PERSONAL HEALTH AND HYGIENE

T h i s c h a p t e r d e a l s w i t h d i f f e r e n t a s p e c t s of

p e r s o n a l h e a l t h and h y g i e n e among t h e c h i l d r e n from b i r t h t o

c h i l d h o o d . C a r e o f t h e t e e t h , h a b i t of b a t h i n g , h a b i t o f

t r a i n i n g and s l e e p i n g a r r a n g e m e n t s , i m m u n i z a t i o n , major

i l l n e s s and o t h e r a s p e c t s o f c h i l d h e a l t h and h y g i e n e a r e

d i s c u s s e d i n t h i s c h a p t e r . The c h a p t e r d e s c r i b e s how t h e

c h i l d r e n g e t t r a i n i n g i n t a k i n g c a r e o f t h e i r p e r s o n a l

h e a l t h and h y g i e n e .

P e r s o n a l h y g i e n e i n c l u d e s a l l t h o s e p e r s o n a l

f a c t o r s which i n f l u e n c e t h e h e a l t h and w e l l - b e i n g of an

i n d i v i d u a l . I t c o m p r i s e s many day-to-day a c t i v i t i e s s u c h a s

c a r e o f t h e body r e l a t i n g t o c l e a n s i n g t e e t h , b a t h i n g ,

t o i l e t t r a i n i n g , and c a r e of c l o t h e s . P e r s o n a l h y g i e n e

a f f e c t s p r i m a r i l y t h e h e a l t h o f t h e i n d i v i d u a l and i s

l a r g e l y c o n n e c t e d w i t h t h e s t a n d a r d o f l i v i n g . The p e r s o n a l

h e a l t h a n d h y g i e n e r e s u l t i n g f r o s p o v e r t y and e x t e r n a l

e n f o r c e m e n t i n f l u e n c e s t h e deve lopment of p e r s o n a l i t y and

temperament of t h e c h i l d .

s e a r s , R . R . ( 1 9 5 5 1 and Whi t ing ( 1 9 6 3 ) made an

a t t e m p t t o f i n d t h e r e l a t i o n s h i p of b e h a v i o u r p a t t e r n s of

c h i l d r e n w i t h t h e l e a r n i n g e n v i r o n m e n t r e c e i v e d t h r o u g h ihome

a n d p a r e n t s .

'Tee th ing i s v e r y i m p o r t a n t t o c h i l d h o o d . T e e t h i n g

s t a r t s a t t h e n i n t h month t o t i l l 2 years o f a g e . T e e t h i n g

e r u p t i o n s t a r t s i n t h e baby w i t h i l l h e a l t h . R t this t i m e t h e

b i t i n g h a b i t i s d e v e l o p e d .

B a t h i n g i s s o m e t h i n g v e r y c l o s e and i n t i m a t e w i t h

o u r I n d i a n c u l t u r e and l n d i a n c l i m a t e , and t h e r e f o r e ,

i n t e r e s t e d i n s t u d y i n g t h e v a r i a t i o n a b o u t t h i s p r a c t i c e s i n

t h e s lum c u l t t l r e . Hindu m o t h e r s b e l i e v e t h a t o i l is used t a

s t r e n g t h e n and s n ~ o o i h e n t h e b a b y ' s body. I t i s a p r a c t i c e t o

e x p o s e t h e c h i l d t o i n c e n s e i m m e d i a t e l y a f t e r a b a t h .

T o i l e t t r a i n i n g is u s u a l l y a s s o c i a t e d w i t h t h e

o r a l p h a s e o f p s y c h o - s e x u a l d e v e l o p m e n t , which h a s been

c o n s i d e r e d t o be a g r e a t i m p o r t a n c e f o r t h c c i e v ~ l o p ~ ~ r e n t of

p e r s o n a l i t y . Accordir lg t o F r u e d i a n t h e o r y , tire c i i i l d d e r i v e s

much of h i s p l e a s u r e from bowel movements and when t h i s is

i n t e r f e r e d w i t h by e a r l y and s e v e r e c o n t r o l o r t r a i n i n g , t h e

c h i l d r e s p o n d s by i n h i b i t i n g h i s p l e a s u r e seekin(1 a c t i v i t i e s

i n g e n e r a l . I f t o i l e t t r a i n i n g i s c l i a r a c t ~ r i s c d b y s c o l d i r r y ,

p u n i s h m e n t , and much t e n s i o n on t h e p a r t cf t h e inother Llle

c h a n c e s a r e t h a t t h e c h i l d way become a n x i o u s and t h u s

d e v e l o p s an a t t i t u d e o f f e a r t o w a r d s s o c i a l s i t u a t i o n s .

E r i k s o n ( 1 9 5 4 ) b e l i e v e d t h a t t h e r e is t h e d a n q e r

o f deve lopment o f shame and g u i l t i f t o i l e t t r a i n i n g i s t o o

s e v e r e a n d r i g i d . T o i l e t t r a i n i n g t h u s becomes an a r e a Qf

d r a m a t i c c o n f l i c t amung t h e emerg ing s e l L c o n t r o l o f t h e

i n f a n t and t h e r e q u i r e m e n t s o f t h e o u t s i d e w o r l d .

The S a m s k a r a s a r e v e r y much b a s e d or1 t h e

p r i n c i p l e s of sound h e a l t h and h y q i e n e c o n c e p t s . ~t is

a l m o s t v e r y d i f f i c u l t and a t new s L a g e o f l i r e which is

l i k e l y t o c r e a t e a n x i e t y , f r u s t r a t i o n s , f e a r and c o n f u s i o n

i n t h e c h i l d . I t f u l l y r e c o g n i s e s t h e i m p o r t a n c e o f mothers

who h a v e p r i m a r y r e s p o n s i b i l i t y t o b r i n g up c h i l d r e n i n

e a r l y y e a r s (Upadhayaya , R . K . 1 9 7 2 ) .

C h i l d r e n who d e v e l o p s e v e r e m a l n u t r i t i o n d i e

u n l e s s p r o p e r t r e a t m e n t i s a v a i l a b l e i n t i m e . Many o t h e r s i n

whom i t is r e c o g n i z e d a s m a l n o u r i s h m e n t , e a s i l y d i e o f

m e a s l e s , d i a r r h o e a , r e s p i r a t o r y i n f e c t i o n s and o t h e r common

d i s e a s e s o f c h i l d h o o d which a r e n o t s e r i o u s i n w e l l -

n o u r i s h e d c h i l d r e n . O t h e r s who s u r v i v e become o f t e n r e t a r d e d

i n t h e i r growth and d e v e l o p m e n t , p h y s i c a l and m e n t a l , and

become t h e c h r o n i c a l l y m a l n o u r i s h e d and u n e d u c a t e d p a r e n t s

o f a n o t h e r g e n e r a t i o n w i t h t h e same f a t e ( B e h a r , 1 9 7 9 ) .

The c h i l d r e n r e c e i v e t h e b e s t p o s s i b l e nour i s l i r~ ten l

f rom t h e i r m o t h e r s . I n p o v e r t y c u l t u r e , t h e poor n u t r i t i o n a l

s t a t u s o f t h e m o t h e r s i n f l u e n c e t h e n u t r i t i o n a l s t a n d a r d s of

t h e s lum c h i l d r e n . The p o p u l a t i o n s which a r e poor

e c o n o m i c a l l y poor w i t h i n s a n i t o r y e n v i r o n m e n t , b o t t l e

f e e d i n g o f c h i l d r e n w i t h m i l k i s e x t r e m e l y d a n g e r o u s which

e x p o s e s them t o s e v e r e m a l n u t r i t i o n a n d d e a d l y i n f e c t i o n s a t

a v e r y e a r l y a g e .

The UNICEF r e p o r t o f t h e ' S t a t e o f t h e Wor lds '

C h i l d r e n , 1990 ' s a y s : Approximate ly 40 p e r c e n t o f a l l yaung

c h i l d r e n who d i e i r ~ t h e i ~ o r l d every y e a r , 35 p e r c e n t o f

t h o s e who a r e m a l n o u r i s h e d , 35 p e r c e n t o f t h o s e who l i v e i n

a b s o l u t e p o v e r t y a r e t o be found i n j u s t t h r e e c o u n t r i e s :

I n d i a , P a k i s t a n and B a n g l a d e s h .

