Bacteriology of chronic suppurative otitis media (CSOM) in children in Garissa district, Kenya: a point prevalence study.

Objectives: To identify by type and sensitivity to drugs the bacteria found in ears of school-going children with chronic otitis media in Garissa district.

Study Design: This was a descriptive prevalence study of CSOM bacterial flora in eligible ears conducted among a cohort of children attending public and private primary as well as Islamic religious schools, screened for chronic ear discharge in Garissa district, Kenya. Procedure and bacteriological techniques: We used sterile swab-sticks to collect a specimen of the discharge from eligible ears of consenting pupils at the induction stage of the zinc supplementation trial for treatment of chronic suppurative otitis media conducted between January and July 2010.

Multiple opportunities for creating sanctuary.

This article describes the experience of five change agents from a diverse group of settings: two residential treatment programs for children and adolescents, a group home for disturbed adolescents, a residential substance abuse program for urban women, and an acute care psychiatric inpatient unit. What all of these innovators share is a willingness to engage in the challenging and complex process of changing their systems to better address the needs of the traumatized children, adolescents, and adults who populate their various programs. Using the Sanctuary Model as originally applied to a specialty inpatient psychiatric program for adult survivors of childhood abuse as their guide, the leaders of each of these organizations discuss the process of change that they are directing.