Created by the Global Transformation Network, Inc. and Global CHE Network

POLIO 1 – WHAT IS POLIO? Date: 05/09 (~1 HOUR)

OBJECTIVES: 1. Participants will know that polio is often mild, but is can be a serious disease causing paralysis. 2. Participants will be able to list some of the symptoms of polio. 3. Participants will know when to take a child to a health care worker or clinic. 4. Participants will be able to explain that the polio virus attacks the nerves to the muscles and produces floppy muscles.

OVERVIEW FOR TRAINERS: GTN (The Global Transformation Network) is a Global CHE Network disability consultant and partner assisting in the development of disability focused lessons.

METHOD TIME KNOWLEDGE

Role play: Act 1 10” A mother is talking to her neighbor about her young son. Mom Dora, I am worried about my son, Marc. Dora What is the matter? Mom At first I thought that Marc just had a bad cold. But now he has a fever and he says his headaches. His neck seems stiff, and he says that his arms and legs ache. Dora Don’t worry. I am sure that he will be okay. Role play: Act 2 (Several days later) The mother, carrying her young son in her arms, runs to Dora’s house. Mom Dora, what is the matter with Marc? What should I do? Dora What is happening? What is the matter? Mom He is crying from the aches in his neck and legs. And look! They bend over the boy, who lies limp. Mom His arms and legs seem loose and floppy. Dora What is happening? Let’s go to the doctor right away!

----SHO questions---- S = What do you See? H = What is Happening? O = Does this happen in Our place?

This lesson is part of an extensive series created by LifeWind International for use in Community Health Evangelism (CHE). In CHE, facilitators skilled in participatory learning methods enable communities to escape cycles of poverty and live as followers of Jesus. For information about CHE and how you can be trained as a facilitator, go to communityhealthevangelism.org, or contact LifeWind International. 2 Polio I – What is polio?

METHOD TIME KNOWLEDGE

I. What is polio? 10” I. What is polio? Discuss in large group. A. What is polio? A. What is polio? 1. Polio is an infection caused by a virus. 2. A virus is a germ that is too small to be seen with a regular microscope. 3. Polio is highly infectious. It spreads easily between people. 4. Polio is a common cause of disability in many developing nations. B. What are some other names for B. What are some other names for polio? polio? 1. The official name for polio is poliomyelitis. 2. Sometimes polio is called infantile paralysis, because it often affects babies. C. Who is at risk to get polio? C. Who is at risk? 1. Polio is usually an illness of babies and young children. 2. Polio affects children under five years of age. 3. Children under the age of three are most often infected. 4. Most children receive immunizations (shots, or vaccines) to prevent polio. 5. (The polio vaccine may either be given as a series of shots, or as drops taken by mouth.) 6. Children who have not been immunized are at risk to get polio. 7. Children who are behind on their shots may also be at risk. 8. Polio is no longer a problem in many parts of the world. D. How does polio spread? D. How does polio spread? 1. Polio spreads from person to person. 2. Often polio spreads through the stool (or poop). 3. The polio virus can contaminate 3 Polio I – What is polio?

METHOD TIME KNOWLEDGE

food or water. 4. So polio is most common where there are no bathrooms or latrines, or where there is poor hygiene.

II. What are some symptoms of polio? 20” II. Symptoms of polio Divide into small groups. A. What are the first symptoms of A. At first the initial illness? 1. Most children infected with polio have no symptoms. 2. But they may still pass the polio virus in their poop; 3. Others may seem just to have a bad cold. 4. They may also have a fever or headache. 5. Some children have vomiting or diarrhea. 6. They may have back pain or a stiff back. 7. They may have neck pain or a stiff neck. 8. Their muscles may be sore or tender. 9. These symptoms usually only last a few days. B. Most people with polio get better B. Paralytic polio after a few days. However, a few 1. Only one out of every 100 or will go on to a more serious form 150 children infected with polio of polio, called paralytic polio. will become paralyzed. What does this mean? 2. They may develop severe muscle aches or spasms. 3. They will lose their reflexes (see below). 4. They may become floppy and loose. 5. “Paralyzed” means being floppy or not able to move. C. Demonstration of knee reflex C. Demonstration One way to check for diseases A person with paralytic polio will like polio is to check the lose this knee reflex. reflexes. Doctors often use a reflex hammer to tap just under the knee cap to see if the leg will jerk or kick. (Demonstrate.) 4 Polio I – What is polio?

