Bringing up Babies: Lack of parental education and awareness threatens Georgian children's wellbeing and development
By Sarah Marcus for UNICEF Georgia February 2010 Nino Kikodze sighed as she explained how at the emergency department of the Iashvili Children’s Hospital in Tbilisi, Georgia, of which she is head, her staff all too frequently find themselves treating children poisoned by consuming products like household detergent when their parents or minders were not watching them. These cases typify a problem plaguing Georgia. Many parents, said Kikodze, are careless with their young children and fail to supervise them properly, or to spot early warning signs of physical, mental or psychological illness. This is due to a lack of education on the parents’ part and a shortfall in parental education opportunities and materials in Georgia. ‘I was not given any information on medication or how to spot symptoms of childhood illnesses,’ she said. ‘All I know is that if one of my children has a fever I should take it to the doctor.’ Recently she followed internet instructions on how to treat a minor illness, with successful results, but she said that she would much rather this information had been supplied to her directly by a healthcare professional. Also visiting the Mtskheta clinic was Zhuzhuna Kalandadze, mother of one-year-old Nino. Zhuzhuna and her husband live below the poverty line and receive targeted financial assistance from the Georgian government. Zhuzhuna’s inadequate education impacted negatively on her own mental and intellectual development. Despite these factors, this new mother was not provided with any instructions or education on how to take care of her baby, something which almost led to catastrophe. ‘Once my baby had a fever, but I did not realise it at the time. It was only when she began to have convulsions that I saw something was wrong and called an ambulance,’ Zhuzhuna said. Although baby Nino recovered and is fit and well now, she could have suffered serious complications due to the fact that her mother had not been educated in how to care for a child. It is not only parental lack of awareness of warning signs of illness that damages children, but often just simple neglect. Back at the Iashvili Hospital, Kikodze said that the majority of over 900 cases of trauma and poisoning treated there in 2009 were down to inadequate supervision of children. Poisoning was particularly prevalent, with young children taking the wrong medicines or consuming household products such as detergent.
The multiple 0-3 year olds with minor head traumas and minor cuts treated at the hospital is yet another indication that young children in Georgia are accidentally hurting themselves when their parents are not around to supervise them. Kikodze said that most of these accidents occur when the child is in the care of its mother and not a nanny or childminder who might supervise the child more carefully. Sadly, the hospital also receives many young victims of car accidents – in Georgia it is quite usual to sit a small child on the knee of a passenger travelling in the front seat of a car, without the protection of a seatbelt. Inevitably, some of these accidents lead to the death of the child, while the adult passenger usually comes off better, said Kikodze. Parents are, unsurprisingly, reluctant to listen when hospital staff point out that they may have been to blame for their child’s injury or accident. ‘They start to yell at us and ask us if we think that we love their child more than they do, for example,’ said Kikodze. But most parents simply have not been educated on how to care properly for their children, said Kikodze. Many children are suffering pain and trauma simply because their parents do not know enough. ‘Parental education is very important for us and for children,’ said Kikodze. Meanwhile at one of the Family Doctors’ clinic in Tbilisi, Dr Nino Kiknadze shares many of Kikodze’s concerns. Dr Kiknadze said that in addition to lack of supervision, parental reliance on the advice of neighbours or on traditional cures often caused complications. ‘In one case we saw a child with a burn whose mother had applied butter rather than water to it and it got infected,’ she said. Overmedication and medication without doctor’s advice is also a problem, she added. Dr Kiknadze is part of a UNICEF-supported group of experts which prepared a ‘baby passport’, a book with helpful advice on taking care of babies and young children to be distributed to new mothers at maternity hospitals throughout Georgia. But although the book has been written, funds are currently being sought to print, publish and distribute it. Such education for parents needs to be institutionalised so that all parents have access to it as soon as they deliver a new baby. At the Mtskheta clinic Dr Nino Brachuli described an issue she sees frequently which underlines how urgent and vital the need for such information is. ‘When babies are newborn they have a milky substance in their breast area. It is not necessary to do anything about this, it must be just left alone and it will go away,’ she explained. ‘But I often see cases where parents have attempted to draw the liquid out, with their hands or with their mouths. This is dangerous and causes infection,’ she said. All of the doctors interviewed agree that lack of parental education causes many health and developmental problems for Georgian children. But it needn’t be that way. According to Dr Kiknadze, as long as advice and guidance is sensitively provided, most parents that she comes into contact with are glad to receive it. If such sensitive advice and guidance were formalised regularly provided to parents throughout Georgia, much fewer children would fall victim to accidents and untreated illnesses.
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