Consequences of Natural Disasters

A  Stress on Children’s Development

A landslide is a geological phenomenon, a natural disaster, which includes a wide range of ground movement, such as rock falls, deep failure of slopes and shallow debris flows, which can occur in offshore, coastal and onshore environments. Debris flows, also known as mudslides, are a common type of fast-moving landslide that tends to flow in channels. Landslides are caused by disturbances in the natural stability of a slope. They can accompany heavy rains or follow droughts, earthquakes, or volcanic eruptions. Mudslides develop when water rapidly accumulates in the ground and results in a surge of water-saturated rock, earth, and debris. Mudslides usually start on steep slopes and can be activated by natural disasters. Areas where wildfires or human modification of the land have destroyed vegetation on slopes are particularly vulnerable to landslides during and after heavy rains.

Here is a video clip of what exactly landslides are and what causes them.

http://www.youtube.com/watch?v=JrV4uCVwmfk&feature=related

The reason I chose to write on landslide is because of a tragedy that took place in my family. I was just about 4 or 5 years old when my cousin, a talented and charming young man to whom I was very much attached became victim of this fatal natural disaster. He was out with his friends in a waterfalls area when suddenly there was a flash flood leading to a landslide. On hearing the oncoming gush of a strong current, his friends managed to get to the shore leaving just him and a friend stranded in the middle just holding on to a rock.
I found this video in Youtube that fits exactly the descriptions that we heard from his friends  – have a look at this. http://www.youtube.com/watch?v=O5SyBTy6j24&feature=fvst

The news of this tragic event came as a bolt to me and something that I found difficult to accept at that very young age. Ever since any water body has always terrified me and has always send shivers up my spine at the thought of getting into water. Till date I have not been able to cope with this fear. Going to places like water theme park has always kept me away.

Environmental hazards create a greater impact on the younger children’s mental health, growth and development than on the older, more developed ones. Young children are the most vulnerable ones at times of crisis, and the effects of stress during critical periods of brain development and physical growth may be irreversible. Natural disasters and man-made catastrophes, such as war, are major causes of emotional and behavioral manifestations and disorders in childhood. Most children will be able to cope over time with the help of parents and other caring adults. However, some children may be at risk of more extreme reactions. The severity of children’s reactions will depend on their specific risk factors. These include exposure to the actual event, personal injury or loss of a loved one, dislocation from their home or community, level of parental support, the level of physical destruction, and pre-existing risks, such as a previous traumatic experience or mental illness. Symptoms may differ depending on age but can include: 

• Preschoolers—thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, and withdrawal from friends and routines.
• Elementary School Children—irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, and withdrawal from activities and friends.
• Adolescents—sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration.

Talking to children about disasters, creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties. A website that I found by the American Psychiatric Association gives guideline on how to open such a conversation with children and make them aware of the catastrophe. http://www.healthyminds.org/More-Info-For/Children/Talking-to-Children-about-Natural-Disasters.aspx

Storm Sendong in the Philippines
Only a few months ago, tropical storm Sendong (international name: Washi) landed in Mindanao on the Southern tip of the Philippines, bringing with it hours and hours on end of torrential and unrelenting rain. Flash floods then followed causing landslides, ravaging property and leaving Filipinos hapless against the power of nature. In only two days, Sendong ravaged Mindanao, leaving in its wake flattened houses, lost property and disrupted life routines. But, beyond this, Filipinos, most of all, mourn 1,268 of their countrymen who perished under the ruthlessness of Sendong. The floods may have, by now, become forgotten and many believe that things are back to normal, but they are not. Hundreds of thousands remain affected by Sendong. The children who woke up in the middle of the night to find their homes being washed away by the floods are still living in evacuation centers. The families who lost their livelihoods are still struggling to figure out how to feed their children, how to gain an income, how to rebuild their homes, and how their children will be able to go back to school after the summer.

Public Health Measure – Nutrition/Malnutrition

Fundamental changes takes place in the first two years of a child’s life like weight gain, sprout hair, start to walk, communicate and solve problems, cross important milestones like first step, first words, first tooth and so on. By the time the child reaches 2 years old, he/she is already half their adult height and about 20% of their adult weight. The period of greatest vulnerability to nutritional deficiencies is very early in life: the period beginning with the woman’s pregnancy and continuing until the child is 2 years old. During this period, nutritional deficiencies have a significant adverse impact on child’s survival and growth resulting in symptoms of malnutrition.

 When we think of malnutrition the first impression that comes to our mind is that of the poverty or famine stricken skinny, pot bellied children with flies swarming around them. When we readily associate malnutrition with poverty what we do not realize is malnutrition is very much existent in the developed countries and affluent societies today due to improper diet and lifestyle. Insufficient protein, energy and micronutrients, frequent infections or disease, poor care and feeding practices, inadequate health services and unsafe water and sanitation can also result in malnutrition.

