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SARPV Efforts

Makes RICKETS Free Bangladesh

SARPV’s one of greatest attention is to prevent childhood disability. Rickets is one of the major causes to make a child disabled which is curable and preventable. Rickets was first brought to broad attention in 1991 by SARPV after visiting the Chakaria region of southeastern Bangladesh after a devastating cyclone. In 1991, Md. Shahidul Haque first came to Chakaria for a relief operation. As he worked there, he discovered many children had leg deformities. Sometimes the deformities were so severe that the child could no longer walk. Very quickly he met with national and international authorities and it was discovered that the children were suffering from rickets and if this children does not get proper treatment then their life will be turned in to physical disability. This word disability was the key factor to Mr. Shahidul Haque how to prevent the disease and can save their life from future disability.

Since then SARPV is working for the rickets affected children and raising awareness towards rickets prevention. SARPV is the only organization in Bangladesh that has a long working experience in the area of rickets.

In Bangladesh, initial studies suggested that vitamin-D deficiency was not a major causal factor in rickets in Bangladesh, rather calcium deficiency is assumed to be the primary etiological factor of the disease.

Chronological Steps by SARPV on Rickets

1991 : Identification of a high prevalence of in Cox’s Bazar district by Md. Shahidul Haque, Founder Secretary, of SARPV after the devastating cyclone.

1991-1993 : SARPV raised campaigns through Newspapers, Dialogue forum, Letter correspondences,

Annual reports and Workshops SARPV treated 25 rachitic children at MCH

1993-1997 : Nutritional survey on clinical and pathological examination of rachitic children by Ami des Enfants du Monde (AEM), France Rapid prevalence-assessment by ICMH, UNICEF and SARPV.

1994 : Diagnosed as calcium deficiency rickets by Dr Cimma of AEM, France

1995 : Supplementation trial using different Calcium & Vitamin D doses by AEM (Dr J.P. Cimma)

1997 : Two Bangladeshi boys were operated in France (AEM) Formation of a Consortium on rickets in Chakaria, Bangladesh by SARPV, Cornell University, BRAC, ICDDRB, AEM, MCH, UNICEF, and ICMH

1998 : Confirmation by the consortium - the rickets in Bangladesh is a Calcium deficient form.

Rachitic children clinically and pathologically examined by Cornell University, University of Dhaka, SARPV and MCH Supplementation trial of Calcium on 2-5 years old children by Cornell University, CIMMYT and SARPV Household Study on Food habit of the inhabitants of Cox’s Bazar and Dinajpur districts by Cornell University.

1999 : Prodipaloy (an integrated school) was set up to supervise control children under rickets research by AEM, France Physiotherapy training started for community level physiotherapists by KDM, France

2000 : Rapid Assessment on Rickets by BRAC and HKI under Rickets Consortium

2001 : Training of Bangladeshi physiotherapists starts with 4 trainees by KDM jointly with SARPV and AMD.

2001-2003 : Study on the role of Aluminium dishes on rickets by Shahidul Association.

2002 : Surgery begins at Cox’s Bazar Baitush Sharaf Hospital (CBBSH) in collaboration with AMD, KDM, SARPV.

2003 : Brace center at Chakaria with support from AMD, France 200 children given nutritional treatment under close supervision

2004 : CRG (Convergence Rickets Group) formed under the leadership of Dr. Craviari Thierry for concentrating and involving more expertise on rickets and sharing experiences.

2005 : Operation of 128 Ricketic children in Bangladesh initiated by SARPV with the help from AMD, France and KDM, France under the supervision of Dr. Craviari Thierry

2006 : International Rickets Conference held at Dhaka, Bangladesh organized by SARPV with participation from USA, Nigeria, South Africa and France inaugurated by the French Ambassador to Bangladesh and the President of BMA.

2007 : Rickets Interest Group (RIG) formed as a follow up of International Rickets Conference Dr. Thierry proposes formation of Bangladesh Rickets Society.

2008 : Prevention of the Rickets program undertaken at Cox’s Bazar district with the assistance from UNICEF.

National Prevalence Study on Rickets by ICDDR,B with supports from SARPV, CARE, UNICEF and NNP

National Consultation on Childhood Rickets in Bangladesh organized by SARPV Bangladesh and RIG with supports from UNICEF.

2009 : Finding of National Prevalence Study on Rickets: 1% of the population below 15 yrs is suffering from Rickets.

2010 : SARPV conducted a baseline survey in Cox’s Bazar, Gazipur and Sunamgonj districts with supports from DFID and Health link Worldwide- UK. Finding of baseline survey is the Gazipur has the highest prevalence of Rickets (1.9%) among all the districts of Bangladesh. rickets in the children of Chakaria


Collaboration and Network to Combat with Rickets

SARPV works in close collaboration with Aide Médicale et Développement (AMD), an association for international solidarity created in 1986. AMD work in developing country for: Improving health care management; rehabilitation of hospitals and health centres; providing medical equipment; training for health workers, nurse, doctors; and public health education, prevention and research. AMD currently works in Bangladesh, Vietnam, Zanzibar, Madagascar, Armenia and Cambodia.

Since 2001 SARPV, AMD and KDM collaboration has developed a group of professional workers- physiotherapists and prosthesis experts trained out of the community person’s deal with rickets patients and physically challenged persons at the community level and a group of trained facilitators in advocacy, communication, mainstreaming and Community Based Rehabilitation of the disabled people (CBR) and rickets affected children through nutritional program


Syndrome of Rickets:

The following five symptoms of Rickets were observed among the children 1-15 years of age who were not definitely identified as Rickets patient..

Symptom-1: Less than normal height (Poor growth) with respect to age

Symptom-2: Wrist joint is increased

Symptom-3: Feels pain at the leg while walking

Symptom-4: Ribs of the chest are raised

Symptom-5: Legs are curved from knee to ankle




Treatment and prevention measures adopt by SARPV

At the primary stage of rickets, it may be cured completely if proper step is taken. Nutritional advice, Medicine, brace and surgery are different mode of treatment to against rickets.


SARPV’s current works for rickets prevention

SARPV is the only organization in Bangladesh that has a long experience of working in the area of rickets. SARPV is working with organizations, communities, other stakeholders and funding agencies in order to promote the prevention of the rickets and save the future generation from disability in the society. Currently, SARPV supports more than 10,000 children with rickets in Cox’s Bazaar District, 3000 being under nutritional program.

SARPV at present are working with the rickets issue under following steps. This all are depends on after need assessment of the rickets children what s/he needs.

  • With Nutritional Advice and through awareness raising
  • Nutritional Advice including Assistive support
  • Nutritional Advice and Medicine
  • Surgery if the deformity is more 30 degree and age beyond 6 years.
  • Raise mass awareness among stakeholders ( UP members, doctors, imams, teachers, village leaders and religious leader by developing different mode of IEC materials as booklet, poster, etc
  • Organized video show at villages, schools and madrasha on rickets prevention and identification which has developed SARPV, besides this also arrange stage drama at grass route level.
  • Provide training program to family planning and health workers, health assistance, nutrition workers of NNP and teachers community
  • Arrange press media campaign to sensitizing media personnel’s
  • Organize seminar and workshop at district level with GO and NGO’s officials
  • Maintain lobby with concerned policy makers for considering rickets as an immerging health problem in Bangladesh.




 

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