1. Rashes +1 Staff can act some of the slides if they wish to

2. Village visit one day by a health centre team

3. The village school usually has lots of children but today many are absent. The school teacher says many children have ammai and so parents are keeping them at home

4. The nurse visits a home of one of the children with fever
The nurse visits a home of one of the children with fever. The parents say ammai oothi irrukiral and they cannot let the child come outside the house

5. In another house the parents have gone to work
In another house the parents have gone to work. Grandmother says the ammai villayadukiral and the child is inside and they are giving home remedy. She does not need medicines?

6. 7 children are unwell in the village and no one will let the nurse or doctor see them. Some of these children can be treated at home. Some of them should be shown to the doctor. We will tell you the stories of these children so that you can decide which treatment is best

7. Simple viral rashes Senthil’s story: chicken pox. Mild fever 3 days
Simple viral rashes Senthil’s story: chicken pox. Mild fever 3 days. Rash appears with little blisters. No high fever. He does not look ill. There is no itching and there are no large sores- the blisters are small. Next slide shows the body

8. Senthil’s rash on the body
Senthil’s rash on the body. Remember he has only mild fever He looks well and the rash is only small blisters and is not itchy. What do you call this rash at home? Ask people. Some might say ammai or chinnammai.

9. You can give home remedy
You can give home remedy. (if you have time ask about home remedies and good and harmful practices) But keep clean. Give good food and fluids. Gargle the mouth. Can you give paracetamol?

10. Ranjit’s story. Mild fever. Rash 4th day
Ranjit’s story. Mild fever. Rash 4th day. Looks sad because he could not go to school but drinking well No vomiting. No itching. How would you treat? Home remedy ok

11. Ravi’s story. High fever 4 days. Vomitted x2 Looking unwell Treatment
Ravi’s story. High fever 4 days. Vomitted x2 Looking unwell Treatment? Home remedy? His story- treated at home as ammai. Became very sick and breathless. Taken at last to hospital. Got better after 15 days – doctors said they had come too late-cost 30000Rs. What went wrong? Any ammai with high fever or vomiting or not getting better 4th day needs medical treatment.

12. Selvi’s story. No fever. Not looking ill. Itchy rash all over
Selvi’s story. No fever. Not looking ill. Itchy rash all over. Lasted 1 week. Home remedy or need to see Health worker? More slides next

13. This rash is very itchy. Ask people what rash is it Its called scabies or sori sirangu

14. What is scabies sorri sirangu due to
What is scabies sorri sirangu due to? Its due to an insect so small you cannot see it. Use video clip attached- video 1 explain it was taken with a microscope and you cannot see this insect with the eye

15. Scabies How it cause itching? Treatment? Ask-next slide

16. Scabies treated by gammaxene how to apply it and also talk about sheets clothes whole family and all children in the hostel

17. Vasugi’s story. Little fever
Vasugi’s story. Little fever. Sores which are larger than a blister in different parts of the body

18. Can affect any part of the body. Is this chicken pox Chinnammai
Can affect any part of the body. Is this chicken pox Chinnammai? DiscussSores are open and bigger than chickenpox chinammai

19. The parents thought the child had chicken pox. They tried home remedy
The parents thought the child had chicken pox. They tried home remedy. 4 days later what happened? Pictures before and after treatment Discuss and talm about impetigo can damage kidneys now or it can cause renal failure later. Vasugi was taken to hospital and given penicilin injections and survived. But she waqs lucky. Parents should have taken her to hospital earlier: Revise skin sores that are larger than a blister and do not heal or are in many places may need penicillin injections to prevent kidney disease. Some also may have scabies if they have itching and sores- so you sometimes need penicillin and scabies treatment together.

20. If time permits. These children had a little fever and then what happened? They do not look ill and the swelling only hurts a little. What is it (ammaikatty) what is the treatment?

21. This child had this swelling and it was painful and not healing in 1 week? Home treatment? Or doctor?

22. Rules- not ammai! (translate)
High fever, vomiting, looking ill
Fever or rash not getting better after 4 days
Itchy rash that last more than a 4 days
Open sores bigger than small blisters
Swelling that is painful discharging pus or not improving

23. You decide what to do? 7 days rash no fever

24. John: 3 days rash mild fever not looking ill No itching

25. Ranjit: High fever Breathing fast vomiting