Consequences of Stress on Children's Development

VIOLENCE AGAINST CHILDREN

From the list of stressors, I have selected ‘Violence’ or rather 'Violence against children' for my deliberation.  'Violence against children' includes neglect to infants, corporal punishment, sexual, psychological and emotional abuse of children, malnutrition of children, and employment of underage children. I will concentrate more on Corporal Punishment. Berger (2018) has defined Corporal punishment as punishment that physically hurts the body such as slapping, spanking, etc.  (p. 297)

I had been a victim of corporal punishment. In my elementary classes whenever I missed homework, the teacher used to put a pencil between my two fingers and press the fingers with a pencil in between. Striking with a cane stick or a ruler on the palm of boys and girls was a common practice. It was very painful to go through these punishments. In those years, I hated school, I hated books, and I hated teachers. When I complained to my mother, she said that the teacher has a right to punish you when you do something wrong. My mother always repeated a proverb, 'Spare the rod, spoil the child’. Those were horrible days!  It was my father who came to my rescue. He understood my woe and convinced my mother that these corporal punishments are harmful to a child's education. Consequently, my school was changed, and I took a sigh of relief. But memories of those days still haunt me. These corporal punishments in schools were not only painful but also embarrassing. It took me several years to come out of this trauma.

In Pakistan, though, there are laws forbidding corporal punishment in schools, but incidents of teachers inflicting physical punishment on students keep on emerging. And then there are thousands of madrasas (religious schools) which follow their own system and where corporal punishment is a norm. In the US, class discipline is maintained either by 'timeout' or by 'induction of parent in behavior correction of children'. (Berger, 2018)

Corporal punishment is not the only stressor which children in Pakistan face. There are many others, such as infant mortality, malnutrition, war, transport accidents, and environmental pollution. 

Most of the children start their lives with malnutrition and starvation. They face parents' neglect in their childhood. The infant mortality rate in Pakistan is 60 per 1000, while it is six deaths per 1000 in the US. Forty-four percent of children are stunted. Stunting is a term used for children that are below standard height and weight for their age. This stunting is almost always due to inadequate food intake starting as early as a few months after birth.

Fifty percent of Pakistani children do not go to any school. They work in workshops and factories. The travel on top of the buses or cling to its sides. It is a common sight to see an entire family, including a few children, being carried on a motorcycle. 

But it is not only Pakistan that is facing 'Violence against children.' World Health Organization (WHO) has indicated in its report of June 2019 that up to 1 billion children aged 2–17 years globally have experienced physical, sexual, or emotional violence or neglect in the past year.

Berger (2018) in the textbook has included Violence in its definition of Maltreatment.

"Thus, child maltreatment includes both child abuse, which is a deliberate action that is harmful to a child's physical, emotional, or sexual well-being, and child neglect, which is a failure to meet essential needs." (p. 242)

She adds: "About three times as many neglect cases occur in the United States as abuse cases, a ratio probably found in many other nations."

According to Berger (2018), reported maltreatment cases in the US ranges from about 2.7 million to 3.6 million per year.

References

Berger, K, S, (2018). The developing person through childhood (8th ed.). New York, NY: Worth

            Publishers.

Violence against children-United Nation Secretary General’s study. Retrieved from

https://www.unicef.org/violencestudy/profileindia.html

Actin against hunger-Pakistan. (2019). Retrieved from

https://www.actionagainsthunger.org/countries/asia/pakistan

Child Development and Public Health

Nutrition/malnutrition

I have seen the effects of malnutrition in Pakistan; its horror follows me here in the USA. I intend to gain more and more knowledge about nutrition so that I may be of some help to underprivileged children in the USA and in other parts of the world. 

Nutrition is essential at every stage, but it is more important for children because it helps them to stay healthy and strong and grow up healthy and strong. Nutrition of the child begins from the conception stage when mothers should have proper nutrition and healthy foods for the child. After birth, breastfeeding becomes another source of nutrition for the child. Nutritious diet during pregnancy results in a good fetus brain and in healthy birth of the child. Nutrition for women in pre-pregnancy, pregnancy, and over the first two years of the child’s life is very important for the mothers and their children. The nutrient reserve built over the pregnancy produces breast milk for the post-childbirth phase. Exclusive breastfeeding is recommended for instants during 0-6 months of age. This will meet all the nutrition needs of the children to protect them from infection. Even after six months, breastfeeding with appropriate complementary feeding should continue to two years of age of the child.

                                                      Image from Dietary Guidelines for Americans. 2015-2020

Harvard T. H Chain recommends the following proportion of food in your child’s plate or lunchbox.

·       Vegetables and fruits – ½ of the   plate ·       Whole grains – ¼ of the plate ·       Protein power – ¼ of the plate ·       Drink water, milk, juice: Avoid beverages, limit milk and dairy products to one to two servings per day, and juice to a small glass per day. ·       Use healthy plant oils

 I teach pre-k children of age are 4-5. To develop an interest in young children about green food, we I I teach pre-k children of age are 4-5. To develop an interest in young children about green food, we have developed a garden. During springtime, our children start gardening under our guidance. While doing this, we educate children on how to stay healthy, why water is necessary for all living things? what will happen if we do not give water to plants? how many glasses of water should we intake during the day? Every Friday after circle time, we have a food project. We prepare salad sometime using vegetables from our school garden. With children, we prepare smoothie using blueberries, strawberries, low-fat yogurt, and milk.

It is true that nutrition deficiency in the USA has diminished, infectious diseases have gone, and life expectancy has increased; But in spite of the above facts, we have children with LBW in the USA which results in undergrowth and disability of the child. Another malnutrition prevalent in the USA is hidden hunger caused by a lack of essential nutrients. 

