Gasping young

Children's health has become a worldwide concern, especially in developing countries such as India where they are at risk from a fast-degrading environment and health
facilities.... Asthma is the new urban childhood disease.

By Mukesh Khosla

A few years ago, a study conducted in Hyderabad as part of the Andhra Pradesh School Health Project revealed a sharp rise in asthma cases among children. The study concluded that nearly 25 per cent of children aged between six and seven years suffered from lung diseases, as against the earlier presumed figure of around six per cent.

Another study conducted in Jaipur recently by the SMS Medical College and Hospital confirmed that 6.8 per cent of Indian children suffer from asthma. The study involved 4,000 students in Jaipur city.

In many Indian metros the level of suspended particulate matter (SPM)—dust and carbon particles coated with toxic gases—is many times higher than the World Health Organization (WHO) norm of 200-micrograms/cubic metre. The main culprit is the increasing number of cars, buses and trucks that contribute to 70 per cent of the SPM.

Worldwide, more than five million children between 0-14 years die annually from environment proximity diseases—places where they live, learn, and play. These places should be the safest, but ironically pose the biggest threats to their health. Diseases such as malaria, cholera, dengue fever and schistosomiasis have debilitated half a billion children across the globe.

This severely impacts social and economic development: children with long-term disabilities and chronic diseases won't grow up healthy and productive people. According to a recent UN report, Africa's gross domestic product could have been US$ 100 billion higher if malaria had been tackled successfully. Mexico could benefit by US$ 2 billion a year if the particulate matter in the environment were reduced by just 10 per cent. In the late 1990s, pollution cost China up to 7.7 per cent of its potential economic output.

Toxic exposure is costing the developed nations more than US$ 300 billion every year. In the US alone, the annual cost of certain childhood environmental diseases is estimated to be US$ 55 billion.

This grim scenario galvanised various organisations into action. Says Dr Mirta Rose Periago, Director, Pan-American Health Organization, "Every child deserves the right to health and no child should face threats to health from unsafe environment at home, in school or in the community."
Children are particularly vulnerable to unsafe drinking water, inadequate sanitation, indoor air pollution, insufficient food hygiene, and inadequate waste disposal.

WHO reported these cases
Devi Priyadarshini collects water daily from a contaminated stream, and then cooks food in an open fire which creates breathing problems, as there is just one window in her house. Her younger brother often complains of pain in his eyes due to the smoke. Both suffer from bouts of diarrhoea from the dirty water. Devi says, "I have often been told that I could get sick because of the water and mosquitoes and other insects that are here in my dirty locality. But what else can I do?"
Devi's case is similar to those of Europeans in low-income housing districts. They have high levels of asthma and domestic accidents among young children. They suffer a very noisy environment, and almost all of them have serious cockroach infestations. The poorest children live in places that have not been painted for 40 years and are constantly exposed to dust.

The condition of the school in Latin America where Esmeralda Montoya teaches is pathetic. She says, "The roof of school has been leaking for years now, [but] we don't have heating facilities and when it rains in winter, things become worse. Due to the dampness, children get cold and cough." The school, says Montoya, "doesn't even have functioning toilets for the last one year and children have to go into streets or nearby bushes. It's dangerous for girls as there is a lot of crime in the area."

The WHO is emphasising global, grassroots strategies. It has divided environmental health hazards into six groups:
1) lack of water in the household;
2) lack of hygiene and poor sanitation;
3) air pollution;
4) vector-borne diseases;
5) chemical hazards; and
6) unintentional injuries.

Diarrhoea, which arises from contaminated water,is responsible for 1.3 million child deaths a year,
or 12 per cent of deaths of children under five in developing countries.

Contaminated household water leads to hepatitis A and E, dysentery, cholera, and typhoid fever. The WHO and UNICEF estimate that more than 1.1 billion of the world's 6.6 billion people lack access to a clean water source, and about 80 per cent live in the rural areas.

The solution lies not just in providing access to better water but also in hygiene education, which includes safe treatment and storage of water. The next big issue is that of sanitation, including the safe disposal of human faeces and garbage.

Globally, 2.4 billion people, mostly living in semi-urban or rural areas, have no access to good hygiene. Of these, 48 per cent are in Africa and 31 per cent in Asia. People need to be better educated about basic sanitation practices such as washing hands with soap, proper waste management, the relocation of dumps away from human settlements and—most importantly—preventing children from scavenging.

Another important WHO agenda is to impress upon various governments to adopt strict to make their skylines pollution-free. Every year, roughly two million children under the age of five die of respiratory infections. Indoor air pollution is more dangerous than outdoor pollution. Providing good ventilation, using clean fuels, and protecting children from secondhand tobacco smoke are imperative.

The most dangerous diseases are vector-borne. The commonest, malaria, is spread by mosquitoes. Concentrated in the sub-Saharan Africa region, it kills about one million children every year. Dengue fever, a waterborne disease, kills about 100,000 children every year.

Last year, 685,000 children under 15 died of ‘unintentional injuries’, including traffic injuries and drowning. The African, Southeast Asian and Western Pacific regions account for 80 per cent of children's deaths from unintentional injuries.

All this adds up to an immense challenge. With today's children far more vulnerable to opportunistic diseases, diminished immune systems, and the vagaries of modern living, humanity might just be compromising its own future.

N ewsmen Features