METHOD TIME KNOWLEDGE

Divide into pairs to try this out. One person will cross her legs. The other will use the side of his hand (like a karate chop) or a small object to tap just below the knee cap. Does the leg jump or move?

From: Disabled Village Children

III. Initial treatment of polio 10” III. Initial treatment of polio A. When should you take the child A. When should you go to the clinic? to a health worker or clinic? 1. If there are signs of paralytic polio 2. If she is weak or floppy 3. If he has a stiff neck 4. If he has very sore muscles 5. If she has trouble breathing. This is an EMERGENCY. Go to the hospital right away. 6. If he has difficulty swallowing. This is an EMERGENCY. Go to the hospital right away. B. What treatment can you give to B. What is the treatment for polio? a child with polio? 1. Polio is caused by a virus. So no medicine will cure polio. 2. Antibiotics will not cure polio. 3. A child with polio needs to rest. 4. Avoid too much exercise. 5. Avoid injections. 6. Give good food so that the child gets stronger. 7. Sometimes a hot water bottle or a heating pad may make the muscles feel better. 8. Watch for difficulty swallowing and for difficulty breathing. Go to the hospital right away if this happens. 9. Position the child with arms, hips and legs as straight as possible. 10. Later on, the child will receive therapy to prevent 5 Polio I – What is polio?

METHOD TIME KNOWLEDGE

complications from polio.

IV, What is happening? How does polio 10” IV. Why is the child floppy? cause floppy muscles? A. Show the diagram of the A. Parts of the nervous system nervous system. What are the 1. The brain parts of the nervous system? 2. The spinal cord 3. The nerves B. Pinch yourself. What is B. What is happening? happening? 1. The nerves in your skin feel the pinch. 2. They pass the message on from the nerves to the spinal cord to the brain. 3. You feel the pain. C. Pick up a pen. What is C. What is happening? happening? How do your fingers 1. The brain sends a message know to pick up the pen? through the spinal column and nerves to the muscles. 2. The muscles react and pick up the pen. D. The polio virus enters the nerves D. Nerve damage and destroys some nerves that 1. If the nerves were destroyed, go to the muscles. What would the muscles would not get the happen if the nerves to the message from the brain to pick muscles in your hand were up the pen. destroyed? Could you still pick 2. You would not be able to pick up the pen? up the pen. 3. Your hand would become floppy. E. What would happen if the nerves E. Damage to the nerves to the throat to the muscles in your throat, or or chest muscles? the muscles that help you 1. You need throat muscles to be breathe, were damaged? able to swallow. 2. You need chest muscles to be able to breathe. 3. If those muscles are paralyzed, you may die. F. Usually, polio mostly affects the F. Damage to the nerves to the leg nerves to the muscles in the muscles legs. What happens then? 1. The legs become floppy. 2. The person cannot walk. F. However, in polio the nerves to F. If you had polio, would you still feel the skin (the sensory nerves) are pain? not damaged. Imagine you had 1. The sensory nerves to your skin polio and pinch yourself again. are not damaged. What would happen? 2. You would still feel pain. 6 Polio I – What is polio?

METHOD TIME KNOWLEDGE

G. Next time we will talk more F. Next time about the complications of polio. References: Mayo Clinic. 2009. Polio. Available from: http://www.mayoclinic.com/health/polio/DS00572/METHOD=print Werner, David. 1999. Disabled Village Children. Chapter 7: Polio. The Hesperian Foundation. Available from: http://www.fastonline.org/CD3WD_40/CD3WD/HEALTH/H2116E/EN/B257.HTM Wikipedia. 2009. Poliomyelitis. Available from: http://en.wikipedia.org/wiki/Polio World Health Organization. Global Polio Eradication Initiative. Available from: http://www.polioeradication.org/disease.asp

ATTITUDE: Participants will want to work with people with polio.

SKILLS: Participants will know some signs of a polio infection, and will know when to take a child to the clinic. They will understand that the polio virus can damage the nerves to the muscles.

EVALUATION: Are the participants able to teach their neighbors about polio?

MATERIALS: - Newsprint, marking pens, tape - Signs for the starter: “Act 1”, “Act 2—several days later” - Reflex hammer (if available) - Illustration, The nervous system This lesson is part of the Disability Series. THE NERVOUS SYSTEM