As a paediatrician in Mumbai, I would see children coming from a slum to the municipal hospital I worked in, having had no vaccination, and not having eaten a square meal a day. I would see children brought in from the street with no family or guardian. And elsewhere, I would see a child born to a billionaire whose bare feet have probably never touched the soil.
Mumbai’s children are a study in contrast: stark at the ends and a million hues in between. It is home to some of the world’s richest children and millions of those who may not be assured of their next meal. Forty per cent of them live in slums while others live in plush apartments or bungalows, in one-room tenements with large families, or on the street. The vast spectrum of children and the situation they inhabit is mind-boggling.
But this is just a reflection of the Maximum City, one of the most fascinating — and peculiar — places in the world. Mumbai is a vast swathe of humanity, with a population of more than 12 million living in a small area of 603 sq. km., with 21,000 people thrown together per sq. km.
As a city largely built in reclaimed land, we have only a small ethnic population and humongous influx of immigrants; Mumbai poses its own set of problems for children. These problems can be looked at across two areas: infrastructure and child and adolescent development.
Let’s start with how a child comes to birth here and how she goes through life in the city.
Where are our children born?
A tiny fraction of Mumbai’s children are born in seven-star hospitals, the large middle section in small-to-medium-sized nursing homes, and a much larger number in poorly-equipped municipal hospitals.
There is a need to standardise the facilities and care all new-borns get. We must ensure a minimum of focused ante-natal care, adequate nutrition, safe and hygienic labour and birthing, an immediate breastfeeding initiative and close observation for the new-born’s behaviour and feeding for the next two days. We must reserve excellent care for those at high risk, like premature babies, low-birth-weight babies, babies with birth asphyxia or anomalies. A simple add-on to what we already do could help: checklists, which have proven to ensure compatibility with norms. Evidence shows this results in better outcomes.
Where do they go for routine health care and vaccinations?
Parents should be encouraged to follow up with the child at a suitable facility close by. There are government facilities as well as a wide range of private health providers; though parents may choose what they can afford, the government must ensure minimum coverage for all kids. This must ensure regular ‘well baby’ visits every month for the first three months, then every three months for the first year and every six months for the second year. Again, a checklist for normal growth- and development-monitoring, nutrition advice and immunisation is the norm. This doesn’t require any expensive equipment, just due diligence and a mandated referral. It can nip many problems in the bud and the child starts off on a healthy note.
Where do they live?
As a society and a nation, we must aim for safe and hygienic housing for all, though it may be a challenge at the moment. To bypass this, we need to educate people on how they can contribute to their own physical and mental health with their own actions. Emerging economies like Brazil and Mexico have succeeded in doing this to a certain extent. Local self-governments and non-governmental organisations specialising in urban housing can spearhead this. Poor indoor hygiene, including smoking, can contribute as much to infections and allergies like asthma as much as dirt and pollution outside. A case in point is the awareness drive against water stagnation inside the house to prevent mosquito-borne malaria and dengue. Similarly, simple and cost-effective measures for clean drinking water, like rainwater harvesting, have to be adopted.
Mental health and safety, while worthy topics on their own, are closely tied to where we live.
The equation between mental health and housing is an interesting one. Living in plush high rises and not letting your child know your neighbours may be worse than living in a slum: children from a slum often show higher emotional intelligence thanks to the need to interact for survival. Related to this, our safety often depends on the networks we establish, so whether we live in towers or in housing societies or small tenements, our children’s safety depends on the degree to which the local community is integrated. Having a local 24-hour helpline where children may call for anything that troubles them is important. We must also do more to increase awareness of the nationwide 1098 children’s helpline. And we must encourage children to approach the police for help: we often get our kids to fear the cops; it is necessary to get them to look at the police as friends.
What and where do they eat?
Where do kids eat outside of home and school? Are there designated children food areas or fairs? (I’m not talking about food courts!) Can we encourage restaurants to have children’s menus, child-friendly seating arrangements, a small play area for young kids, a room for mothers to nurse? These are things the state, civil society and entrepreneurs can collaborate on.
What is the social structure?
The government may leave personal care to families. However, children without families and in disadvantaged circumstances are in special need of care and attention. Not only does this enhance the human content but it also leads to a fair and just society.
The city is in urgent need of closely-monitored institutions — perhaps on a public-private partnership model — that can not only ensure disadvantaged children’s physical wellbeing, but also their emotional and intellectual progress.
What is the stimulation? Where do they play?
While we keep lamenting the lack of open space in Mumbai, the solution is to deal with the challenge intelligently. Gully cricket has always thrived in India, beaches were the cradle of cricket and other games in the West Indies. England, which has the largest number of cricket and football pitches, is not necessarily the best in these games.
We need to maximise available spaces. Schools could adopt a ground and nurse it by sharing the costs with the administration. Each school could get one day a week by rotation. The important thing is to put your kids on the field and more importantly, to encourage sports or at least make it seem as important as academics.
Related to this, but not completely overlapping, we must also ask, what is the sports and fitness training available?
One needs to just surf the Internet to see the variety of options available for sports and fitness. However, not even the few who can afford it reach for it. The reason is the lack of a fitness culture. We have an academic culture, a social culture and even a financial culture. We need to develop a fitness culture that will make our kids want to climb the stairs rather than take the elevator.
