NOVEMBER 8 — There are many challenges to the health of our children in Malaysia. The health needs and challenges have dramatically changed in the past four to five decades. Previously they were predominantly infection related and concerned with mortality of small children. However today, problems that cause significant morbidity have emerged as equally important.
This article outlines three major unaddressed and often unrecognised challenges to the health of our children. If we do not address these health challenges for our children, they may not live the same lifespan that we have come to expect for ourselves.
1. Killing our children softly with our cars
Air Pollution is a major threat to our children’s health. Every day we are breathing in not just particulate matter (PM10 — smaller than 10 micrometers) but more importantly noxious chemicals (sulphur dioxide and nitrogen dioxide) that will damage our lungs and heart over time.
The World Health Organisation (WHO) recently stated that 90 per cent of the world’s children breathe toxic air every day with serious health and development risks. They estimate that 600,000 children died from respiratory infections caused by polluted air in 2016.
Recent data from China has shown that exposure to air pollution can have serious negative effects on our cognitive performance (Xin Zhang 2018, PNAS). Children are more susceptible to air pollution as they breathe more rapidly than adults and have developing brains and bodies.
Since the 1990s we have had growing air pollution in most of our major cities in Malaysia, to the extent that we have accepted it as a fact of life. We like to call our air quality “haze” when we should term it “smog.”
The Breathe Life Organisation calculates, from available data, that the average air quality in the Klang Valley is 2.5 times above WHO safe levels. It also estimates that the health burden to Malaysia exceed 10,000 deaths per year.
While we would like to blame the air quality on open burning from our neighbours, the fact is that the majority of the air pollution comes from our cars. There is no way we can block out these chemicals, not even in our air-conditioned houses. Air pollution is an invisible, slow killer lurking in our homes.
The solution to air pollution is for us to aim for a 50 to 70 per cent reduction in cars and motorbikes. Due to our government’s desire to earn revenue by selling us cars and taxing us on highways, they have failed to establish a meaningful public transport system.
Hence we have become addicted to our cars and motorbikes. We need to go back to a culture where public transport, cycling and walking are valued. We need a highly efficient and cheap (government subsidised) public transport system that is bus based and not an LRT.
In addition we need enforcement to ban all single occupant vehicles in cities. It is also important to advocate against the development of a third car in Malaysia. Electrical cars are a useful solution but only if we generate clean energy. Currently the majority of our electricity production is polluting.
2. Feeding our children plastics
Plastics have become pervasive. They permeate every aspect of our lives and have resulted from our enormous plastic pollution of the environment. This pollution returns to us in the form of micro-plastics (plastic pieces measuring <5 mm and often not very visible to the naked eye).
One third of all fish that we eat has ingested plastics. Most of our water supply (>80 per cent) and table salt (90 per cent) has micro-plastics. The biggest known source of micro-plastics that we consume is bottled water (90 per cnet).
The impact of this on our children’s long term health is uncertain; but it cannot be good. To ingest such a large quantity of micro-plastics over a long period of time can only add chemicals to our body that are potentially toxic to our system.
The government is attempting to make changes by controlling plastic usage but these changes are happening far too slow. It is imperative that we do not wait for government or other authorities or legislation for change. It's important that the average Malaysian make change now to save the environment and thereby saving our children and their future health.
Stop using, buying, throwing away plastics. Avoid goods with plastic packaging; bring our own containers and bags when we go to tapau food or groceries; don’t buy plastic bottled water. If we all cooperate, we can reduce plastic waste by more than 60 per cent and offer our children and animals a future.
3. Screen addiction
One serious threat, not just to the physical health of our children, but more to their emotional psychological and mental health is screens. Screens dominate our lives — whether they be hand-phones, tablets, televisions or billboards.
Screen, screen, screens everywhere — screens in the morning when we wake up, screens at school and work, screens for entertainment, screens when we eat, screens in the car, screens. We study, work, eat, sleep and dream screens. This is truly the universal addiction of our times.
There is data from good animal studies to show that the radiation from excessive handphone use is linked to cancer of the brain and cancer of other organs (National Toxicology Programme, USA 2018). How this translates to humans is uncertain but the usage of handphones in our young children is very large.
One study by the Clinical Research Centre at Perak showed that two-year-olds used screens for an average of six hours a day. Numerous studies have documented the enormous emotional mental and psychological impact of screens on children. They make our children feel restless, distracted, lonely, depressed, disconnected and disempowered.
We cannot act on our children’s screen addiction until adults and parents deal with their own addiction to handphones. International guidelines advocate avoiding all screens (including TV) in young children under two years and limiting older children to one hour a day.
Parents and family need to spend screen free times together on a regular weekly basis — perhaps a morning out on the weekend with no internet connection and silenced phones. It is important that we bring back the communication and communion between individuals, especially families.
Face-to-face friendship and relationships is vital if we want to deal with the loneliness and suicide epidemics that are pervasive in our society.
These emerging challenges of our time have the ability to significantly impact children’s health and their future. It's important that we deal with them today so they do not have an epidemic of illnesses in the future — chronic lung and heart disease and possibly cancers will grow exponentially in our community.
We need to work on prevention. There is no way that the Ministry of Health or any other agency can make a significant change without societal change. Meaningful change needs to be made by the individual person and family and that will influence society at large.
It's important that every parent and child and family becomes an advocate to our neighbour and society at large. We must talk about and recognise these hazards to our children's health and our own health.
These three challenges are intertwined. As we have damaged and trashed our environment, cemented our gardens and polluted our air, our children have retreated into buildings and homes to be occupied with virtual reality.
We need to become a nation conscious of and advocating for a clean environment by our own life style change. We need to stop the destruction of our cities and homes and bring back green lungs for our children. We need safe places where children can go out and play and run about as an alternative to screens.
We need to make our streets safe and cool for cycling and walking by planting many, many more trees. Our own homes need to be green. If we do not work now the future health systems will never be able to cope with the volume of unwell adults and children. We need to work together, today, to offer our children a meaningful future.
* Datuk Dr Amar-Singh HSS is a senior consultant paediatrician.
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
