XV International conference on Pediatrics held in Delhi

A victim of the biggest killer - malnutritionIf children are to grow up into healthy adults, the safeguards of health care have to catch them while they are young. The fact that India's children are too often left outside this protective net is reflected in the sorry statistics showing that the 0-5 age group, which comprises 17 per cent of our population, accounts for 40 per cent of the total annual deaths. What is even worse, the death toll among newly-weaned Indian children is 50 times higher than in the west.This is the backdrop - of some 120 million little Indians - against which the XV International Congress of Pediatrics was held in Delhi last month. It was a triennial assembly full of luminaries who have devoted their lives to improving the health of children.They met - 3,500 of them - to review the condition of children afresh in the light of today's needs and living standards around the world. During the seven days of the Congress, more than 250,000 newborn babies joined the ranks of the Indian population - and about 3,500 of them were doomed to die in infancy, while many others will be condemned to poor growth. Not surprisingly, it was the health needs of children like these that dominated the Congress agenda. And chief among them are - not the treatment of any complex disease, but the simple and staggering problems of malnutrition and an environment teeming with dirt and well-known, commonplace germs.That the pediatrics' world is aware of the truth was evident from the subject-matter of the sessions. There were 19 focal discussions on varied aspects of malnutrition, and a similar number on gastrointestinal and hepatic infections.Other special symposia highlighted respiratory ailments. A major plenary session centred on the need to make pediatric education relevant to the health needs of the community. And the final plenary session zeroed in on the biggest poser: the global challenge of malnutrition.Deliberations on esoteric themes like cystic fibrosis or complicated endocrine and cardiac conditions may have sounded much more newsy and exciting but the value of the Pediatrics Congress for countries like India lay in its capacity to focus non-medical attention on the basic health problems of children of the developing world.It is ironic that India - where the discipline of pediatric medicine had its birth - should today be such an object-lesson in poor child health and poor child care. But it is. According to an eminent Delhi-based pediatrician, Dr Shanti Ghosh, the combination of diarrhoea, gastro-intestinal infection, plus malnutrition is the leading cause of early childhood deaths. And it is weakness due to inadequate nourishment that makes our children so powerless to fight this and other infections. "In more than half the deaths that occur, malnutrition is a major contributory factor," said Dr Ghosh. Yet this big villain never gets listed as the cause of death.The deadly combination strikes the hapless child in a vicious cycle: each episode of diarrhoea makes the malnutrition worse and further reduces the child's capacity to absorb whatever nutrition is available, and this further aggravates the diarrhoea and consequent dehydration in a lethal chain-reaction until the last, frail bodily defences crumble. Not a very impressive ailment in the medical books - except in its effects.Yet, it is in the developing countries that this is the "killer" malady. Child health statistics of the developed world do not mention it as a major problem; there, the leading causes of child deaths listed by the World Health Organization are "accidents and malignancies". In such countries, the old foes like hunger and every day germs have been pushed into the past. In the Third World, the battle to subdue them has yet to begin. Because of them, infant mortality in India is still six to seven times higher than in the developed countries, varying between 122 and 150 per thousand births. Care of the unborn is slipshod and beleagured with unhealthy taboos so that mothers are undernourished and "small-for-date" babies are common.By the time an infant is four months old, the mother's breast milk is usually far too little, and the child's growth curve begins to slump. Some mothers try to supplement their milk with uncleaned bottles of poorly-prepared tinned powdered milk, and the menace of infection is introduced. The baby enters the stark six-month to 24-month danger zone of its life.Even if it survives the first part of this period, the crucial weaning stage of the second year is still ahead. It is in this year that sample studies show that the child death toll in India is 50 times higher than in western countries. The child is weaker, ill-fed-and more exposed to infection, more vulnerable to diet-related plights like vitamin A-deficiency blindness.The Pediatrics Congress did not fail to reflect this situation. But it could do little more than underline the need for remedial action. And this action lies not just in having better-educated pediatricians but in making a policy change that will give health care the vital transfusion it needs."The cures for our pediatric problems will come from realizing that things like village drinking water supply, hygiene education, and diet improvement are all part of the health effort, and should be tackled in a coordinated way," declared Dr Ghosh. If the Congress has helped to get this approach accepted it has brought more than mere conventional glamour to Delhi.Published By: AtMigration Published On: Sep 8, 2014 14:44 IST--- ENDS ---

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XV International conference on Pediatrics held in Delhi

This is the backdrop - of some 120 million little Indians - against which the XV International Congress of Pediatrics was held in Delhi last month. It was a triennial assembly full of luminaries who have devoted their lives to improving the health of children.

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