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Nightblindness Can be Controlled

by Dr M A Bari and M A Rashid
I tw w y E anr «U‘,ly °f
\AZ many error* and
V V many fault* but our xvorst crime Is abandoning the children neglecting the fountain of hfe Many of the things we need can wait The child cannot Right now Is the time ht* bones are being formed. h1s blood Is being made and hts senses are being developed. To him we cannot answer Tomorrow His name is
The above is poem titled Tomorrow is too late by Gabriela Mistral. Nobel Prize Winning Poet from Chile.
Just now more than 100 children from the age group 0 6 years (most vulnerable gyoup) Mil go blind only due to vitamin A' deficiency Thus ev-cry year about 40.000 children add to the present blind population of more than 10.00.000. If goes uninterrupted, it will reach 15,00.000 at the end of the year 2000.
About one-fourth of our total population fall in the age group of 0-6 years comprising a total population of 2.75.00.000 (App). At least 4% of these children have been suffering from vitamin A deficiency, out of them 2% will go blind for ever
At least 72.000 government field workers along with more number of NGO health workers have been working tn public health sector. Still. Instead of declining the figure rose from 30,000 to 40.000 during the last two years.
We can get vitamin A' both from animal and plant sources. The animal source* are liver, fish liver oils, dairy products etc and the plant sources are green leafy vegetables, coloured vegetables (carrot*, putnkin) and fruits such as ripe mango, papya. jack fruit etc. Vitamin A' we receive from animal sources can work directly tn the body after It* Ingestion and subsequent ab-Sorbtion But there Is a difference with the plant sources tfiat we get in some form of vftamln A' named beta-carotene that needs to be changed tn our Intestine to be active vitamin A’. Vitamin 'A' Is stored tn the liver and released tn the blood on demand from the body
Role of Vitamin 'A'
Vitamin A is needed In our body for vision, to maintain structural integrity and thereby functional smoothness of nil the hollow organs and duct*. Thus It contribute* to the smooth functioning of the respiratory tract, gastrointestinal tract, genital urinary •rart and skin. So. shortage of vitamin A tn the body leads to visual defect gradually leading to blindness, repeated respiratory tract Infections, nutritional diarrhoea and repeated infection of genital urinary sys-tem. toad skin appearance and ulceration of skin leading to constant source of infection which Is virtually responsible for high Infant mortality rate It is worth to note that infant mortality rale can be lowered by seven time* by eliminating
vitamin A' deficiency. This has been shown In scientific study tn Indonesia.
Out of all these problems, eye problems draw our attention Instantly as the public Is more concerned about it rather than Others.
Causes of high Incidence of nightblindness In Bangladesh:
Lach of information about the tourer* of vitamin ’A' and Us important roles.
h) Ai hand availability of the •ources either due to Une pur chasing capability of natural disaster* hindering gross th of the tource*.
e) High rate of incidence like diarrhoea, measle* which cause depletion of vitamin 'A'.
d) Lack of information of the target people about the readily available mum (high potency vitamin 'A' capsule).
e) Faulty distribution and monitoring of vitamin 'A' caprule.
To intervene and solve the problem, there should be short snd long term strategies. Except the last cause, longterm strate^ should be taken for proper functional health education up to the graasroot level with the participation of ■chool/madrasha teacher*. Imams of the mosque* and students. As most of our mothers are Illiterate, audio visual method may be applied a* for as possible This has been experienced at Mtrzagonj Upazila of Patuakhah district and found highly effective This I* the first upazila from where night blindness has completely been eradicated by a small NGO (ICHO) with the full coopers
machinery This has also con tributed to lower the Infant mortality rate from IM to 67 during the last five year* In the same upazila Probably, this Is the lowest tn the country.
Existing facilities have two-faced works to cortfoat the par Ocular problem.
1 Motivation and health education.
2 Distribution of high potency vitamin A capsule*. Dosing comprises the formulae of triple 6. From 6 month* up to 6 year* after every 6 month* every child should get one capsule.
We have reason* to believe that the number of personnel and the chain of delivery 1* unique. But still the situation I* becoming frustrating Probably, there Is one single reason. The distribution from the Civil Surgeon to the target group is not properly done and monitored. Which In fact mean* a lack of social commitment and dedication on the last part of chain, specially the government health worker* who themselves are not motivated enough and not aware of the consequences of their negligence In their duties.
What can lx? done
a) No change Is required in the existing structure. But change Is required to make It functional.
b) The ctvll surgeons should be responsible and accountable for their respective areas.
c) The health worker* must not leave the house of the client without becoming sure that the capsule Is properly put into the mouth of the child.
d) One medical officer may be assigned only for this particular Job. if civil surgeon /TH * FPO fell necessary.
e) Proven faulty service by any health workers should be severely dealt with.
We have already proved many times that our collective efforts can tackle the crisis irrespective of It* nature and gravity. For example, small pox and malaria have been eradicated and cholera has been controlled tn the health sector.