt z`aqeo`cm wmnnc`a.61

    Tfaea 12 Mnna~~ to ~tm`dmxd }qmlcts txamtea`t to ~mwa lcwa~ gxoez`aqeo`cm Txamt Z`aqeo`cm Yctf Tfa Yo`dax Dxqi~.66 M`tchcotcn Tfaxmzs2 Tfa Z`aqeo`cm Zm`mnam.3= Txamt nfcldfood z`aqeo`cm hagoxa ct iat~ too lmta3> Hmxxcax~ to mnna~~c`i txamtea`t gox nfcldfood z`aqeo`cm31 Nfcldfood z`aqeo`cm m zqhlcn famltf nfmlla`ia..39 Nfcldfood z`aqeo`cm c~ nqxmhla.33

    ^ZAMK SOQX YOXLDMTFMXWM2 Tall%tmla og m z`aqeo`cm nxq~mdax.=:=

    Mhoqt tfa N@^ yxctax~. =:1

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    4 | W o c n a ~ g x o e t f a g c a l d o ` n f c l d f o o d z ` a q e o ` c m

    MNK@OYLADIAEA@T^

    Tfc~ xazoxt ym~ yxctta` hs ta` N@^ yxctax~ gxoe C`dcm m`d Tfmclm`d, m`dzqhlc~fad c` tfxaa lm`iqmia~ &A`ilc~f, Fc`dc m`d Qxdq#. Tfa zxobant ym~

    em`miad hs Mhfc`mw Hfmxmt Goq`dmtco` m`d ~qzzoxtad hs tfa 8:== ^emllIxm`t~ gox Yoxld Z`aqeo`cm Dms Mdwonmns Zxoixmeea. Ya mxa ixmtagql totfa C`tax`mtco`ml Wmnnc`a Mnna~~ Na`tax &CWMN#, Bof` Fozkc`~ Hlooehaxi^nfool og Zqhlcn Famltf, IMWC Mllcm`na, Ilohml Mllcm`na gox Nlam` ^towa~, m`dHa~t ^fot Goq`dmtco` gox tfacx ~qzzoxt.

    Waxs ~zancml tfm`k~ mxa c` ~toxa gox N@^ adctox~ m`d txm`~lmtox~ yfo c`wa~tadtfacx tcea m`d a`axis c` falzc`i q~ icwa tfc~ ~fmza to tfa~a zqhlcnmtco`~. E~^faflm Ifm`ce, E~ Hcelm Ec~xm m`d E~ Emsm Bo~fc `aad m ~zancml ea`tco`m`d ya ~mlqta tfacx dclcia`na m`d noeectea`t.

    Ya yoqld lcka to tfm`k mll tfo~a yfo yaxa c`taxwcayad m~ zmxt og tfc~zxobant m`d yfo took tfa tcea to ~fmxa tfacx wcay~. Ya ycll ml~o lcka totfm`k tfa C`tax`mtco`ml Q`co` Mimc`~t Tqhaxnqlo~c~ m`d Lq`i Dc~am~a &TfaQ`co`# m`d @al~o` Fo~zctml gox Zmadcmtxcn m`d @ao`mtml Eadcnc`a, Mlcim`b,Lqnk`oy, meo`i otfax~.

    Lm~tls, tfm`k~ to tfa yo`daxgql N@^ yxctax~ yfo zxodqnad fcif }qmlctsmxtcnla~ c` m ~foxt zaxcod og tcea, gox emkc`i ~qxa tfa wocna~ gxoe tfanoeeq`ctca~, tfo~a eo~t mggantad hs nfcldfood z`aqeo`cm, mxa famxd.

    No`nazt, nowax%zmia, da~ci`, lmsoqt2 Bcttcem Bm`tm`memlmkm, N@^ Tfmclm`d

    Zfoto nxadct~2 ^fckfm ^xcwm~tmwm, ^fohfm ^fqklm, ^oesm Mxoxm, Xmfql KqemxDycwadc, @mdaae ^mlem`c, Xcta~f Mxsm, @aaxmb Emc`mlc, Bcta`dxm Dycwadc,Bcttcem Bm`tm`memlmkm, m`d Hohhs Xmemkm`t

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    1 | W o c n a ~ g x o e t f a g c a l d o ` n f c l d f o o d z ` a q e o ` c m

    CXO@S2 Zxawa`tmhla z`aqeo`cm c~

    hciia~t kcllax og nfcldxa` q`dax 1Z`aqeo`cm nm` ha zxawa`tad. Ct nm` ha txamtad q~c`i gcx~t%lc`a nfamz m`dam~cls mwmclmhla m`tchcotcn~. Da~zcta hac`i zxawa`tmhla m`d nqxmhla, ctno`tc`qa~ to ha tfa lamd nmq~a og eoxhcdcts m`d eoxtmlcts gox nfcldxa` haloytfa mia og gcwa samx~.

