Treatment of leg ulcers by Dr Sherri Kirkpatrick. Children in many Third World countries suffer from painful leg ulcers. One group of school-age children in Chiba, in the Democratic Republic of the Congo, decided to take action and asked for help. Some of the children had legs covered with scars from previous ulcers – sometimes their legs were either deformed or crippled from the effects. All suffered pain from current weeping leg ulcers. The children knew that the Community Health Workers ...

When Drs Rajanikant and Mabelle Arole graduated from medical school they were both concerned about the medical care of the rural population of India. They went to work in a rural hospital. After five years they realised that despite all their hard work in caring for hospital patients, the general health of the community around had not improved. They realised their need for training in public health and returned to college for further study.

Many people have difficulty remembering the schedule for childhood immunisation. This means that children often miss some or all of a series of…

by Aisha Yousafzai, Maria Kangere and Sheila Wirz. A disability can result from many kinds of medical conditions and will limit the activities in which a person can participate. People with disabilities are frequently ignored by their communities. However, UNDP (United Nations Development Programme) figures suggest that, on average, 5% (1 in 20) of the population of most countries have either a moderate or severe disability.

by Dr Kris Prenger

We carried out a survey in Bunia, Democratic Republic of Congo to analyse certain factors concerning AIDS among young people. Our findings included the following information:

by Nyangoma Kabarole. Recent figures from the World Health Organisation (WHO) show us that the AIDS situation is very serious indeed. In January 1994 they estimated that over 15 million adults and children were infected with HIV. Over three million cases of AIDS have so far been reported.  

by Dr Hans-Martin Hirt and Dr Keith Lindsey. When Europeans first arrived in Africa, Asia and the Americas and witnessed practices such as ritual sacrifice and ancestor worship, they quickly labelled these as primitive. Instead, they introduced the people to European customs, culture and religion. However, we now recognise that there is much to learn from these traditional cultures. In rejecting some dangerous practices, many other beneficial practices were ignored.

by Robert YeeIs there a biblical model for health care? Health care in many countries is delivered by professional health care workers, based in a hospital or clinic. These people are highly trained to provide specialised care to individual patients. Although such care may be effective, this approach is expensive and reaches only a limited number of people. It is often not accessible to poor people, particularly in remote rural areas, and it discourages independence and self-reliance in local ...

Advocacy for healthcare.   Thousands of people die every day from preventable diseases, from lack of proper healthcare or information about health issues. Many of these deaths are related to issues of international debt, corruption and bad governance. Injustice kills and, unfortunately, this is the reality for many people across the world.

In the midst of suffering by Jane Bates Bring to mind a time when someone, perhaps a family member or someone in your community, was suffer-ing from an incurable disease.

Our approach to community health and development by Stan Rowland.  Many Christian groups are concerned with meeting either spiritual needs or physical needs.

Some Christians believe that seeking medical help shows a lack of faith in God. This Bible study challenges that idea.

The Blood of Christ. Blood may be thought of in many ways - it may be seen as a sign of weakness, injury and death. But we also talk of our ‘life blood’. Blood keeps our body healthy and alive. Blood may bring life to others by transfusions. Immunizations give our blood the ability to fight off diseases.

What do we really know? by Rev Michael Beasley Read Luke 8:42a-48. As human beings, we often know less about others than we think we do. Consider the story of the woman with the haemorrhage. What do the following people know about the situation described, and what don’t they know?

By Dr Heather-Louise Williamson. These two case studies illustrate how difficult it can be for doctors and health workers to put Dr Lankester’s advice into practice, when patients will not accept the advice they are given. Use these stories to help your patients, and others, to understand the points which Dr Lankester is making.

by Rachel M Smith. Cambodia has one of the highest rates of people with disabilities in the world, partly a result of years of war and civil conflict. Nearly half of Cambodia’s population is under the age of 18, so many people with disabilities in Cambodia are in fact children.

Goal 6 aims to reduce the incidences of life-threatening diseases. More than one billion people - one in six people in the world - suffer from one or more of the diseases that the World Health Organization has called 'neglected tropical diseases'. These diseases can debilitate (weaken), deform, blind and kill. Here we share some practical advice about four diseases, one in each of these categories.

COMPETITION WINNER by Lois Ooms. We are involved in a community-based health programme and would like to share an idea which has proved very useful here and has also helped us to expand our community health work.

by Mike Wall. ‘If we are thrown into the blazing furnace the God we serve is able to save us.’(Daniel 3:17). People involved in disaster situations have to cope with high levels of stress, so it helps to understand what stress is and learn how to deal with it.

