Last week, UNICEF’s Regional director for South Asia George Laryea-Adjei was quoted as saying that children have suffered enormous setbacks in their learning journey due to school closures across South Asia which have forced children and their teachers to transition to remote learning in a region with low connectivity and device affordability.
The Sunday Observer spoke to Consultant Child and Adolescent Psychiatrist, Colombo South Teaching Hospital and Vice President Sri Lanka Association of Child Development Dr Yasodha Rohanachandra for her views. When asked whether she agreed, she said, “Yes I definitely agree. School closure has had an enormous impact on learning, mental health and social development of children. Loss of their daily routine, peer interactions and opportunities for extra-curricular activities may have long term effects on them”.
To our query on the psychological problems that could arise from these prolonged closures, she said that, “An increase in emotional and behavioural problems in children and adolescents has been reported worldwide during the pandemic. Fatigue, loneliness, negative thoughts, lack of enjoyment of activities, boredom and fidgety behaviour have been reported. In addition, the rates of psychiatric disorders have increased by 2-3-fold in children as a result of the pandemic. ”
Underprivileged children
Since many underprivileged children are now taking on additional roles doing part time jobs to keep home fires burning, we inquired how these multiple roles and responsibilities could lead to mental problems in children.
She said, “Taking on economic responsibilities robs the time that is available for children to engage in age-appropriate academic and leisure activities, besides placing extra stress on children who are not developmentally mature enough to handle the stress of being responsible for generating an income. It may result in negative psychological consequences.”
Asked about children staying home due to prolonged school closure being vulnerable to other threats such as sexual abuse, physical assaults, she said that, “Rates of both child sexual and physical abuse have risen globally during the pandemic. Children have less contact with other supportive adults such as teachers and extended family. Widespread disruption in child protective and community services that support child welfare has collectively contributed to the increase in child abuse. Parents can help by promoting routines at home, encouraging physical activity and hobbies taking measures to manage their own stress.”
To Medisnip’s question on suggestions that all children from 12 years to 18 years should be fully vaccinated so that schools can reopen again, she said, “A global study that tracked school closure in 191 countries have shown that there is no association between school status and the Covid-19 infection rates. My personal view is that we do not need to wait for all children to be vaccinated to open schools”.
Access to learning
Asked if she had alternative solutions, she replied, “As television or radio is available in a majority of the homes, these can be used to ensure that the majority of children have some access to learning.”
As the Vice President of the Sri Lanka Association of Child Development (SLACD), the Sunday Observer asked what interventions the Association had made to fill this seemingly insurmountable gap during the 18-month school closures due to the lockdowns. “Our association has conducted webinars to parents, especially parents of children with special learning needs, on how to support their child’s education at home,” she said.
She added, “Parents and teachers need to have realistic expectations about distance learning and accept that children may not have the same engagement with distant learning as for in-person learning. They must also be aware of any change in behaviour that may indicate an underlying mental health problem in their children, to access timely psychological support for them.”
Responsible pet ownership, key to preventing Rabies deaths
Compiled by Carol Aloysius
“Rabies remains a cause for concern in Sri Lanka despite drastic reduction rates in recent years. Between 20 to 30 people succumb to it annually”. Emeritus Professor of Forensic Medicine and Toxicology of the University of Colombo and Senior Professor of Forensic Medicine at the Sir John Kotelawala Defence University and former Chairman of the National Dangerous Drugs Control Board Raweendra Fernando told the Sunday Observer recently.
In an interview with Medi snips, he said, “We must put a stop to these needless rabies related deaths as it is hundred percent preventable in humans”.
Asked if there was a cure for Rabies, he said, “Unfortunately, NO.’
Since many readers still don’t know much about what exactly rabies is, we asked if he could tell us what Rabies was, its source, and how it spreads. He said, “Rabies is a 100 percent fatal viral disease. It usually spreads to humans by saliva, through bites or scratches. Dogs are the source of the vast majority of human deaths from rabies.”
So do all stray dogs that roam our streets have rabies? We asked. He said, “No. However, all dog bites should be treated unless you know the dog has been rabies vaccinated in the last year.”
Early symptoms
Discussing early symptoms to look for in a rabies infected people, he said, “Watch out for fever, headache, nausea, vomiting, agitation, anxiety, confusion and hyperactivity. They can be the early symptoms of rabies.”
When queried as to what happens to the human body when it progresses further, he said, “When the virus spreads to the central nervous system, a progressive and fatal inflammation of the brain and spinal cord develops and other symptoms appear. The person may experience delirium, abnormal behaviour, hallucinations, hydrophobia (fear of water) and insomnia. Once these clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. The disease occurs in two forms:
Rabies patient
A furious rabies patient shows signs of hyperactivity, excitable behaviour, hydrophobia (fear of water) and sometimes aerophobia (fear of drafts or fresh air). Patient dies in a few days due to cardio-respiratory arrest. About 80 percent of Human Rabies occurs in this form. Paralytic rabies goes through a longer course than the furious form in people. Muscles gradually become paralysed. This starts at the site of the bite or scratch. The patient slowly goes into a coma and dies. After a few days, the symptoms can cause the person infected to go into a coma and later die.
Asked how Rabies could be prevented in humans, he said that, “Post-exposure prophylaxis, which is available in government health facilities, at no cost, to all dog bite patients, has been a main axis of the rabies-elimination strategy in Sri Lanka. “On how soon it should be given, and what part of the body, he said that it should be administered on days 3, 7, and 14 after the first vaccination. For adults, the vaccination should always be administered intramuscularly in the deltoid area (upper arm). ’
On precautions regarding an animal suspected of having Rabies, he said, “An apparently healthy domestic dog, cat, or ferret that bites a person should be confined and observed for 14 days from the day of exposure.”
So how do we prevent rabies? “Provide education and information on responsible pet ownership, how to prevent dog bites, and what immediate measures to take after a bite. We also need to scale up dog vaccination,” he said.