Case Report
This is a case report from GGDKA (project code- 3006).
ORBIS & Partners united effort set solution for triple burden in single family
Introduction
Azalech Hamusa a 35 years old woman lives in Gamo Goffa Zone, Arbaminch Zuriya Woreda, Dega Chenge Kebele, Buro village.
She has been suffering by eye health problem called trachomatous trichiasis for more than 7 years together with her daughter.
The condition of the road: - about six kilometers from the main road (The road from Arbaminch to Kemba Woreda) is dry season road(hand dug road). The rest 34 kilometers from Arbaminch is accessible(all weather road)
The housing condition of the beneficiary: Traditional House(Grass covered Hut with single door) not ventilated enough. The house is built from local materials such as: wood, bamboo and grass.She has been using pit latrine constructed from locally available materials a year ago, but she has no dry waste disposal pit.She is using river water for food preparation and other activities and unprotected spring for drinking (it takes 10 minutes to fetch water). She is using properly covered plastic gallon for drinking water.No separate rooms for domestic animals and for kitchen for food preparation (not isolated).
The Housing Condition of W/ro Azalech Hamusa
Before the surgical treatment
W/ro Azalech Hamussa is 35 years oldand economically the poorest of poor(abject) live on making and saling pottery , people do this kind work be out casted. Mother with eye health problem (trachomatous- trichiasis) who lost her husband by death of unknown cause and living with her 5 children of which the first daughter(Alemitu) was also suffering the eye health problem (impaired vision).Totally tragedy of triple burden (poor, eye health problem-TT of mother and her 16 years old daughter) in single family existing more than 5 years but worsened after the death of the head of house hold. Being poor is one of the problems for w/ro Azalech Hamusa further extended to eye health problem called trachomatous trichiasis which is real obstacle to her daily activity(pottery) . According to Azalech” she is epilating her eye lashes early in the morning before she starts her routine activity for her family survival”. Besides to the discomfort and pain she suffer the responsibility of epilating inward lashes of her daughter (Alemitu) is wasted her duty time before she treated surgically by sr. Mamitu(IECW).
She said “Thetriple burden” worsened after her husband’s death. That is the first problem was economical then eye health problem of both the mother and her daughter followed by death of husband (the head of household).She is taking care of her family members and she has the role of income generation for the family by making pots for sale twice a week. She had great challenge (pain) due to smoke during the heating (burning) the pots after preparation to make hard.
As explained above on epilation for six years herselfby using mirrors and epilation of her daughter’s lashes (Alemitu) is also a duty of the mother. This was the challenge to make the number of pots using clay soil for income generation so as to provide family subsistence. She has also limited participation in social activities i.e., weddings, funerals, religious activities.
How W/ro Azalech epilate eye lashes by using mirror and local epilating material.
She said, “Responsibilities were fall in my hand after my husband’s death; taking care of family members at home and income generation.”
She said, “I have been misinformed about the stay after surgery (fear of death due to surgery) and frightened for surgery because of taking care of my family members.”
She replied, “At a time I was in mixed feeling i.e. happiness to get my eye problems resolved and the other was fear to undergo surgery. However, my feeling of getting surgery outweighed because I have to work with my full potential to support my family members.
She said, “She asked her neighbors who had surgery previously and the Health Extension worker (HEW) W/ro. Zinash D. informed the date and place of the surgery.”Then I decided to be operated after the information from the HEW and my neighbor previously operated.
After TT surgery by IECW
The patient has received the service (TT surgery) by sr.Mamitu Adasho who trained as integrated eye care worker (IECW) by ORBIS at her nearby Health Post (access); it is about half a kilometer from her house, about 10 Kilometers away from the cluster Health Centre and 40 kilometers away from the Zonal Hospital Arbaminch.
W/ro Azalech had two eyes (bilateral) in ward growth of eye lashes (chiro) She had been operated both upper lids bilateral tarsal rotation (BTR) in local language (Shoke) a month ago (August 24/2012). As she said she had been removing the eye lash (epilating) six years ago, moreover, since then she had been complaining of fear of light, tearing, redness and discomfort of the eye.
W/ro Azalech Hamusa on her income generation duty (pottery).
Her 1st daughter Alemitu Biere (16 years old) had been suffering from trachomatous trichiasis since seven years ago and her left eye(OS) had been operated for TT(BTR) two years ago (2010); and her right eye(OD) is operated for TT (BTR) in the same day with her mother.
She (Alemitu) had difficulty to attend class because of her eye health problem since seven years.
By now she has started class because of her eye problem resolved
Therefore after TT surgery of the mother and her 16 years old daughter the tragedy of triple burden in single family stopped by integrating with existing primary eye care service, accessible, affordable and community involving intervention.
Photo of Alemitu Biere after her both eyes operated(started her class)
W/ro Azalech and her family members(productive&happy)
Her two daughters and the second child in the house support their mother in taking care of the family members and in collecting clay soil for makingdifferent home utilities like pot and others.
Her son prepares food during their surgery and until the end of post operation period; this indicates how people are trying to win the challenges in their life by searching many options (struggle for survival).
As she said she went to the health post for treatment with her neighbor W/ro Asnakech Ayele and she didn’t paid any money (affordable) for transport, because the surgery is performed in her nearby Health post(access), which is half a kilometer from her house.
As she said, she didn’t pay any money for surgery, treatment, medicine and food. Her child Alemitu who had right eye upper eye lid surgery (BTR) at the same date at Dega Chenge Health Post prepared home- made diets.She didn’t pay any money for every activity and service. She thanks a lot for all things she and her daughter received. As she replied, she went back to the health post after one week for the removal of stitches only.
After her relief from her discomfort, she applied what the care giver (IECW) taught her about the cause, the predisposing (triggering) factors, modes of transmission and prevention for her family members. Also she informed a patient who has inward growth of eye lashes to have treatment, but he refused to have surgery due to the time of collection of agricultural products and the coming “Meskel”.
After collection and the celebration of Ethiopian Meskel he planned to have the surgery, she explained. She became the advocator for the service after getting relief from the problem.
Now she perform without any difficulty (previously she had problems during burning of pots) and increased the frequency of making local home utilities and earns money much better than previous years, so she let her daughter and the second son who gave up their school due to economic problems, and the problems related with trachoma. Again her participation in social events and celebration dramatically increased.
Economic, social and eye health problems solved by integrated, comprehensive and committed efforts of ORBIS and partners. Family with triple burden became productive and happy.
Photos of S/r Mamitu Adasho(IECW) and W/ro Azalech’s family members