I n f a n t B a t h i n g

Women massaye t h e body of t h e i n f a n t s w i t h o i l a s

a c l e a n s i n g a g e n t . B e f o r c g i v i n g b a t h t o t h e c h i l d , t h e

m o t h e r g i v e s some h e r b a l m e d i c i n e t o t h e c h i l d . s h e u s e s

s h i k a k a y a ( s o a p n u t ) p a i ~ d e r o r g r a m f l o u r o r s o a p a s

i n g r e d i e n t s t o t h e body and h e a d . R f t e r c o m p l e t i o n of b a t h

s h e waves r e d c o l o u r e d w a t e r t o waive d i s t i ( e v i l e y e ) . They

f u m i g a t e w i t h i n c e n s e i m m e d i a t e l y a f t e r t h e b a t h a s one of

t h e p r e v e n t i v e h e a l t h m e a s u r e s .

The cus tom of d r e s s i n g t h e new born f o r t h e f i r s t

week w i t h o l d c l u t h e s is f o l l o w e d by a l l t h e c u l t u r a l

g r o u p s . The comnlon b e l i e f f o r t llis cus tom i s t l in t t h e c l i i l d

s h o u l d become h a l e , h e a l t h y and l i k e t h e qrown up c h i l d r e n .

S i m i l a r l y , t y i n g a b l a c k s t r i n g o r b l a c k b e a d s a r o u n d t h e

w a i s t t o e n s u r e t h e c h i l d a g z i n s t e v i l e y e . T y i n g w h i t e

b e a d s a r o u n d t h e s t o m a c h , shoiis t h a t t h e baby d o e s n u t vomit

t h e m i l k . T h e r e is a l s o a custom of p u t t i n g b l a c k d o t s on

t h e f o r e h e a d , cheek and f o o t a f t e r t h e b a t h , t o r e d u c e t h e

a t t r a c t i v e n e s s of the c h i l d .

C h i l d r e n a r e b a t h e d by e l d e r s f o r a longer p e r i o d

if t h e y s p a r e t i m e from n t h e r h o u s e h o l d d u t i e s . C h i l d r e n i n

some f a m i l i e s u s e d t o have an i n d e p e n d e n t b a t h a t a n e a r l y

a g e b e c a u s e t h e i r m o t h e r s used t o b e v e r y busy w i t h t h e

h o u s e h o l d d u t i e s . Nomen i n t h e s e f a ~ n i l i e s d o n o t h a v e t i m e

t o s p a r e from o t h e r household d u t i e s t o b a t h e t h e i r

c h i l d r e n .

The grown u p c h i l d r e n comb t h e i r h a i r

i n d e p e n d e n t l y w h e r e a s t h e younger depend upon t h e e l d e r

s i b l i n g s o r mother o r any o t h e r e l d e r members o f t h e f a m i l y .

A few f a m i l i e s u s e c o s m e t i c s f o r t h e i r c h i l d r e n b u t low

income and low c a s t e L a l n i l i e s d o n o t u s e c o s m e t i c s . The

women i n t h e p o o r f a m i l i e s a r e n o t p a r t i c u l a r a b o u t t h e

h y g i e n e o f c h i l d r e n and b e l i e v e t h a t c h i l d r e n will not be

a b l e t o c l e a n s e t h e m s e l v e s t h o r ~ u g h l y a t such an e a r l y a g e .

B a t h i n g H a b i t s

D a i l y b a t h i s a n e c e s s i t y f o r p e o p l e p a r t i c u l a r l y

d u r i n g summer b u t most o f t h e slum d u e l l e r s d o n o t b a t h e

r e g u l a r l y . They u s u a l l y t a k e h o t w a t e r b a t h b u t some poor

f a m i l i e s a r e h a b i t u a t e d t o c o l d w a t e r b a t h . C h i l d r e n below 3

y e a r s were b a t h e d w i t h ho t w a t e r . The f o l l o w i n g t a b l e 5 . 1

shows t y p e of w a t e r used among t h e s l u m c h i l d r e n .

The t a b l e 5 . 1 c l e a r l y i n d i c a t e s t h a t b a t h r n g

c o n s c i o u s n e s s i s d e v e l o p e d o r i n c u l c a t e d among slum c h i l d r e n

a t t h e a g e oL 7 y e a r s o r a b o v e . The c h i l d r e n below 1 y e a r t o

6 y e a r s o f a g e t o o k b a t h more i n co-ordination w i t h p a r e n t s

c a r e t h a n on t h e i r own i n t e r e s t .

Table 5.1. D i s t r i b u t i o n of a g e and t y p e of w a t e r u s e d among t h e s lum children

................................................................................ S1. Age o f Chlldren y o . o f c h i l d r e n Type of w a t e r T o t a l C h i l d r e c No. ( ~ n y e a r s ) --------------- ------------- -------------------

Female Male Hot Cold Number p e r c e n t ................................................................................

1. Below 1 y e a r 4 11 1 5 1 5 6 - 0 0 --

7. 7 y e a r s above 70 7 0 40 100 140 55.00

........................................................ T c z a l 118 1 3 2 112 1 3 1 2 5 C 100 - 0 0

The t a b l e 5 . 2 i n d i c a t e s o n e hundred and L h i r t y

n i n e c h i l d r e n ( b e l o w 1 y e a r t o 4 y e a r s dnd a b o v e ) i n t i le

s lum s u r v e y , r e v e a l e d t h a t t h e y were h a b i t u a t e d i n h a v i n g

d a i l y b a t h where a s 91 c h i l d r e n o f a b o v e 4 y e a r s a g e t o o k

b a t h on a l t e r n a t e d a y s . I t is i n f e r r e d t h a t c h i l d r e n i n s l u m

t a k e b a t h d a i l y and on a l t e r n a t e d a y s w h e r e a s a few c h i l d r e n

( 1 3 ) t a k e b a t h o n c e i n 3 d a y s .

The c h i l d r e n who c o u l d n o t t a k e b a t h d a i l y were

f rom f a m i l i e s who had no w a t e r f a c i l i t y i n t h e i r h o u s e s . But

t h e y b r i n g w a t e r from p u b l i c t a p s o r b o r e w e l l s . I t was due

t o t h e s c a r c i t y o f w a t e r and n e g l i g e n c e a f t h e p a r e n t s t h a t

some c h i l d r e n do n o t t a k e b a t h d a i l y . The f o I l o w i n g t a b l e

5 . 3 shows t h a t t h e f r e q u e n c y o f head b a t h among t h e slum

c h i l d r e n .

The t a b l e 5 .3 i n d i c a t e s t h a t , t h e m a l o r i t y of

c h i l d r e n ( 4 7 . 2 0 % ) t a k e head b a t h o n c e i n a week, 2 6 . 4 0 % of

t h e c h i l d r e n on a l t e r n a t e d a y s , 14.40% o f t h e c h i l d r e n t a k e

head b a t h t w i c e i n a week and 1 2 . 0 0 8 of t h e r h i l d r e n t a k e

head b a t h d a i l y . 118 c h i l d r e n t a k e head b a t h o n c e i n a week

a t t h e a g e of 4 y e a r s and above. The younger c h i l d r e n depcnd

upon t h e m o t h e r , e l d e r c h i l d r e n o r o t h e r f a m i l y members. The

y o u n g e r c h i l d r e n aged above 4 y e a r s t a k e b a t h i n d e p e n d e n t l y .

1t was a p r a c t i c e t o c l e a n t h e h a i r w i t h s o a p o r

s h i k a k a y a ( s o a p n u t ) powder o r shampoo o n c e i n a week. The

g i r l s had a head b a t h on e v e r y F r i d a y o r T u e s d a y . The g i r l s

i n some of t h e f a m i l i e s had head b a t h o n c e i n f o r t n i g h t a s

I I I I l i -1 I I I C I I C l O I I U I U I l i l l I I ' l l ir I 1 4 1 m I 1 . 3 1 a I I < 1 I I U I I I I I 14 1 I I ~ I L . I I U I m I l 0 l Q 1 I F i I E I I 1 3 1 I 1 2 I I I I I I I I I I U11 I I h i I I c m i I 1 " U I I I I I I m a 1 c I ~ u m i

m I r l C h 1 b l u l o r l u I ~ I U I 4 I U I I i l l I .c I W I I u 1 0 1 I

I I 0 I I X I U I 5 ~ u l m I

3 I C l C I U1 I W I i l h l

1 3 1 m q 1 01 I C r l J J U l .c l a 1 4 1 IJ I i l I U I

l k l I @ I I I C l I I 0 1 1 I E l l I m I I > , I

I 13 1 I: 1 1 4 I U I 1 1 0 1 m I t o I I) I I

I I 'U 1 2( I 0 I r l I

I ri I Zi 1 c - I u I U f f l I C l l i I m om I 3 1 r O l I

I I U h I L. I W C I h I 0 . d I

1 - I * 1 0 I

N 1 0 1 I 1 4 I

L9 I I I I

bl I I I I

I

6 I I

t h e i r m o t h e r s were t o o busy t o g i v e them head b a t h . The g i r l s

a p p l y t u r m e r i c powder t o t h e i r f a c e s and l e g s w h i l e t a k i n g

b a t h .

