Hesperian Health Guides
Prevent violence to prevent epilepsy
HealthWiki > Epilepsy and Seizures > Chapter 9: Preventing violence can prevent epilepsy and seizures > Prevent violence to prevent epilepsy
Imagine you are at a peaceful demonstration with hundreds of people to oppose cuts in your countryâs health budget and to support more resources for people with health conditions like epilepsy. This angers the government, which calls out the police to break up your rally. As a policeman raises his baton, you realize it is too late to think about preventing the head injury that could cause epilepsy. However, there are various ways that violent injuries could have been prevented:
- Use of personal protective equipment: Wearing a helmet could protect you.
- Change part of the situation: Not arming the police or training police not to attack peaceful demonstrators could protect you.
- Remove the problem: Full government funding of the health budget, which would eliminate the need to protest, could protect you.
Each of these actions suggests a way to prevent epilepsy-causing head injuries. And each kind of action has its benefits and limitations.
A benefit of personal protective equipment is that it may be easy to get and use. For example, wearing a helmet when playing contact sports or putting a flashing light on a bicycle may be within a personâs reach. A limitation of protective equipment is that it is often a personal solution, not a community solution.
In the same way, solutions to problems that change part of the situation can protect more people, which is good, but these solutions still do not protect everyone. An example is requiring all cars to have seatbelts. Using seatbelts can protect people in a car from injuring their heads during an accident, but they do not protect people the car might hit, like a person riding a bicycle or crossing the street.
Removing the problem for everyone is the most effective solution but also often the hardest to do. For example, if a child gets an infection in their brain and a high fever, they need immediate treatment. If their parents have good health insurance or enough money to see a doctor and buy the medicine they need, the child will recover. But if the family is denied health care because of poverty, there is a chance the child could get seizures and epilepsy. A government guarantee of the right to health would remove the problem for everyone.
Contents
Prevention strategies
What can you do to stop the harm caused by physical and structural violence in your community before it leads to epilepsy and seizures? A good place to start is to examine the root causes. Bring together a group of people to create a list of what is contributing to violence, discuss which issues are most important, and identify the problems the group might be able to affect. Then you can begin to plan specific actions that can make change happen.
There are often many ways to solve a problem. For example, if your group decides to try to stop head injuries caused by violence in relationships, you might talk about how to help people learn that hitting their partner is never OK, how to limit the heavy use of alcohol that can make domestic violence worse, how to teach basic self-defense skills, or how to increase economic support for those who leave a violent relationship.
Creating a world that supports and improves our lives rather than harms us is the aim of prevention strategies and working for change. Ending the physical and structural violence that can cause epilepsy and seizures is a big goal that may seem overwhelming, but like all big problems, it can be broken down into smaller, more manageable pieces to work on over time.
These four stories show the ways that people in various communitiesâa school in Cambodia, a refugee camp in Uganda, a factory warehouse in Jamaica, and in different parts of Indiaâidentified a source of violence that can cause injuries that may lead to seizures and epilepsy. They each addressed physical and structural violence by developing prevention strategies, including community education and actions for change.
Convincing students to wear helmets
Where I teach in rural Cambodia, lots of students come to school on bicycles, scooters, or motorcycles on crowded, bumpy roads. Because the government does not maintain roads well in rural areas, too many students get hurt in traffic accidents. Hardly any students wear helmets. I spoke in class about the importance of wearing a helmet and even got helmets for kids who needed them. But it didnât work. After a few weeks, they stopped using them.
Then our school became part of the Cambodia Helmet Vaccine Initiative and the Helmets for Kids campaign. That succeeded where I had not. Why?
We learned that the solution is more than just getting a helmet. Our school developed lesson plans on how the brain works and what can happen when it gets injured. We invented quizzes and games about traffic safety to make it fun. Local artists painted bike safety murals on school walls and even put a helmet safety billboard up on the main road. We got funding to hand out helmets the first year, and then to replace the lost or broken ones the next year.
We measured our results during the year by counting how many kids arrived at school wearing helmets, and how many put them on before leaving. Instead of nagging them to wear helmets, we created a culture of safety to motivate helmet use when riding bikes or motorbikes! So now, even though the government still neglects the roads, our students are safer.
Preventing epilepsy by promoting safer births at Nakivale Refugee Camp
The huge Nakivale settlement area in Uganda houses more than 270,000 refugees who cannot safely return to their homes in Burundi, Democratic Republic of Congo, Eritrea, Ethiopia, Rwanda, Sudan, and Somalia. Refugees from war and conflict experience more epilepsy and seizures than others because they experience more head and brain injuries, untreated infections, and psychological trauma. To address this, aid organizations partnered with health workers and community leaders to start an epilepsy care project to help people who did not have access to the right antiseizure medicine, faced stigma, and could not consult epilepsy specialists. This project improved the lives of those with epilepsy in the camp.
But it did not explain why so many children born in the camp had epilepsy. A lack of trained health workers, long distances to the main camp hospital, and few ambulances together resulted in mothers not getting enough care during pregnancy, labor and birth, and after delivery. These were the preventable causes for 7 out of every 10 Nakivale children who were born with epilepsy.
The Nakivale epilepsy care project responded by promoting safer births and improving the identification and treatment of seizures in the camp. The team built a maternity ward with an operating room (operation theatre) for C-sections, trained more health workers in maternity care, seizure first aid, and epilepsy referrals, and improved training and conditions for birth attendants.
Village health team members from the refugee communities were also trained to recognize signs of epilepsy, like shaking, falling, loss of consciousness, and unusual sensations. Camp translators learned the right words to describe epilepsy and seizures in the languages people speak, which improved communication among health workers, people with epilepsy, and their caregivers. Health center nurses learned more skills to assess and treat epilepsy through an online course designed for them.
These improvements have reduced brain injuries during birth that can cause epilepsy and have also made safe and healthy births available to everyone in the Nakivale settlement area.
Making work safer
I work in a factory warehouse in Jamaica. We are not well paid, and the management did not care about making our workplace safe. When we had large shipments of supplies, we stacked everything on top of each other because there just wasnât enough room. Then the stacks would get too high and the boxes fell over. People got head injuries and materials were damaged. We explained to the boss how using industrial shelving would save money: fewer parts would break and fewer people would lose time recovering from accidents. He agreed and we got the shelves. There hasnât been a warehouse accident in months.
Breaking the silence on gender-based violence
Breakthrough India, a non-governmental organization that works to fight gender-based discrimination and violence, created a large media campaign using radio, video, leaflets, bulletin boards, and town meetings to carry the message that women have the right to be free from violence. An album and music video called Mann ke Manjeere (My Mindâs Rhythm) was heard and seen by millions of people and was especially popular among youth. They told the true story of a woman who left a violent husband and became a truck driver to support herself and her children.
Then Breakthrough India took their work to another level. They started a 2-year campaign called âStand Up,â during which they taught young people how to intervene when they witnessed sexual harassment and public crimes against women. And they taught those young people how to share what they learned with others. Campaign organizers reached hundreds of thousands of young people, as well as village leaders, law enforcement, and government workers with their community-based trainings.
Campaigns like Breakthrough Indiaâs not only improve conditions for women, they also unite communities to build a more just and less violent world.
It is impossible to know how much epilepsy these strategies were able to prevent, but by working together, people improved community life. As more people get involved, more meaningful change can be made, which will help everyone, with or without epilepsy.
Every piece of the problem we address leaves us better able to take on the next challenge, and being successful in one area strengthens our belief that greater changes are possible. Your commitment to change and your efforts to achieve it will inspire more people to participate. As your numbers grow, so does your power to make change happen.
