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Thursday, April 17, 2014
- A group of Argentine paediatricians has been combining work on environmental protection and child health for more than 10 years. It appears a basic principle to apply, but the task is turning out to be increasingly challenging and complex.
“We can’t clean up a river, or give a family a new house, but we can teach people to put chlorine in the water,” Dr. Stella Maris Gil, the coordinator of the Environmental Paediatric Unit (UPA) at the Pedro de Elizalde Children’s Hospital in the Constitución neighbourhood of Buenos Aires, told IPS.
The UPA provides health care with a strong environmental component, educates the public using the hospital, trains doctors and carries out research, explained Gil and other paediatricians belonging to the unit.
“The idea arose in the 2001 crisis,” Gil said, referring to the economic and social collapse at the end of that year, when poverty and unemployment reached unprecedented levels in Argentina and also had an impact on health.
“We were seeing a lot of illness connected to poor living conditions: respiratory diseases, gastroenteritis, skin infections … So we decided to give courses on the impact of environmental pollution on health, and we devised a project aimed at protecting the environment in order to provide better health care for children,” she said.
The project, which gave rise to the UPA, had a healthcare component “with strong environmental awareness,” Gil said, “and also a component for educating the public, another for training our colleagues and ourselves, and one for researching environmental topics.”
The hospital authorities accepted the proposal, and in 2005 it was adopted by the government of the Autonomous City of Buenos Aires. The first UPA was created, and the model was later reproduced in other hospitals in different parts of the country.
At first, colleagues looked askance at members of the unit, but as information about climate change spread, they began to treat the unit members with growing respect and consult them for advice.
This type of unit exists in other countries, like the United States, Canada, Mexico and Spain. The World Health Organisation (WHO) recommends formation of the units to focus the attention of health professionals on the stage of life that is most vulnerable to the effects of pollution.
The paediatricians are motivated by the concept that children “are not just small adults.” Their organs are in the process of developing, and their physiological and metabolic systems are immature. This is even truer of foetuses in the womb, where damage can be irreversible or fatal, the experts warn.
As well as seeing patients and acting as consultants when doctors suspect disease or symptoms of exposure to pollution, the UPA paediatricians spend a lot of time working with families on preventive health care.
“Doctors are trained to work with illness, but the main thing is prevention,” said another of the doctors on the team, Graciela Masu. “In recent years there has been a change in attitudes; previously, medicine was regarded as identical to health,” she said.
The UPA holds workshops to train colleagues; gives talks to family members in the waiting room while they wait for their children to be seen; and promotes projects like replacing mercury thermometers or limiting prescriptions of examinations that involve exposing patients to radiation.
Mercury thermometers are extremely polluting if they break. The campaign led to their replacement, first in the hospital, and then in other clinics and hospitals. The city government no longer purchases them, Masu said. However, achieving change is not always a simple matter.
“In our role as doctors, we can advise mothers about the best living conditions for their children’s development, about the importance of hygiene, of not smoking, of clean water tanks, about consumption and waste disposal,” Masu said.
“We don’t concern ourselves with eradicating waste dumps because that is not something we are responsible for. What we try to do is to improve the interior environment,” she said.
Another important campaign they carried out was aimed at limiting the use of ionising radiation, which is used in X-rays, radioscopy and tomography. “Children are more vulnerable to this radiation, which can leave them more prone to developing leukaemia or thyroid cancer,” Gil said.
She said medicine cannot do without these diagnostic tools, but it is necessary to raise awareness about “the rational and justified use” of these tests in the fields of neonatology or paediatrics.