Abstract

Open mole is a condition perceived by Liberians as a "hole" in the frontal part of the child's skull. The usual course of treatment of this condition is traditional medicines, which in many cases results in the child's death. From the medical point of view, open mole represents the sunken fontanelle which is caused by dehydration as a result of severe diarrhea and/or vomiting. This project will gather information on the knowledge, attitudes and practices of parents with children who have open mole. This information will be used to design educational packages to be used in the national primary health care programs aimed at educating parents on dealing with this condition more effectively. The research will be conducted in two countries representing three ethnic groups. A total of 500 parents, 42 traditional healers, and 7 health workers will be interviewed using prepared questionnaires.

Post-Project Summary

The results indicated that the 500 parents questioned had experienced at least one open mole episode with respect to a total of 965 (44%) of their 2 180 children. The episode occurred within one month after birth in 56% of cases; between 2 and 3 months (31% ); between 4 and 5 months (12%); and between 6 and 12 months (1%). Over half of the parents did not know what causes open mole and only 5% gave a scientifically correct explanation; almost 98% indicated that it was very serious, however. Of the 500 parents interviewed, 429 (86%) preferred traditional treatment, 9% preferred western treatment and the remaining 5%, both kinds of treatment. While 69% perceived no danger in the use of traditional medicines, mainly topical application of herbs, 30% mentioned some dangers such as burns resulting from too heavy an application, application of the wrong herbs, etc. It was concluded that parents and traditional healers tend to mistake the symptom (sunken fontanelle) for the disease (dehydration due to diarrhea), and to treat it accordingly.

The researchers also conducted a more limited study (180 parents) on the prevalence and treatment of diarrhea. About 59% of the 645 children involved in the study had experienced at least one episode of diarrhea, a large percentage of them at less than 5 months of age. During these episodes, 96 of the 180 parents turned first to traditional medicine, a solution of leaves, bark and roots boiled together. The researchers considered that this solution was insufficient in salt and sugar to adequately replace lost fluids. The remaining 84 parents turned first to western medicine: 95% went a clinic where their children received oral rehydration solution while only 5% applied the same solution at home.

It was concluded that a health education program must concentrate on 1) educating parents about the relationship between open mole, diarrhea and dehydration and 2) teaching parents how to prepare and use oral rehydration solution at home. In view of the respect that people in the area accorded to community development leaders, chiefs, elders and traditional birth attendants, it was suggested that ways of involving them in the health education effort be investigated.

Recipient Institution(s)