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Week of April 2:   His parents don't know what day he was born, but they claim Eric Yaw was three years old when he had a fever and convulsions. The most common diagnosis for these symptoms in Africa is of course malaria. He was taken to a local clinic called "New Life," and given an injection of chloroquine for combat malaria. No tests were taken, since the clinic did not have any such facilities, not even a microscope if they did want to look for malaria parasites. Although the date was not known, they did know that it was on a Monday. On Thursday of the same week Eric convulsed again and this time he was taken to a traditional village healer, who treated his convulsions with herbs. When Eric was brought home after treatment the parents noted that he couldn't walk and that his left arm and leg were both weak and he had difficulty moving them.

      
(Please click on pictures to enlarge them)

Between 6 weeks and 2 months later a group of volunteers for the National Immunization Day detected his AFP (Acute Flaccid Paralysis). They had came to Eric's home to immunize all the children and they asked the parents if there was any child that had recently become paralyzed. "Yes," their son had recently become paralyzed -- first his left arm and leg and now only the leg is weak and he is having difficulty walking. The local herb doctor was treating him.

To shorten the story, two samples of his stool were taken, 24 hours apart, and sent to the Regional Lab authorized to isolate polio viruses. The Lab did not isolate a Wild Poliovirus that typically is the cause of paralysis, but they did isolated a poliovirus that is used in the oral vaccines. Now Eric had never been immunized, even though an immunization team comes every month and sets up an immunization table under a mango tree close to his house. His parents didn't seem to realize how important that was, however, the neighbor mothers had taken their children and the live vaccine virus that was given to one of their children had spread around, as expected, and infected others. Had this vaccine poliovirus caused Eric's paralysis? I don't think so.

He had no evidence of paralysis until after his second seizure and then it was the combination of his left arm and leg. The paralysis appeared within about an hour, unlike polio paralysis, which usually takes longer than 24 hours and progresses to the maximum within 3 days. Also he had excellent deep tendon reflexes, which are usually minimal or absent in polio. He had been infected with the polio virus, however, and it was just circumstantial that his paralysis, most likely caused from his seizure, coincided with the growth of the vaccine poliovirus that a neighbor child had shared with him. He is now being given the immunizations that he should have had before he finished one year of age. Fortunately, he is able to walk with a drop foot and by dragging his leg. We provided a set of instructions for exercise and physical therapy and trust that he will

I am fascinated by the way babies are carried around all day. The mothers wrap a simple cloth around the baby and themselves, somehow secure it in front without a knot and the babies either look around or go to sleep. Sisters and brothers also carry these little ones around in the same position, but without the cloth. Often I see mothers carrying their little ones behind them, secured with the carrying cloth, and with a heavy load of wood, water or some agricultural product balanced on their head.

It seems to be a favorite delicacy. It's called a "grasscutter" and looks like a cross between a mole and a ground squirrel. All along the road there are village people who hold one in their hands as you go by, hoping that you will stop and buy one they killed. For 50 - 60 cents it's yours to enjoy and they even skin and roast it without extra charge. I haven't tasted one yet and I don't seem to be in a rush to eat this little creature that reminds me of a gopher. My driver and fellow Disease Control Officer, however, take advantage of the low price of protein and will stop to make their purchases.

These signs are found all over Ghana. It's true, Malaria Kills Children, but it seems that there is nothing anyone is doing about it. The Ministry of Health doesn't have a plan to combat malaria and WHO can't do anything, other than sensitizing the public on the danger and seriousness of malaria (as if they don't already know) until a plan of action is formulated. Hopefully, as I wind down with the polio activity I will be able to contact officials and help initiate stimulate some action to "Roll Back Malaria."

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