The social context a mother lives in affects her decision to start and continue breast feeding. Absence of breastfeeding is among the major causes of malnutrition in infants in such affluent societies. Virtually all doctors worldwide recommend exclusive breast feeding for the first four to six months due to its various benefits. Breast milk provides babies who are exclusively breast-fed with antibodies against any diseases to which the mother is immune, decrease the risk of many diseases that appear in childhood and adulthood such as obesity, asthma and heart disease. Compared with cow’s milk, human milk is sterile, at body temperature, with iron, vitamins and other nutrients for body and brain. The specific fats and sugars in breast milk make it more digestible than any other prepared formula.

In today’s fast paced world the growing dependence on fast food which is faster and easier, coupled with soaring rates of binge-drinking, means many are lacking the vitamins and minerals essential for health. Junk food may be loaded with calories but do not add anything to our bodies other than fats and carbohydrates. If you look at the lunch boxes children bring to school you mostly find French fries, cream filled biscuits and packet chips. In such cases of disproportionate nutrition gaps, malnutrition can result in Protein-calorie malnutrition, Vitamin malnutrition, and calcium malnutrition and so on. Read more on Junk food and malnutrition: http://www.dailymail.co.uk/news/article-453099/Junk-food-causing-famine-symptoms.html#ixzz1obAjIQDb

Micronutrient malnutrition can result in inappropriate intake of food rich in vitamin (A,B,C,D,E, K) and minerals like Iodine, Iron and Zinc. Young children and pregnant women are most vulnerable to these deficiencies. During pregnancy, deficiency of iron and zinc can produce cognitive and growth impairment of the foetus, which may continue into infancy.

These micronutrient malnutrition dimishes motivation and development of children consequently impairing mental and cognitive abilities. The proportion of the population affected by iodine deficiency is highest in Europe (52 per cent). Read more to know the benefits of vitamins
http://www.livestrong.com/article/420254-vitamins-malnutrition/

Excessive consumption of only one type of food or sustaining on a single source of nutrition can also lead to lack of proportionate nutrition. Coupled with this a sedentary lifestyle and junk food culture in developed countries are among major causes of malnutrition in children and young adults these days, making way for malnutrition diseases like anemia, goiter, kwashiorkor, marasmus, etc. While malnutrition can be fatal, in more mild forms it can cause a host of symptoms that impact on everyday life, from hair loss and muscle wastage to food cravings and lethargy. Simple dietary changes can make significant improvements in the quality of children’s diets. The researchers suggested parents should consider snacks as “mini-meals" and offer healthy options such as fruits, vegetables, low-fat yogurt and whole grain foods.

A publication by UNICEF -Tracking Progress on Child and Maternal Nutrition - provides information on nutrition strategies, progress made by programmes and current challenges, based on the most recent data available. The report profiles 24 countries where 80 per cent of the world’s stunted children live.
UNICEF. 2009. Tracking Progress on Child and Maternal Nutrition: A survival and development priority . Retrieved from: http://www.unicef.org/publications/index_51656.html

Eating a good, well-balanced diet helps to prevent most forms of malnutrition. Hence, eating wisely and proportionately accompanied by a physically active lifestyle can enhance the well being of our children!

 Read more

The big picture

My Personal Birthing Experience

Recalling my son’s birth is one experience I wish I had the power to change, to rewind, delete and restart. My only child, boy 13 years is mentally retarded confirmed by the doctors who have diagnosed him owing to his trauma at birth. We stay in Abu Dhabi, the capital of United Arab Emirates where we have a huge expat community working and living here. So when I chose to have our baby here instead of going to our hometown in India, thinking I could get better and quality medical attention, I thought I was making a wise decision. Only later after the birth of my son did I realize things could have been different and my son would have a normal life had I reconsidered my decision then.

