“When someone has cholera, they start losing all the water in their body. They can’t drink water fast enough to keep up with how much they are losing.” Thokozani works with me to create a visual using a plastic bottle with a hole in the bottom. Pastor Nixon helped us make a hole in the bottle earlier, and the knife he used was so big that the bottom was now missing from the bottle. Sure enough, when Thoko poured water into the bottomless bottle, it poured straight through.
“If you use oral rehydration solution instead of water, then the electrolytes help keep the fluid in the body.” Now, we pour the water in, but I keep my hand over the hole in the bottle. A bit still drips around, but the concept is there – the loss of fluid has slowed and the “body” gets a chance to fill back up with water.
We’ve tried to teach about oral rehydration (ORS) in this church before, but it’s hard to talk about the exact amount of salt and sugar to add to water when nobody has teaspoons or tablespoons. Today, we told everyone to bring their own water bottles. We divide them up into groups of ten, and the leaders come up to get portions of salt and sugar to bring to their groups. We realize that filling a plastic bottle cap is almost exactly a teaspoon, and each leader sees for themselves how level their cap looks compared to a teaspoon. Three teaspoons sugar and a quarter teaspoon salt – that’s the amount of electrolyte to add to a 500 ml bottle to make ORS. Years ago, we tried to explain that the recipe used just a pinch of salt, smaller than your pinkie nail. This year, we realize that the amount is equivalent to the inside ring on the plastic water bottle cap. Again, all the leaders measure their bottle caps against the quarter teaspoon measurement and bring the quantities back to their groups.
Everyone looks at the color of the ORS in the bottles and tastes the flavor so that they can compare it in the future. We use the water bottle to share about how much someone should drink if they have cholera. Adults can drink the full bottle each hour, children can have up to the halfway point. Thokozani and I go between groups and answer questions: Can someone drink ORS if they are not sick? How much should a 12-year old drink? Can you use chlorinated water to make ORS? These are good questions and the groups are thinking through together how they will use this electrolyte solution to help people with various gastrointestinal diseases.
At the end of the training, we hand out smaller bottles of water purifier. We explain that these bottles will only purify 600 liters each, and that they will have to work with their churches and communities to purify water after they run out. The local community health worker wasn’t able to attend this meeting, but he told us to remind the people to ask him if they had concerns about chlorine. Different purification solutions used different amounts, and a village member had died recently when he drank undiluted chlorine trying to cure himself from cholera.
Already this group is making plans to help a visually impaired woman to purify her water. Groups coming from different villages are discussing the future together. They have their bottles of ORS and their chlorine to take back to their villages. They take extra attention to wash their hands before they sit down to lunch. We close in prayer, asking for protection from illness, strength for our bodies, and wisdom to help our communities during this difficult time.