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| March 20, 2019

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We have made great strides in health, but not reached the millennium development goals. -

We have made great strides in health, but not reached the millennium development goals.

A renowned pediatrician, Dr. Benny Benjamin has over 35 years of experience in the medical care of infants and children. He has achieved his graduate and post graduate degrees from prestigious universities both in India and abroad. He completed his M.D in Pediatrics from Christian Medical College, Vellore which is the most esteemed medical school in India and further went on to do his M.R.C.P and F.R.C.P from Edinburgh, U.K. He has received numerous accolades for this work and won awards such as the ‘Mary Israel Prize’ in Medicine, the ‘Thomas Dina Prize’ in Physiology, the ‘T.C.F. Silver Jubilee Gold Medal’ in the Pediatric Prize Examination, the ‘Capt. JaisinghJadhav Memorial Award’ for Best Student in M.D Pediatrics and the ‘Mrs. Mariaviakulam David Memorial Medal’ for Best Outgoing Medical Student.
He has worked in various hospitals around the world such as the Assir Central Hospital in Saudi Arabia, Aberdeen Maternity Hospital and West Cumberland Hospital in the U.K., Christian Medical College Hospital, India, etc. He has teaching experience in universities such as King Saud University in Saudi Arabia, Aberdeen University Medical School in the U.K., Christian Medical College in India, etc.
Dr. Benjamin has made presentations on his clinical research interests at international conferences and has several papers to his credit in local and international medical journals. With a passion for medicine and deep compassion for children, Dr. Benjamin stands out as an outstanding pediatrician in the medical field.

Dr. Benny Benjamin shares with Marie Banu his thoughts about Childcare in India.

Being a silent philanthropist, what are the social causes that you support?
I am not into social pediatrics, and work in the private sector. I do not serve the poor directly, but just contribute to organisations who do so. It is an easy way for me to do something without burning my hands.
I would like to contribute to organisations that I believe are doing a good job and have people whom I know working in those NGOs so that I know that the funds are being utilized properly. I have been contributing to organisations that work with children. Well known organisations may be flush with funds from India and abroad, but if I believe in their work I would still contribute to them as well as to local lesser known groups.
Although my interest lies in the welfare of children, being a senior citizen myself, I do contribute to Helpage as well.

What are your thoughts about Childcare in India?
During my undergraduate medical and post-graduate pediatric studies, I grew up in a service-oriented environment. I got my initial pediatric grounding and philosophy from there and these were honed over years and decades of working in various settings and environments around the world. I worked in Mission Hospital situations for a while and then went abroad.
I returned to settle in India some 19 years ago, and I joined the private sector. I view childcare in India from that prism and I have a bit of international perspective also on that. Ideally, the government should provide essentials like nutrition and healthcare for the people. But, due to various constraints, there are lacunae. So there is a private health care co-existing with and complementing the government sector in providing healthcare facilities for children. Though I am part of it, I am of also a critique of the private health sector as it seems to becoming ever more expensive and unaffordable for common folk. Parents may seek private medical care for their kids rather than Government health centres because of the perception that they may be getting better care. There are also health institutions in the private sector doing a great job, such as Mission Hospitals or service-oriented community hospitals that offer good childcare at reasonable costs.
India accounts for 20 percent of child mortality worldwide and a shocking 48 percent of Indian children under the age of 5 are chronically malnourished. What do you think is the major reason?
I do agree with you. The problems of malnutrition and child mortality are interlinked. It is estimated that almost 50 percent of child mortality (below 5 years) is related to malnutrition. The reasons could be many, but poverty is a major factor. Inequity, lack of access to food are other contributory factors. We need basic grains, pulses, vegetables and fruits to have a healthy diet. There is the paradox of food rotting in godowns, but not available to the people. Although there is public distribution system there is a lot of leakage and corruption. Therefore access to variety of foods by the poorer segments is poor.
As a leading pediatrician what is your advice to come out of this?
The government should strive to improve its attempts to provide health care services to the poor in a form that is easily accessible, available and affordable. We have a network of public health centres, integrated child development services, and the National Rural Health Mission that help towards better nutrition and healthcare, leading to reduced childhood mortality.
As far as mortality figures are concerned, the country has made considerable progress in reducing the infant and under-5 mortality rates in health, but have some way to go in reaching the millennium development goals of the WHO. There are regional differences with some of the southern states such as Kerala and Tamilnadu performing better than others.
I think the private sector can also contribute. We should certainly appreciate the efforts of organisations in the private sector, like hospitals, which are helping in this area.

Has the pre-natal, post-natal and neo-natal care services in the govt. hospitals improved in India? How and why?
The government has done a lot to improve neonatal services over the years. This has helped to bring down the neonatal mortality rate and provide better institutional deliveries. For example, the ‘JananiSurakshaYojana’ scheme has improved hospital based deliveries. Through this scheme, hospital based services are offered to the mother and child and a sum of 500 rupees is paid to them.
Government Insurance schemes for the poor enables them access free healthcare at government as well as in private hospitals. The government reimburses the private hospitals directly for the treatment they offer to the poor towards any critical illness.
The National Rural Health Mission has contributed by starting newborn stabilisation units in each district. In Tamil Nadu, there were several efforts initiated about a decade ago to improve neonatal care services. A lot of improvement is there, but we need to go further to reach the MDG figures!

At what age can a parent identify their child to have lesbian/gay/Bisexual/TG symptoms? Your advice for parents who have children with such symptoms?
This is an issue which has been hibernating in my subconscious till your question made me sit up and start thinking more about it. The early symptoms of homosexual orientation can be noticed even at the age of 4 or 5 years of age when we look at the way the child behaves, the kind of play activities, and the roles the child like to play. This becomes more set when the child enters older school age. The parents can become aware of this when they notice the child’s behavior during later childhood, around 14 or 15 years of age or may be unnoticed till there is a coming out on the part of the child/adolescent and the parents are made aware
It is like handedness. A child can be initially left handed or right handed or ambidextrous, but settles down to one pattern. Similarly, sexual orientation may go through various phases before it is set in stone.
In a very religious society like India, the views about sex and sexuality tend to be conservative and ‘old-fashioned’. Heterosexual orientation is accepted as the norm, whereas homosexual orientation is thought of as deviant behavior. Things are changing now, as people are getting exposed to the world through travel, media and easy access to information.
I am liberal in my outlook. I feel that once a person reaches adult age, we must respect his/her individuality and opinions even though it may be different from one’s own line of thinking. I will advise the parent not to excommunicate the child but to listen to and understand the child or risk losing the child forever. Spend time discussing the issue and make him/her come around to your point of view. Inform the child of consequences that he or she may face in society in pursuing such a lifestyle. You may need to seek professional help and counseling to resolve conflicts which may arise.