Consequences of Stress on Children’s Development

No one I know has had to overcome a childhood with any of the listed stressors for this assignment.  The only incidence I’m aware of that possibly qualifies comes under the violence category, but not in the form of shootings or street violence.   My mother has had to deal with being a victim of incest as a child.  I don’t know many of the details because she hasn’t ever talked about it.  My father told me about it several years ago when my mother was having a trying time in her life.  I do know she compensated by dropping out of high school and marrying when she was 16 in order to leave her home.  I think the experience is responsible for the depression she has experienced in her life and some of the negative feelings she felt toward her mother and brothers.

I researched childhood mental health in Iraq.  I recently heard an Iraqi woman, who along with her husband and children immigrated to Des Moines, Iowa, speak about their escape in the middle of the night from their home in Baghdad to a family member’s house in Israel.  They lived and worked in Israel for a few years and then came to the United States.  They have three small children and I have always wondered what impact the situation in Iraq and the circumstances surrounding their leaving would have on the children.  

The article I found was published in 2010.  The war in that country resulted in malnutrition, child trafficking, kidnapping, poor educational expectations and death of all ages among many other atrocities.  These by-products of war definitely affected the mental health and feeling of security the children in that county have but the researchers speculated that the beginning of these stressing situations began years before.  Public health services for children under five years of age are few and far between, especially in the remote areas of the country.  Child mortality for this age group is the highest in the Middle East. 

The authors of the study stated that help for the mental problems for children and adolescents in Iraq was hard to come by because of inadequate human resources and research facilitators, poor funding, and safety threats to the researchers.  Where past study results do exist, post traumatic stress symptoms were evident in 14% of children in Baghdad and 30% of children living in Mosul in 2005.  Also, in 2005, 22% of children had anxiety disorders, 18% had behavioral problems, 14% stuttered and 13% had depression.  In 2006, 15% of school children in the southern town of Nassiriya were found to have ADHD.   Mental health issues in the Arab countries are misunderstood and are even met with indifference, especially with children.  There are very few psychologists, psychiatrists, or mental health facilities in the country.

The study writers suggested that Iraq develop a policy specifically targeted at improving the mental health of children and adolescents in their country.  The recommendations for the leadership in Iraq were to:

1)      conduct a needs assessment

2)      get evidence of what is already successful

3)      work to get agreement with all agencies to compile a policy

4)      work with other countries to get ideas for the policy

5)      develop a policy that had goals, visions and values for children

6)      decide which agency would be responsible for which action of the policy

Once the policy is in place, education about good mental health equaling good physical health should take place as well as addressing the various stressors in a war region.  Legislation, evaluation, and implementation of the policy would put childrens’and adolescents’ mental health at the top of the priority list.

Reference

Al-Obaidi, A., Budosan, B., & Jeffrey, L.  (2010).  Child and adolescent mental health in Iraq:  current situation and scope for promotion of child and adolescent mental health policy.  Intervention, 8(1), 40-51.  doi: 10.1097/WTF.0b013e3283387adf

Blog Assignment for Week 2

I researched the immunization regulations in the Eastern Mediterranean Region which includes countries such as Saudi Arabia, Afghanistan, Jordan, Iran, Iraq, and Egypt among others.  I am interested in this topic because I have seen discussions in various publications and heard some parents’ opinions about whether vaccinations are really necessary and may even be potentially dangerous, such as being responsible for autism.  Even though all children need to be vaccinated before entering school in the United States, some children can be exposed to diseases that have a vaccination available.  If the children contract a disease, the possibility of spreading it to the public could have been prevented.   I have a few children in my class from this region and it is interesting to me what protocols are in place in their home country and what requirements are in place should their families move back and the children begin attending school.

I found an interesting article from the World Health Organization for the Eastern Mediterranean Region published in 2011.  The report assessed the vaccinations available in this region and compared it to the deaths of children five years of age and younger.  Statistics for 2008 showed that 1.239 million children died and more than 20% of these deaths were from diseases that have a vaccination.  The Hib virus, rotovirus and streptococcus pneumonial virus which causes pneumonia were primarily responsible for the children dying.  Also in 2008, an estimated 7000 deaths were attributed to measles.  That averages out to 20 deaths per day. The WHO states that 95% of measles deaths happen in poverty stricken countries where the children are more likely to be malnourished. 

