Health is wealth. An apple a day keeps the doctor away. Prevention is better than cure and so on and so forth. Dig a little deeper and we realize that the roots of our health today – and perhaps destiny itself – are deeply embedded in our early years. Or even earlier. Remember Abhimanyu?
In stories from the great epic, Mahabharata, as told to us by our Nanis and Dadis (grandmothers), Abhimanyu stands out as a favourite character for many: young, dashing and tragic. He was the son of Subhadra, sister of Krishna, and the great Arjuna. His training in the art of war – particularly in the breaking of the ‘Chakravyuha’, a defensive battle formation – started when he was in his mother’s womb. His knowledge remained incomplete, however, and he lost his life in his 16th year, in a valiant effort to break the circular formations, during the epic battle at Kurukshetra.
Today we know that sensory pathways start to develop from the last trimester of the mother’s pregnancy – vision, hearing and the higher cognitive function – and the formation of synapses in a child’s brain depends on early experience. So much so that certain ‘windows of opportunity’ are open only for a short time, say between the 6th and the 12th month. In the absence of appropriate and adequate stimuli some neural connections do not happen and the child suffers developmental deficits.
The deprivations can be on account of poverty, social marginalization, abuse or a particularly traumatic event in early life. According to research in the US the difference in cumulative vocabulary, between children from high and low socio economic status (SES) backgrounds, for instance, starts to surface after the 14th month; by the 36th month it stands at over 700 words. Studies have also shown a positive relationship between the number of adverse childhood events and the likelihood of cardiovascular disease in adulthood. Cognitive and educational deficits accumulated by stunted children are estimated to result in a 22% loss of annual income in adulthood.
On the health front, a scientific consensus is emerging that the origins of adult disease are often found among developmental and biological disruptions occurring during the early years. And, most unfortunately, there can be a lag of many years, even decades, before early adverse experiences are expressed in the form of disease. See C.A. Nelson, Institute of Child Development and Department of Pediatrics, University of Minnesota, USA, 2000. It is this ‘lag’ that blinds us from what’s staring us in the face: we have got to start early. From a policy perspective, therefore, confronting the origins of disparities in physical and mental health early in life may produce greater, positive effects than attempting to modify health-related behaviors or improve access to health care in adulthood.
Again, we are back to the adage, prevention is better than cure.
In the Indian context, we are all familiar with the oft-sited, vicious circle of poor diet and neglect of girls, anemic adolescents, low body-mass in women, early marriages, multiple and short-spaced pregnancies, low birth weight children, weak lungs, poor nutrition, stunting, and high disease burden as children become young adults. It is an unholy nexus of neglect in early childhood, inter-generational poverty and gender inequities. We need to intervene at every stage to weaken every link of the vicious circle. But first, prioritize the most fundamental connection – pregnancy and early childhood.
At Mobile Creches, we nurture the early years in many ways. At our daycare centres we ensure the following:
Working mothers take breaks to breastfeed the infants
Timely introduction of complementary foods at six months
Age-appropriate complementary feeding, adequate in terms of quality, quantity and frequency for children 6-24 months
Hygienic practices when feeding children (e.g., washing hands for food preparation, serving and eating)
Immunisation and vitamin A supplementation with deworming
Early detection and therapeutic feeding (ready-to-use therapeutic foods) and care for all children with severe acute malnutrition
On a regular basis we have discovered that a majority of children, who stay at our centres for at least four months, improve their nutritional status. In 2015- 16, for instance, 82% improved and retained the ‘normal’ status, 10% remain unchanged and 8% suffered a decline.
MC’s efforts are only demonstrative of what needs to be and what’s possible. The national picture, however, continues to look dismal. India is one of the countries that spend the least on the healthcare sector with a public spending of around 1% of GDP as compared to 3% in China and 8% in the UK. Consecutive governments and expert groups have recommended that at least 2.5 per cent of the GDP must be devoted to public expenditure on health because of the huge burden of diseases in India. The union budget announced earlier this year emphasized on health insurance schemes and Public Private Partnerships, as the solution to India’s health woes.
This is a narrow view. We are fully aware that decline in death rates did not happen only on account of immunizations and penicillin; it was really thanks to clean drinking water, sanitation and decent housing. We need to look at Health in all its dimensions: promotive, preventive, curative, rehabilitative, mental, emotional, physical. Holistic is the word we are looking for.
In the meanwhile, what should you and I do as parents, as individuals? As parents, we need to start early with our children, to lay strong foundations for health and learning. For us adults, Indu Balgopal, Medical doctor and former Chairperson of Mobile Creches, who believes in holistic health and has worked for decades with young children, believes in the following simple rules:
Harmony – Disease takes root when the system is conducive to it. A disappointment or a shock can act as a trigger. The mind as a powerful coping mechanism is least understood and most illnesses are treated by their clinical symptoms. Develop your inner harmony and strengthen that immune system – a positive approach, aided by Yoga, meditation, altruistic attitudes and moderate life styles.
Hygiene – The world is getting more crowded and the health-giving vital elements are getting depleted and polluted. Simple rules of hygiene become even more critical: washing our hands, keeping our bodies clean, conserving water and preserving the fresh air.
Humour and Laughter – Research has shown that happy people live longer and healthier lives than those who succumb to their sorrows. So cultivate like-minded friends and learn to see the lighter side of life.
Yes, we forgot to mention this one – Laughter is the best medicine.
Suggested Readings: http://www.thehindubusinessline.com/economy/india-spends-least-on-healthcare-among-brics-nations/article3317902.ece
#Mynameistoday, the Mobile Creches blog, will attempt to inform, provoke and connect, on issues of critical importance to our present and future.
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