In a nation with one of Africa’s most challenging doctor-patient ratios, access to pediatric expertise is limited, leaving many at the mercy of “Dr. Google.” This reliance on the internet can lead to unnecessary panic, even when a simple issue like teething is the culprit behind a child’s discomfort.
Millennial and Gen Z parents in The Gambia are caught between traditional wisdom and the digital age’s infinite stream of information. A basic internet search for a child’s cough can lead to a bewildering array of advice, mingling time-honored remedies with modern-day debates on medical blogs and forums. This merging of old wives’ tales with the internet’s medical musings can leave young parents adrift in a sea of misinformation, where the urgency for immediate relief may tempt them to overlook the tried-and-true methods of their ancestors for the sake of expedient, yet potentially misleading, online solutions.
Striking a balance between readily available online information and traditional practices is a delicate art for Gambian parents. Recognizing the value of well-vetted online resources while maintaining a healthy skepticism of unverified sources is key. Millennial and Gen Z parents must become curators of knowledge, sifting through the digital noise to find harmonies that resonate with reason and relevance in the context of their African heritage.
In these tender moments of infancy, the cries and murmurs of a child remain unchanged, but the tools at a parent’s disposal have transformed. Embracing the best of both worlds—honoring the legacies of traditional remedies while vetting them against scientifically sound advice—can illuminate the path forward. The challenge is not merely to interpret the language of a child’s cries but to ensure that the response is informed, measured, and mindful of the rich tapestry of heritage and the rigorous scrutiny of science.
Journeying through the multifaceted terrain of pediatric health in the Gambia is akin to navigating a river with unpredictable currents. With a healthcare system marked by fragmentation, caregivers must often become amateur diagnosticians, advocates, and medical historians for their children, a role both daunting and vital. From the moment of birth to the cusp of adulthood at 18, each developmental stage is a new chapter with its distinct milestones and potential ailments, requiring a discerning eye and a depth of understanding.
A fever in a child, for example, while a source of concern for parents, serves as an indicator of the body’s internal battle. It is a beacon of the immune system’s engagement—an intrinsic call to arms against invading pathogens. This febrile response is not merely a symptom to be quelled but a sign of the body’s resilience, a resilience fortified by immunizations, those guardians of health, administered throughout childhood. Here lies the intersection of natural physiology and medical intervention, where the body’s inherent defenses are augmented by the shield of vaccines.
Acknowledging the Gambian Ministry of Health and its global allies like WHO and UNICEF is crucial, for their endeavors have painted a silver lining on the clouds of healthcare challenges. They have worked tirelessly to weave a net of protection against diseases that once claimed countless lives, ensuring that vaccines reach the arms of the nation’s children. These efforts reflect a triumph not just of policy and program implementation but of collective willpower and international solidarity.
Yet, the task remains complex. Beyond vaccinations, understanding a child’s fever demands nuanced knowledge of the individual. Has the child been exposed to a particular pathogen? Is there an underlying condition that predisposes them to recurrent fevers? The answers are often hidden within the child’s personal health history, a tapestry of past illnesses, responses to treatments, and familial health patterns.
Moreover, the building blocks of a child’s immune system are laid from the moment of birth, with breastfeeding playing a crucial role in providing essential nutrients and antibodies from the mother. This natural form of nourishment not only promotes healthy growth but also helps protect the child from various illnesses.
However, when it comes to treating ailments in children, the lack of digitization in most public and private health institutions in the Gambia poses a significant challenge. Without a centralized system to track a child’s healthcare journey, caregivers often find themselves starting from scratch with each medical encounter. This fragmentation is further compounded by the fact that many drugstores and pharmacies in the country are staffed by individuals who may lack the necessary knowledge and expertise to provide accurate guidance on children’s medications.
Administering medication to children is a precise science; it is a delicate balance where the scales must be set with meticulous care. The crux of this balance lies in dosage determination, which should be finely tuned to the child’s weight, a variable that changes much more rapidly in the young than in adults. It is astonishing, yet not infrequent, that in various healthcare settings, medication is prescribed without the verification of a child’s most recent weight. This oversight can veer dangerously towards two extremes: an overdose, which can overwhelm a child’s developing system, or an underdose, which may render the treatment ineffective.
Parents and caregivers must often take on the role of vigilant advocates in the healthcare process, ensuring that their child’s weight is not only considered but is a cornerstone of any medical decision. This insistence is far from overzealous; it is a necessary safeguard against the risks of improper dosing. The consequence of neglecting to account for a child’s weight can be grave, with young bodies being particularly sensitive to the effects of medications.
Dosage by weight is not a mere guideline; it is a directive that ensures the efficacy and safety of pediatric care. Medications, after all, are not one-size-fits-all solutions. They must be tailored to the individual, and for children, weight is a crucial measure of this individualization. It is a metric that reflects not only the volume of distribution within the body but also the rate of metabolism and elimination of the medication.
The responsibility to ensure accurate dosing extends beyond the parents to the healthcare providers and systems within which they operate. There must be protocols in place that mandate weight measurement as an integral part of the prescribing process. This includes updating electronic health records promptly (where they exist), training healthcare workers to understand the importance of weight-based dosing, and creating checks and balances to prevent errors.
