The World Health Organization (WHO) estimates that by 2013 about 1.5 million Syrian refugees will be in Lebanon, Jordan, Egypt and other neighboring countries (El-Khatib et al, 2013). Among these refugees about 75% are under age 18 and are most vulnerable for health problems. For the past few months I have been looking at tremendous efforts made to get financial and medical aid to children suffering in camps of Syria. In order to give a broader perspective to our discussion post this week, I would like to approach this week’s topic from a global view point.
Asthma is a ‘chronic lung disease that inflames and narrows the airways’ (National Institute of Health, NIH). Symptoms of asthma include wheezing, chest tightness, shortness of breath, and
coughing. Today about 25 million people suffer from Asthma, among which about 7 million are children (
www.epa.org, learning resources). According to the Environmental Protection Agency (EPA) Asthma fact sheet, asthma is one of the most chronic childhood diseases and third biggest cause of hospitalization for children.
In 2011, the International Study of Asthma and Allergies in Childhood (ISAAC) released The Global Asthma Report 2011. This report showed an increase in the numbers of childhood, adolescent asthma patients. The increased numbers maybe due to many reasons but in my opinion there are some environmental factors that could be the major contributors to the increased prevalence.
In the last semester when I wrote a paper on Post Traumatic Stress Disorder (PTSD) suffered by those who were involved in the tragedy of 9/11 (directly or through the loss, trauma of a loved one) I found in my research development of asthma as a major PTSD symptom among this population. In the beginning of this discussion I mentioned Syrian refugees among who a major number is of young people. El-Sharif et al (2002) found that children living in refugee camps are at a higher risk of developing asthma as compared to those living in cities. Situations like refugee camps, children and adolescents living in refugee camps or not having access to healthcare have occurred often in the past few years globally. This has had a direct impact on the diseases that young people are prone to. Similarly, tragic events like 9/11 have increased PTSD cases with conditions like chronic obstructive pulmonary disease (COPD) and asthma. According to Davidson et al (1991) PTSD is associated with breathing problems and asthma attacks with an increased frequency of attacks when suffering from PTSD.
For adolescents, children life today is more active, demanding than it was until a decade ago maybe. Issues like cyber bullying, texting and social media maybe a considerably new phenomena but it is not uncommon. With development of these new technology mechanisms there has also been an increase in cases of anxiety, depression and behavioral problems among adolescents (O'Keeffe et al, 2011). Research has shown that anxiety increases the frequency of asthma attacks among children and adolescents (Richardson et al, 2006). Dealing with these social and peer pressures are probably triggers, reasons of higher rate of asthma cases among young people.
Educating the parents/ guardians of children and adolescents is a primary step in getting the asthma situation under control. In case of adolescents it is essential that a strong support system is also created among the peers of the patient as this is the age when peer supports matters to almost all adolescents. Social acceptance is crucial to this age group and if parents are made to understand this, then they can be in a compatible mentality with their children. This balance and understanding by parents can have effects on handling the disease by the parents/ guardians as well as the adolescents. An integral step for this education would be to make a referral of a psychologist or therapist to the parents of adolescents suffering from asthma. Family counseling in these cases can be very helpful and educating.
For parents of young children it is crucial that there is an understanding of the disease, its symptoms and most importantly its triggers. In developing and under developed countries parents/ guardians are not educated about the disease and non compliance is not uncommon ( Wilkinson, 1994).
Also, in these regions triggers like smoking, dust mites or factors like anxiety , stress is not possible to be controlled due to living conditions and lack of education.
References
Davidson, J. R., Hughes, D., Blazer, D. G., & George, L. K. (1991). Post-traumatic stress disorder in the community: an epidemiological study. Psychol Med, 21(3), 713-721.
El-Khatib, Z., Scales, D., Vearey, J., & Forsberg, B. C. (2013). Syrian refugees, between rocky crisis in Syria and hard inaccessibility to healthcare services in Lebanon and Jordan. Conflict and health, 7(1), 18.
El-Sharif, N., Abdeen, Z., Qasrawi, R., Moens, G., & Nemery, B. (2002). Asthma prevalence in children living in villages, cities and refugee camps in Palestine. European Respiratory Journal, 19(6), 1026-1034.
O'Keeffe, G. S., & Clarke-Pearson, K. (2011). The impact of social media on children, adolescents, and families. Pediatrics, 127(4), 800-804.
Richardson, L. P., Lozano, P., Russo, J., McCauley, E., Bush, T., & Katon, W. (2006). Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms. Pediatrics, 118(3), 1042-1051.
Wilkinson, D. (1994). High-compliance tuberculosis treatment programme in a rural community. The Lancet, 343(8898), 64
asthma can be a result of untreated allergy which in refugee children probably is quite likely as they might have been deprived of medicare in the past
ReplyDelete