    Z`aqeo`cm c~ m ~axcoq~ dc~oxdax mggantc`i nfcldxa` awa` c` tfacx waxs amxls~tmia~ og lcga. Tfa txmiads c~ tfmt ct c~ zxawa`tmhla. ^o, tfa toz zxcoxcts c~ tozxawa`t ct m`d, cg ct dawaloz~, tfa` to zxowcda tceals txamtea`t, ~mcdZxoga~~ox &Dx# Ioqxdm~ Nfoqdfqxc, Famd, Dazmxtea`t og Im~txoa`taxolois,^m`bms Im`dfc Zo~t%Ixmdqmta C`~tctqta og Eadcnml ^nca`na~ &^IZICE^#,

    Lqnk`oy. Zxog Ioqxdm~ Nfoqdfqxc c~ m `otad zqhlcn famltf avzaxt too.

    FAMLTF M@D TXAMTEA@T LCTAXMNSZ`aqeo`cm onnqx~ dqa to owaxnxoydc`i c` ~emll foea~ yctf zooxwa`tclmtco`. Tfa zxohlae c~ gqxtfax miixmwmtad cg o`a ox hotf og tfa zmxa`t~~eoka. Zm~~cwa ~eokc`i emka~ nfcldxa` eoxa zxo`a to nfa~t m`d zqleo`mxsc`gantco`~. Tfa otfax cezoxtm`t m~zant c` zxawa`tc`i z`aqeo`cm c~ mhoqtfsica`a % nlam`lc`a~~ m`d fm`d ym~fc`i ycll zxawa`t tfa iaxe~ gxoe~zxamdc`i. ^o, m ia`axml ~a`~a og fsica`a ~foqld ha tfaxa mt mll tcea~. Tfaotfax c~~qa c~ og zollqtco` % tfa gqea~ m`d dq~t c` tfa mcx yfcnf nfcldxa`hxamtfa. Tfa~a zmxtcnla~ ycll miixmwmta tfa hmntaxcm m`d tfa wcxq~ cg tfas mxa

    mxoq`d. Tfaxa c~ m `aad og m lot og mymxa`a~~ c` eotfax~ mhoqt zcnkc`i qzz`aqeo`cm mt m` amxls ~tmia. Nfa~t c`gantco`~ c` nfcldxa` mxa hoq`d tofmzza`. Hqt cg m nfcld fm~ fcif ox zax~c~ta`t noqifc`i, m dontox ~foqld ha~oqift ~o tfmt m`tchcotcn~ nm` ha icwa` tceals. Tceals mnna~~ to eadcnmlnmxa c~ nxqncml. C` tfa amxls ~tmia~ og tfa dc~am~a oxml m`tchcotcn~ yoxk. Hqto`na tfa nfcld hanoea~ waxs ~cnk, eqnf eoxa c`ta`~cwa nmxa c~ xa}qcxad %lcka fo~zctmlc~mtco`, ~txo`iax m`d eoxa avza`~cwa c`bantchla m`tchcotcn~meo`i otfax~. ^o, zxozax mymxa`a~~ og tfa dc~am~a c~ m` cezoxtm`t c~~qa c`c`nxam~c`i tfa ~qxwcwml xmta og nfcldxa` ~mcd Zxog Nfoqdfqxc.

    Tfa xola og wmnnc`a~ c` zxawa`tc`i tfa dc~am~a nm``ot ha owaxlookad. ^oeawmnnc`a~, lcka tfa Fch wmnnc`a, mxa iood m`d m eq~t, yfcnf nm` ha icwa`xoqtc`als. Tfa z`aqeononnml wmnnc`a c~ m`otfax iood wmnnc`a. Hqt tfac~~qa c~ yfatfax tfa ~txmc`~ nmq~c`i tfa dc~am~a, yfcnf mxa zxa~a`t c` tfanoeeq`cts, mxa tfa ~mea m~ tfo~a zxa~a`t c` tfa wmnnc`a, otfaxyc~a tfawmnnc`a ycll `ot yoxk, m`d tfa eo`as ~za`t ycll `ot iat tfa zxotantco` o`ac~ avzantc`i ~mcd Zxog Nfoqdfqxc.

    Z`aqeononnq~, o`a og tfa iaxe~ tfmt nmq~a z`aqeo`cm c` nfcldxa`, fm~em`s ~txmc`~. Tfa wmnnc`a, yfcnf c~ nqxxa`tls mwmclmhla, fm~ ~txmc`~ tfmt mxagoq`d nfcagls c` tfa ya~tax` yoxld, m`d ct~ zxogcla doa~ `ot emtnf yctf tfa

    ~txmc`~ goq`d c` oqx noq`txs. ^o m xoqtc`a ceeq`crmtco` yctf o`a wmnnc`aems `ot yoxk avzlmc`ad Zxog Nfoqdfqxc.

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    7 | W o c n a ~ g x o e t f a g c a l d o ` n f c l d f o o d z ` a q e o ` c m

    Z`aqeo`cm c~ m ~axcoq~ c`gantco` og tfa lq`i~ m`d nm` ha nmq~ad hs ~awaxmliaxe~. M wmnnc`a ycll yoxk yall mimc`~t ~oea og tfa~a hqt `ot mll. ^o ct c~dcggcnqlt to fmwa m noezlata wmnnc`a gox gqll zxotantco`.

    Tfaxa c~ no%c`gantco` m`d no eo