I t is a p r a c t i c e among t h e s lum d u e l l e r s t o use

t h e above i n g r e d i e n t s t o t h e i r c h i l d r e n . Muthayya , B.C.

( 1 9 7 2 ) f i n d s t h a t p r a c t i c e o f u s i n g d e t e r g e n t s o a p f o r head

b a t h i s q u i t e common i n low c l a s s f a m i l i e s .

I t is a p r a c t i c e among t h e s l u ~ n f a m i l i e s t o mass-

a g e i n f a n t s w i t h a l i t t l e t u r m e r i c powder mixed w i t h c o c o n u t

o i l and then g i v e h o t w a t e r b a t h . T u r m e r i c powder i s

s u p p o s e d t o h a v e t h e q u a l i t y o f removing s u p e r f l o u s h a i r on

t h e f a c e and u n d e r t h e arm p i t s of i n f a n t s . T h e f l o u r i s

i n t e n d e d t o k e e p t h e s k i n s ~ ~ ~ o o i l l , w h i l e t h e u s e o f s o a p is

s u p p o s e d t o c h a p t h e t e n d e r s k i n of i n f a n t s . Use of gram

f l o u r and o i l t o r i n f a n t s ba th t i l l 1 2 t h month a l o n y w i t h

s o a p i s p r e v a l e n t i n t h e s e f a m i l i e s .

Habit T r a i n i n g

The \uotI iers b e g i n t o t r a i n t h e i r c l ~ i l d r e r i irl

b l a d d e r and bowel c o n t r o l . The i l l i t e r a t e women t r a i n t h e

i n f a n t s t o do i t t h e m s e l v e s n a t u r a l l y . I l ~ e l i indu c u l t u r e

a t t a c h e s a g r e a t s t i g m a t o t h i s n a t u r a l phenomenon and o f t e n

we come a c r o s s m o t h e r s who p r o u d l y announce t i le c o m p l e t i o n

of bowel t r a i n i n g of t h e i r i n f a n t s a t v e r y e a r l y a g e . T h e r e

a r e a l s o c u l t u r a l v a r i a t i o n s i n t h e t r a i n i n g . The t o i l e t

t r a i n i n g s h o u l d be smooth and t a k e i n t o c o n s i d e r a t i o n t h e

d e v e l o p m e n t o f bowel and b l a d d e r c o n t r o l i n t l i e c l i i l d . On

I 1 1 I U I I C I K l ol l 0 l U 1 1 - 1 1 I V l ir I d l o I .ri I a 1 . C I U I I I 141 I 6 I i ! l U l 0 1 0 1 4 / " / , " I I Z I I I I I 0 1 I 1 w 1 I 1 3 1 I 1 4 1 1 1 0 1 1 l i r l I I U I I I C I 1 1 0 1 I I U I I I l l I C I C I 1 0 1 0 1 11-1121 l V l I 131 I d 1 1 x 1 I U I I 1 1 W I I 0 1 I I l l I I T 1 I . I U I 1 0 13 1 [ Z l - 1 1

1 0 1 I l i r l I I U I I I C I I 1 0 1

1 l V / I I I rg I d l i I G - I um

h I a m 1 c m

I I W C I 0 . d I - l a I m I a

t h e c o n t r a r y i f na t r a i n i n g is g i v e n a b o u t t o i l e t , t h e c h i l d

w i l l n o t be i n a p o s i t i o n t o u n d e r s t a n d t h e h y g i e n i c

p r i n c i p l e s o f d e f e c a t i o n and u r i n a t i o n .

Prom t h e t a b l e 5 .4 i t is d i s c e r n a b l e t h a t

i r r e s p e c t i v e of economic and sexual . d i s c r i m i n a t i o n , s lum

c h i l d r e n d e v e l o p e d s i g n i f i c a n t c o n t r a 1 o v e r bowel and

b l a d d e r a t t h e a g e of 2 t o 3 y e a r s . I n t h e p r e s e n t s t u d y i t

is i n t e r e s t i n g t o n o t e t h a t p a r e n t s ' a t t e n t i o n a n d t r a i n i n g

f o r c h i l d r e n t o a t t e n d t h e n a t u r e c a l l is v e r y

i n s i g n i f i c a n t . Only 40 c h i l d r e n i n t h e p r e s e n t s t u d y c o u l d

n o t d e v e l o p c o n t r o l o v e r bowel and b l a d d e r even a t t h e a q e

of f o u r .

I t i s o b s e r v e d t h a t t h e upper c a s t e f a m i l i e s gave

t o i l e t t r a i n i n g t o t h e i r c h i l d r e n a t l e a s t b e f o r e c o m p l e t i o n

of s e c o n d y e a r w h i l e working m o t h e r s and i l l i t e r a t e p a r e n t s

d o n o t i m p a r t s u c h t r a i n i n g . I n t h e p r e s e n t s u r v e y 6 t o 1 2

months t r a i n i n g was r e q u i r e d t o a t t a i n c o n t r o l o v e r bowel

and b l a d d e r amonq 195 c h i l d r e n . o n l y 15 c i ~ i i d r e r ~ cnri d e v e l o p

t h i s c o n t r o l w i t h i n 4-6 months ( T a b l e 5 . 5 )

T a b l e 5 .5 . Time t a k e n t o t r a i n t h e c h i l d r e n t o bowel and b l a d d e r .

S 1 . T r a i n i n g p e r i o d ~ o . o f C h i l d r e n No. ( i n months ) .................................

Female Male T o t a l P e r c e n t

1. 4 - 6 a 7 15 6.00 2 . 6 - 0 30 20 5 0 20.00 3 . 6 - 1 0 20 2 5 4 5 18.00 4 . 1 0 - 1 2 2 7 2 3 50 20 .OO 5 . 1 2 and above 20 30 50 20 .OO 6 . S t i l l c o n t i n u i n g 13 27 40 16.00

T o t a l 1 1 8 132 250 100.00

I t was no ted t h a t t h e y do n o t have i n - b u i l t

l a t r i n e f a c i l i t i e s n o r p u b l i c l a v a t o r i e s . The c h i l d r e n and

t h e a d u l t s i n t h e slum have t o g o t o n e a r b y f i l t h y open

s p a c e f o r d e f e c a t i o n . U s u a l l y , t h e c h i l d r e n d e f e c a t e on t h e

sewage c a n a l o r i n t h e open s p a c e . ~ n t h e p r e s e n t s t u d y i t

was r e c o r d e d t h a t 55 c h i l d r e n o p t e d sewage c a n a l f o r

d e f e c a t i o n whereas t h e r e m a i n i n g 195 c h i l d r e n i n slum i n

v a r i a b l y use apen s p a c e .

B l a d d e r c o n t r o l d u r i n g day t i m e i s g a i n e d e a r l y i n

t h e f i r s t y e a r b u t some c h i l d r e n c o u l d n o t c o n t r o l t h e i r

b l a d d e r movements a t n i g h t t i l l 4 o r 5 y e a r s of a g e . The

i l l i t e r a t e mothers c o u l d no t i n c u l c a t e t h e h a b i t o t

c o n t r o l l i n g t h e b l a d d e r movements i n t h e i r c h i l d r e n . I t is

a t t r i b u t e d t o t h e i n f l u e n c e s o f e n v i r o n m e n t , s o c i o - e c o n o ~ n i c

c o n d i t i o n s , t o i l e t t r a i n i n g p r a c t i c e s a n d c u l t u r a l

v a r i a t i o n s .

