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vinadiemtrung · Chu Nhan Joined: 23 Aug 2011 Posts: 667

Preventing of esophageal stenosis caused by caustic soda in Guinea. The extent of esophageal stenosis in Guinea

Each year, between 100 and 300 cases of esophageal stenosis caused by caustic soda are believed to take place. This is a new phenomenon, started in the mid-90s, when caustic soda began to appear in the country’s markets. This chemical product is mainly used by women involved in generating revenue activities, for the creation of soap or detergent. Unfortunately, caustic soda looks like other harmless commodities such as sugar (in its solid form) and water, milk or chocolate (in its liquid form). Women usually work from home, where small children are around. Due to ignorance, caustic soda is very often kept in used drink bottles and can be reached too easily.

80% of the ingestion are done by children aged between 2 and 8 as a result of domestic accidents. When swallowed, caustic soda causes very severe damage to the mouth, the tongue and the esophagus, often resulting in esophageal stenosis or even death. Children that have swallowed caustic soda suffer tremendously. Families do not know how to react to such accidents, and very often try to make the child regurgitate the chemical product thus causing further damage. Treatment is possible but lasts between 6 to 12 months. Children must undergo several painful surgical acts to dilate the esophagus.

Mothers are forced to stop their income activities to take care of their child, having to come to Conakry (the capital) for extended stays and then to attend very regularly to the wounds and feed their child through a tube directly linked with the stomach. Women usually feel guilty for the accident and are held responsible by the entire family. Due of the length and difficulty of the treatment, as well as its cost, it is sometimes stopped, putting the child at risk of death by severe malnutrition. In the most severe cases, the esophagus must be reconstructed, a surgical act that cannot take place in Guinea. The poorest families, where most of the cases happen, cannot face such an expense. The beginning of the project protecting Guinean children from the dangers of caustic soda.

Terre des hommes is a Swiss based child relief international organization that has been working in Guinea since 1987. It implements several projects on health and protection of children. For many years, it has organized medical transfer to Switzerland for life-threatening cases of children in need surgeries not available locally. In the past few years, it has been increasingly faced with cases of severe esophageal stenosis caused by caustic soda ingestion. Concurrently, the pediatric surgical unit of the Ignace Deen Hospital (the only one able to attend to esophageal stenosis locally) requested the organization’s support in coping with this raising public health issue.

The best way to deal with esophageal stenosis caused by caustic soda is to de facto prevent those ingestions to happen. Very simple means can be implemented such as putting this chemical product out of children’s reach in bottles secured by protective caps. A new Terre des hommes’ annual project is currently in its final planning stages.

Thanks to public messages, widely broadcasted through medias, as well as public events, more than 900’000 people will be sensitized on the dangers of caustic soda and the preventive steps that can be undertaken;

2’000 children and 1’000 adults involved in using caustic soda for income generating (mainly women) will be specifically empowered to better prevent those domestic accidents;

100 affected children will be taken care of;

Their families will be supported during the treatment of the esophageal stenosis; and

100 health workers will be better equipped and trained to deal with and refer those cases to the appropriate stakeholders.

Working as an ambassador

As an ambassador of this project, I was involved in the definition of the prevention message to be broadcasted and some fundraising activities. I have also worked together with media to increase the level of awareness in Guinea on this very important, yet unknown, issue. In the next few months, I will take part to TV and radio advertisement, TV shows, and give interviews. I will also be involved in sensitization events. I will also work with the children to make them sure that they can be have a normal life and that they can be saved,because a lot of them are discriminated by the normal children in school.

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