School's out, dangers in: The hidden health crisis striking children on holiday
Sporting activities also contribute significantly to the caseload. Injuries related to football, riding bicycles, and playground equipment, especially among in children under 10 years, are common.
What you need to know:
- A new concern is the rise of lifestyle-related diseases in children, an issue compounded by poor nutrition, leading to diseases such as diabetes and hypertension.
School holidays, a time eagerly awaited by children, are paradoxically the period when they face the greatest risk of severe injury, illness, and abuse, according to leading paediatric specialists.
In comprehensive interviews, Dr Paul Mang’oli, an orthopedic surgeon, and Dr Tim Jumbi, a paediatric surgeon from Kenyatta National Hospital, provided a sobering analysis of the most critical conditions afflicting children during breaks, drawing a clear link between free time and rising trauma cases.
Dr Mangoli, focusing on orthopedic trauma, highlighted that falls from a height constitute one of the most serious threats.
"One of the common reasons we receive patients is mainly injuries that result from fall from a height," Dr Mangoli stated.
He explained that in apartment-heavy urban areas, children often fall from balconies while playing, while in rural settings, falls from fruit trees like mango and avocado are frequent. The consequences are often devastating, ranging from multiple fractures of the limbs to life-altering head or spinal injuries, sometimes resulting in paralysis.
"It could be a fracture of multiple bones of the lower legs and upper limbs. It could be also other-related injuries like head even spine. Depending on the severity, some of these children become paralysed.
Sporting activities also contribute significantly to the caseload. Injuries related to football, riding bicycles, and playground equipment, especially among in children under 10 years, are common. The majority of these are upper limb injuries, including fractures around the wrist and elbow. Dr Mangoli pointed out that many of these cases require surgical intervention, underscoring the severity of the "accidents."
Safety standards
Echoing this, Dr Jumbi pointed to lax safety standards in residential buildings. "Sometimes, if children fly off through balconies because the standards are not okay," he warned. He also cited unsafe travel, lamenting: "You will see them loaded onto a motorcycle, five of them, without helmets," as a major, preventable cause of trauma.
Beyond accidents, both doctors stressed that holidays see a tragic spike in non-accidental injuries resulting from abuse and neglect.
Dr Mang’oli detailed the challenges of identifying child abuse. Children are often too scared to talk, and caregivers give conflicting stories. Examinations can reveal a "series of scars: some fresh, others healing," indicating persistent abuse.
A distinct but equally tragic problem, he noted, is the sheer neglect and abandonment of children, particularly when parents are incapacitated or absent. Dr Mangoli spoke of children whose parents are “drunkards and they are hardly at home." "You're stuck with them because you can't just drop them on the streets," Dr Mang’oli explained, noting that resolving such cases involves prolonged stays in hospital wards while awaiting placement in children's homes.
Dr Jumbi added that unsupervised children are vulnerable to physical and sexual abuse from nannies or neighbours. Simple household hazards also increase, with burns from kitchen fires becoming more common.
While trauma dominates holiday admissions, Dr Jumbi explained that children in hospitals are a mixture of those suffering from communicable diseases, such as malaria and viral infections, and a significant group suffering from chronic non-communicable diseases like cancer, heart issues, kidney issues and issues to do with the brain."
A new concern is the rise of lifestyle-related diseases in children, an issue compounded by poor nutrition, leading to diseases such as diabetes and hypertension.
At Maseno University School of Medicine, Dr Walter Otieno, the head of paediatrics and Child Health Department, says parents should expect a spike in respiratory infections, diarrhoeal diseases and infections among children during the school holidays.
While the health expert is yet to start receiving cases of the infections, Dr Otieno says parents should be on the lookout and seek medical attention in case of any symptom of ill health. He added that western region is currently facing a surge in asthma attacks among children.
“The medical condition is however not in any way related to closure of schools. The asthma attacks are due to heavy rains being reported in parts of the country.”
Going by the previous medical history, the expert says one of the common infections among children is upper respiratory infections resulting from increased interactions due to closure of schools.
“Normally when they are in school, they are sort of confined. When out of school, they spend the whole day interacting,” says Dr Otieno.
The health expert says in an event that a child contracts upper respiratory viral infections, it compromises the integrity of the mucous membrane.
The result is activation of resident bacteria in the throat and upper airway, leading to tonsillitis, upper respiratory tract infections and sometimes coughing.
The children, he says, may also be exposed to diarrhoeal infections while travelling upcountry due to stress of traveling, change of diet and environment.
“When children go upcountry, there is also a lot of feasting amid the festivities that could impact on their health.”
Other infections which may result from contact is the hand, foot, and mouth disease, which is common among under five and older children.
The symptoms
The infection is always accompanied with symptoms including fever, rushes in the lower limbs, buttocks, hands and mouth.
“The infection may be contracted from the older members of the community while out in work places and passed to children.”
The paediatric doctor at the Jaramogi Oginga Odinga Teaching and Referral Hospital, however, says the health condition can be managed through controlling the fever and hydration within a period of seven to 10 days.
He also cautions parents travelling to Western Kenya from different parts of the country to ensure their children sleep under treated mosquito nets to prevent malaria infections.
This, he says, is due to the high malaria prevalence in the lake region.
“There are places in the country where children under the age of five are not presented with malaria vaccines due to the low prevalence of the disease. Such children can be exposed to severe malaria symptoms due to lack of immunisation,” he explains.
The Maseno University School of Medicine lecturer says parents and caregivers should rush children to health facilities in case of any health discomfort.
The cases to look out for, he notes, include fever, running nose or blockage, difficulty in breathing or laboured breathing.
“In cases of fever or lack of appetite, the children should be taken to a health facility, where they can be checked by medical personnel and treated,” he says, adding that children’s health tends to deteriorate faster.
