27/01/2018
Q: What are some of the common diseases among children in Pakistan?
Diarrhea is the most common disease among children under one and two years of age. Every year in Pakistan, approximately 250000 children die due to the disease. Respiratory tract infection or pneumonia is the second most common problem seen here especially in winter season. Next comes malnutrition and anemia, as 40 percent children in Pakistan are malnourished whereas another 40 percent are anemic. Vitamin D deficiency has become more common nowadays because of the changes in our lifestyle. Increase in junk food intake, lack of physical activity and not getting enough sunlight due to small and congested houses are the reasons to this deficiency. Now coming to neonates let me tell you that because our mothers are malnourished, children are born before time or with low birth weight. 20- 25 percent babies are born premature and this makes them prone to health problems. Respiratory tract infection, jaundice and liver haemorrhagic disease are common in them. Many problems also occur due to cousin marriages such as congenital malformations.
Q: Which of these diseases are preventable?
Generally, 80 percent diseases are preventable in children. And the diseases I have mentioned are all preventable. Diarrhea for instance, can be prevented with proper sanitation, hygiene and clean water. And even if diarrhea does occur, death due to it can be prevented by keeping the child well hydrated. Acute respiratory tract infections are also preventable but people have problems reaching the right doctor and they keep switching doctors. People usually are unaware about nutritional aspects as well. They do not know what to give to the baby and what not to. Other than this, completing vaccination course is an issue, though it can help prevent many diseases. The nine month measles vaccine is usually missed because of the gap between the third and the ninth month dose. Parents usually forget about it because they do not prioritize it. Anemia can also be prevented with intake of iron-rich diet. Sanitation, hygiene and immunization are all important to prevent diseases. However, rare diseases are of course an exception.
Q: What is the state of newborns nowadays in Pakistan?
Honestly speaking, there is no change since the last decade, although many programs have been initiated by the government. There is no major change in the figures. It is sad that we are far from bringing drastic changes when compared to our neighboring countries, Bangladesh and India. There is a major loophole either in the policy or its implementation. Nevertheless we should have hope. To overcome this, we need to first accept that there is a problem, identify why it has happened and then move on to brining improvement. Nothing is impossible. If other countries are improving in health sector then why can we not.
Q: Vaccination is a controversial subject. Some people are doubtful about or even against their use. Your view on it?
Well, I am a strong advocate of vaccinations. According to global statistics, countries who regularly use vaccines have almost eradicated many types of bacteria, and diseases like tetanus, measles etcetera. The status of vaccines, however in our country is not really good. We have definitely overcome some diseases but diseases like tetanus still persist. There are third largest cases of tetanus in Pakistan. We just cannot reject science and say immunity cannot be developed through vaccinations. Surprisingly, even well educated and sensible people do not give priority to them. People even tend to delay the right time of vaccines. It is partly due to the fault in system. Parents are usually given reminder calls in many countries when their child’s vaccination is due. And schools take a look at vaccination card before admission.
Q: Which diseases or symptoms should doctors look out for during screening?
There are simple screening tips recommended by WHO. A child’s weight is the major aspect to be looked at while screening. If a weight machine is not available, just check a child’s Mid-Upper Arm Circumference (MUAC) which will show if the child’s weight is going downhill. This should be an alarming sign. Other than this, mothers should be informed about the danger signs of respiratory tract infection, in which case they should directly come to the hospital instead of going here and there. Doctors should also check for anemia and vitamin D deficiency. A doctor can assess a patient as soon as he enters the room; whether the child is lethargic, dull, has glowing skin, etcetera. Instead of letting these signs go unnoticed; the doctors should immediately alert the parents and take steps to rectify the issue. Prevalence of tuberculoses in kids is reducing worldwide whereas it is on the rise in Pakistan. Patients usually delay taking treatment and it spreads quickly. So even children acquire it. Many things are linked to lack of awareness in the country.
Q: What are the things parents are doing wrong that are affecting their child’s health?
