Experts explain: a child’s malnutrition in the first 5 years affects his health in adulthood

All issues related to children’s health and diseases were discussed at the 58th Turkish Pediatrics Congress organized by the Turkish Pediatric Institute in TRNC between May 9 and 13. 1,788 pediatricians and doctors of subspecialties from all over Turkey attended the congress. At the conference press conference, where 75 scientific panels were held, the members of the board of directors of the Turkish Pediatric Institution discussed important topics related to the health and diseases of children in our country, and mentioned the problems faced by pediatricians . . President of the Turkish Pediatric Institution Prof. Dr. Haluk Çokuğraş underlined that the main topic of the congress on the occasion of the 100th anniversary of the republic was the achievements of the republic and its health benefits, and made important statements. Board members Turkish Pediatrics Pediatric Breast Diseases Specialist Prof. dr. Dr. Bülent Karadağ, Pediatric Gastroenterology, Hepatology and Nutrition Specialist Prof. Dr. Fügen Çullu Çokuğraş, Pediatric Rheumatology Specialist Assoc. Dr. Kenan Barut, Pediatric Gastroenterology, Hepatology and Nutrition Specialist Prof. Dr. Ömer Faruk Beşer, Specialist in Pediatric Rheumatology Prof. Dr. Özgür Kasapçopur, Specialist in Pediatric Endocrinology and Metabolism Prof. Dr. Çiğdem Aktuğlu Zeybek, Pediatric Nephrology Specialist Prof. Dr. Cengiz Candan and specialist in infant nutrition and metabolic diseases Prof. Dr. Ertugrul Kıykım participated.


TPC Chairman Prof. Dr. Haluk Çokuğraş noted that it has been almost three months since the earthquake and that the earthquake victims are starting to fall off the agenda, saying: “It will be important to help the earthquake victims from reach now. Not only children are victims of earthquakes, but also health workers. Our assistant friends in Malatya still have no shelter. We brought 5 containers. As an association, we have a plan to build a kindergarten in Arsuz. 0-5 year olds need places like this. There are more than 800 children who have lost several limbs. There is an organization we created for both prosthetic and physical therapy opportunities, psychological support and training needs, So far, 3 children’s prostheses have been placed in the places where their treatment is applied. 140 children have applied, there are 18 children in the evaluation phase,” he said.


Noting that they discussed the problems of children’s health and diseases at the congress, Prof. Dr. Çokuğraş said, “We talk about all kinds of problems, from assistants to specialists, to sub-departments. Pediatrics has 17-18 sub-branches. But there is a life safety issue for pediatricians and assistants. Sometimes it is verbal, sometimes physical violence. This is our number one priority. Again, we have a malpractice problem. You are meticulous when making a transaction and there are high fees. In most of the high-risk industries, intensive care, newborn oncology, there’s always a risk of losing these patients. But unfairly serious fees turn to doctors. There are very difficult working conditions, especially in the earthquake zone. Through it all, we come across: Pediatrics is no longer a preferred specialty. Those who study medicine choose departments such as dermatology, biochemistry, radiology, where they are not attacked, where attacks are relatively easier. They don’t want to be surgeons either. They don’t want affiliates dealing with risky business. Medical faculties were opened in our country just as a health center was opened. There are no more child assistants to work here. For example, Elazig is a very old university, there were 60 child assistants, now there are 8 left. In a few months there will be 1 person left. This is also the case in places like Maraş, Malatya, Kırıkkale, Trabzon, Samsun. However, there are 320 pediatric assistants in Ankara City Hospital,” he said.


prof. Dr. Çokuğraş continued his words as follows: “If you work with fewer doctors, the service you provide decreases, the quality of the service decreases, but the number of patients remains the same. This also fuels health violence. For example, hematological oncology is a very important subspecialty. But in many places we cannot find a small assistant. Our preference for branches such as pediatric intensive care, child emergency, newborn or pediatric nephrology is decreasing. There is compulsory torture that has been going on for 42 years. There is no such system anywhere in the world. At this rate, it will be very difficult to reach a pediatrician in the coming years.”