Examples from Zambia of how to communicate health messages engagingly in prisons.

[Communication] ‘Prevention is better than cure’ is a well-known proverb. Non-communicable diseases often develop because people do not know basic health information which would help them to reduce their risk of disease. It is im-portant to communicate health messages to people in ways that are engaging and which will help them to remember.

by Dr Mathew George

by Professor Malcolm Molyneux. When you come to think about it, a surprising number of different diseases can be spread between people by insects. Some of these diseases will be discussed in this issue of Footsteps. They are among the most important and serious diseases in the world, especially in areas which are not yet industrially developed.

Keeping mosquitoes out of your home is one of the most important ways of protecting your family from malaria and other mosquito-borne diseases. Here…

Drenching is the forced pouring of liquid preparations down the throat of an animal. Drenching can be used for all livestock. During drenching, the animal’s head must be raised so that the liquid does not enter the lungs. A bamboo tube, gourd or bottle (glass or plastic) can be used for drenching ruminants and pigs.

by Dr John Townsend, Medical Director of ECHO. An anxious mother brought her child to me: ‘What’s the problem?’ I asked. ‘She pushed a hard black bean into her ear three days ago and it won’t come out.  Now it’s really hurting her.’

Children are everywhere. Whether you are running mobile clinics, holding training sessions, encouraging community meetings, meeting people – all around will be children. Sometimes irritating, sometimes distracting, but always curious to see something new. In our last issue, we were reminded of how rapidly the number of children in the world is increasing. In many low-income countries, children under 15 now make up half the entire population! Whatever kind of work we are involved in, we need to ...

The role which various small livestock play in the nutrition and economy of most families is an important one. In rural areas, many farmers unable to keep larger livestock regard sheep and goats as an investment - ready cash when money is needed for school fees or sickness. Smaller livestock - chickens, rabbits, etc - mean that hospitality is always available for visitors, and provide a supply of eggs and meat for the family, even though this is often only for special occasions.

This edition of Footsteps takes the topic of vision. The gift of sight is a very precious one - a gift that many in this world lose through the lack of appropriate eyecare. The study of ophthalmology is a very detailed and specialised field. But simple steps to improve eye-care could be taken by many health centres, to help protect the sight of many.

I am always very encouraged when Footsteps readers send me articles to include in Footsteps. Sometimes I manage to fit them quickly into issues and sometimes they may not be suitable to publish. However, I always have a number of good articles and no space to fit them in. This issue, therefore, has no main theme. Instead, we cover a number of different subjects, often from previous issues which readers have responded to. A number of articles raise crucial questions about what is at ...

For many families, the animals they keep often act as their bank, providing them with a source of income for use in emergencies or for special occasions such as weddings and funerals. The loss of an animal through disease is therefore a real blow. If healthcare for people is often not adequate, it is certainly true that in many countries healthcare for livestock may be completely lacking. In this issue we therefore look at ways of improving animal health, through the training of paravets, ...

Good accessible healthcare is something we all need. Without it many of us would be unlikely to recover from serious diseases, infections or wounds. In an ideal world everyone should have access to good, affordable primary healthcare. No government would claim otherwise. However, the reality is often different…

It’s been very encouraging to receive so many appreciative messages of congratulation for our tenth anniversary. Your comments are always read and valued – as are the many articles contributed by readers, though it may take a while to find space to use them in a future issue.

Traditional medicine is a subject that touches everyone, since we are all interested in our own health. All of us are likely to have experienced some kind of traditional medicine from childhood onwards. Herbal remedies form part of our cultures, but such knowledge is often rapidly being lost. Modern medicine has most of the answers to health problems, but is not always available or affordable. In addition, many countries experience considerable difficulties in obtaining medical supplies.

In this issue we look at a very complex subject. There are many different kinds of disability which range from minor ones that others may not notice, to life-threatening ones. In a few pages we are not attempting to give very much practical information. Instead, we have chosen to concentrate on our own attitudes to those with disabilities. Each one of us can change our way of thinking, our way of responding, our way of ensuring that people with disabilities are fully included in our ...

Dr Ted Lankester, co-founder of InterHealth, shares his insights on the relationship between faith and health care.

by Cíntia F Rojo Accidents often happen in and around school. Children’s natural curiosity exposes them to situations of risk, which are not always anticipated by the adults in charge. Often, it is only after an accident that the teacher realises the danger in the classroom of a chair too close to a window or furniture with sharp corners. Most teachers do not receive specific ‘first aid’ training and so when faced with a crisis do not know how to respond.

