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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 .