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Indian Journal for the Practising Doctor

Vol. 4, No. 6 (2008-01 - 2008-02)


ISSN: 0973-516X

The last issue of the 4th Volume is in your hands; completion of the 4 successful years of the the ‘Indian Journal for the Practising Doctor’ has been a testimony to the global acceptability of the Journal by authors, contributors and readers alike. The articles we receive for publication are as diverse as people’s health problems. The journal is aimed at the enthusiastic practicing practitioner, who wants to remain abreast with clinically applicable review and research around him.

The articles take some time (average of 5-6 months) before publication since each article is reviewed by the editorial board and then by two independent referees. Our contributors understand the importance of thorough review and revision, and bear with us during the entire process, from receipt of the article to its final publication.

Under fives – a highly critical group – form a sizeable proportion of the population in developing countries. The regretful side to their enormous morbidity and mortality is that both are largely and easily preventable. The main factors which affect, disable or kill the U5 child are infections and infestations, less nutrition and unregulated fertility.

Majority of them are ill on and off – with diarrhea, acute respiratory infections and childhood fevers. An average of 3-4 diarrhoeal episodes each year is a norm! Each episode lasting for 5-10 days implies that every U5 is ill for 20-40 days with diarrhea.. Then there are repeated respiratory tract infections, restriction of food and further malnutrition. An underfive, who survives the onslaught during neonatal and infantile period, may remain ill for 3 months each year with one infection or the other.

We know that the number of under-fivers is enormous; our waters are unsafe; our food is inadequate in quantity and quality; our parents are poor, illiterate and ignorant, but inexhaustibly fertile, so that each year a sibling makes entry into the family further draining the mother and the ‘family basket’. Then there are worms – straight, round and convoluted! No concept of personal hygiene and environmental sanitation. Indifferent and tired workers and jeopardized welfare system.

The results are evident: In 1990, the National Nutrition Monitoring Bureau study revealed a jolting percentage of under-nutrition among the Indian underfives (69% underweight; 65% stunted). Various National Family Health Surveys conducted later showed some improvement but figures still stand at above 50% for both the groups. For any country, it is a slur to keep half of its preschoolers nutritionally deprived, particularly if that country dreams of becoming a world power!

WHO recognizes that children form a very large group in developing countries and that their preventive and curative care can not be kept restricted to doctors. With newer or refined national programmes we want to involve health workers and parents in a big way in the promotive, preventive and curative care of the underfive children. Accordingly, we want to create a health conscious community where parents will diagnose and categorise the risk of dehydration and ARI and gross-root health workers will provide immediate treatment.

Studies conducted by us and published in IJPD and elsewhere show that we are still far away from enlisting the enthusiastic cooperation of family members and peripheral workers in child care. And unless that happens we should not expect dramatic reduction in U5 morbidity and mortality. Currently, pneumonia accounts for 9 lakh deaths every single year in India; diahhoea with its share of 7 lakh death does not lag far behind.

February 29, 2008

Bashir Gaash


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