I t is o b s e r v e d t h a t a icw m o t h e r s a r e n o t !n~ucl~

c o n c e r n e d a b o u t e a r l y t o i l e t t r a i n i n g and a f ~ w mothers

s c o l d and p u n i s h ti~elri and e x p l a i n f o r b e t t e r m e n t . I t i s an

e y e s o r e o b s e r v a t i o n t h a t a t l e a s t h a l f - a - d o z e n c h i l d r e n of

d i f f e r e n t a g e s s q u a t t e r i n g on t h e s i d e of t h e d r a i n a g e c a n a l

o r open s p a c e f o r d e f e c a t i o n a t a n y t i m e o f t h e d a y . U s u a l l y ,

t h e c h i l d r e n d e f e c a t e and u r i n a t e i n t h e i r h o u s e s t i l l t h e

a g e o f 3 y e a r s and from t h e n onwards i m i t a t e t h e h a b i t of

d e f e c a t i o n on t h e s i d e of t h e d r a i n a g e o r i n t h e open s p a c e

l i k e o t h e r grown-up c h i l d r e n . S e l f c l e a n i n g a f t e r d e f e c a t i o n

is n o t l e a r n t t i l l . t h e a g e of 5 y e a r s . T i l l t h e n e i t h e r t h e

m o t h e r o r o l d e r women o r e l d e r s i b l i n g a t t e n d t h e baby f o r

c l e a n i n g a f t e r d e f e c a t i o n .

S l e e p i n g A r r a n g e m e n t s

The t r a n s i t i o n from i n f a n c y t o e a r l y c h i l d h o o d is

marked by s e v e r a l c h a n g e s i n t h e t r e a t m e n t 01 t h e c h i l d , t h e

most i m p o r t a n t o f which a r e weaning and a c h a n g e i n s l e e p i n g

a r r a n g e m e n t s . Dur ing i n f a n c y t h e c h i l d s l e e p s i n t h e same

bed w i t h i t s p a r e n t s o r more r a r e l y i n a c r a d l e n e x t t o i t s

p a r e n t s ' bed . I n t h e e a r l y c h i l d h o o d , t h e c h i l d s l e e p s a l o n g

w i t h g r a n d m o t h e r o r e l d e r s i b l i n g s . I h e t h i r d i m p o r t a n t

c h a n g e i s t h a t t h e c a r e o i t h e i n f a n t which h a s been

p r i m a r i l y i n the hands of t h e mother is t r a n s f e r r e d t o o l d e r

s i b l i n g s o r c o u s i n s . From t h i s t i m e onwards bo th t h e l i t t l e

boys and g i r l s a r e c l o s e r t o t h e i r g r a n d rnotliers a n d o l d e r

s i b l i n g s t h a n t h e i r m o t h e r s .

I n t h e s l u m , 244 c h i l d r e n ( 9 7 . 6 ' , ) Iind t l i e c l o t l i

c r a d l e a s t h e i r s l e e p i n g a r r a n g e m e n t a t i11ia11L s t a g e . 'Yhis

i s i n c o r r e l a t i o n w i t h tlje a v a i l a b i l i t y s p a c e i n t h e l tu t .

T h i s c l o t h c r a d l e i s made up of o l d s a r e e o r b l a n k e t t i e d t o

a n i r o n - r o d o r a wooden r a f t e r i n t h e h u t w h e r e a s c a n e -

c r a d l e u s e d f o r 6 c h i l d r e n ( 2 . 4 % ) i n t h e p r e s e n t s t u d y is

n o t o n l y c o s t l y b u t a i s o n o t a c c e p t a b l e i n s m a l l h u t s which

r e f l e c t s t h e economic c o n d i t i o n s . blore o v e r c l o t h c r a d l e h a s

a n o t h e r a d v a n t a g e . The c h i l d r e n , a c c o r d i n g t o t h e i r m o t h e r s ,

f e e l s a f e t y and c o m f o r t i n i t .

T a b l e 5.6. D i s t r i b u t i o n o f age of t h e c h i l d r e n s l e e p i n g i n t h e c r a d l e .

91. Age o f t h e No.of c h i l d r e n No. c h i l d r e n

( i n y e a r s ) r l i t hou t c r a d l e w i t h c r a d l e ----------------- 1. one 24 15 2 . Two 70 8 3. Three 113 10 4 . Four 10

T o t a l 217 33

With r e g a r d t o t h e d u r a t i o n of c r a d l e s l e e p

a r r a n g e m e n t , 113 c h i l d r e n a r e w i thou t c r a d l e f o r s l e e p .

Though most Of t h e mothers p r e f e r t h e i r c h i l d r e n Lo o f f e r

c r a d l e s l e e p t o e n a b l e them t o a t t e n d o t h e r d o m e s t i c work,

i t c o u l d not be p o s s i b l e t o c o n f i n e t h e c h i l d t o c r a d l e a s

t h e a g e advances

T a b l e 5.7. R e l a t i o n s h i p o f t h e Companions o i t h e s l u m c h l l d r e n a t bed

S 1 . Companion r e l a t i o n s h i p No.of c h i l d r e n No. w i th c h i l d ...........................

Number Per c e n t ............................................................

1. Mother 75 30 .00

2 . Fa the r 16 6.40

3 . s i b l i n g s 1 4 7 5 8 . 8 0

4 . O t h e r s 8 3 .20

5 . Without companion 4 1.60

T o t a l 250 100 .OO

M a j o r i t y o f c h i l d r e n ( 5 8 . 8 0 % ) s l e e p t o g e t h e r w i t h

t h e i r s i b l i n g s and 30 .00% o f t h e c h i l d r e n s l e e p w i t h t h e i r

m o t h e r s . Very few c h i l d r e n ( l . G O % ) s l e e p w i t h t h e i r f a t h e r s

o r o t h e r s o r w i t h o u t companion a s t h e l i v i n g s p a c e i s v e r y

l i m i t e d t o Only one rooirl ( T a b l e 5 . 7 ) . I n summer p a r e n t s

a l o n g w i t h c h i l d r e n s l e e p i n open s p a c e s u r r o u n d i n g t h e i r

h o u s e .

The c h i l d r e n g o t o bed a t d i f f e r e n t t i m i n g s . The

i n f a n t s a n d y o u n g e r c h i l d r e n g o t o bed e v e n b e f o r e 8 p.m.

The e l d e r c h i l d r e n s l e e p a t i r r e g u l a r t i m i n g s . The f o l l o w i n g

t a b l e shows t h e d i s t r i b u t i o n t i m i n g s o f t h e c h i l d r e n g o i n g

t o b e d .

T a b l e 5.8. Time s c h e d u l e of t h e c h i l d r e n f o r g o i n g t o b e d .

Sl. Time s c h e d u l e Nn.of c h i l d r e n No. ( i n h o u r s ) --------.--.--.----.-------

P . M . Number Per c e n t

1. 6 - 7

2 . 7 - 8

3. 8 - 9

4. A f t e r 9

T o t a l 250 1 0 0 . 0 0 ............................................................

With r e g a r d t o t h e t i m e s c h e d u l e f o r s l e e p i n g 8-9

p.m. i s optimum t i m e f o r m a j o r i t y o f t h e c h i l d r e n 149.29, ) .

T a b l e 5 .8 c l e a r l y i n d i c a t e s t h e d i f l e r e n t t i m e s c h e d u l e s t o

g o t o b e d . The y o u n g e r c h i l d r e n g o t o bed e a r l y and tile

c h i l d r e n below t e n y e a r s go t o bed between 8-9 p.m. a s t h e i r

a t t e n t i o n i s drawn by ~ e l e v i s i o n programmes o r household

d u t i e s . The c h i l d r e n i n t h e age of 10-14 y e a r s s t a r t

s l e e p i n g a f t e r 9 p.m. a s they spend t ime wi th f r i e n d s o r go

t o movies. c h i l d r e n below 3 yea r s of age s l e e p even dur ing

day t i m e . A few c h i l d r e n do not mainta in r e g u l a r t ime f o r

s l e e p i n g . The fo l lowing t a b l e shows t h e d i s t r i b u t i o n o f

c h i l d r e n g e t t i n g up from bed.

T a b l e 5.9. Time a t r i s i n g from bed by s l u m c h i l d r e n .

......................................................... 31. Time schedu le No.of c l i i l d ren No. ( i n h o u r s ) ...........................