The very architecture of the city’s public spaces can encourage more fitness. It’s not just the city government’s responsibility — though yes, they must pay more attention to better footpaths, designated cycling or jogging lanes or tracks — we as citizens must also be involved. We could pay more attention to footpath encroachments and work with local bodies to ensure they stay usable, for instance. We could organise more events and competitions that promote and celebrate this culture.
What is the opportunity for intellectual training?
I refuse to believe any city can be more stimulating than Mumbai. The problem is, we are focused on keeping our kids out of things rather than helping them understand and learn from things. Be it religious events, local festivals, political rallies, street theatre, local customs and food, all these constitute the local flavour and you can’t love your city if you are unaware of these. Parents, teachers and guardians need to be ready and available to help kids to interpret and deal with them.
Similarly, it’s not possible that your kid would have been raised in Mumbai and never seen a person under the influence of alcohol or someone smoking weed, sniffing glue, or snuggling up to a lover in a cab or auto. You can’t brush these things under a carpet or wish your kid won’t see them. Every time you counsel your kid, you are basically helping her think of the pros and the cons, in a controlled, non-threatening manner. A mentor is more import than a monitor.
Also, when we were young, there were enough classes or places where kids could learn and enjoy art, music and dance. If these are dwindling, it’s not for lack of anything except time and inclination, both for parents and children. Parents are busy with their chores, while kids are expected to be nerds. Here again a sea change is needed in perspective rather than any defining infrastructure.
What are their schools like?
Mumbai could be regarded as a hub of education, but again that’s only for a particular class of children.
The state of education in government-run schools is, sadly, dismal. The way to make these schools child-friendly is for public private partnerships, or initiatives like Teach For India. A simple solution is for parents to adopt or mentor one child in addition to their own, perhaps the child of an employee or a street child. Mentoring does not mean a financial burden; just sharing resources or even a few words of guidance can be exemplary.
In addition to mainstream education, there is scope for improvement in educational support for challenged and gifted children. In a city that prides itself on achievements and success, the mind-set is against accepting someone who may be different. Having recognised that a child has special needs, it devolves on society as a whole to provide for it.
Inclusion is not only about hearing aids and ramps, which of course the government is mandated to provide, but it’s about our attitude as a city. Inclusion is about being equally accepting of all differences, whether it’s to do with your own child who tops her school and wants to study the fine arts rather than run your nursing home or chartered accountancy practice as much as it is about the neighbour’s kid who has learning difficulties in spite of being born to IITian parents. In a way, it’s being fine with Bombay and not insisting on it being called Mumbai. Historically, this has been the spirit of this city.
What do kids do during their holidays?
It’s true that kids would need more opportunities to play outdoors during holidays but a child-friendly city would also have opportunities to make friends, learn new things, see parts of the city not seen before. Though we may not recognise or respect it, Mumbai is a veritable treasure house of heritage and history. It’s essential in a child-friendly city to allow its children to be acquainted with these, so they learn to care for them as adults.
Schools and colleges could organise heritage walks for their students. How about asking them to do projects on their city? How about local self-improvement group training and getting older kids to manage traffic outside the school or services like filling in forms at offices or working with a senior citizens group?
What is the transport?
Not much of Mumbai’s transport is child-friendly. There are designated seats for children, but this needs to be done more uniformly. Safety during travel and immediate attention and help during crisis is essential.
What are the opportunities for citizenship training and participation?
This brings us to the most crucial agenda. All across the world, cities are being made child-friendly so as to make the city leaders, the city councillors and mayors more connected, engaged and accountable for their cities.
I was amazed to read about ‘Our Journey Together: Strategic priorities for Young People in Bristol’, a youth conference in Bristol in January 2016. This symposium was designed to bring together a wide range of people from different backgrounds (from play, youth work, research, health, the arts, urbanism, community work, education, grassroots activism), and ages (around 20 children aged 9–14 years). All of them shared thoughts and experience and contributed to the beginnings of a vision for Bristol’s future as a more child-friendly city.
A child-friendly city is most likely to make its future better. And this can start by giving children an opportunity to voice what they want in their city. Hearing young people, listening to their opinions, giving them a say, however small, in how their want their city to be, will most likely result in their participation in caring for it in childhood as well as the future. Giving them responsibility and training to deal with the underprivileged and the disadvantaged is the best way to create an attitude of inclusion in these future city leaders.
Setting up a city child council or a local area child council will foster a sense of enjoyment, participation, responsibility and accountability. Making a city child-friendly by invoking children’s participation is the best we can do for our future.
The name Mumbai, one school of thought says, is an amalgamation of Mumbadevi, the goddess, and aai, the mother. This city is indeed mother to us all. Making it child-friendly will help our children develop better and eventually, to take care of their mother, the city, once they grow up.
About the author
The author is a developmental pediatrician who has founded New Horizons Child Development Centre and Research Foundation that works closely with children and communities for their development. He is a Law graduate and works on the Expert Committee of the Maharashtra State Commission for the Protection of Child Rights. He is also the President of the Mumbai branch of the Indian Academy of Pediatrics.