Health Awareness blog

Today, I went to the 7^th Biennial Scientific Meeting Postgraduate Medical Education Society today at Hospital Sultanah Bahiyah, Alor Star, Kedah. I was lucky to be there and listen to the talk of the very one and only Dr Ang Swee Chai, an orthopaedic surgeon. I am sure that many of us have heard of her and her nobel work at Palestine since 1990s. Dr Ang was a pro-Israel at first, but changed her mind after what she had seen in Jerusalem. Some people may misunderstand claiming that there are only Muslims in Palestine. It is wrong. There are also other religions including Christian. And all persons are the same in Gaza. I just mention this so we know that not only Muslims were killed.

I know myself cannot do even close to what she has done to Palestinian people. I am touched when she said that by walking through the ruin buildings, she can only passed by and whispers her prayers. Because the damage is so bad and nobody can do anything. The building was ruin by a “vacuum bombs” and the bombs damaged the whole building buried with them hundreds and thousands of lives, and of course, there were no survivors, just dead bodies…  No wonder she said that “no help” is needed there, just prayers. Apparently Israeli just knew how to be the worst people of all nations. The way they choose their bombs and armaments are “excellent”. It is almost nothing remains after their attacks.  

It is ashamed when human doesn’t react like a human anymore. I wonder how humanity has left their spirit. What have they done till their eyes so blinded and can no longer see. What have their done till their ears are deafen and can no longer hear. They are truly monsters in human disguised.

I am touched with the song by Michael Heart-We will not go down (Song for Gaza). Please do something for the people in Gaza showing that you are a true human in your heart. If you cannot give your service directly, maybe you can donate for them. Kindly do so to the charity bodies that may be available at your own place. If none, you can visit to http://www.unrwa.org/ for your donation. If you have nothing to donate, please say your prayers – hopefully they will have some peace. And with a bit of luck, we can feel the peace as well…

WE WILL NOT GO DOWN (Song for Gaza)
(Composed by Michael Heart)

A blinding flash of white light
Lit up the sky over Gaza tonight
People running for cover
Not knowing whether they’re dead or alive

They came with their tanks and their planes
With ravaging fiery flames
And nothing remains
Just a voice rising up in the smoky haze

We will not go down
In the night, without a fight
You can burn up our mosques and our homes and our schools
But our spirit will never die
We will not go down
In Gaza tonight

Women and children alike
Murdered and massacred night after night
While the so-called leaders of countries afar
Debated on who’s wrong or right

But their powerless words were in vain
And the bombs fell down like acid rain
But through the tears and the blood and the pain
You can still hear that voice through the smoky haze

We will not go down
In the night, without a fight
You can burn up our mosques and our homes and our schools
But our spirit will never die
We will not go down
In Gaza tonight

The original song available at: http://www.michaelheart.com/songforgaza.htm

When we talk about children and hospital, we can say that admission to hospital will be a distressing for everyone, especially the children and their parents. Small child, especially those under 5 years old may be frightened by a lot of things including the illness itself. Painful procedures like intravenous infusions and blood tests can be very terrifying. However, separation from family and being to an alien place can be the most upsetting to these children. This is the reason why it is very important that someone close to the child to stay together in the hospital. These people not only will help with nursing like feeding and toileting, but they may comfort the small child, which is the most important task of all.

In my experience in pediatrics ward, some parents can be very wonderful, but some can be very annoying (sad but truth). I am sure they are very worried about their child however it will be a great help if they understand that we doctors and paramedics are trying very hard to make things better for their children. However, most of the relatives are very helpful and understanding, which I do respect and appreciate. Parents, siblings and other relatives on the ward often add to the work of the staff because they naturally expect to ask questions about tests and treatment they see. I don’t have any trouble at all to entertain those as long as I have enough spare time to do so. In my experience in pediatrics department, the staffs are usually willing to spend time with the children and parents as long as they have opportunity to do so. Even so, their presence in the ward helps all the staff to care for the child better, and makes stay in the hospital less fearsome. A controlled trial has shown that after effects, such as nightmares, clinging and recurrence of enuresis were less common in children whose mothers stayed with them in the hospital.

A good children hospital will provide a space for playing and schooling which are essential for the children, especially when they have been in ward for a long period of time. Play will allow the children to bear the strain of the hospital admission and separation from family. This often reveals information about their physical and emotional problems. Furthermore, it is very important that a long illness do not interrupt their school work.

Over the last 50 years, children health care has change a lot. The good thing is that pediatrics departments in many centre is now applying the policy and try to keep hospital admission as short as possible and tends to discharge patients as soon as they recover. Every effort is made to minimize the child’s stay in hospital. Many medical and surgical procedures are done as daycare cases where parents are actively involved in their children’s care. Outreach nursing teams and day assessment units significantly reduce the need for hospital admission. Neonatal care also makes increasingly heavy demands on resources.  My own practice is try not to admit the children if possible (if the illness is mild and the care takers and their transportation is reliable should the child deteriorates at home). However, I will arrange for a near appointment for follow up if necessary.

Hospitals are not a risk free place. The children are exposed for cross infection. Long unnecessary hospital stay will lead to other social problems, school refusal, etc. One may not realize that the mother-child bonding has been broken (especially 1-4 year olds) and need to be rebuilds. At this age, the children are old enough to grieve over the separation from their mother but still very young to understand the reason and the separation are only for a brief period. For these toddlers, tomorrow has no meaning at all and what they care is “now”.

A toddler that has to be separated from mother will usually undergo 3 important stages; protest, withdrawal and denial. Initially they will protest and cries for the mother. The withdrawal stage involves emotional deprivation when this child may losses interest in food and play. They may refuse to communicate and choose to stay alone on their bed. The worse stage is denial where they seem to be happy and making indiscriminate friendships with people around them. One might thought that the child has settled but the truth is the mother-child relationship has been broken and like I’ve told earlier, it need to be rebuilds. Once they return home this child may exhibit tantrums, enuresis, etc. These problems can be avoided or minimized by prevent or reduce hospital stay and arrange for parents to stay with them in the ward or arrange for frequent visit if the parents cannot stay with them.

I have got colleagues that ends up come to the hospital every day, including weekends and may stay late throughout the night before going home each day. I did that myself when I was in the pediatrics department. I keep wondering what it feels like to do the same thing each and every day for the entire life and ends up ignore our own children and family at home. No need to say that they need us as well. Hmm… that is why I am very proud of my colleagues that willing to dedicate their life to the unfortunate children. I am sure that Allah will repay what you have done (and will do) for these kids.

Reference:

1. Simon J Newell et al. Lecture notes Paediatrics. 8^th edition. 2008. Blackwell Publishing.
2. Paediatrics Colour Guide. Mosby Elvisier.