[Health] By Helen Gaw Obstetric fistula is a hole in the birth canal that develops as a result of long or obstructed labour. Women who have a fistula cannot control the flow of urine and suffer continual leaking, which can cause a bad smell. Usually their babies have not survived labour. They are often excluded from family and community and develop other health problems.

One of the targets for this goal is to reduce by three quarters the number of women dying in childbirth.

How long would it take you to get to hospital, and how would you get there? According to a 2014 report, the average distance from home to an Accident…

How often do you laugh together? every day  5 every week or two 3 not very often  1

by Dr Shobha Arole

by Dr Ted Lankester

by Mark Larson

[Health] by Dr Ann Ashworth. The ‘double burden’ of disease Many low- and middle-income countries are facing a ‘double burden’ of disease. They continue to have the old problems of infectious diseases, but at the same time are experiencing a rapid increase in non-communicable diseases such as diabetes and heart disease. Being overweight is one of the underlying factors.

As a result of routine vaccination programmes, polio has been largely eradicated in most parts of the world. But polio is found in some places. It’s…

In the Surkhet district of Nepal lies the village of Gadi. The village was one of the least developed in the area, so the community struggled to…

by Robert Bowen and Mirjam Andriessen. Nearly everyone has heard the term community health worker (or primary health worker). However, the term paravet is likely to be new to many. Paravets are the equivalent of community health workers but for animals instead of people! Like health workers, they may not receive formal training, but instead receive practical training within their communities.

by Sue Yardley. Reducing child and maternal mortality are targets within Millennium Development Goals 4 and 5. In 2010 many donor governments and international agencies are focusing on these issues. There has been some encouraging progress in meeting these goals, but greater effort is still needed to achieve them. Improving access to water, sanitation and hygiene education (WASH) can help significantly to improve the life chances of children and ...

by Pastor Eduardo Barja

Moises Frausino da Silva has faced many droughts in his lifetime and lived much of his life with a lack of water. He is a father of 11 children and…

by Roger Drew and David Kabiswa. Being part of a group can be extremely helpful, but it can also be a very challenging experience. Challenges often faced by groups of people with HIV include:

Sue Hanley, a midwife with experience in Sudan and Kenya, provides some helpful answers to Dorothy’s problems, concerning traditional practices at birth in the area of Cuzco, Peru (Footsteps No. 4).

by Yudith Contreras Veloso

Planning with love. The reformed Church of East Africa started an Integrated Rural Development Programme (IRDP) in 1986 to respond to the pressing needs in the rural communities where the church serves. The pioneer programme was in agriculture, but we soon found that there was no way we could deal with a single problem and leave the others (health, income generation, etc) because all of them were interwoven together. Following the last issue, I thought I would share our experiences in family ...

Protecting crops from birds We are trying to protect our rice crops from bird pests. Rice is a major crop here. We are finding it very difficult to control and avoid the threat from birds. Farmers are staying in the fields all day to chase away the birds. This tires them and prevents other domestic activities. Can you provide us with technical advice so that our farmers can grow their rice, sleep peacefully and also develop more effective techniques for controlling these predators without ...

Local consumption of cowpeas – potential dangers. Cowpeas form a staple in most parts of Nigeria. Consequently, a variety of cowpeas is grown and sold in Nigeria. Cowpeas are notably very nutritious. Cowpeas balance the other starchy staples – yams and cassava. However, as the crop is produced in large quantities, storage has become a problem for local farmers. They use all kinds of chemical insecticides for storage of the crop, endangering the health of the potential consumers. This is ...

Stigma in Brazil In Brazil there is huge stigma for those who come from the ‘interior’ to live in a big city. It is much worse for those who migrate from anywhere in the north-east to the south-east. Local prejudice and ignorance creates a barrier to social mobility and success for many capable people. To survive, people keep their origins quiet, trying to blend in to their new surroundings.

1. The 3 pot system This is a very simple system for providing cleaner water. It will not provide pure water, but some of the diseases will be removed.

Cultivating medicinal plants ensures that they are preserved for your own use and for future generations. Many fruits provide medicine as well as food. These include banana, pineapple, mulberry, passion fruit and pawpaw (papaya). Food plants that also provide medicine include onion, garlic, groundnut, cabbage, chilli, coffee, pumpkin, sunflower, sweet potato, rice, maize, ginger, black pepper and sesame (Sesamum indicum).

by Ines Vivian Domingo. The use of plants to cure ailments is an age-old practice. The preparation of herbal medicines remains an important part of healthcare for both humans and livestock, especially in rural areas. Small and subsistence farmers in remote communities depend largely on the use of medicinal plants in the absence of veterinarians and modern veterinary medicines. And even if these were available, farmers could ill-afford to pay for the services or buy the medicines anyway. ...

