Doctors are 'gatekeepers' of child health

Call for national programme with doctors as key for prevention and to protect young not just from disease but also bad habits.

ABU DHABI // Doctors should think in terms of prevention and not only treatment when they teach parents to be vigilant about their children's health.

That was the consensus of health experts from across the country who gathered in the capital for two days for a child health promotion course.

Dr Mohammed el Abiary, consultant paediatrician and head of paediatrics at Zayed Military Hospital in Abu Dhabi, said without a programme to promote child health before problems start, there remains a gap in primary healthcare.

Dr el Abiary has called for a dedicated national programme that would combine the scattered, country-wide services aimed at improving child health.

"Through such a programme, we will get doctors thinking in terms of prevention and protection, as well as educate parents on what constitutes child safety," he said.

Dr el Abiary was chairman of last week's child health promotion course, which brought together more than 350 paediatricians, general practitioners, family doctors and paediatric nurses from public and private healthcare facilities.

"We are the ones at the front lines; we are the ones that should act as the gatekeeper of the child's health from the moment of conception and birth, by teaching the pregnant mother how to take care of herself, up to the child's transition into adulthood," Dr el Abiary said. "Child health does not stop at simply vaccinating a child or treating diseases."

Doctors have to safeguard a child not just from disease but from bad habits, such as poor diets or a lack of exercise, or accidents that can occur in the home, school or cars.

Dr Majeed Jawad, consultant paediatrician and principal regional examiner for the UK's Royal College of Paediatrics and Child Health in the Middle East, agreed that the nation needed a dedicated programme to ensure that when they see children, doctors also survey their emotional, mental and social well-being, and arm parents with the knowledge needed to protect that child.

"We are the ones to advise parents, to tell them to use car seats, or breastfeed a child for the first six months at least, or put fences around a pool, or watch out that a crawling baby does not have access to electricity wires and sockets," he said. "This should be part of the consultation."

Dr Asma Ali al Nuaimi, paediatric pulmonologist at Zayed Military Hospital, said: "People assume doctors are taught this in medical school or in training, but this kind of practical information that can be dispensed easily during a 15-minute consultation is crucial and should become a priority."

In one example of how prevention saves lives, the incidence of sudden infant death syndrome (Sids) in the US was halved once parents were told to put their babies to sleep on their backs, she said.

"This is the kind of information that is our duty to impart, so we can prevent disease or harm from setting in," she said.

The course, which was held in Abu Dhabi, also advised doctors on how to detect autism in children, when to recommend speech therapy, obesity screening and how to discuss the importance of vaccinations with parents who are against immunisation. They were also reminded that parents in the UAE needed to be advised about the best and safest sleeping environments for their babies.

"Mothers here think it is OK for their babies to sleep with them in the same bed," Dr al Nuaimi said.

"Babies should be in their cribs in the mother's room, sleeping on a firm mattress, with no toys or cushions anywhere near them. They should not be overclothed, and the temperature in the room should be controlled.

"It is the role of the doctor to help parents create a safe environment for their children."