A . M . Number Per cent --------------------------.--.---------------------------

3 . Afte r 'I 7 0 28.00

The above t a b l e c l e a r l y shows t h a t m a j o r i t y of

c h i l d r e n (68 .00%) g e t up between 6-7 am i n t h e morning and

28.00% of t h e c h i l d r e n ge t u p a f t e r 7 am. Tlie i n f a n t s and

t h e young c h i l d r e n g e t up e a r l y i n t h e morning.

D e n t i t i o n

The lower i n c i s o r s began t o form a t t h e age o f S i x

months. I n most of t h e c a s e s , t h e t e e t h fo rma t ion began

between 9 and 12 months of age o r even a l i t t l e l a t e r . Ttle for

f o l l o w i n g t a b l e i n d i c a t e s t h e d i s t r i b u t i o n of s g e ' e r u p t i o r ~

o f t e e t h among t h e c h i l d r e n .

Table 5.10. Age a t t e e t h fo rma t ion anloilg s lom c t ~ i l d r e n .

-------------------------------.--.-------------------------

$1 . Age of t h e N O . ~ £ c h i l d r e n No. c h i l d ...........................

( i n months) Number Per c e n t ............................................................

I . 7 - 8

2 . 8 - 9

3 . 9 - 10

4. 10 - 11 5 . 11 - 1 2

6 . More t h a n 1 2

7 . No r e sponse 18 7.20

T o t a l 250 100.00

Teeth fo rma t ion took p l a c e i n 91 c h i l d r e n a t t h e

age o f 11-12 months and t h e t e e t h f o r m a t i o n t ook p l a c e from

7 t h t o more t han 12 months of age f o r slum c h i l d r e n

( T a b l e 5 . 1 0 ) .

Some of t h e women informed Lhat t h e i r c l ~ i l d r e n

s u f f e r e d from i l l - h e a l t h o r t o o t h a c h e d u r i n g t h e t e e t h

forming p e r i o d a p a r t from d i a r r h o e a , v o m i t i n g , f e v e r and

cough d u r i n g t h i s p e r i o d , and i t c o u l d n o t be p o s s i b l e t o

a r r i v e a t any c o n c l u s i o n .

Care of t h e Teeth

The slum people c l ean t h e i r t e e t h w i t h t h e i r

second f i n g e r ( coun t ing from thumb) o r us ing t h e thumb too

a t t i m e s . Mother began t o c l e a n s e t h e t e e i h of t h e i r

c n i l d r e n soon a f t e r t h e e r u p t i o n of t h e i r f i r s t two t e e t h ,

and cont inued t o c l e a n s e t h e c h i l d r e n s ' t e e t h t i l l they were

a b l e t o c l e a n s e t h e t e e t h by themselves . Chi ldren i n t h e s e

f a m i l i e s were al lowed t o e a t or d r i n k wi thout c l e a n i n g t h e i r

t e e t h i n t h e morning. Usually t h e mothers s t a r t washing

t h e i r c h i l d r e n s ' t e e t h a t t h e age of 2 or 3 y e a r s . But t h e

c h i l d r e n s t a r t washing t h e l r t e e t h by themselves a t t h e age

of 3 y e a r s .

Tab le 5.11. Teeth c l e a n i n g among s l u m c h i l d r e n .

------------------------------------.--.--.-..-------..-----

N O . ~ £ c h i l d r e n S 1 . R g e in years ........................................ No. Female Elale T o t a l Per cen t

1. 2 - 2 1 / 2

2 , 2 1 / 2 - 3

3 . 3 Years and above

4 . Did not c l ean ing

- T o t a l

The above t a b l e c l e a r l y shows t h a t t h e c h i l d r e n of

2 t t o 3 yea r s age group a r e a t t h e helm of l e a r n i n g tile

t e e t h c l ean ing h a b i t . Except f o r 23 c h i l d r e n i l l t h e presell t

s u r v e y , c h i l d r e n do c l ean t h e i r t e e t h aL 60111e aye o r tile

o t h e r .

G r a d u a l l y , c h i l d r e n l e a r n t o c l e a n s e t h e i r t e e t h

i n d e p e n d e n t l y a f t e r t h e t h i r d y e a r . The f o l l o w i n g t a b l e

shows t h e d i s t r i b u t i o n of c h i l d r e n vho began t o c l e a n t h e i r

t e e t h by t h e m s e l v e s .

T a b l e 5.12. S e l f t e e t h c l e a n i n g p a t t e r n by s lum c h i l d r e n i n r e l a t i o n t o a q e .

hge g r o u p of No .n f c h i l d r e n S l . c h i l d r e n -----------------------.----------------

No. ( i n y e a r s ) Female 1.1 a 1 e T o t a l P e r c e n t

1. Below 2 1/2

2 . 2 1/2 - 3

3. 3 - 3 1 1 2

4 . 3 1 / 2 - 4

5 . 4 and above

6 . Depends on mother

7 . Not c l e a n i n g

T o t a l

The above t a b l e shows t h a t o u t o i 118 f e m a l e

c h i l d r e n , 99 c h i l d r e n c l e a n t h e i r t e e t h a t t h e a g e of 3-4

y e a r s and 9 c h i l d r e n d o no t c l e a n t h e i r t e e t h . o u t o f 132

male c h i l d r e n , 104 c h i l d r e n s t a r t c l e a n i n g t h e i r t e e t h a t

t h e a g e of 3-4 y e a r s and 14 c h i l d r e n d o no t c l e a n t h e i r

t e e t h .

The nla jor i ty of t h e c h i l d r e n ( 8 1 . 2 0 ) p e r cen t c l ean

t h e i r t e e t h by themselves a t t h e age of 3-4 y e a r s . The

younger s i b l i n g s i m i t a t e t h e i r e l d e r s i b l i n g s i n c l e a n s i n g

t h e i r t e e t h . B u t t h e m o t h e r ' s c a r e t o t r a i n t h e i r c h i l d r e n

i n this regard is very i n s i g n i f i c a n t .

A number of c l ean ing agen t s a r e used t o c l e a n t h e

t e e t h of t h e c h i l d r e n i n t h e s l u m . The t a b l e 5.13 shows t h e

t y p e s of c l ean ing a g e n t s used by c h i l d r e n i n t h e s lum. Cow-

dung ash is being used a s a c l ean ing agent by 120 c h i l d r e n

i n t h e p resen t s t u d y .

Table 5.13. Type of c l ean ing agent used by c h i l d r e n

............................................................ N O . ~ £ c h i l d r e n

S 1 . Type o f A g e n t ........................................ N O . Female rlale ' rota1 Per cent

1. Cow dung ash 64 5 6 110 48 .OO

2 . Tooth powder 30 36 66 26.40

3 . Tooth p a s t e 15 ? 6 4 1 16.40

4. Did not use 9 1 4 7 3 9.20

T o t a l 118 132 250 100.00 ----------------------------------------.-------------------

Major i ty of t h e c h i l d r e n (48.00%) use cow-dung ash

a s c l e a n s i n g a g e n t . Among 42.80 per cen t of t h e c h i l d r e n

us ing too th powder o r p a s t e , t h e male c h i l d r e n ou t number

t h e female c h i l d r e n and t h i s shows t h e d i s c r i m i n a t i o n

towards t h e female c h i l d r e n . Mothers say t h a t t h e female

c h i l d r e n b d j u s t t o t h e budgets . U s ~ a l l y t h e male c h i l d r e n

d o m i n a t e i n t h e f a m i l y . They d o n o t a d j u s t . E l d e r women i n

t h e f a m i l y ( g r a n d m o t h e r s & f a t h e r s ) s u p p o r t e d t h e male

c h i l d r e n .

I t i s o b s e r v e d t h a t most of t h e s lum d w e l l e r s u s e

o n l y f i n g e r method t o c l e a n t h e l r t e e t h d u e t o l a c k of

money. A few p a r e n t s u s e t o o t h b r u s h . G e n e r a l l y t h e y a r e

v e r y poor and s p e n d t h e i r income o n l y on b a s i c n e e d s i . e . ,

food a n d s h e l t e r .

T a b l e 5.14. Methods used f o r c l e a n i n g t h e i r t e e t h

T e e t h c l e a n i n g No.of c h i l d r e n S l . method by ...................................... NO. Female i.1 a 1 e T o t a l P c r c e n t ............................................................