Traditional medicines often include one or more tree parts or products. These may be the fruit, leaves, flowers, bark, roots, seeds or oil. Here we share some information about a few medicinal trees in the humid and arid tropics. We strongly recommend that you consult a local herbalist first about the correct quantities and use. In the case of serious symptoms, you should consult a doctor.

by Theodore Mbata Misuse of antibiotics is a problem in countries across the world, but particularly in the South, where people often use them to treat any minor infection, with or without a doctor’s prescription. Inappropriate use of antibiotics frequently leads to the development of resistant strains of the bacteria that cause infection. This means that in future these antibiotics will not be effective in treating infections. Excessive use of antibiotics also increases the cost of treatment ...

by Neil McDonald. Two-thirds of the world’s healthcare professionals work in industrialised countries amongst one-third of the world’s people. This means that many poor people have little access to healthcare services. The situation is a challenge to both planners and health workers in low income countries.

by Geoff Folkard and John Sutherland. River water taken for household use can be full of suspended matter, particularly in the rainy season. The water carries silt particles, solids, bacteria and other micro-organisms (some of which can carry disease). It is very important to remove as much as possible of this material before people use the water. Large water treatment centres do this by adding chemical coagulants to the water. These cause the particles to stick together (coagulate) and ...

Here are just a few examples of the detailed recipes available in Anamed’s book Natural Medicine in the Tropics (see page 14).

Traditional property rights and biopiracy by Nigel Poole. For many centuries, the medicinal value of the leaves and seeds of neem (Azadirachta indica) has been known in India, its country of origin. Neem products have valuable medicinal properties and many traditional uses as medicines, pesticides, insect repellents, fertiliser, diabetic food, soaps, toothpaste and contraceptives.

New hope for malaria vaccine. For many years scientists have been working to try to find a vaccine for malaria without success. Malaria is becoming more difficult to control, as the parasites, which cause malaria, are developing resistance to many of the drugs used to cure the disease.

‘The rise of chronic non-communicable diseases presents an enormous challenge … Non-communicable diseases deliver a two-punch blow to economies and development. They cause billions of dollars in losses of national income, and they push millions of people below the poverty line, each and every year.’

1. Problems and prejudices People with disabilities are often made to feel excluded from society. We use the image of a closed door to show that negative attitudes towards these people mean that they are not given the skills or the opportunities that can improve their quality of life. Sometimes children are hidden away behind a closed door.

by Nimaya Kenyi Mogga. ACCOMPLISH is a local NGO in Terekeka District in southern Sudan. They have established a paravet project to improve animal health care in the area.

State health centres are almost non-existent in rural Guatemala. In an emergency – and even for a minor illness – sick people have to travel in…

by Dr Maureen Dar Iang. In some countries in the world, women can choose how and where they would like to give birth. Different kinds of care are available. Often women can choose whether to give birth in a hospital or at home.

The preparation of a medicine from a plant that contains a beneficial chemical varies according to the chemical and the plant. Sometimes the chemical is extracted from the leaves by the use of boiling water. Sometimes the roots are dug up and ground. The most basic and common process for producing medicines is to use liquid and heat.

Our health depends on many things. We may be born with disabilities or health problems. We may suffer serious long-term health concerns through…

There is a high incidence of burns in East Africa due to the need to cook on charcoal fires and use kerosene for lighting. Knowledge of first aid for…

Child-to-Child Material. These Activity sheets are produced by Child-to-Child as a resource for teachers, and health and community workers. They are designed as a resource for those wishing to introduce the Child-to-Child approach. They help children understand how to improve health in themselves, in other children, their families and their communities. They can be reproduced and adapted to suit local conditions. There are 27 activity sheets available which are grouped under various ...

Outreach education packs There is a set of three useful Outreach packs on Genetic Diversity and Food Crops with a total of over 200 pages. These packs are available free-of-charge to ‘multipliers’ in the Outreach network. Multipliers include newspaper journalists, radio broadcasters, community workers, representatives of NGOs, teacher trainers, curriculum developers and others involved in educating children in third world countries about environmental and health issues. If you would like to ...

A Curriculum Guide for Teaching Young Learning Disabled Children by Robert Deller This is a very useful and practical curriculum developed for those working with children who have mental disabilities. The curriculum uses a system of checklists to help identify what a child can do. An individual education plan can then be developed for each child, focusing on the skills that a particular child needs to learn. For example, physical skills include head control, learning to sit, learning to crawl, ...

A selection of books, websites and training material about health care.

