In 2006, I wrote in the Guardian that it was not a good time to be a child in T&T. Has anything changed? The recent case of a child apparently shot in the back of her head, execution style, highlights that opinion. There is talk that she was disabled.
Although this incident is highly alarming and has people upset, it is the daily experiences of disabled children that is the problem.
Sometimes I am ashamed to be a paediatrician in T&T. Not a week goes by without my seeing a disabled child whose parents are not being helped by our medical and social system.
It begs belief that children are attending child clinics in health centres for their immunisations at two months, four months, six months, one year, a year-and-a-half and two years and are not being properly evaluated for delays in their development at the various visits they make for their shots.
Last week, I saw a five-year-old girl who walked at two years, said her first words at three and finally last year began to put words together in short sentences. She is really unable to communicate her needs to her parents. Her pronunciation is poor. She has never seen a speech therapist in her life. In addition to the above visits, she attends a hospital clinic every three or four months for delayed development and no one has ever said to her parents, “she needs to see a speech therapist”.
I questioned this repeatedly, even for me, a bit sternly, “no doctor, no one has ever told us she needs her speech assessed”.
In religious terms, this is a mortal sin.
At birth, she took long to breathe, was assisted by a machine for the first three days of her life and needed oxygen for the first three weeks. Oxygen can damage vision. She has never had an eye test.
She was jaundiced and was under light therapy for two weeks. High jaundice causes hearing loss. Hearing loss causes delayed speech which is often unintelligible. She has never had a hearing test. No one, no one has ever recommended that she have a hearing test. A child with newborn jaundice, delayed speech and attending a clinic every couple of months for years and no one has ever suggested a hearing test!
In religious terms, there is no chance for the doctor or doctors who are “taking care” of this child, they are going to hell.
She received various antibiotics during her stormy newborn hospital course. She developed severe staining on her teeth. Antibiotics can cause this. She has never seen a dentist. The one her parents carried her to, on their own, because the doctors in the clinic never recommended a dentist, could not get her to open her mouth. The parents were told there was nothing he could do.
Well, there is a special place in hell for dentists like that.
The parents keep hearing that she is “retarded”. Yet she has never seen a child psychologist. To confirm the “mental retardation”. Maybe she is not “retarded”. Maybe she is autistic. Maybe she is hearing impaired. Maybe she has cerebral palsy. Even if she is “mentally retarded”, to what degree? What’s her prognosis? What is she capable of? What will she be capable of in the future? How much care will she need? Will she be capable of independent care? Will she need custodial care? Will she be able to take a taxi? Cross a road? Feed herself? Cash a cheque? Wipe her bottom? Exactly where is she going, what is going to happen to her? Should the parents set aside a fund for her in case they die before her?
All these are valid questions that need to be ventilated and discussed with the help of a child psychologist and a social worker. These parents did not even know that they might be entitled to a disability grant.
If she is developmentally slow, has she had a test for thyroid function? Poor thyroid function affects brain development. She has never been tested.
On her medical report, it says her liver function was found to be abnormal at age two months. Was this test repeated? No.
But what the France is going on here?
It would seem that somebody decided that this child was “mentally retarded” and therefore there was no need to do any more testing or evaluation. This child has been abandoned by the medical profession. In my experience, this is common in T&T.
She stupid yes! Forget about her. Is too much work to help her. Let the parents fight up with her.
How many more are there like her in T&T? Heaven help us all.