When I see the facts and figures of child malnutrition in Pakistan, I find it most alarming. About 9.6 million children are experiencing malnutrition in Pakistan.

Fifty percent of Pakistan’s children and mothers suffer from malnutrition. According to the National Nutrition Survey (NNS), 44 percent of children under the age of 5 are stunted or too short for their age, 15 percent suffer from wasting or too thin for their height and 32 percent are underweight. The study also found that more than half of all Pakistani women are anemic, mostly due to iron deficiency. During pregnancy, this condition becomes particularly alarming, because anemia contributes to maternal mortality. Thirty percent of children in Pakistan also suffer from anemia, which hinders their growth and make them vulnerable to disease, disability, and death.

The information and facts which came to me through this study on nutrition have shaken me. I intend to help underprivileged children in their nutrition. The first step will be efforts to increase awareness about the problem of malnutrition.

References

Healthy Eating Plate. (2020). Retrieved from https://www.hsph.harvard.edu/nutritionsource/healthy-

eating-plate/

Poverty and Malnutrition. (2019). Retrieved from

https://features.unicef.org/state-of-the-worlds-children-2019-nutrition/

Personal birthing experience

I have not gone through the birthing experience myself—my husband married me after the death of his 1st wife. From my husband's side, I have two grandsons and three granddaughters. For this assignment, I will go through the birthing experience of my sister, Fariha. I may miss some details because I have not gone through it myself.

Fariha lived in a joint family system with her mother-in-law at the time of the birth of her first child. The news of 1st pregnancy was a cool breeze for everyone in the family. Fariha gave birth to her child in Aga Khan Hospital of Karachi, Pakistan which may surpass many US and European hospitals in professional expertise and care. I will tell you the rest of the story in the words of Fariha.

“When I missed my period, I suspected pregnancy. This was a planned pregnancy, and I was expecting it. I went to the doctor; she did a urine test and confirmed pregnancy. The doctor recommended a scan test at Week 6 and recommended Adnan’s (her husband) blood group to be checked to. The doctor also recommended multivitamins. My mother in law was very excited at this news. She started to prepare rich food for me.

The major issue was nausea, I started having it at week 5, and it stayed till the first trimester. I did not have any other issue. My vitamin D level was low, so the doctor recommended supplements for this and asked to take a sunbath. During the first trimester, I could not work at all. I spent almost all day in bed and near the bathroom.

I started feeling the movement of the child in the 4th month and leg kicks in the 5th and 6th month.

The most challenging time was the time of delivery. I was scared about this since the time of conception, but as the delivery date came nearer, I became more worried. I used to think and worry about how the baby will come out. My husband accompanied me all the time and tried to console. The day finally came. I had long labor of 15 hours. At one time, the doctor gave up and decided she will do surgery if the baby does not come out in 3o minutes. I was very tense, and I cried. I almost gave up, but then it finally happened through normal delivery.

My mother in law was very excited and happy to see the baby. She gifted me her family bangles of gold because it was a family tradition in my in-law's family. She also took good care of the baby for the 1st few weeks.”

The story from Fariha ends here. Since I have not myself went through this experience, I studied these delivery phenomena. I found the following series of pictures from Berger’s book, “The Developing person..." relevant and interesting:

I also found that active labor spreads over 14 hours. It may be double in some cases and a half during second and third birth. The doctor defines an active labor period as beginning with regular contractions which pushes fetus out of the uterus, passing through Cervix and the active labor period ends when the fetus head passes through the vagina as shown in the above image.

All efforts should be made to have a positive birth experience. This positive experience will help in the child development process.

Birthing experience in Rural Pakistan.

My sister Fariha belongs to the privileged class. She gave birth in the best hospital of Pakistan. This Aga Khan hospital where she gave birth may be compared with best European and American hospitals in expertise, facilities, and care. But this is not accessible to common Pakistanis living in urban areas, not to speak of those living in rural areas.

Homebirth is a common practice in Pakistan. This results in the tragic deaths of both child and mother. Pakistan’s pregnancy-related mortality ratio is one of the highest in South Asia. Some 178 women die of pregnancy-related causes per 100,000 live births as compared to 12 in developed countries. 

Cultural norms restrict women’s movements outside their home. Culture also limits their ability to make independent decisions about their health care. Hospitals with trained doctors exist only in big cities. Remote areas are covered by mid-wives often untrained. A male doctor cannot attend a pregnant woman. The doctors and hospital staff are considered untrustworthy in this culture.

Only slightly more than 50% of women, giving birth in Pakistan, are attended by skilled health personnel. The percentage drops to about 20% in rural areas. So-called unskilled midwives handle the rest of the pregnant women.

Here I will share the experience of my maid who met a tragedy while giving birth to a baby. Asma is the name of the maid. She went to the parents of her husband who lived in the remote village of Sindh, Pakistan. There was only one mid-wife in that area. These mid-wives of remote regions do not give much importance to sanitation. When Asma went for her checkup, the mid-wife was already checking an elderly lady who had fever for several days. When the mid-wife called Asma for her checkup, she did not care to wash her hands. After a few days, Asma felt unwell; she had high temperature and shivered. There was no hospital nearby. Asma’s mother-in-law gave her some herbal medicine, she got better, but she was losing the weight. She became weaker and weaker; she was worried about her first baby. She wanted to go to the city, consult the doctor, and get the ultrasound done for knowing the condition of the baby inside her belly. But her mother in law stopped her. She became weak and was hardly able to walk. One day while doing household work, she moved a heavy cupboard, she immediately felt a cramp in her stomach, and bleeding started, she got fainted. This all resulted in the loss of her first baby.

Let me say that birthing experience in rural Pakistan mostly results in fatalities of children & mother, disabilities of child and mental trauma of surviving mother.