Parents belonging to the lower socio-economic class, lack resources to give balanced diet to their children. But parents from the higher socio-economic class are also not providing nutritional food to their kids. They are more into eating junk food therefore not getting enough nutrition. With awareness however, lower socio-economic class parents can at least know what is healthy and therefore help prevent problems like anemia and stomach worms. At school level, every child should be dewormed (medicine given to children for worm infestation) as a precaution once a year. Worms are responsible for various problems such as anemia. Parents on the other hand, should take care of sanitation and hygiene at home. Breastfeed your babies. And cut down on junk and unhealthy food. Avoid giving money to school going children. Stick to homemade food. 50 percent diseases can be prevented with proper hand washing. Parents should teach right techniques of washing hands. Above all, do not give over the counter medicines, especially antibiotics. Because diseases like typhoid are becoming resistant to medicines. Go to a doctor not medical store.
Q: Do home remedies work for colic pain?
Firstly, colic pain occurs due to gas and there is nothing that can prevent it. It starts in about a month old baby and goes on till two and a half months. The pain subsides when the child is around three months old. Secondly, there is no treatment for it in allopathic medicine. There are various types of drugs available in the market which can only provide temporary relief like any herbal medicine or home remedy for this purpose. Some of the home remedies can be helpful unless contradictory.
Q: Does colic pain have anything to do with what the mother is eating?
Not necessarily. It is only a misconception.
Q: What does green p**p mean? Does it signify the baby has caught cold?
No, there can be many reasons for green p**p. For instance, malabsorption or presence of mild organism can change the color. But it does not mean it is a sign of disease and medicine is required. Not all green stools should be taken seriously. There is a virus called anteroviral infection which is asymptomatic. But due to bad sanitation in the country, this virus is present in 50 percent of normal healthy children. And it can change color of stool.
Q: What are the signs of vitamin D deficiency?
In severe vitamin D deficiency, bones of the front part of the head and ribs become prominent. Moreover, nodules develop, wrists widen, legs become slightly crooked and knock-knees develop. However, in an initial state, patients usually complain of foot pain at night. A child should get tested for vitamin D. Medicines should never be given without conducting the test, though it is an expensive test. General practitioners usually prescribe medicine without the test. This is not a good practice because they can cause problems in the long run.
Q: Why are respiratory problems so common nowadays? Is its precaution, treatment?
There is a difference between respiratory tract infections and general problems related to it. If a child has dry cough at night but has no fever, it is not an infection. And therefore every patient should not be given medicine for it. Respiratory problems usually occur due to an allergic reaction to pollution. It can be due to construction around you, dust and pollen grains. Even animals and carpets can trigger a reaction. These environmental factors cannot be controlled much. Another factor is artificial flavors and preservatives found in drinks, tomato ketchups, confectioneries etcetera can also cause these issues.
Q: Many mothers nowadays complain their child does not eat anything (healthy). How should mothers make them eat?
There are few reasons to it. Firstly, mothers do not inculcate proper eating habits since beginning. A mother usually runs after the child to make them eat. Some kids eat only in front of the television. All these are wrong habits. Secondly, they prefer nuggets over chicken, fries over cooked potatoes and burgers and pizza over chapatti. Moreover, kids are given money to eat from the school instead of giving homemade food. And eating out is the new trend. When a child is born he does not know what to eat and what not to. It is a parent’s duty to teach and form healthy habits in children. Moreover, media and schools also play a role in this regard. School canteens offer unhealthy options. So when kids see their peers buying such stuff they tend to do the same. It is a constant struggle. And everybody should step forward in creating a healthy environment for children. Home, however is the main nursery. Other than inculcating healthy eating habits, a mother should also develop proper eating and sleeping patterns too.
Q: Well, anything left you would like to add at the end?
Pay special attention to your children regarding their diet, sanitation and habits so that they can be kept away from diseases. Moreover, Montessori schools should also take care about their children’s health because young children are seen to fall ill every month once they are admitted to schools. A child who develops cough and flu should immediately be sent home so that other kids are not infected.
