VALANCHERY/MANJERI: Six-year-old Nasih looks frail, and not much taller than his three-year-old sister. Once a happy and healthy child, he now needs constant care and frequent hospital trips. An accident when he was four has left him unable to eat or drink normally.
He ingested a water-like compound found at home, which was actually a mixture of chemicals used to make soap. The villain in his innocent life was the soap kit that his family bought, like thousands of others do in Malappuram, with the objective of not wasting used cooking oil, and making some cheap soap instead.
Unlike Nasih, five-and-a-half-year-old Safir needed a surgery after a similar accident. The boy from Kottakkal underwent the procedure last March. Not just Nasih and Safir, but scores of children in Malappuram district have fallen prey to the use of 'soap kits'. Safir was one-and-a-half years when he drank the chemical-mixed liquid. Soon, his face and lips became swollen and he was rushed to a hospital.
"After making soap, a bucket was kept behind the house and he mistook the liquid remaining in it for water and drank it. Since then, our life has been about visiting hospitals and waiting for him to eat. Initially, he was fed using tubes. Now dilatation is done whenever he is unable to eat or drink," said Safir's mother Zaffana (30). She has two sons, and for treatment requirements, she has been staying in Kochi for over a month now.
"Last time the dilatation was done, there was a burst and a surgery had to be performed. Now he can hardly sit up without support. At least, I got him back," said Zaffana, a resident of Kottakkal.
'Soap kits', which people use to make washing soaps at home, are easily available in shops across the district. It costs around Rs 60. The kit contains sodium hydroxide, or caustic soda, a highly corrosive alkali. Children can mistakenly drink the mixture made with caustic soda as it appears as clear as water. Even with colour added, it can look like juice.
Dr Geetha Mammayil, a paediatric gastroenterologist in Kochi, has treated more than 40 cases of internal burns among children, especially from Malappuram. "Caustic soda is the main villain. Imagine a situation where the entire oesophagus is burnt and damaged, and that too in young children. They are robbed of their childhood and education. In severe cases, even death has happened," Dr Geetha said.
Nasih was unable to join school last year as he was under treatment. "He loved to eat. But since ingesting soap ingredients, he is unable to do so and has become frail," said Nasih's grandmother Suhura, a resident of Valanchery.
He has been undergoing the dilatation procedure for over a year now. "Many such cases have been reported around here. Two months ago, a seven-year-old from Theyyala died after suffering for a couple of years," Suhura said.
In Manjeri, two-year-old Ryan suffered burns after accidentally licking the soapy liquid left behind in a steel container. "The ingredients were mixed and used while Ryan was asleep. But I forgot to wash the container and he licked the liquid that was dripping. That was enough to burn his mouth," said Ryan's grandmother. Prevention is the only way to deal with it, said Dr Geetha.
"The youngest child I have treated was just eight months old. Surgery is impossible for all children. Dilatation - the process of expanding and widening the oesophagus whenever it is closed - is another way of treating it," she pointed out. Another Kochi-based paediatrician said doctors are advising people not to use these kits at home.
What are 'soap kits'?
Soap kits contain substances and chemicals used to make washing soaps at home. Caustic soda, a key ingredient, is a corrosive alkali. The kit also contains soap base, oil and colours.
What caustic soda does to the body
Since it’s a chemical, ingestion of caustic soda causes spontaneous vomiting, and chest and abdominal pain. It burns tissues leading to corrosive injuries to mouth, throat, oesophagus and stomach.
When oesophageal tissues are injured, it can cause tears/holes, which means food and saliva can leak into the chest cavity. If the injury is superficial, it heals with scar formation, causing a narrowing of the oesophageal tube, which makes swallowing food difficult.
Dilatation endoscopic procedure is done through which the oesophagus is widened.
Depending on the amount of alkali or acid ingested, it would take years for a child to get back to the normal routine of eating.