Case presentation Isabelle is a four-year-old girl who lives with her mother and father in a rural community in country in the WHO Eastern Mediterranean Region. The family is of working class and their neighborhood is facing problems involving poor sanitation. She is an active child who loves to play outside with her older sister and brother. Saturday, Isabelle and her family spend a day at a lake near their home for a family reunion. All 52 members of the extended family attended the gathering. Isabelle went swimming with her siblings and cousins while the adults prepared the picnic. The children got out of the water when Isabelles mother called them when lunch was ready. The next day, Sunday, Isabelle woke with a fever and throughout the day she developed abdominal pain, nausea, and diarrhea. By the end of the day, Isabelle would not eat or drink anything because she was having watery diarrhea and her tummy hurt so bad. All she wanted to do was snuggle with her mom and sleep. Her father brought her to the hospital in a city thats 30 minutes away from their community. The doctor diagnosed Isabelle to having a stomach bug. Her father received medication to ease her symptoms. The doctor advised him to bring her back in five days if her symptoms dont improve. Isabelles parents brought her back to the hospital the next days later with worsening symptoms- she will not eat or drink, continues to have watery diarrhea, and is very weak. Isabelle is admitted to the hospital and a stool sample is sent for pathology. 1. What do you suspect is the cause of Isabelles illness? What are the primary symptoms that made you suspect this illness? 2. List the risk factors that may have contributed to Isabelles illness: 3. Is there a cure for this illness? What is the standard of treatment according to the World Health Organization? 4. What social determinants that you believe contributed to this case? Name at least two determinants and explain why you chose them (100-300 words). 5. Based on the World Health Organization recommendations to prevent water-borne illnesses, what would you advise to prevent future infections for Isabelle? For the family? For the community? (100-300 words) 6. Isabelles community is at risk for diseases caused by inadequate sanitation. What are the challenges, in general in the Easter Mediterranean Region, in addressing the problem?.

1. Case presentation Isabelle is a four-year-old girl who lives with her mother and father in a rural
community in country in the WHO Eastern Mediterranean Region. The family is of working
class and their neighborhood is facing problems involving poor sanitation. She is an active child
who loves to play outside with her older sister and brother. Saturday, Isabelle and her family
spend a day at a lake near their home for a family reunion. All 52 members of the extended
family attended the gathering. Isabelle went swimming with her siblings and cousins while the
adults prepared the picnic. The children got out of the water when Isabelles mother called them
when lunch was ready. The next day, Sunday, Isabelle woke with a fever and throughout the day
she developed abdominal pain, nausea, and diarrhea. By the end of the day, Isabelle would not
eat or drink anything because she was having watery diarrhea and her tummy hurt so bad. All she
wanted to do was snuggle with her mom and sleep. Her father brought her to the hospital in a
city thats 30 minutes away from their community. The doctor diagnosed Isabelle to having a
stomach bug. Her father received medication to ease her symptoms. The doctor advised him to
bring her back in five days if her symptoms dont improve. Isabelles parents brought her back to
the hospital the next days later with worsening symptoms- she will not eat or drink, continues to
have watery diarrhea, and is very weak. Isabelle is admitted to the hospital and a stool sample is
sent for pathology.
1. What do you suspect is the cause of Isabelles illness? What are the primary symptoms that
made you suspect this illness?
2. List the risk factors that may have contributed to Isabelles illness:
3. Is there a cure for this illness? What is the standard of treatment according to the World Health
Organization?
4. What social determinants that you believe contributed to this case? Name at least two
determinants and explain why you chose them (100-300 words).
5. Based on the World Health Organization recommendations to prevent water-borne illnesses,
what would you advise to prevent future infections for Isabelle? For the family? For the
community? (100-300 words)
6. Isabelles community is at risk for diseases caused by inadequate sanitation. What are the
challenges, in general in the Easter Mediterranean Region, in addressing the problem?