David E Bratt, MD

There are many quo­ta­tions about the im­por­tance of the hu­man ex­pe­ri­ence of child­hood. The best known is: "Give me a child un­til he is sev­en and I will show you the man." This is at­trib­uted to ei­ther St Ig­natius of Loy­ola or St Fran­cis Xavier, the co-founders of the Je­suit or­der, but al­so to Aris­to­tle who seems to have said every­thing be­fore every­body else.

An­oth­er not­ed founder, Vladimir Ilyich Lenin, is sup­posed to have said: "Give me four years to teach the chil­dren and the seed I have sown will nev­er be up­root­ed." Hah!

The Ro­man Catholic church replied with Proverbs 22:6: "Train up a child in the way he should go and when he is old, he will not de­part from it." The Bible says a lot of strange things but this one most will agree with.

In fact every­one agrees with any form of the state­ment.

Sci­ence makes sim­i­lar claims: "Brains are built over time, from the bot­tom up." "The ba­sic ar­chi­tec­ture of the brain is con­struct­ed through an on­go­ing process that be­gins be­fore birth and con­tin­ues in­to child­hood." Or, "Tox­ic stress (chron­ic, un­re­lent­ing stress in ear­ly child­hood, caused by ex­treme pover­ty, re­peat­ed abuse or se­vere ma­ter­nal de­pres­sion) dam­ages de­vel­op­ing brain ar­chi­tec­ture, which can lead to life­long prob­lems in learn­ing, be­hav­iour and phys­i­cal and men­tal health."

An­oth­er way of putting it is that per­sis­tent fear and anx­i­ety can af­fect young chil­dren's learn­ing and de­vel­op­ment. It's not on­ly ac­tive stress­ful sit­u­a­tions. The per­sis­tent ab­sence of re­spon­sive care dis­rupts the de­vel­op­ing brain. This is what hap­pens when the ba­by or child cries for help and is re­peat­ed­ly ig­nored.

Why don't peo­ple act on these be­liefs? Why do we ig­nore chil­dren? Why do we al­low chil­dren to be abused? Doesn't that in­flu­ence their men­tal and emo­tion­al and sex­u­al de­vel­op­ment in­to adult­hood? Why do we al­low chil­dren to be­come obese? Doesn't that in­flu­ence their phys­i­cal health as adults?

The an­swer is sim­ple. Par­ents are too busy with their lives to be over­ly con­cerned about their chil­dren.

Busy to­day means spend­ing four hours a day dri­ving to and from work to make enough mon­ey ei­ther to just get by or mak­ing so much mon­ey that you can pay some­one to take care of your child.

Schools are too busy teach­ing chil­dren how to take SEA so that they can have the Min­is­ter of Ed­u­ca­tion come take pic­tures with the suc­cess­ful can­di­dates. Gov­ern­ments are con­cerned with get­ting back in­to pow­er and chil­dren do not vote, so that's that.

In a small is­land so­ci­ety where Gov­ern­ment con­trols the mon­ey, no one in busi­ness wants to up­set the co­conut cart so Gov­ern­ment gets away with aban­don­ing chil­dren un­til they grow up and start caus­ing trou­ble when at­tempts are made to buy them off by call­ing them "com­mu­ni­ty lead­ers" or "vil­lage el­ders."

True, the Ear­ly Child­hood Care and Ed­u­ca­tion pro­gramme (EC­CE) is an at­tempt to ad­dress the prob­lem but it starts too late in the life of the child (three years) and has run in­to a se­ries of prob­lems in­volv­ing the build­ing of the Cen­tres and the em­ploy­ment sta­tus of its teach­ers.

It is now al­most 20 years since the first study demon­strat­ing the link be­tween ad­verse child­hood ex­pe­ri­ences and adult dis­ease was pub­lished. The "Re­la­tion­ship of Child­hood Abuse and House­hold Dys­func­tion to Many of the Lead­ing Caus­es of Death in Adults," al­so called the The Ad­verse Child­hood Ex­pe­ri­ences (ACE) Study came out in 1998.

"Sev­en cat­e­gories of ad­verse child­hood ex­pe­ri­ences were stud­ied: psy­cho­log­i­cal, phys­i­cal or sex­u­al abuse; vi­o­lence against moth­er; or liv­ing with house­hold mem­bers who were sub­stance abusers, men­tal­ly ill or ever im­pris­oned. The num­ber of cat­e­gories of these ad­verse child­hood ex­pe­ri­ences was then com­pared to mea­sures of adult risk be­hav­iour, health sta­tus and dis­ease."

Peo­ple who had ex­pe­ri­enced four or more cat­e­gories of ad­verse child­hood ex­po­sure, com­pared to those who had ex­pe­ri­enced none, had four- to 12-fold in­creased health risks for al­co­holism, drug abuse, de­pres­sion and sui­cide at­tempt; a two- to four-fold in­crease in smok­ing and poor self-rat­ed health; a strong pos­si­bil­i­ty of hav­ing over 50 sex­u­al in­ter­course part­ners over a life-time plus a sex­u­al­ly trans­mit­ted dis­ease as well as a 1.4- to 1.6-fold in­crease in phys­i­cal in­ac­tiv­i­ty and se­vere obe­si­ty.

The num­ber of cat­e­gories of ad­verse child­hood ex­po­sures showed a grad­ed re­la­tion­ship to the pres­ence of adult dis­eases in­clud­ing is­chemic heart dis­ease, can­cer, chron­ic lung dis­ease, skele­tal frac­tures and liv­er dis­ease, ie the more ACEs you had the greater the pos­si­bil­i­ty of hav­ing one or more of the above.

The most preva­lent of the sev­en cat­e­gories of child­hood ex­po­sure was sub­stance abuse in the house­hold, one in four; the least preva­lent ex­po­sure cat­e­go­ry was ev­i­dence of crim­i­nal be­hav­iour in the house­hold (3.4 per cent). More than half of re­spon­dents ex­pe­ri­enced more than one cat­e­go­ry of ad­verse child­hood ex­po­sure; 6.2 per cent re­port­ed more than four ex­po­sures.

OK, now ap­ply this to our pop­u­la­tion. How many of our chil­dren ex­pe­ri­ence psy­cho­log­i­cal abuse? I would say over 75 per cent. Phys­i­cal? Sex­u­al? How many live with moth­ers who reg­u­lar­ly get beat­en up? Or live with peo­ple on drugs or who are men­tal­ly ill or sui­ci­dal? Or have been in prison?

If you don't know, nei­ther do I, your guess is as good as mine. Or try work­ing back­wards. How many adult Tri­nis are at risk for al­co­holism, drug abuse, de­pres­sion and sui­cide at­tempt? Or have had over 50 sex­u­al part­ners? Or a sex­u­al­ly trans­mit­ted dis­ease? Obese any­one?

It starts in ear­ly child­hood. That's where we have to be putting the mon­ey. The Bible say so. Lenin say so. Even saints say is so!