Anyway, to recall my experience, pregnancy as such was uneventful, with no complications, undergoing periodic prenatal checkups and ultra sounds all revealing a healthy pregnancy. The only slight problem that did occur was I developed hypertension in the last few weeks prior to delivery.  However, even that was taken care with immediate medical attention and diet control. I went for my checkup on my due date with no pain or any sign of labor when they noticed that I had slight hypertension so decided to induce me and start the labor so as not to stress the baby. Now, it is from this part that I wish I could alter the course of events. I was admitted on that morning, the 6th January 1999 and given tablets to start the contractions It was only much later around late in the evening that I started to have pain that was beyond my tolerating level. I must confess at this point that my threshold level of pain is too low. So, I called the midwife who was to attend my case and she examined me and decided it was time to take me into the labor room. With the intention to ease my pain and discomfort she decided it would be apt to break the water bag right then and gave me to use the oxygen mask as and when I needed. After consulting my obstetrician she gave me a dose of pethidine a pain killer which not only eased my pain but knocked me off as well. So I was lying there with no consciousness unable to do the job what a woman in labor must do – push. Every now and then I would come and go off my senses. Then without my consent or my husband’s who was with me the whole time in the labor room, my midwife gave me a second dose of pethidine. This time I was really knocked off which only prolonged my labor leaving me in there for 18 hours. Until then my OB did not think it was getting too long and do a c-section to get the baby out and ease both our discomfort (when cesareans are easier on the fetus and quicker for the doctor and the mother, if an intervention like a c-section is needed, then I am of the opinion that the doctors should go ahead and do the surgical procedure instead of waiting for hours for a normal delivery and put both mother and child in distress). At the end of 18 hours however, they started me on drip to increase my contractions and finally my senses were awakened and I felt the need to give that giant push which brought my son into this world with a faint cry. However his Apgar scores were normal then. After removing the cord that was around his neck and cutting it, they took the baby to the corner of the room where there was a washbasin to clean him. While doing so they noticed he was turning blue and immediately paged for the neonatalist on duty to rush to the delivery room. After examining the baby he instructed to get him quickly to the NICU which they did carrying him by hand all the way to the floor above. We are talking of minutes being lost here where even seconds matter (from my understanding damage to the brain occurs if it is deprived of oxygen for more than 7 seconds).  What had happened was he had swallowed the fluid and his lungs being filled with the fluid, could not take in oxygen. He was asphyxiated and inadequate oxygen caused him brain damage. His Apgar scores which was 7 indicating normal at birth dropped down to 5 in 3 minutes indicating he was in critical condition. Resuscitation included bag and mask O₂ and volume expansion.  His clinical features which included abnormal neurological signs such as lethargy, hypotonia, poor suck and Moro reflexes was attributed to either the doses of pethidine that was administered to me or the asphyxia that he suffered which resulted in mild hypoxic –ischaemic encephalopathy (brain injury). The first glimpse that I had of my son was a photograph that they took of him to show me in the NICU a few minutes after they had taken him there. Because I had a suffered heavy loss of blood, I was not allowed to walk or get up from bed until the next day. Though I was discharged after 3 days, I was allowed to stay back for my son who was still in the NICU. He was finally discharged after 9 days. My husband and I along with my parents were excited to bring him home finally after the tough battle that he fought. It is heart breaking to see these tender beings fighting life’s war with pain and struggle just as they enter into this gruesome world. Inspite of being in one of the best maternity hospitals in Abu Dhabi that was under European management, attended by a mid wife trained from UK, a well experienced obstetrician from India and a Neonatalist from South Africa who was the head of the Neonatal medicine, I was not given the timely medical attention. We did several abnormality tests even genetic test which ruled out any chromosomal abnormality. It was the trauma at birth that deprived my son of  a normal life. I still wish I could go back and change the course of events, demand a c-section be done when labor was prolonging and have all the necessary equipments in case of an emergency to attend to the baby. Starting from conception to birth, every stage is critical and any stress or teratogens in any form can affect the child’s development. I wish to see my child be able to talk and converse, read and write and do things like any other child of his age and the religious side of me want to believe that my God in whom I have faith, for whom ‘all things are possible’ will answer my prayer one day.  Despite all his shortcomings and incapability, we are thankful to God for bringing him into our lives, for entrusting us with the responsibility to take care of His treasure

As the old proverb goes “Experience is the best teacher” my experience in childbirth has taught me that this is something that should not be taken lightly. If lack of immediate medical attention at childbirth can affect a child’s development and as a result his life, then personally, I feel that giving birth at home as is the traditional custom is too much of a risk. Any complication can become more serious both for the mother and the baby if either have to wait for emergency medical help. True hospital births risk too much intervention (like I received 2 doses of pethidine) but considering the safety of the mother and child I think it is far safer than home births which risks complications. The home birth rate in the Netherlands is the highest in the developed world thanks to a streamlined transportation and referral system that allows women who plan a home birth to access specialist, emergency obstetric care in hospital should complications arise (Sydney Morning Herald, April 17, 2009). Though from a developmental perspective such combinations of traditional and modern method of birthing practices are helpful (Berger, chapter 4 p.118), in my opinion it still poses a risk.

http://www.smh.com.au/lifestyle/life/midwife-home-birth-as-safe-as-hospital-says-study-20090416-a8wu.html

http://news.bbc.co.uk/2/hi/7998417.stm