To improve these statistics, the WHO recommended in 2010 the development of a public health initiative in this area for one week every April.  The goal is to take on the challenge of reaching every child in every district in an attempt to eradicate diseases by vaccinating all children.  Unfortunately, 1.5 million children failed to get the third dose of DPT in 2010.  The target by 2015 is to reduce the preventable disease death rate by 60-70% in children under five years of age.  Health officials recognize many obstacles to meeting this goal.  Many countries in this region do not offer the Hib vaccine so 31% of infants in this region do not have access to it.  Other countries do not offer rotovirus or the pneumonia vaccines so 88% of infants in this area will not be covered.  Reasons some countries do not offer these vaccines are the high cost, poor government decision-making, poor allocation of resources and minimizing the affect of the diseases.  The WHO has made recommendations to the leaders in this region on ways to improve the percentage of children who receive vaccinations and improve the mortality statistics. 

It is my desire to share this information as well as information about vaccination policies in other countries with my future education students.  It’s important to see how other countries approach various issues, not only to compare and contrast to the United States, but to foster a greater appreciation of what America has to offer.

Reference

World Health Organization Regional Office for the Eastern Mediterranean.  (2011).  Scaling up the expanded programme on immunization to meet global and regional targets.  Retrieved from  http://applications.emro.who.int/docs/RC_technical_papers_2011_4_14220.pdf

A Personal Birthing Experience
The night my first child was born was pretty uneventful until 12:00 am when my water broke.  We drove to the hospital, about 2 hours away, and I was admitted.  The nurses put a fetal heart monitor on me right away.  My contractions lasted until 9:00 the next morning when my doctor said I was ready to push.  I had to walk to the next room where I was put in a birthing chair.  I was reclined back and began to push.  My daughter was born at 9:33.  She was wrapped and put in an incubator to warm while they stitched my episiotomy. It took them over an hour because I had torn internally as well as externally.  I had lost a lot of blood during delivery and was getting very light headed.  I almost passed out during the stitching process.  I was able to hold my daughter after I became steady.  I was sent home in an anemic state with iron pills to build back my blood.  I refused a blood transfusion because my hospitalization occurred when some of the blood supply in the U.S. had been found to have been affected by AIDS.  It took quite a long time to feel energetic enough to resume a normal life style again but I felt it was the safer choice. 
I chose this example because it was my first pregnancy.  The first pregnancy experience is so unique and foreign.  I wasn’t able to understand what other mothers I knew were talking about until I experienced the same thing.  I did all I could to be active and healthy during my pregnancy and after.  I required a lot of rest after getting home but it didn’t affect the care I gave my daughter.    
The variables surrounding a birth are numerous but I think that modern health care can anticipate many of them.  I was fortunate that I was healthy and active during my pregnancies and didn't have any problems during or after the deliveries but I know not everyone's experiences are like that.  If a couple is not healthy both before they conceive and after, the baby can suffer in the way it develops.  Complications during the delivery can also be a source of problems and stress for the family and birth.  Adults have a lot of control over the type of pregnancy they will have.  Prenatal education is very important as is prenatal care.  A normal, healthy birthing experience will enable a normal healthy child to develop.   
I read about childbirth in Italy.  Most births occur in a hospital but unlike here, 2-3 beds are in a room instead of each mother having a private room.  An average stay in the hospital is 3 days.  In Italy, you can deliver in a private clinic but you have to pay for it and those institutions aren’t always prepared with the proper equipment for an emergency.  Otherwise, your care and medical supplies are provided free if you pay into social security under their universal health care system. Mothers have to provide clothing, bedding and supplies for the baby.  Italy has family planning centers that provide services for all stages of pregnancy.  The services are free, also.  According to a woman’s blog who has delivered more than one child in Italy, fathers are not allowed to attend the births, until the very end, and are not allowed to care for the new mother; only other females are.  She also said that epidurals are not given and comforts such as CD’s, candles or being able to get up to use the restroom are not allowed.  Another American woman’s blog who lives in Italy said that doctors and midwives work together to deliver the baby, fetal heart monitoring isn’t used often, women have to lie flat during delivery, episiotomies are usually routine, and having the baby room with the mother is uncommon. 
Differences between my experience and an experience in Italy include the ability of the father to attend the birth and care for the mother, the set-up of the hospital rooms, the cost of the birthing services, the comforts brought from home, the use of fetal heart monitoring, the use of midwives, providing supplies for the baby, and rooming with the baby.  Similarities include the amount of time in the hospital, the use of episiotomies, and being mostly reclined back to deliver. 
I didn’t learn any new information about the affect of childbirth on child development during my research.  It appears that having a child in Italy is as safe as it is in America so if a birth is uneventful in Italy, as it is in the U.S., a child’s development should be normal.

References

Fassio, C.  (2012).  Childbirth.  [Blog message].  Retrieved from http://www.expatsinitaly.com/node/96

Maria.  (2011).   Giving birth in Italy.  [Blog message].  Retrieved from http://bellinisbeerbabybottles.blogspot.com/search/label/Having%20Babies