When my wife and I decided to get married, both of us were still students. So we had to find work that could put food on the table and a roof over…

by Barry Coleman

When was the last time you saw someone with a disability on the cover of a magazine? Disability is all too often hidden away. Sadly, this is…

It is very easy to associate risks with places and events outside the home, but every day thousands of people are injured within their home by accidents that could have been avoided. Here are four simple ways of reducing the risk of injury or death to household members.

There are some Christians who believe that seeking medical help shows a lack of faith in God. Some Christians wrongly think they should throw away…

The local church, Christian organisations and individuals can all advocate effectively for improved health services.

compiled by Maggie Sandilands Preventing illnesses and accidents from happening is as important as being able to treat them when they occur. The expertise of professional health workers or hospital treatment may be required to treat a serious illness, but prevention has to begin in the home. There are many simple ways to help your family to stay healthy.

[Health] The four main non-communicable diseases (NCDs) share common risk factors. Tobacco use, an unhealthy diet, physical inactivity and harmful use of alcohol can lead to heart disease, cancer, diabetes and chronic obstructive pulmonary disease. Read more about recognising the signs of NCDs and how to help to prevent yourself and others from developing these diseases.

Tetanus is a very serious disease which makes a person’s muscles contract and become very stiff. It is very difficult to treat and over half of the adults who catch tetanus will die.

by Lesley and David Mundy

This is a very useful teaching method which has been developed and used by Kumasi Health Education Unit in Ghana. It encourages community health workers to participate in discussion and to develop self confidence in thinking through the problems and needs of their community. It is also an exercise which will help trainers to assess the understanding and knowledge of their trainees.

by Markus Müller and Innocent Balagizi. We opened a seminar about traditional medicine in Asmara, Eritrea with the question, ‘Do any of you have some experience with traditional medicine?’ There was a complete, even hostile, silence in the room. Finally some participants said, ‘We are Christians. We have nothing to do with it.’

COMPETITION WINNER by Revd Francis King’ang’a. African traditional salt or lye (uvusaaru) has been used for generations in our area of Western Kenya. In recent years it has been replaced by common table salt. Lye was used for cooking vegetables, soap-making and for some medicinal purposes. Older people believe that using lye for daily cooking helped people to live longer because of its medical benefits.

Recent research has been carried out to examine the effectiveness of insecticide treated bed nets. Here in Tanzania, malaria is the main cause of illness and death. Over 93% of the population is at risk of contracting the disease. Research findings showed that the use of treated bed nets reduced child deaths by 20% and reduced illness from malaria by 50%. Please make sure your bed nets are ready!

Female genital mutilation/cutting (FGM/C) describes the act of cutting, destroying or removing some or all of the external parts of the female…

By Dr William Hart and Isabel Carter. 1. Read the manufacturers instructions carefully before buying.

Compiled by Rebecca Dennis. Board games can be fun to play and can be used to teach adults and children (aged seven and upwards) some important lessons. One example is the popular game of Snakes and Ladders, which is shown and explained on these pages. One of the strengths of this game is that the messages and language can be adapted to the local situation. This version shows how everyday risks can be reduced and what can happen if we do not manage them.

In many countries, people treat three quarters of all illnesses by using medicines without first seeing a health worker. This is called ‘self-medication’. They may obtain medicines from their home, friends or relatives, a market stall, local shop, traditional healer or a pharmacy. Though some of these sources may provide good quality and appropriate medicines, others may supply inappropriate and potentially dangerous medicines.

Our church buildings are a great resource for spreading health messages. Here are some ideas...

Dr Ted Lankester, now Director of Interhealth which is based at Mildmay Mission Hospital, worked as a doctor in India for a number of years. Though this article is written for health workers and doctors, we can all learn from what he writes. All of us need medicine at some time in our life – this article will help us to realise that medicine is not always the answer to our problems. The misuse and over-prescription of drugs is a growing problem all over the world and one that should concern all ...

A case study from Zambia After many years of trying, through a very expensive law enforcement campaign, to deal with the poaching of wildlife, Zambia realised that no progress was being made. Poaching continued at the same rate – in some areas it even increased.

For Evelyn Letio, peacebuilding in South Sudan means restoring peace within communities and between family members. As a coordinator and co-founder…

Having a child with disabilities is a challenge for all parents, whether they see the child as a punishment or, rightly, as a gift from God. Although most parents care for these children in the sense of keeping them warm, sheltered and fed, there is often little understanding of the importance and value of stimulating their development. It is easy to think that they can never respond or develop, but the experience of a centre for children with disabilities in North Africa shows that progress ...