Dr. Rajendra Mishra — Consultant Pediatrician
Many years ago infant mortality was a statistic that every nation feared to dole out. This virtually prompted most societies and particularly families to put the health and well being of infants and children as of paramount importance. Pediatrics, the branch of medicine that deals with the medical care of infants and children, thus became a science of critical importance for every society. The word itself has its roots in Greek which means ‘healer of children’.
The most notable difference between pediatrics and adult medicine lies in reference to body size differences and are paralleled by maturational changes. The smaller body of an infant is substantially different physiologically from that of an adult, and herein lies the uniqueness that practitioners in field possess.
In many ways, pediatricians often have to treat the parents and sometimes, the family, rather than just the child. In basic terms, pediatricians take care of all of the children’s needs from emotional support to medical support. Dr. Rajendra C.Mishra, Consultant Paediatrician & Neonatologist at International Clinic, Salmiya spoke to The Times about his experiences in the field.
As an introduction, tell us about your entry and early experiences in the field of pediatrics?
After school, I joined B.J. Medical College in Ahmedabad, which is one of the oldest and most reputable institutes in India and I completed my M.B.B.S. At that time, pediatrics was among the top four branches in medicine and I decided to join that particular field, completing my M.D. in 1982. After completion of my residency course in pediatrics I started my own private practice in Ahmedabad.
At the time, the concept of combined hospitals was not in vogue. Most people had their own clinics and some were going in to establish nursing homes. A few colleagues from B.J. Medical College decided to come together and use an already available commercial space as a medical center. It was unique as though each of us had our own individual space and our own nursing home. We arranged it so that there would be no duplication of specialties and all amenities would be available and had a common name as a hospital catering to all the required fields of medicine, surgery and diagnostics.
Essentially it was a conglomeration of nursing homes, made to work and projected outside as a hospital. It was the first of its kind in that whole area and was named Samjyobha Hospital. Additional space in center was allocated for charity work where all the doctors provided free care to the patients of the locality once a week.
I was instrumental in starting a polyclinic subsequently in starting two hospital s in different localities of the city. I was also providing free care to clinics and hospitals run by trusts.
I was Secretary and President of the Indian Academy of Pediatrics for a long period and contributed significantly to many health programs and lot of academic activities. For example Pulse Polio was devised during my tenure with the help of certain NGOs and after it got huge coverage, it became a national program. Similarly we started government funded school health programs where around 18 diseases were studied yearly and I was the national trainer for the same.
Doctor, what was the turning point in your career?
After a really short span of time, Apollo and SAL asked me to join them. This was a turning point for me as I had never before had a ‘job’ outside of my private practice and when the opportunity arose to work for Apollo in Kuwait; I decided that it would be nice to explore the health field outside India.
I came to Kuwait in 2004 and helped establish Apollo Clinic where I was the only Consultant Doctor from its inception. I helped in establishing and subsequently making it a profitable and well known name in the local health field. I contributed in all ways to its all round growth and Image which in turn generated immense respect and need for Indian Doctors in the private sector. A year ago, I joined International Clinic as a Consultant Paediatrician & Neonatologist.
Can you shed some light on the field of pediatrics in general?
A neonatologist provides comprehensive care for critically ill premature and full-term infants from birth. Neonatologists often begin their work by providing antenatal consultation in the context of preterm labour or a fetus. In addition to the day-to-day management of critically ill infants, neonatologists also attend high-risk deliveries, providing supportive care of infants from birth, and frequently perform technical procedures.
In pediatrics, there are two main aspects, namely preventive and curative. Children from one year on experience the most changes in their physiology. At this age the rates of infection and allergy are very high, but at the same time immunization of the child takes place.
Vaccines form a major part of the preventive aspect. In the late 1970s small pox was eradicated with the systematic use of vaccines and a huge part of a pediatricians job is ensuring children get the necessary vaccinations at the right time to ward of illness that is preventable.
As part of the curative aspect, the child nutrition, growth and development are elements that are in play. I have noticed that many expatriates here form nuclear families and new parents sometimes have a tough time dealing with intricacies of childhood without elders of the family present for guidance. When development is hindered, we pediatricians act as guiding principles.
Pediatrics is the only branch of medicine where the preventive aspect is used to reduce the curative population. We keep children from falling sick even though it is our job to treat sick children.
How you got associated with Indian Doctors Forum and what has been your role and contribution?
The IDF was founded a year before I came to Kuwait and I became a member right from the start of my work here. Since I was in private practice for most of my career and had still been able to actively devote time in social, charitable & Indian Academy Paediatrics & Indian Medical Association work, I was used to long hours and I found eight hours of work with the rest of the day being free rather peculiar. I wanted to be involved in more than just work.
I became an active member upon my entry into the forum. I had the opportunity to serve the public as the secretary for community welfare which involved organizing and attending all the health camps we set up. We also conducted — and continue to organize — school health programs, which involve workshops, quizzes and interactive sessions with school children. We also conduct meet the specialist programs to answer to the queries of the general public. After two terms as an office bearer I am still an active executive member and take part in all the activities organized by the forum.
What are the main concerns when it comes to the healthcare of children in Kuwait specifically?
With my work in India, I used to notice that there was a very high infection rate among children there but in Kuwait I find that allergies are very prevalent. A large number of children suffer from skin allergies, nasal problems and asthma while the infectious diseases occur less often.
The health care system here is very sound, where every individual has their own health card and access to government clinics and hospitals. Many people though, still opt to go to the private sector for health care and advice.
Do you have any advice for parents in terms of their children’s health?
One of the most common problems I have seen in children here is a deficiency in Vitamin D, caused due to a lack of exposure to sunlight — which is the best natural source of the vitamin. Deficiencies in Vitamin D have been conclusively found to compromise immunity systems and many children here fall sick due to a poor immune system. I recommend that children are allowed at least 30 minutes in the sun, even through a window to avoid the intense heat we have here in Kuwait. This will help immensely.
Next, I have noticed that despite the abundance of food, children are not provided with a proper, balanced diet. I have treated obese kids who suffer from anemia — an iron deficiency. Parents need to include more fruits and vegetables into their children’s diets and reduce fast foods and frozen treats.
Third, the amount of cross contamination in schools and homes has lead to rapid spread of infections. Simple things, such as air-conditioning vent filters that have not been cleaned, contribute to illnesses in children. Carpets too, need to be washed and cleaned more frequently — preferably every month. Children need to be encouraged to use hand sanitizers, wash their hands frequently and avoid touching their faces and mouths, to keep infection at a low.
Additionally, desert pollens and dust also contribute to several allergies in children and care must e taken to keep them away from such allergens. Another fact that parents are unaware of is that cockroach droppings are highly allergenic and care should be taken to keep surroundings as hygienic as possible to ward off this risk factor, especially when children are in the picture.
Last, I notice that there is quite a delay in speech development here, where children of even three years of age have not yet began to communicate through any purposeful sounds. This is a problem that is unique to nuclear families.
As a remedy I believe parents need to spend more time communicating with their children.
I understand that most parents are working parents, but once done with work, they should spend some time interacting with the child. Studies have shown that babies who are spoken to with at least three different voices have the most effective speech development patterns.
Furthermore, experts on touch therapy also recommend carrying and constantly implicating touch when dealing with babies as it has significant positive effects on both physical and psychological health of the infant.
By Darlyn Amara
News Editor
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