Our little one is a marvel of Irish size, consistently earning a top place in the charts used for tracking developmental growth. He was directed to a general practitioner by our public health nurse due to his astonishing physical size. Interestingly, we don’t have his exact growth figures as they’ve been computed using a chart derived from data related to breastfed babies, despite him being fed on formula.
You might wonder why that’s the case? Apparently, it’s to endorse breastfeeding as the best feeding option, as per what the HSE included in its policy explanation. They believe that the growth curves for formula-fed and breastfed infants differ in the first year, and supposedly, this promotes breastfeeding. However, in my opinion, it’s just an excellent demonstration of incorrectly using growth charts. This has landed us once again into the radar of public health authorities.
Parental instincts naturally include fretting over a child’s developmental progress. As public health is primarily data-driven, certain developmental stages are prominent in a parent’s concerns, appearing alongside considerations like childcare, schooling, and overall welfare. During a referral for our boy for extra evaluation, we were fortunate enough to be greeted by an incredibly empathetic and skillful community health doctor. This person was able to quickly establish a connection, providing us a sense of expertise, compassion, and practicality.
People who dedicate their time and effort to child care in our nation are a blessing. I recall a lady at the Eastdoc reception who energetically encouraged my sick daughter, ending the visit with meeting her small pet dog. Such a gem in the right profession. Additionally, I think of the myriad of childcare professionals, both local and international, whose commendable efforts during an intimidating public health situation ensured that many of us were able to keep our lives afloat during the peak of the pandemic.
Public health examination rooms are private areas where we initially articulate our concerns that are difficult to voice, and where several obtain life-changing news. These rooms are also typically busy. A standard developmental assessment for a child the same age as my son would evaluate their ability to crawl, walk, and interact with toys. They may want to observe the child rolling a ball to and fro, or their reaction to the actions of other people. It’s common knowledge amongst parents that once a child of about one year old begins to move around on their own, they become virtually unstoppable.
The term “kip” had not been in my vocabulary since my youth, nonetheless, this was surely the least appropriate location to perform the necessary examination. The room had two heaters. One was a movable heater placed in the corner, presumably to combat the cold seeping in from old windows. The other was a fully plumbed radiator coupled with some heated metal pipe that extended from the main unit and run alongside the room’s base. My vocabulary in central heating isn’t sophisticated, and you can understand that when I searched online for radiator diagrams to help accurately describe the parts, it was challenging to find compatible ones, as the equipment appeared to have been fitted in the period between the two world wars.
Maybe the initial burn he suffered was my oversight. I didn’t immediately notice the freestanding heater, and when he started crawling under the table, I was more than willing to let him, allowing the doctor to observe his natural behaviour. To pull himself up to stand, he attempted to hold on to the hot object, which startled him.
After comforting him and barricading the relevant corner with a seat, I assumed we were safe, yet not more than five minutes later he had discovered the hot piping that practically filled the room floor. These weren’t grave burns but they were enough to upset him and disrupt a meeting we had been waiting for, where it would have been ideal for him to behave as normally as possible.
In such a situation, not every child will have quick reflexes and one can only imagine the potential seriousness of the situation if he hadn’t let go. Everyone was horrified when it happened again, which raises the question: Who in their right mind would consider this room safe for a toddler’s examination?
Ignoring the jarring red floor design, reminiscent of molten lava, that would undoubtedly unsettle anyone with sensory or mental health issues, the room was simply a hazard. It seemed a small-scale reflection of wider public health issues: incredibly skilled, committed individuals trying to function in dilapidated, or completely absent, infrastructure.
Putting aside the issue of appointment postponement, the demoralising reality that it could potentially take half a year for the next one to occur still knocked the wind out of me. This waiting period only amplifies the stress caused by the pressure to hit developmental milestones. The narrative we are supplied with is often about early intervention. But if this intervention doesn’t manage to get you an appointment promptly, then what really is its usefulness?
I am an advocate for public services and am aware that private healthcare can often undermine public healthcare, but our commitment towards such principles is tested when it concerns our children – in the worst-case scenario, I will arrange for private consultation. However, remember that not everyone is in such fortunate circumstances. This level of disparity is simply unjust. Following a budget introduction week leaning more towards gratuitously scattering spare funds amongst voters, rather than allocating them towards strategic service enhancement, hope for change appears dim.
Just last week, I watched the Fine Gael’s advertisement, declaring their objective to make Ireland the world’s best country for children. But, recalling the chaos in the children’s hospital, waiting lists for scoliosis surgeries, the hardly forgivable scarcity of special-education school spots, and the continual failure to roll out the long-overdue second level of child benefit for the country’s most deprived children, I cannot help but question their detachment from reality.
I am Dr Clare Moriarty, a postdoctoral fellow of the Irish Research Council, based at Trinity College Dublin.