The Rashtriya Bal Swasthya Karyakram (RBSK: National Child Health Program) had to begin somewhere.
Someone had to come up with it; someone had to have had a dream – a vision of a national program which would screen every single child in the country for anything that might prevent that child from reaching her full potential.
Introducing – TA DA!!! – Dr Arun Singh.
Arun Singh is a neonatologist, based in Calcutta. He has that rare perspective on children at risk which sees them as part of a whole picture: they cannot be separated from their parents, their grandparents, their brothers and sisters, their community. And yet, precisely because they are so interwoven in the fabric of their societies, these children often escape our notice. They are brought into crowded doctors’ clinics when they have a fever or a rash or a bad cough and the doctor treats only that, not having the time to do tests, ask probing questions or even examine other parts of the child’s body (the child becomes nothing but a walking “sore throat”, “high fever” or “persistent cough”).
So underlying conditions like malnutrition, vitamin deficiencies and disability go undetected or ignored. If the mother happens to mention hesitantly that the child is 3 and still not talking, her concerns are brushed aside. “Boys talk late,” the doctor may say as he writes the prescription for the cough. “Next!”
Dr Singh’s program is a massively ambitious one which sets out to screen 27 million children through mobile health teams which will be sent out to schools and anganwadis throughout the country, armed with simple assessment tools which will help them identify the four Ds: Disability, Disease, Deficiencies and Defects.
Children who are thus identified will be referred to child monitoring centres which are slated to be established in every district in the country. There, they will be treated whenever possible (these centres will be staffed by 2 doctors, a dentist and a range of paramedical staff) or, if required, referred to tertiary centres for surgeries, more sophisticated assessments or for medical treatment.
Dr Arun Singh is after us to open and operate one of these centres – he and his colleague Dr Anubhav Srivastava (another true believer!) came to see Gubbara and were impressed with the team’s dedication and skill, with the smooth functioning of the program and the similarity of our approach to theirs.
We are considering it. Although our commitment and expertise is only in one of the Ds the program addresses, we also feel we could bring a child development perspective which is so urgently needed to the way the other 3 Ds are looked at. And it fits in with our overall vision: when you plan for the most vulnerable, you make the system work better for everyone.
If, through our work with kids with special needs, we could end up helping thousands of typical kids, we will prove our point resoundingly. And because it would be part of a national effort, we might end up changing the world.
So yes, Dr Singh. We are tempted. But no promises yet!