An Indian couple in Norway have been convicted because they threatened to send their child back to India if he continued to wet his bed. The boy complained to his school and this resulted in the parents’ arrest.

The incident brings to memory my days in the U.K., where I worked as a paediatric surgeon at Birmingham Children’s hospital. As an Indian, I found it a bit odd that extreme care was being taken in the management of children. The child in the hospital could not be allowed to express pain for anything. The belief was even the slightest trauma in childhood would lead to permanent scars in later life. The child would be comfortable without pain even after a major surgery. Forget big surgeries, even the most minor of procedures like putting an intravenous cannula would have to generate the least amount of physical or mental trauma.

A local anaesthetic cream would be applied before intravenous cannulation. And during the actual procedure, the child would be entertained by a nurse or a play therapist. There would be some cartoons being projected on the wall!

One of my colleagues from India, a very experienced paediatric surgeon, in his initial months could not quite understand the fuss and almost landed himself in trouble. The local anaesthetic has a peculiar effect of collapsing the relevant veins, and cannulation becomes difficult. This would mean another application and a wait for another half hour or so for the cream to take effect. And in the middle of freezing winter nights, that would hardly be a pleasant experience. My friend once got fed up with the local anaesthesia stuff and before the nurse realised, in a few seconds, introduced a cannula, but sadly into an unanesthetised area of a patient. The nurse fumed and promptly reported the matter to the consultant. The consultant luckily understood the Indian style of working and gently told my friend to be a little careful with the protocols.

If western medical and police officials tour Indian hospitals, most of the doctors and nurses would shock the visitors to the core with their extreme brutality. Given a chance, they would get most of us arrested with no hope of reprieve in a lifetime.

A simple case of abscess for drainage would sometimes take one whole day organising with the bed manager, the ward nurse, the anaesthetist, the theatre nurse, etc., and post-procedure details like talking to the parents, the GP and writing the discharge note. The actual surgery would not last more than a few minutes. This was because the child could not be made to experience any kind of pain. This is all fine, but practically impossible in our country with the sheer patient load and abundant poverty.

Such a luxury, we can never have. Here, a similar case would be taken to the minor OT, given a local anaesthetic, the child rendered immobile, sometimes by the parents themselves, and the abscess drained and the parents are out of the hospital in half-an-hour. The parents are filled with gratitude, and not with anger towards the doctor. This is not to suggest that one is better or worse, but the conditions are so different here and abroad.

It is amazing that despite all the pampering and extreme care of the child in the western world, the family structure there is much weak. It used to surprise me when I was told explicitly by my British colleagues not to ask anything about the father of the newborn in the nursery. Unwed mothers were common and it would be a sacrilege to ask questions about the father of the child, unlike in India where it is a common practice. So, I learnt that pretty fast. Drug abuse and teenage pregnancies were very common, and I have often wondered where does this chain go wrong in the system.

The love and affection seen in Indian families between the elders and siblings is something which can never be replicated in the western world. An elderly woman’s dying wish was to see her cat, though she had four children! At 18, most kids are out of the house and old-age homes were the places where most of the elderly folks end up in. Here, many kids, even college-going, would sleep in their parent’s bedroom. After retirement, parents still live with their kids in many cases.

This is something which my British friends never understood. It was pretty shocking for them. Parents selling properties for their kids’ well-being or daughter’s marriage is quite common here but quite unusual in the west. Most of us got spanked by our parents in childhood, but there is no grudge. I am not talking of pathological abuse which, of course, has to be condemned.

We still have a strong family structure despite the entirely easy and casual attitude (recklessness in the western eyes) we show to our kids compared to the West. The West and the East probably can never understand each other on an emotional platform. It would have been so much better for everyone, had there been some deep counselling of the family. Instead, the parents have directly punished the child like criminals. The child’s future has been permanently jeopardised, the family permanently scarred, and a normal feeling of love and affection would be difficult to imagine in the family involved.

(The writer is a consultant paediatric and neonatal surgeon at Hanamkonda, Warangal, Andhra Pradesh. His email: pingaligopi@gmail. com)

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