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Choices to be made
Most brain development happens before a child reaches three years old. Long before many adults even realize what is happening, the brain cells of a new infant proliferate, synapses crackle and the patterns of a lifetime are established. In a short 36 months, children develop their abilities to think and speak, learn and reason and lay the foundation for their values and social behaviour as adults.
Because these early years are a time of such great change in a young life and of such long-lasting influence, ensuring the rights of the child must begin at the very start of life. Choices made and actions taken on behalf of children during this critical period affect not only how a child develops but also how a country progresses.
No reasonable plan for human development can wait idly for the 18 years of childhood to pass before taking measures to protect the rights of the child. Nor can it waste the most opportune period for intervening in a childs life, the years from birth to age three.
The time of early childhood should merit the highest-priority attention when responsible governments are making decisions about laws, policies, programmes and money. Yet, tragically both for children and for nations, these are the years that receive the least.
In Sri Lanka, Priyanthi, a 28-year-old mother in the Matale District, remembers the evening that she carried her daughter, Madushika, 7 kilometres to the closest medical facility. It was about five in the late afternoon and almost dark when the small woman began her frightful journey with the 18-month-old toddler in her arms struggling for air. Stumbling over the fallen branches and underbrush cluttering the narrow dirt paths, she heard her daughters laborious gasps growing weaker. By 6 p.m., she and the baby reached the clinic.
The doctors words still haunt this woman with tired eyes and underscore her race against the clock. Had she delayed the trip by a mere 15 minutes, she remembers him saying, her baby, whose chest cold had turned into pneumonia, would have been dead. Had Madushika, now a healthy five-year-old, been born just a decade earlier, without the availability of life-saving drugs, the pneumonia would have likely won the race.
Priyanthis children, Madushika and her younger brother Madusha, have benefited from Sri Lankas system of health services and early childcare programmes. Both children were born in the relative safety of a hospital, like nearly 90 per cent of Sri Lankan live births today. When the young mother was pregnant with her two-year-old son, she received regular health check-ups in the village clinic and pregnancy advice from the village midwife. She learned how talking to her infant during breastfeeding would improve his mind and body. She learned that cooing and babbling to her child in response to his sounds, commonly called motherese, would help the baby boy learn to talk.
Once released from the hospital, Priyanthi and her newborn participated in a programme in which trained volunteers visited them in their home. Madushas height and weight continued to be monitored. Priyanthi also continued to get support and advice on the importance of touching, talking and singing, as well as on bathing and feeding her baby.
Priyanthis family is 1 of 22 families from Ambanganga, a small village about 25 kilometres from Matale, involved in a home-based programme carried out by a local NGO called Sithuwama, with UNICEF support. Sithuwama, which means raising a child with enjoyment, promotes early childhood care, including healthy childcare practices and cognitive stimulation. Its services are provided through home-visiting programmes for infants up to three-year-olds and for pre-schoolers from age three to five.
Through Sri Lankas home-based service, Priyanthi learns that good nutrition, home hygiene and sanitation practices and cognitive stimulation are all necessary ingredients for her children to grow and develop. Now, she is investing the focused time, care and attention that are vital for improving her childrens lives. She collects extra firewood to boil water for her children to drink. She finds legumes that add to the nutritional value of their meals. She makes certain that they use the latrine and wash their hands afterwards. She asks her children their thoughts about the birds chattering overhead during their baths in the stream. She takes them to village health days.
Priyanthi, her husband and children live in a small, four-room, cement house without electricity or running water. They sleep together on a dirt floor on woven straw mats. The family survives on a little over 2,000 rupees (about $27) a month that Priyanthis husband earns on a tea plantation.
Sithuwamas volunteer home visitors helped Priyanthi figure out how to promote her childrens psychosocial and cognitive development without spending much money. The NGOs volunteers teach her the importance of play for her childrens physical and mental well-being. She and her husband constructed a playhouse for the children. The airy structure is made from twigs and branches tied together with pieces of cloth and covered with a tarp. Little wooden shelves are filled with colourful boxes, gourds, coconut shells, ceramic bowls, metal cans and flowers they have picked. Through play, Madushika and Madusha are learning about colours, shapes, sizes, labelling and sorting. They are also learning to dream and imagine.
Priyanthi meets weekly with a programme volunteer and once a month with a group of other parents in support sessions. Learning from each other, the parents compare notes about their babies height, weight and other milestones. They review the opportunities throughout the day to engage their children in teachable moments waking up, mealtime, washing and bathing, cooking, visiting, working outdoors, playing and getting ready for bed.
Less than a kilometre from Priyanthis home is a family not regularly involved in early childhood care programmes. Wimalarathne, a 33-year-old farmer, explains that he recently learned about the home-visiting programme and wants to get his daughter, Sasika, involved. When the two-year-old girl sees strangers coming towards her house, she begins to cry. Her seven-year-old brother, Asanka, carries the tiny girl, a frightened toddler who clings to her brother, never uttering a word. Her piercing, dark eyes remain fixated on the stranger who visits. Both children are uncommunicative. Wimalarathne explains that his children are shy but they play well together.
The father, clearly concerned about his daughters development, beckons to his wife, Kusumawathi, 30, to get their daughters growth chart. The graph on the chart shows the childs weight and height spiralling downward from average readings at birth to below average as a toddler. Wimalarathne said that the doctor is at a loss about her slow growth and has recommended that the family become involved with the home-visiting programme.
Two families in the same village, in similar circumstances, yet the children are so different. The families in Matale, like millions throughout the world, are poor. Most are subsistence farmers and casual labourers who work in nearby factories or on tea plantations. Although 99 per cent of the children are immunized, almost 40 per cent are malnourished. Some families have access to early childhood care programmes. Many more do not.
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