1. F i n g e r 84 63 1 4 7 58.80

2 . Tooth b r u s h 2 5 5 5 80 32.00

3. No c l e a n i n g 9 14 2 3 9.20

----.----------------------------------

T o t a l 118 1 3 2 250 1OO.UO

Tooth b r u s h i n g i s l l m i t e d t o 80 c h i l d r e n i n t h e

p r e s e n t s t u d y and t r a d i t i u n a l melhod is s t i l l p r e v a l e n t

among 147 c h i l d r e n ( T a b l e 5 . 1 4 ) . Twenty t h r e e c h i l d r e n who

a r e below 2 y e a r s a g e g r o u p have n o t d e v e l o p e d t h e t e e t h

c l e a n i n g h a b i t .

Walking

C h i l d r e n b e g i n t o s t a n d u p r i g h t and w a l k w i t h

o t h e r s s u p p o r t from 9 t h month. I t i s a p r a c t i c e t o t e a c h

c h i l d r e n t o walk w i t h t h e a i d of a w ~ o d e n c a r t , p l a y t h i n g

and g r a d u a l l y c h i d r e n l e a r n t o walk u n a i d e d . Some c h i l d r e n

may b e g i n t o walk a t t h e a g e o f 9 months and some o t h e r s may

d o s o a f t e r t h e second o r t h e t h i r d y e a r . The f o l l o w i n g

t a b l e i n d i c a t e s f i r s t s t e p s of t h e c h i l d d u r i n q i t s l i f e .

T a b l e 5.15. Walking s t a g e among s l u m c h i l d r e n .

S 1 . Age a t w a l k i n g No.of c h i l d r e n No, s t a g e .............................

( i n months) Number Per c e n t -----------------------------.--------.---.-------------.---

1 4 below

1 4 - 1.6

1 6 - 18

1 8 - 20

20 - 22

2 2 - 2 4

24 above

I n f a n t s

T o t a l 250 1 0 0 . 0 0

The t a b l e 5 .15 i n d i c a t e s t h a t most o f t h e c h i l d r e n

( 3 8 . 8 0 % ) s t a r t w a l k i n g a t t h e a g e between 20 t o 24 months ,

37 .60% of t h e c h i l d r e n s t a r t w a l k i n g a t t i l e a g e between 1 4

to 20 months. Majority of the children start walking at the

age of 20 to 24 months. The physical development in children

due to malnutrition or under-nutrition lead to late walking

in some of the poor families as is evident iron, the above

table.

Talking

Children begin to talk a tew words like " A a i "

(mummy) and Baba (Daddy) by the time they are about 12

months old while the others may begin to talk after two or

three or four years. Gradually, they begin to learn more

words on hearing conversation that goes on around them.

Table 5.16. Talking stage among slum children

Age at talking stage (in years)

Total

No.af children .......................... Number Per cent

The above table indicates that majority of

children(83.20%) start talking a few words at tile age of 2 to

3 years, 16 ( 6 . 40%) children began to talk at the age of 3

to 4 years and 19 (7.60%) children still do not talk because

16 chidren are below 1 1/2 years age and 3 children are

dumb. one of them is dumb since his birth, while 2 children

became dumb after serious illness due to polio and measles,

t'wo began to talk 3 1/2 - 4 years because the children were

premature babies and they are physically and mentally

disproportionate. The children growing slcwly began to talk

late.

Immunization

Immunization aqainst small p o x , diphtheria, and

tetanus, :hooping cough, typhoid tuberculosis is provided

to the children below six years of age. immunization against

polio~nyelitis, measles, is given at the age of 6-12 months.

Usually, the children are vaccinated against

infectious diseases between 3rd and 12th rnonti~s. Fornlerly,

people used to avoid or delay in getting their children

vaccinated. with the spread of education and w i t l i t h e

compulsion of health department of the Municipal

corporation, and Rayalaseema Seva Samithi i R A S S 1 , people get

their children vaccinated at an early age. The doctors and

referral services visited these centres to vaccinate the

children on the fixed days in a week.

Table 5.17. V a c c i n a t i o n s c h e d u l e among t h e slum c h i l d r e n .

........................................................... 31 . Age o f t h e c h i l d N O . ~ £ c h i l d r e n N O . ( i n months ) ............................

Number P e r c e n t ...........................................................

Below one month

1 - 3

3 - 5

5 - 7

7 - 9

9 - 11

11 months a f t e r

Only o n e d o s e

9. No b e l i e f 9 2 36.80

1 0 . No V a c c i n a t i o n 10 4.00

T o t a l 250 100 .00

The t a b l e 5.17 c l e a r l y i n d i c a t e s t h a t o u t o f t h e

m a j o r i t y of t h e c h i l d r e n 9 2 ( 3 6 . 8 0 8 ) a r e n e i l h e r vnccinaLed

n o r immunized due t o i g n o r a n c e and p r e j u d i c e s of t h e

p a r e n t s . 70 ( 2 8 . 0 0 % ) c h i l d r e n immunized a t t h e a g e 9-11

months , 26 ( 1 0 . 4 0 % ) c h i l d r e n immunized a f t e r 11 n~al l t i l s a g e ,

and 42 ( 1 6 . 8 0 % ) c h i l d r e n a r e immunized a t t h e a g e of 9

months and t h e r emain ing 1 0 ( 4 . 0 0 3 ) c h i l d r e n a r e immunized w i t h

o n l y o n e d o s e .

Only a few f a m i l i e s g o t t h e i r c h i l d r e n i n l e c t e d

w i t h t r i p l e a n t i g e n v a c c i n e a s a p r e v e n t i v e measure a g a i n s t

whooping cough and t e t a n u s . F i f t y six p e r c e n t o f t h e

children in the slum are immunized against diseases like

B.C.G., Polio, D.P.T. and measles. The majority of children

have received immunization from health check up and referral

services. Some of the children have received imniunization

through Government hospitals. Inlmunization of all children

below six years and immunization against tetanus to all the

expectant mothers is given by the Integreated Child

Development Services ( ICDS) project.

Dabi, D.R., Sinha, R.N. and Gupta, B.D. (1983)

reported that reduction in family size and increased

awareness on immunization may lead to improving the socio-

economic status of the community. Vilaya, N. et a1 (1976) - - revealed that the educational status of the parents is

positively correlated to the overall immunization status of

children. The better economic and educational status of

mothers lead to increased acceptance of all immunizations.

Major Illness

The major diseases suifered by the cllildren were

whooping cough, measles, chicken-pox, polio and jaundice. 48

children suffered from measles, 50 from chicken-pox, 1 from

Gajulamma, 3 from Nukalamma, 7 Tattamma, 12 from At.al.atalnma,

1 frorn Gowadalamma, 3 from Agniamma, 3 from polio, 2 from

janudice, 10 from Sandulu (vomitings and diarrhoea), 10

from fever, 4 from whooping cough, 2 from Madamur 2 from

Pakshidosam (low birth weight) and 5 from Kurupulu.

some o f t h e o t h e r common i l l - h e a l t h and d i s e a s e s

a n d t h e way of c u r i n g t h e d i s e a s e s a r e g i v e n h e r e u n d e r .

U m b i l i c a l S e p s i s

Among t h e new born b a b i e s t h e commonest i n f e c t i o n

was u m b i l i c a l s e p s i s . U s u a l l y , i t f a l l s o f f between 5 t h and

7 t h d a y a f t e r b i r t h and i f th is p r o c e s s i s d e l a y e d , t h e

women i n t h e household a p p l y a p a s t e o f t u r m e r i c powder and

c a s t o r o r c o c o n u t o i l . The way t h e y a p p l y u s u a l l y d i s l o d g e s

t h e u m b i l i c a l s tump l e a v i n g somet imes a rough a r e a , o r

b l e e d i n g s u r f a c e . To t h i s t h e y u s u a l l y a p p l y t u r m e r i c

powder. They do n o t c o n s i d e r t h i s a s a s e r i o u s d i s e a s e . The

mother b e l i e v e s t h a t u n l e s s t h e baby i s g i v e n b a t h on

a l t e r n a t e d a y s , u m b i l i c a l c o r d d o e s n o t f a l l . Tha t is why

t h e baby is b a t h e d on a l t e r n a t e d a y s even b e l o r e t h e r i t u a l s

( b o t h on 1 1 t h day1 a r e c o m p l e t e d .

