Care for fever and gut sickness

Give rest and lots of safe water with a pinch of salt and sweet, and learn the danger signs that mean go for help now.

takes patience⏳ half a daytradition — not yet hand-tested

Fever, vomiting, and diarrhea are the sicknesses you will meet most often, and the thing that actually kills is almost never the germ itself — it is dehydration, the body running out of water and salt. A person with bad diarrhea can lose more water in a day than they normally drink. So the whole job of home care is simple to say: keep the water and salt going in faster than they come out, let the body rest and fight, and watch closely for the signs that mean this is beyond home care.

You cannot cure these sicknesses at home. The body cures them. You keep the person alive and comfortable while it does.

You need

• Boiled, cooled water — plenty of it, kept covered. Every drop the sick person drinks must be safe, or you feed the sickness.
• Salt — a small amount. Diarrhea drains salt as well as water, and water alone cannot replace it.
• Something sweet — sugar or honey. Sweet is not a treat here: it helps the gut pull water and salt into the body. (Never give honey to a baby under one year old — it can carry a germ that harms babies.)
• A clean cup and spoon — used only by the sick person.
• A cloth and cool water — for wiping a hot forehead.
• A quiet, shaded resting place — with a way to reach the latrine or a bucket fast.

Steps

1. Mix the rescue drink. In one litre of boiled, cooled water (about four cups), stir in six level teaspoons of sugar and half a level teaspoon of salt.
   • Taste it. It should taste no saltier than tears. If it tastes salty like the sea, pour it out and remix — too much salt makes things worse.
   • No measuring spoons? A level teaspoon is a small mound the size of the tip of your thumb.
2. Give it in small, constant sips. A few swallows every five minutes, all day. Small sips stay down even in a vomiting person; big gulps come straight back up.
   • If they vomit, wait ten minutes, then start the sips again, smaller.
   • A rough goal: one cup of drink after every loose stool, on top of normal drinking.
   • A baby at the breast keeps nursing — more often, not less. The instinct to stop feeding a sick baby is strong and it is wrong: breast milk is the best rescue drink a baby can get, and it carries the mother's own defences with it. Offer the breast more frequently than usual, and give small sips of the mix as well if the diarrhea is heavy. A baby is the person dehydration kills fastest; never starve one of fluid to "rest the stomach".
3. Let them rest, and keep food gentle. Sleep is medicine. When they want food, give small amounts of plain soft food — rice, thin porridge, banana, plain broth. Do not force food; do force fluids, gently and always.
4. For fever, cool gently. Dress them lightly, keep air moving, and wipe the face, neck, and arms with a cloth dipped in cool (not icy) water.
   • Do not pile on blankets to "sweat it out," and do not plunge them in cold water — violent shivering drives the body's heat up, not down.
5. Keep everything separate and clean. Wash your hands with soap or ash after every contact, especially after helping with the latrine. Their cup, spoon, and bowl touch no one else's mouth.
6. Check them every hour. Are they peeing? Is the urine pale or dark? Are they alert when you speak to them? Write it down or remember it — you are watching for the danger signs below.

Watch out

• Go for real medical help now if you see any of these: no urine for eight hours or more, or very dark urine; sunken eyes, dry mouth, no tears when crying; skin on the back of the hand pinched up stays tented instead of springing back; the person is drowsy, confused, or hard to wake; blood in the stool or vomit; a stiff neck with fever; a fit or seizure; fast, hard breathing; any fever in a baby under three months. These mean home care is losing.
• Fever lasting more than three days, or any sickness getting worse day after day — go for help. Most simple gut sickness improves within two or three days.
• Water without salt and sugar is not enough in heavy diarrhea. Plain water passes through; the mix is what the body can hold.
• Do not give medicines to "stop" diarrhea in a child or in anyone with fever or bloody stool. Trapping the sickness inside can make it far worse.
• The carer gets sick next if hands are not washed every single time. This is where families lose two people instead of one.

How it works

The gut absorbs water best when a little sugar and salt ride along with it — the sugar acts like a key that opens the door for the salt, and water follows the salt in. That is why this simple drink, used worldwide, saves millions of lives that plain water cannot. Fever, meanwhile, is the body deliberately heating itself to fight germs; your job is not to crush the fever but to keep the person comfortable and full of fluids while the fight is won.