CHOLERA AND DIARRHOEAL DISEASE CONTROL

1. Every clinic considers itself part of the Provincial and National Diarrhoeal Disease Control Programme.

2. All staff are trained in the management of diarrhoeal disease and have continuing education every 6 months or when there are reports of cholera outbreaks in neighbouring countries or regions.

3. Every clinic is able to contact and works with the environmental health officer in whose area it falls.

4. Reduce mortality due to diarrhoea in children by 50% (Year 2000 Health Goals and Objectives)

1.1 The clinic has the latest copy of Guidelines for Diarrhoeal diseases and Cholera Control.

2.1 Cholera packs for diagnosis and the protocol for stool collection.

3.1 List of drugs in accordance with the Essential Drugs List
3.2 The clinic maintains a buffer supply of ORS and intravenous fluids.
3.3 Clinic staff know where extra stocks can be obtained quickly in case of emergency

4.1 Staff have knowledge of the clinical presentation of diarrhoeal diseases and cholera and refer severe cases to hospital having first starting rehydration. Less severe cases are managed at clinic level with oral rehydration.
4.2 Clinic staff are able to manage cases of diarrhoea and dehydration daily during epidemics.
4.3 There is always a state of preparedness for an outbreak of cholera by maintaining a buffer supply of ORS and intravenous fluids.
4.4 Staff are able to recognise the clinical presentation of cholera.
4.5 Suspected cases are reported immediately by phone or other communication method.
4.6 Oral rehydration (with ORS sachets) are used and the patients state of dehydration is monitored while having the ORS.
4.7 Clinic staff encourage use of salt and sugar home-prepared solution when ORD sachets are not available.
4.8 Staff know that cholera infection can be asymptomatic or cases can be mild and indistinguishable from other diarrhoea.

5.1 All severely dehydrated cases should be referred to hospital

6.1 All patients and caretakers receive health education on oral rehydration therapy, refuse disposal and cleanliness.

7.1 Patient’s records are kept up to date.
7.2 A weekly chart is kept in clinics showing diarrhoea cases under 5 and cases over five and any undue rise especially of cases over 5 is reported to the District Manager.

8.1 Education is carried out in the community on hygiene, latrine use, hand washing, food safety, boiling of water and milk, chlorination of drinking water if feasible, use of tap water or delivered tanker supplies during an epidemic.
8.2 The value of breast-feeding as a preventive measure is a permanent part of the clinics community health education programme.

9.1 Staff collaborate with other departments like Environmental health, Education and other sections within health like MCHW, Health Promotion.