C o n s t a n t Cry

The c h i l d r e n d u r i n g t h e i r e a r l y i n f a n c y a t one

t i m e or o t h e r must have t r o u b l e d t h e i r n lo thers w i t h c o n s t a n t

c r y . But p e c u l i a r l y t h e c a u s e o f t h i s c r y is t r e a t e d i n

v a r i o u s ways i n t h e s l u m . They b e l i e v e i n f o l k t h e r a p y . They

a t t r i b u t e t h e c r y t o v a r i o u s d i s e a s e s and t r e a t t h e c h i l d

w i t h f o l k m e d i c i n e s .

i) E v i l Eye

c o n s t a n t c r y is a t t r i b u t e d t o e v i l e y e ( D i s t i ) and

t o ward o f f t h e e f f e c t s o l e v i l eye v a r i o u s n ~ c t l ~ o d s a r e

adop ted . A f t e r applying t h e b lack do t ( b o t t u ) on t h e

f o r e h e a d , ch in o r t h e cheek t o a v e r t e v i l eye , a b lack

t h r e a d ( n a l l a t a d u ) o r a s t r i n g of b lack beads ( n a l l a

p u s a l u ) t o t h e w r i s t and t h e wa i s t a r e worn t o a v e r t t h e

e v i l eye . A t h r e a d made of human h a i r or d e e r h a i r i s worn

t o t h e a n k l e s t o a v e r t t h e e v i l eve.

I t i s not only t o cure i l l n e s s o f c h i l d r e n but

a l s o p reven t i t a s we l l . I f t h e c h i l d was very good look ing ,

i t s mother f e l t t h a t someone i n t h e neighbourhood might have

an e v i l eye on i t and t h i s might r e s u l t i n t h e c h i l d

becoming i l l . To avoid t h e i l l e f f e c t of t h e e v i l eyes ,

some women p r a c t i s e t h e i n c a n t a t i o n s I d i s t i ) d a i l y i n t h e

evening. The mother t a k e mustard s e e d s , red c h i l l i e s , and a

p inch o t s a l t . Sonle t i r~~es a mother t d k e s broom s t i c k s , boda

( w i l d g r a s s ) , human h a i r , red c l a y , i n her tvo hands and

then waves her hands round t h e f ace of tlle c h i l d t o t h e

accompaniment of some d i s t i (magic i o r m ~ ~ l a - I t means "may

t h e e v i l eye go may t h e e v i l go , may t h e e v i l 01' t h e p a s s e r s

by, of a bad nlan, of a s i n n e r , of any o t h e r no i n t o t h e

f i r e " . ) and they throw t h e s e t h i n g s i n t o f i r e . I t i s a

b e l i e f t h a t i f t h e c h i l d i s taken possess ion by e v i l eyes ,

t h e s e mustard seeds and o t h e r t h i n g s , when they a r e thrown

i n t o t h e f i r e , w i l l emit bad s m e l l , not o the rwise . I t is

informed t h a t 85 per cent of t h e f a m i l i e s p r a c t i s e " d i s t i "

t o ward o f f e v i l eyes , and t h e remaining do not p r a c t i s e

" d i s t i " , because they do not b e l i e v e .

ii) Abdominal P a i n s

T h i s i s common among t h e new b o r n c h i l d r e n t i l l

one y e a r o l d . T i l l t h e c h i l d i s a b l e t o e x p r e s s t h e c a u s e o f

p a i n , t h e p a r e n t s a t t r i b u t e t h e c h i l d ' s c r y t o a b d o m i n a l

p a i n s . To p r e v e n t abdamina l p a i n d u e t o c o n s t i p a t i o n , t h e y

g i v e c a s t o r o i l mixed w i t h m a t h e r ' s m i l k v i z . , "vuggu" d a i l y

i n t h e e v e n i n g and a l o c a l m i x t u r e v i z . , "karam" f o r

i n d i g e s t i o n i n t h e morn ing . S o ~ l ~ e t l n ~ e s r Lhe b e t e l l e a v e s a r e

h e a t e d a n d a p p l i e d on t h e abdomen.

c r y i s a t h i n g which a t t r a c t s e v e r y b o d y ' s

a t t e n t i o n and a l l t h e f a m i l y members, e l d e r s and n e i g h b o u t s

t r y t o c o n s o l e t h e baby by r o c k i n g , p u t t i n g on t h e

s h o u l d e r s and r o c k i n g i n a c r a d l e . G r i p e w a t e r was used

r e g u l a r l y t o p r e v e n t abdomen o r c o l i c p a i n s .

i i i ) C o n s t i p a t i o n

The baby p a s s e s s 2-3 m o t i o n s i n a d a y . I f i t f o i l s

t o p a s s m o t i o n , j u s t f o r 20 l ~ o u r s i t d r a w s t h e i r a t t e n t i o n .

R e g u l a r p u r g a t i o n p r a c t i c e s w i t h c a s t o r o i l , d r i n k i n g h o t

w a t e r a n d u s e of " m i l k o f I . l agnes ia ' a r e r c p o r t c d t o a v o i d

c o n s t i p a t i o n and a visit t o h o s p i t a l i n a l a s t r e s o r t i n

t h i s r e g a r d .

p a i n i n t h e e a r s is s u p p o s e d t o be a n o t h e r c a u s e

of c o n s t a n t c r y of t h e c h i l d . U s u a l l y t h e q a r l i c p a s t e

h e a t e d i n c a s t o r o i l and sonletimes j u i c e s q u e e z e d l roln t h e

l e a v e s o f Oscimum z. ( t u l a s i aku p a s u r u ) a r e used a s e a r

d r o p s .

i v ) Dia r rhoea

Frequency o f motions i s ano the r th ing t h a t i s

common among t h e c h i l d r e n . Usual ly i t does not draw t h e

a t t e n t i o n of t h e f ami ly members a s t h a t of c o n s t i p a t i o n . The

baby i s allowed w i t h d i a r r h o e a t i l l a day o r two i n

a n t i c i p a t i o n of n a t u r a l c o n t r o l f a i l i n g which "vamu' o r

' r a sam" i s given t o t h e baby. I f i t does not c o n t r o l i t s e l f

and becomes s e r i o u s then t h e p a r e n t s t a k e t h e c h i l d t o t h e

d o c t o r .

V ) Vomiting

Contrary t o t h e r e a c t i o n when t h e r e is incidence

of d i a r r h o e a , vomit ings make t h e e n t i r e household a l e r t .

Even normal r e g u r g i t a t i o n of milk i s t r e a t e d a s abnormal,

immedia te ly , p a r e n t s t ake t h e baby t o a shaman and t h e

shaman repea t c h a n t i n g o ~ a n t r a s a t l e a s t 3 t o 5 Limes t o

expec t a complete c u r e . The a c t u a l mantram cure was not

known hu t t h e r e were many people p r a c t i s i n g t h i s .

Muslims and some o t h e r c a s t e people v i s i t tile

masj id (Mosque) f o r cu r ing some d i s e a s e s o f t h e i r c h i l d r e n .

Every morning and evening s e v e r a l mothers wi th t h e i r

c h i l d r e n pray i n t h e mosque and t h e p r i e s t blow a i r v i z . ,

"vudu ta" on t h e f a c e of t h e c h i l d , which is supposed t a

c u r e many d i s e a s e s l i k e vomit ing, f e v e r and l a i l u r e t o

t h r i v e . When t h e s e p r a c t i c e s f a i l t o c o n t r o l vomiting,

obv ious ly t h e p a r e n t s r e l y on h o s p i t a l f o r t h e a i l m e n t s of

t h e i r c h i l d r e n .

i v ) Cough, Cold and F e v e r

Cough, c o l d and f e v e r i n c i d e n c e among s lum

c h i l d r e n i s te rmed i n f e c t i o u s d i s e a s e s (ammvaru) , and d o n ' t

c o n s u l t a p h y s i c i a n . They w a i t w i t h o u t g i v i n g a n y m e d i c i n e

t o t h e c h i l d f o r 3 d a y s and i f t h e r e is no r a s h o v e r t h e

body t h e n t h e y t a k e t h e c h i l d t o t h e d o c t o r . B e s i d e s t h i s ,

c h i l d r e n s u f f e r f rom s e v e r a l d i s e a s e s and c u r e them t h r o u g h

a c o m b i n a t i o n of t r a d i t i o l ~ a l and modern metilotla.

