On a special visit to PIMS, Islamabad, Muhammad Fareed, Publisher & Managing Editor, Medical Review interviewed Dr. Haider Sherazi, Associate Professor, Children Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Following are the excerpts of the interview.
Q – Tell us something about yourself.
Ans – I did my MBBS from Rawalpindi Medical College., Diploma in Children Health from Quaid -e- Azam University, Fellowship in Community Medicine by WHO, Membership and the Fellowship from College of Physician & Surgeon (CPSP) Pakistan. I joined Children Hospital in 1988 and now working as Associate Professor. During this period I was associated with WHO and worked as Deputy National Manager of Acute Respiratory Infection Control Programme and Diarrheal Control Programme. I also worked as National Clinical Coordinator of Polio Surveillance. I also served as Director at Pakistan Institute of Medical Sciences (PIMS) Islamabad. I was also the Secretary General of Pakistan Paediatric Association (PPA) Federal Branch. At present I am International facilitator for the WHO‘s workshops on childhood illnesses.
Q – What are the most prevalent diseases among the children and how they can be prevented.
Ans – In Pakistan, almost 70% of the diseases are either from Respiratory Infections, Diarrheal Diseases or Neonatal illnesses. In addition, 54% of our children are malnourished contributing to all illnesses. Our mortality would reduce drastically if we improve our nutritional status. The icing on the cake is our poverty and lack of education. The best way to overcome these difficulties is exclusive breast feeding which is the cheapest source to overcome malnutrition and diarrheal diseases.
Q – The effects of water and air pollution are evident among children in the form of various diseases. How can it be minimized.
Ans – Cleanliness is half of our faith but unfortunately we have ignored this fact. We need clean water and clean hands. If our water is clean and we wash hand before having meal then we can reduce our disease burden to almost 50%. Our own local studies from Karachi and Lahore have proved the fact that washing hands reduce the diarrheal diseases to 40 % whereas 50% of respiratory diseases were eliminated.
Basically, cleanliness is our main and important issue. If we don’t focus on this public health issue of hygiene, then the burden of diseases will increase. Different diseases spread by faeco-oral route like Diarrhea, Typhoid, Hepatitis and cholera. If we improve our cleanliness then obviously things would improve tremendously.
Q – Due to dehydration, large number of children suffer from various ailments. Now that awareness has been created has there been sufficient reduction in these disorders.
Ans – You are right, dehydration can cause a large number of complications in children. In this century even only 30 to 40 % of children who suffer from diarrhea get Oral rehydration therapy. This is alarming that 60% of these children don’t get ORT. Although everyone knows that ORS and ORT is a lifesaving measure in acute diarrhea but still it is not being practiced. If we increase the use ORS then we will reduce our diarrheal deaths.
Q – Many children suffer from various Fevers. What are the different types of Fevers.
Ans – Mostly the children of under 5 years suffer from viral fevers but due to malnutrition many of them get super added infections. Here I would like to stress that antibiotics should not be used indiscriminately. They would not only kill our friendly bacteria but would also cause antibiotic resistance.
Q – Can sunstroke cause fever and how it can be prevented.
Ans – In Pakistan, we have high temperatures in summers so children often get sunstrokes which causes high fever. We often recommend the parents to avoid direct sun exposure and plenty of fluids to drink to avoid dehydration.
Q – Among the common infections producing Fevers which are the most prevalent disorders.
Ans – The common illnesses causing fever are either Respiratory or hepato biliary. This includes cough and colds, pneumonias, Typhoid and Hepatitis. Most of these illnesses are caused by lack of hygiene.
Q – Due to inflation and poverty, malnutrition affects children most, they become weak and become more susceptible to various diseases. How this situation affects the children.
Ans – Children are mostly affected by inflation and poverty. Inflation is linked to poverty directly which effects affect the nutrition intake of the children. Undernourished children lack a good immunity so they won’t be able to fight against diseases. Finally they end up with a vicious cycle of disease, under nutrition and disease.
Q – What are the measures necessary to reduce the child mortality rate. What are the numbers in rural and urban areas.
Ans – Our child mortality is mainly because of respiratory and enteric infections. Malnutrition contributes to the mortality in a big way. Exclusive breast feeding clean water, safe disposable of excreta, immunization and hand washing are the few but most important interventions which would bring our childhood mortality to low levels.
Q – Has research work been undertaken to reduce the prevalent diseases and their prevention.
Ans – We have undertaken a lot of Research work on local and international level. The result shows that there is a lack of awareness among the masses. There is need to educate masses about cleanliness and disease prevention.
Q – What are your suggestions to improve the health of children and make them less prone to diseases.
Ans – If we take care of cleanliness and take good nutrition then we will able to improve the health of our children and 40% of the disease will also end. If mothers feed exclusively their milk up to 6 month then the baby would be protected from under nutrition and episodes of diarrhea.
We need to create health awareness amongst the population which need a combined effort by all the segments of society. These children are our and the country is ours.