Diarrhoea doll with happy and sad face Teacher needs Diarrhoea doll with happy and sad face ORS packet 1L bottle IV bottle (empty is ok) Sugar salt and cup 200ml

Why is one plant wilted and one not wilted?

Plants are made of a lot of water. So are human bodies 75% (3/4) water

Meet Kuppu the diarrhoea doll Kuppu is happy when full of water But when diarrhoea starts he loses water Diarrhoea can kill only because it dehydrates Kuppu needs more water to stay alive How do you give this water? By mouth?- will it cause more diarrhoea? Do you need to give IV fluids? To know the answer you need to understand how the small intestine works.

The small intestine looks like a tube at first

But if you look at the small bowel in a microscope it has little hair like structures called villi. The villi contain blood vessels – why?

Now lets see a video that shows how small bowel works Video- explain how the bowel absorbs nutrients and water and how germs can turn the pumps off causing diarrhoea Video 1 Germs switch off the pumps that pump water and nutrients from bowel into the blood You drink 2-3 liters of water a day and make 6L of saliva and bowel juices daily. If the germs switch off the pumps where will all this water go? (Ask the class). It causes diarrhoea and we get dehydrated.

Story of diarrhoea in Africa Africa has many poor countries. When people get diarrhoea they used to need IV fluids to replace the water lost IV fluids cost a lot It needed lots of doctors and Nurses to give IV fluids Will it be easy to find a vein in someone who is dehydrated?

If you mix glucose with the Right amount of salt A doctor gets an idea to help people who need fluids when they get diarrhoea If you mix glucose with the Right amount of salt You can help the small Intestine absorb water!!

ORS saves lives! Many African lives were saved by this finding!

Why is ORS better than IV- ask the class. Cheaper No need for doctors and nurses. You can do it at home yourself Easy to give

ORS can be bought in shops or you can get it from Government PHC or KCPPHC staff. ORS how to make it. Ask class to read label. Why is correct water quantity important? The small bowel pumps blocked by germs will only work if the strength of salt and glucose is correct. Too much or too little water makes it useless.

Home made sugar salt solution Packet ORS is best but if you do not have it you can make ORS at home Use sugar and salt to show how to make SSS SSS can save your child’s life when you are all alone and you get diarrhoea Give it with cup/spoon Video 2

Some people do need IV fluids Video 3 and 4 sick children who had severe diarrhoea Discuss why eyes sunken and skin not elastic These children need ORS and IV fluids

Why do antibiotics and injections not help most people with diarrhoea- revise types of germs Revise antibiotic resistance

Others who need IV fluid or need to go to a health centre Those vomiting lots (ask why) High fever Blood and mucus stool- these People have a bacteria Causing diarrhoea and need Antibiotics

Role plays 1. some one with simple diarrhoea Someone has diarrhoea when its night and not possible to go to a health centre Someone says they need injections when they get mild diarrhoea Someone has severe diarrhoea and vomiting

If you have time talk about mild diarrhoea and lomotil (hyoscine) Giardiasis