Ammavaru - The Exanthematha

Ammavaru i s i n f o r m e d t h a t t h e r e a r e s e v e n t y p e s o f

ammavaru ( i n f e c t i o u s d i s e a s e ) v i z . , At la tammavaru ,

Tha t tammavaru , I sukamn~avaru , Peddammavaru, Gowdlamrna,

Gajulamma and Agniammavaru. They a t t r i b u t e t h e s e d i s e a s e s t o

w r a t h of Goddess Gangamma. Peddarnmavaru is s m a l l pox, A t l a t a

ammavaru i s Chicken-pox and That tammavaru and I s u k a ~ n ~ n a v a r u

a r e m e a s l e s w i t h d i f f e r e n t t y p e s o f r a s h . Wl~en t h e pox is

s u s p e c t e d t h e c h i l d i s c o n f i n e d t a t h e house and i s a s k e d t o

s l e e p on t h e f l o o r on a c l e a n w h i t e c l o t h . No b a t h i s g i v e n

t i l l t h e 9 t h day and no m e d i c i r ~ e r a r e u s e d .

'rhey b e l i e v e t h a t tile modern m e d i c i n r s u i ! l do

harm t h a n c u r i n g i t . D a i l y t u r m e r i c p a s t e or w a t e r w i l l be

s p i r n k l e d w i t h margosa lea.ves ( v e p a k u i i n t h e housm. a n d t h e

l e a v e s w i l l be k e p t n e a r t h e f a c e of t h e c h l l d . The c h i l d

g e t s t h r e e p e l l e t s o f t u r m e r i c itowder and s largosn l e a l

p a s t e as m e d i c i n e t o be swallowed e v e r y d a y . 'Tie d i e t c o n i s t s

o f b u t t c r - m i l l . and r i c e , bantina, c o c o n u t w a t e r . sc.111~ l .~coylc .

u s e g l u c o s e , suga r mixed with water i n t h e d i e t from 5th

day . U s u a l l y , on t h e 9 t h day on Wednesday o r Sunday a f t e r

9 t h day of such i s o l a t i o n , t h e c h i l d g e t s ba th w i th p a s t e o f

margosa l e a v e s and t u rmer i c . On a l t e r n a t e d a y s , t h e c h i l d

g e t s b a t h and t h e d i e t a r y r e s t r i c t i o n s c o n t i n u e t i l l 2 t o 3

weeks, g i v i n g a l l coo l ing s u b s t a n c e s . They b e l i e v e t h a t

Ammavaru c a u s e s e x c e s s i v e hea t i n t h e body, hence they feed

t h e i r b a b i e s w i t h s e l e c t i v e food .

From 9 t h o r 11 th day a f t e r c u r e L r o m the

Agniarnlnavaru mother or e l d e r woman s p r i n k l e s f i r e d coa l

( a g n i ) on t h e body of t h e c h i l d by cover ing a c l o t h on t h e

c h i l d . Some of t h e people wave f i r e d coal t h r i c e around the

c h i l d ' s f a c e .

Trea tment of J a u n d i c e

Slum people b e l i e v e t h a t l aund ice ( p a c l \ i r i k a l u ) i s

never t r e a t e d by s c i e n t i f i c medicines but is p r e l e r r e d t o be

t r e a t e d by conven t iona l methods u n l e s s i t l e n d s t o

c o m p l i c a t i o n s . The conven t iona l t rea tment is brandinq on t h e

w r i s t . During t h e t r ea tmen t t h e person o b ~ c r v e s s t r i c t

d i e t a r y reg ime. The c h i l d should not be al lowed t o e a t green

v e g e t a b l e s except b u t t e r m i l k and r i c e without s a l t . Some

f a m i l i e s t r e a t jaundice wi th he rba l medic ine i e . , l e a f - j u i c e

( P a s u r u )

I n j u r i e s and Frac tu res

In f a c t , t o d d l e r age i s t h e age of a c c i d e n t s . They

t r e a t minor i n j u r i e s wi th t r a d i t i o n a l way oC c u r i n g o r sol\le

m e d i c i n a l o i n t m e n t s . They s e e k d o c t o r ' s t r e a t m e n t f o r major

i n j u r i e s . I n t h e c a s e of f r a c t u r e s , i m m e d i a t e l y a f t e r t h e

F r a c L u r e , t h e p a r e n t s t a k e t h e c h i l d t o a t r a d i t i o n a l bone

s e t t e r .

P a k s h i Dosham (Low b i r t h w e i g h t )

In t h e e a r l y i n f a n c y i f t h e baby d o e s n a t p u t on

w e i g h t , t h e baby i s s u s p e c t e d t n have t h e e v i l e f i e c t of a

b i r d ( P a k s h i Dosham). To p r e v e n t i t , t h e beads made f rom t h e

bone of t h e w i n g o f a " b i r d " u s u a l l y s o l d by t h e Nakkala ( a

Nomadic t r i b e ) i s t i e d t o t h e w a i s t t h r e a d ; I f i t i s n o t

cured by t h i s method, t h e y c o n s u l t t h e p h y s i c i a n .

The p a r e n t s c o l l e c t Pakshi Akulu ( l e a v e s ! and h e a t

w i t h g i n g e r l y o i l ( N u v v u l a ) . A f e v l e a v e s a r e d i p p e d in

b a t h i n g w a t e r and g i v e head b a t h t o t h e c h i l d . T h e Ihead b a t h

is r e p e a t e d f o r 5 t o 7 t i m e s t o c u r e t h e d l i e a s c .

F r e e medica l t r e a t m e n t i s pro.lded hy t h e

M u n i c i p a l H o s p i t a l s and Rayalaseerna Seva S a n ~ i L h i (RASS) and

o t h e r government h o s p i t a l s . Many I a m i l i e s uap i n d i g e n o u s

m e d i c i n e s f o r o r d i n a r y a i l m e n t s .

Domes t ic Remedies ( o r ) T r a d i t i o n a l Remedies

Most o f t h e f a m i l i e s ( 7 3 % ) a r e f o l l o w i n g t h e

t r a d i t i o n a l c u r i n g o f d i s e a s e s . The n a t u r e o f t r e a t m e n t , t h e

r e a c t i o n of t h e p a r e n t s and o t h e r s towards t h e c h i l d h o o d

d i s e a s e s , t h e i r expec ted behaviour and t h e p a r t i c u l a r

conduc t o f treatment v a r y from c u l t u r e t o c u l t u r e .

I n b r i e f , i t c o u l d be s t a t e d t h a t t h e p a r e n t s t r y

t o i n c u l c a t e t h e h a b i t s o f c l e a n l i n e s s f o r t h e i r c h i l d r e n

from e a r l y a g e . The mother s t a r t s c l e a n i n g t h e i r c h i l d r e n ' s

t e e t h a t t h e a g e o f 2 - 2 1 / 2 y e a r s . B u t t h e c h i l d r e n s t a r t

c l e a n i n g t h e i r t e e t h by t h e m s e l v e s a t t h e a g e of 3 y e a r s .

Most o f t h e c h i l d r e n u s e t h e t r a d i t i o n a l method i e . , cow

dung a s h f o r c l e a n i n g t h e i r t e e t h . The e l d e r c h i l d r e n g e t

d a i l y b a t h a t t h e a g e of 4 y e a r s . Most o f t h e n ~ o t t ~ e r s a r e

n o t a b l e t o t r a i n t o i n c u l c a t e t h e h a b i t s o f t a k i n g p r o p e r

c a r e o f p e r s o n a l h y g i e n e f o r t h e i r c h i l d r e n from an e a r l y

a g e . I t i s due t o t h e r e a s o n o t p o v e r t y c u l t u r e . Some of t h e

m o t h e r s f rom h i g h income g r o u p s g i v e p r o p e r c a r e t o t h e i r

c h i l d r e n . Hal f o f t h e c h i l d r e n a r e immunized a g a i n s t

d i s e a s e s . Some of t h e m o t h e r s d o n o t b e l i e v e i n immunizing

t h e i r c h i l d r e n . Some m o t h e r s u s e h e r b a l m e d i c i n e s 1.0 c u r e

t h e d i s e a s e s o f t h e i r c h i l d r e n . I1 t h e d i s e a s e i s n o t cured

t h r o u g h t h e h e r b a l m e d i c i n e s t h e n t h e y t a k e t h e i r c h i l d r e n

t o t h e p r i v a t e o r government h o s p i t a l s f o r t r e a t n l e n t .