It really does take a village

Par P.A. Sévigny le 7 août 2008

After years of work spent on the cutting edge of the city’s paediatric medicine field, Dr. Gilles Julien and Dr. Nicholas Steinmetz aren’t ready to give up on the children.

As the Founder/President and Director repectively of La Fondation pour la promotion de la pédiatrie sociale that helps thousands of underprivileged kids in Côte des Neiges and Hochelaga-Maisonneuve, they not only want to help lead the battle against childhood poverty and social neglect, they want to lead the fight for the rights for all Canadian children to a normal life.

“Not only must we mobilize the community to respect every child’s right for a decent life,” Julien said, “but this is how the community can learn to re-consider its own priorities.”

“Early childhood poverty causes disease and an early death. It’s that simple,” Steinmetz added.

Using evidence gathered over 30 years of applied clinical research, they used a power-point presentation to display disturbing results which he believes will result in a social catastrophe implicating fully one third of the city’s population.

“It all begins with the pregnancy,” Steinmetz said. “When a mother is stressed, the brain reacts with a typical ‘fight or flight’ reflex, but the mother is trapped so there’s no getting out of it. Bad living conditions, abusive relationships, a lack of money, and bad nutrition, (sometimes compounded by a persistent sub-stance abuse habit including cigar-ettes) do not make a healthy baby and that’s the begin-ning of a slip-

pery slope.

“Stress is toxic,” he said. Mothers under perpetual stress produce cortisonol, a cortisone derivative which makes its way through the placenta and into the baby. It kills brain cells, eliminates future synapse development and destroys potential neuron connections. Steinmetz used comparative Magnetic Resonance Images (MRI) to point out the difference between a healthy child’s brain and that of a neglected child. If a single picture is worth a thousand words, the image of a neglected child’s brain is all the proof Steinmetz requires to prove his point. At three years old, the affected child’s brain is significantly smaller than average and displays abnormal development of cortical, limbic and midbrain structures. At this point, the brain’s structural changes lead to altered cognitive and emotional development.

“People have to know about this, “said Steinmetz. “People have got to know what’s happening to these children.”

By the time the child is three years old, all the groundwork is laid out for its potential education and its future social development. If the child was neglected from birth, it will probably display delays in various language, social and motor skills along with a reduced attention span and abnormal activity levels. This will result in isolation and exclusion from social peer groups, which lead to an inevitable isolation and a poor self-image.

Once the pattern is established, violent and anti-social behaviour inevitably leads to the usual substance abuse problems and sometimes prostitution for both genders. Arizona  predicts its future prison requirements by analysing its present third grade failure rates. Recent statistics demonstrate how more than 42 percent of the poorest and most vulnerable children in the city are not prepared to start school at the normal age, which will inevitably lead to failing grades in later years.

Another disturbing statistic demonstrates how a child born in Montreal’s poorer east-end districts can expect to live for barely 59 years as opposed to a child born in the west end where one can expect to live until they’re at least 77 years old. That is to say children born in Montreal’s West Island, only 20 kilometres down the road, can expect to live more than 20 percent longer than the child born in the Hochelaga- Maisonneuve district.

“This is unacceptable,” the doctors state emphatically. They believe the economic status quo is condemning a serious percentage of children to a dull and mostly desperate life of poverty and imminent physical decrepitude. They advocate that the government should consider the Convention of the Rights of the Child adopted by the United Nations in 1989. Julien and Steinmetz point out how respect for the rights of a child as defined by the United Nations closely resembles the minimum conditions required for what paediatric specialists consider being a healthy child.

“Once everybody begins to understand this situation,” they said, “the sooner we can get around to doing something about it.”

The foundation is planning to take concrete steps to address the problems caused by the poverty and neglect among Canada’s children. In the short term, children who are victims of both neglect and abuse must first be rescued. Within the context of the constant failure and the exclusion created and caused by poverty, they propose an inclusive social paediatrics model that includes all the services required by children in need. Partners within the city’s entire social infrastructure must participate, but local community organizations should be considered the key participants in the process along with the city’s universities. The second half of the solution relies on prevention and the recognition of what it takes to raise a healthy child in a healthy society.

“Education must no longer be elitist and become popular knowledge,” Steinmetz said.

He believes coherent leadership and mass participation at the local level may help alleviate some of the damage poverty does to children. “Knowledge has to be linked to values, then emotion because it’s not reason that moves us to action,” he said. “It’s emotion.”  

The Fondation has had many remarkable successes including a very interesting recent one. Public and private partnerships (PPP) took on a whole new dimension as two city neighborhoods decided to do what they could for children. The central city along with the CDN/-NDG borough council agreed to set up a new summer parks project for the borough’s kids.   A number of    the borough’s community or-ganizations are also working on the children’s park project while both the central city and the borough are going to pay for it.

“It’s all about providing an accessible and stimulating environment for children within the heart of their own communities,” said Dr. Julien.

“We’re very happy to see the community mobilized around this project.”

Two teams of child-care workers will organize a summer-long series of events in two CDN parks. Activities in both the Kent as well as the Darlington Place Park will include theatre, assorted games, road trips and other initiatives as a means to create a pro-active and community-based environment for local children as proposed by the Fondation.  Julien said the province’s social services would have to change its priorities if it wants to get serious about solving serious problems affecting many of the province’s children, “especially poor children.” Julien believes an ounce of social prevention at every level of a child’s young life is worth a pound of whatever society considers the cure whenever its welfare is con-cerned.

“By the time the DPJ (Dépar-tement de Protection de Jeunesse) get called in, it’s often too late,” said the doctor. “The damage is done.”

His ideas about social pediatrics arose out of decades on the front lines of pediatric medicine in the poorer quarters of Montreal. He is convinced that a child’s welfare should be the community’s responsibility and not just that of its parents or worse — its single mother.

Julien also believes the United Nations’ declaration of the rights of the child is a good place to start if one is looking for solutions to what is to be done about children’s poverty in Canada. The Fondation encourages local community organizations to work with assorted city universities and local political organizations to help provide suitable environments for children. As a working example, it has already managed to get the city’s school commissions to open summer sessions for children who were already having problems with school work. The Fondation’s new park programs are an extension of his thinking as to how both schools and the community’s environment can be integrated into a child’s life and home environment.

Both he and the province’s DPJ are discussing recent judicial decisions as related to children and their immediate family relationships, and the doctor thinks people will have to reconsider traditional family relationships if anything is to be done about the problems faced by single parents and especially single mothers. When asked about the enduring problem of absent fathers, Julien believes the problem was more a reflection of a bigger problem that society must deal with if it is to care for its children as it should. After years of taking care of the city’s children, the doctor has seen more than enough blame passed around when a child’s life is ruined, but not enough responsibility to have made sure the child wasn’t harmed in the first place.

“The people who make up a community have to take back the responsibility for the welfare of its children. It’s not the government’s job.” said Dr. Julien. “This should be considered a challenge, not a burden.”

For Julien and Steinmetz, it really does take a village.

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