Recalling that a child’s nutrition also determines his health in the following years, Prof. Dr. Fügen Çullu Çokuğraş, on the other hand, pointed out that children’s nutritional disorders increase in the first 5 years and said: “ Unfortunately, the frequency of seeing malnutrition related to infant nutrition will increase in the increasingly difficult economic conditions in our country. We pediatricians have a great responsibility in this regard. We must look at all children from this perspective. Nutrition is extremely important in the first 5 years, in terms of influencing the diseases in later life. Unfortunately, if we can’t tolerate it with a good diet, we will all bear the consequences together. In my own day-to-day clinical practice, I used to be more comfortable saying ‘You’re going to put lamb in your vegetable soup’, now I hesitate. From 3 of my patients I heard the words ‘I haven’t eaten meat in a year’. If we see this in Istanbul, it is much more so in different parts of Anatolia. There is also free nutritional support from the Ministry of Health. It is possible to give these to these children. Some solutions for enteral nutrition, solutions with proteins, fats, carbohydrates are suitable. It must be identified and given to children who need it. It is extremely important to feed not only babies, but also pregnant women.”


Prof. Dr. When he noted that pediatricians now want to go abroad because of violence and difficult working conditions in health care, Çullu Çokuğraş said: “I always said: go, learn, definitely come back. I can say no more. All recent graduates find it very difficult to learn languages. However, we all have patients from abroad. Unfortunately, they cannot reach the specialist there whenever they want. We don’t have this. Our citizens can reach the doctor very easily, they can even be beaten! That’s why experts are running away. We have the best and accessible medicine. Our people don’t understand, they don’t know how the system works abroad. If that system were in place, they would never be able to reach the doctor. Very well trained doctors come here. They are catching up in the air because there is a serious shortage of doctors around the world,” he said.


TPK board member Prof. Dr. Çiğdem Aktuğlu Zeybek said: “We live with drugs coming from abroad, treatments are interrupted. We had these problems for a while, then there was a period when we lived in abundance. Now we are going downhill again. We have a specific problem with drugs that have no equivalent. Due to the fluctuations in foreign exchange and the low price policy, companies do not bring the drug to our country or do not want to lose profits. We cannot produce our medicines ourselves, we depend on foreign countries. There are also problems with the supply of raw materials for the products produced in our own country. We have to use alternative medicines, but we will see how the effects will be on patients in the future. There are some products that are beyond the scope of medicine, especially in metabolic medicine. As such, additional costs are required, most of which are imported products. There were problems with asthma drugs and anti-infective drugs,” he said. Prof. Dr. Haluk Çokuğraş noted that because of the cheap medicine policy in our country, they came to Thrace from Greece and Bulgaria to buy medicine in suitcases and warned that it should be prevented from being sold without a prescription.


Prof. Dr. Ömer Faruk Beşer, on the other hand, pointed out that almost 50 percent of medical faculty students plan to go abroad and said: “There are also trained doctors. Currently, there is a problem to reach doctors in many branches and higher branches of pediatrics in many cities in our country, including big cities. In a few years this problem will become even bigger. 10 years ago Turkey took the top 50 in the specialty of pediatrics, now the ranking has fallen far behind. It has changed from a most preferred field to a branch written not to sit still. Dermatology and radiology used to be at the bottom. At the top were surgery, obstetrics and pediatric neurosurgery. Now no one wants to go to these branches. If measures are taken, we will benefit positively as a country. In the past 2 years, 60-70% of the positions in the departments of pediatric gastroenterology and hematology at universities have been vacant. In a few years, no other specialists will be trained and they will not be conscripted. For example, there is no pediatric gastroenterology or hematology specialist in Urfa. problem in many cities. This also applies to pediatric intensive care. Even in Istanbul there is a problem in this area. Those are the specializations.” associate Dr Kenan Barut said: “We will find many doctors in cosmetology, plastic surgery and hair transplantation in the future, but we will not be able to find a doctor for your child who has cancer, for example, and needs major surgery.”

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