What Are Our Children's Diseases? How Can We Raise Their Standard of Health?

Dr. Jamal Karam Harfush speaking to the correspondent of The Woman's Voice

Dr. Jamal Karam Harfush graduated from the American University of Beirut, and in America she specialized in children; now, in addition to the work of her private clinic, she is a professor in the department of pediatrics at the American University.

From the moment she stepped into working life, Dr. Jamal has shone — shone as a physician endowed with lofty qualities that fit her for distinction in this humane field, and shone as a worker for public causes. The leap of 1943 was the first serious test, which she passed with the boldness of sincere patriotism, and her voice was in the forefront of the voices raised to affirm the standing of the Lebanese woman — and out of that storm broke the founding of the Lebanese Women's League. The young physician, with her companions in the struggle, is still at work raising up two institutions through every stage of their growth; the duties of her profession have never for a day kept her from rendering distinguished services, whether to the Kindergarten or to The Woman's Voice —

Outside Lebanon, too, Dr. Jamal shone, the day Lebanon appointed her adviser to its delegation to the United Nations on health and social questions. She now presides over the Lebanese Child Welfare Union, which will soon open a center for the care of crippled or physically disabled children — the first institution of its kind in this country.

Her personality has, besides, many sides of social activity which, if they prove anything, prove woman's vitality and her capacity for fruitful production and tender giving...

Here she gives, in what follows, a medical talk to the correspondent of The Woman's Voice, for which we thank her...
— The Editors —

1 — Why did you choose the branch of pediatrics?

First — because work in this field harmonizes greatly with woman's nature and inclinations. The child needs affection in both health and sickness, and he draws it first and foremost from his mother's tenderness; the affectionate mother is distinguished by her ability to give her child an ideal upbringing. Yet the child also needs the affection of the doctor and the nurse, above all in sickness, for affection creates in him a feeling of security which makes it easier for him to keep growing steadily and to recover quickly.

The child is a gentle, sensitive creature who takes to crying as his means of expressing hunger and pain; he does not want to be treated the way things are treated, and the attending physician must call on the virtue of patience to be able to understand his needs. Woman possesses enough patience to make it easy for her to hear the child's crying during examination and treatment without complaint or weariness.

Second — I am one of those who believe in prevention through guidance, health education, vaccination, and continuous medical supervision; and I believe too that the best results of prevention are achieved for us if we begin practicing it at the very outset of life.

2 — What is the attitude of Lebanese society toward the woman who specializes in pediatrics?

The difficulties I met in practicing the profession were easy to face, and were at no time insurmountable. Nor do I think they differ in kind from the difficulties the male physician meets in pursuing the same work.

I can say that Lebanese society trusts woman's ability, and to this day I have not run into a mother who doubted my advice or my medical guidance merely because I am a woman. Perhaps that is the result of the positive tradition left us by the midwife, or the "hakima," who in times past played the role of deliverer and of family counselor at one and the same time.

For this reason I encourage women medical students to specialize in children's diseases, and I consider that woman has a complementary mission in every walk of life; and the most prominent field of medicine in which the distinctive marks of this mission appear is the branch of pediatrics.

3 — What are the most widespread children's diseases in Lebanon?

Intestinal diseases such as diarrhea and dysentery still hold first place. They harm the child's health in general, and they cause the greater part of the deaths among those under one year of age.

The chief causes leading to the spread of intestinal diseases in Lebanon may be summed up as follows:

First — the ignorance of our mothers, even the educated among them, of the principles of child feeding.

Second — the low level of public health. We still have a long stage ahead of us before we overcome the flies and secure for Lebanese society in general water fit for drinking, sterilized milk, sanitary housing, and food sufficient in kind and in quantity.

Third — the lack of adequate health services, above all centers for the care of mother and child.

The costs of medical care in Lebanon are exorbitant, out of all proportion to the income of families of the middle and poor classes. The need of certain Lebanese regions for such services is beyond description or definition — such, by their nature, are the provinces of the South, the North, and the Bekaa.

The provinces of Beirut and Mount Lebanon rely for the most part on private effort, and this alone is not enough; it can at no time fulfill the required purpose unless public effort extends its hand to fill, in its turn, the gap that exists.

Fourth — the heat of the climate has its importance as a cause of intestinal diseases. We all know that diarrhea among children increases in spring and summer, because heat affects the digestive secretions and makes the child, in the first months of life, liable to diarrhea. We cannot resist nature; but we can teach the mother the principles of child feeding, and the modifications to be made in it to suit the nature of our region and our climate. We can also show her the dangers of diarrhea, guide her to the ways of prevention and to seeking the doctor's advice at the onset of the illness, and press upon her not to put off seeking that advice until the disease grows grave and takes full hold of the child.

4 — What is the rate of infant mortality in Lebanon?

The rate of infant deaths in Lebanon is still a figure hidden in the unknown, and Lebanese society will not grasp the importance of health guidance and medical care in the early years before it learns the truth of this figure and of its causes.

We are in utter need of exact yearly statistics, for vital statistics are the primary means of bringing out the reality of the problem. We cannot expect the Lebanese people to devote itself wholly to solving the problem of infant mortality — as Western society did during the past half century — before it learns its reality and is convinced of the necessity of improving it.

5 — Can the women's organizations in Lebanon make a positive effort to improve children's standard of health and lower the mortality rate?

Every time I return to the study of the important events that accompanied the growth of a renaissance which led to the creation of organized public programs for the care of mother and child in the Western world, and in certain Asian countries, my faith grows in the Lebanese woman's ability to undertake fundamental and important works in this field — it is her own field, and in it she has courses to run of far-reaching effect and range.

If important historical facts in the renaissance of twentieth-century man have escaped women's society in Lebanon, I would have one fact not escape it: the story of the founding of the American child welfare office known as the "Children's Bureau" — which has rendered splendid services in which American society, government and people alike, takes pride.

This seed, which left so telling a mark in lowering the rate of infant deaths in modern American society, was the fruit of a mighty effort begun by a woman, who formed a public opinion in its favor and found supporters for it in New York City in 1910, until its echo reached Washington and the White House adopted the idea, and it won the standing and support it won in all American circles.

Woman's political right has gained her, in the eyes of Lebanese public opinion, such immunity and strength as make it easy for her to undertake a similar effort; and were she to work in a definite direction and in an organized, scientific manner, she could reform the health situation and turn it upside down.

The overturn I call for in these conditions does not in the least mean changing the administrative machinery, or bringing about destructive political coups. What I mean by it is an overturn in thought, one that will shake the foundations of the negative attitudes which have grown accustomed to the existing health situation, accepted it, and placed it at a rank many degrees below the first. The figures of the public budget bear witness to this, as does the dwindling number of services devoted to the care of mother and child.

Woman has a final word — rather, a fundamental word — in the field of the care of mother and child and the lowering of the infant mortality rate, and I would have her say it at the outset of her political activity: a word of unanimity, a word clear and plain, which she makes a serious subject for bargaining with the responsible men among the candidates of the coming electoral campaign.

Woman is the mother of man, and after today I shall not be content for the Lebanese woman to accept the death of a single human being in Lebanon as the result of neglect and deprivation.