Medicating children requires precision, patience, and an unwavering commitment to their well-being. It is a task that, when done correctly, can alleviate suffering and promote healing, but when done carelessly, can pose a significant threat to a child’s health. Parents, empowered by knowledge and backed by a healthcare system that upholds the highest standards of pediatric care, are the key players in ensuring that every dose of medication administered to their child is as safe as it is effective.
Furthermore, the importance of using the proper measuring tools such as dosing syringes and dosing cups cannot be overstated. Instructions such as “give the child one tablespoon or one teaspoon” can be dangerously misleading, as household spoons come in various sizes. Grandpa’s “Mono” (porridge) spoon is not fit for a 2-year-old’s cough medication (if they need any at all!). A pharmacist knows that one teaspoon equals precisely 5ml, and one tablespoon is 15ml, but this knowledge may not be common among average caregivers. Using inappropriate measuring devices can lead to unintentional overdoses, which can have severe consequences.
It is also essential to understand that, in the absence of a diagnosed bacterial infection or a chronic condition like sickle cell anemia, asthma, or type 1 diabetes, most children’s medications are used to provide symptomatic relief rather than cure the underlying issue. This is because the immune systems of infants and children are often more resilient than those of adults, allowing them to fight off many common illnesses on their own.
It is to be noted that one habit in medical practice that plagues both adults and children is the abuse of antibiotics for every perceived ailment. It’s crazy how often, for example, one has to explain to patients that an antibiotic cannot cure something caused by a virus, but where quality of differential diagnosis is missing, it is quite common to use the “throw as much spaghetti on the wall and hope one sticks!” method of treating child ailments. This approach fails to recognize that even when antibiotics are actually needed, they do what they do well, which is to kill bacteria indiscriminately.
The downside of this indiscriminate bacterial eradication is that our gut is host to some amazing bacteria that is beneficial to our healthy existence. Therefore, antibiotics can wipe out the bacteria in children during its course, which can often manifest as side effects that include diarrhea and subsequent dehydration. The whole “give the kid some yogurt while on antibiotics” advice stems from the fact that the good bacteria, often referred to as “probiotics,” found in yogurt helps replace and balance what the antibiotic wipes out.
It is crucial for healthcare providers to exercise caution when prescribing antibiotics for children and to educate parents about the appropriate use of these medications. The “throw as much spaghetti on the wall and hope one sticks!” approach not only fails to address the underlying cause of the ailment but also contributes to the growing problem of antibiotic resistance.
By promoting the judicious use of antibiotics and emphasizing the importance of accurate differential diagnosis, we can reduce the unnecessary exposure of children to these powerful medications and their potential side effects. Additionally, by encouraging the consumption of probiotic-rich foods like yogurt during antibiotic treatment, we can help maintain the delicate balance of beneficial bacteria in a child’s gut, supporting their overall health and well-being.
In conclusion, parents and caregivers must remain vigilant and attentive to their child’s health. Monitoring a child’s body temperature is one of the most important indicators that something may be amiss. Every household should have a thermometer on hand to accurately assess the presence of a fever. When treating a fever, analgesics such as acetaminophen/paracetamol/Tylenol or ibuprofen/Motrin can be helpful, but consulting with a pharmacist or healthcare professional is crucial for determining the appropriate dosage based on the child’s weight. It is important to note that acetaminophen/paracetamol has strict dosing guidelines, as excessive amounts can lead to liver toxicity in children.
A medication attains the classification of “safe” when administered within its designated dosing limits and prescribed schedule. The therapeutic benefit that one patient may experience from a certain dosage can be detrimental, or even dangerous, to another. In Africa, the concern extends beyond the quantity of medication prescribed; the quality and origins of medications are equally significant. Our global community aspires to a future where the procurement of medications is guided by principles of human dignity rather than the sole pursuit of profit, ensuring that widespread distribution does not compromise safety and efficacy.
The Gambia has faced a sorrowful and sobering history when it comes to the dangers of harmful medications ending up in the medicine cabinets of households with innocent children. As caregivers, it is our responsibility to exercise caution and good judgment when choosing who, where, what, and why any particular medication is being prescribed or dispensed for our children.
By prioritizing accurate weight-based dosing, using proper measuring tools, seeking guidance from knowledgeable healthcare professionals, and being cautious with the use of antibiotics, we can navigate the complexities of children’s medication safety and ensure the well-being of our precious little ones. Together, let us create a future where every Gambian child receives the care and attention they deserve, free from the shadows of medical misinformation and preventable harm.
In peace, love, and good health,
Dr. IDB.
For more information, follow the work of Dr. Badjie and his Innovarx WOW team on www.igh.gm and on social media @innovarxglobal or call +2866200. Ismail is also the author of newly released book “LIFE AS A HYPHEN” available at Timbooktoo Bookstore and Kairo Café (Fajara).
Disclaimer: The information provided in this article is for general understanding and does not constitute a diagnosis. For specific concerns or detailed health advice, always consult your designated healthcare professional.
