Recently a school girl in West Bengal was forced to drink her own urine due to bed wetting.
SHOMA . A. CHATTERJI delves in to this medical problem and offers solutions.
The terrible case of a 10- year- old girl being
forced to lick her urine as punishment for bed- wetting by the warden of her residential school at Patha Bhavan in Santi Niketan set off a furore in the national media that flooded the news channels analyzing the case as torture and child abuse. The National Commission for the Protection of Child Rights decided to visit Santi Niketan to investigate.
But the complete silence by one and all on the medical aspects of the issue is no less appalling.
If the warden was aware of the girls problem, why did she not summon the childs parents before being so harshly punitive for a natural act over which the little girl had no control? If the parents were aware and did not take necessary action, then they are culpable too for what happened to the little girl. If her parents were ignorant about her bed- wetting, then the warden is to blame for not drawing their attention to their daughters problem.
Why does a ten- year- old girl wet her bed? Is it normal? It is natural for a small child to wet his/ her bed while sleeping. But most little kids grow out of the habit of their own by the time they are five or six. If the child continues to wet the bed, it becomes a medical condition called nocturnal enuresis or night time incontinence, a general name that suggests the ailment but does not specify the cause.
For very small children, bed- wetting is of no concern.
But when it continues with the childs growing up, it is not only a health issue for the parents to look into, but also a psychological issue because of the severe embarrassment it can cause to the child who really is not responsible in any way for the act.
This writer met at least one parent who tried to bring about a quick solution to her ten- year- old sons bedwetting by taking him out of residential school to save him from embarrassment and humiliation. But she did not care to put him in a different school or seek medical and psychiatric help to find out what was wrong. The child grew up into a man, uneducated, unskilled, unemployed and frustrated and turned into an emotional wreck.
General practitioners and paediatricians truly do not have any ready- made treatments for children because the causes are often uncertain, varied and vague. Kevin Peterson, a health specialist, points out several causes of bed- wetting. These are – hereditary factors, too deep sleep, slow development in the central nervous system needed for bladder control, hormonal imbalance, irregularities in urethral valves in boys or in the urethra in girls, problems with the spinal cord and a small bladder.
More severe causes pointed out as alt145 secondaryalt39that could lead to bed- wetting in older children are – ( a) urinary tract infections, ( b) juvenile diabetes, ( c) structural or anatomical abnormality, ( d) neurological problems ( e) sleep apnoea and ( e) emotional problems. Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.
Emotional problems result from a stressful home life, such as constant conflict between parents or an ongoing divorce or a remarriage by one parent that could cause children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting.
Children who are being physically or sexually abused sometimes begin bedwetting.
The normal age by which a child is able to control its bladder is around five or six, which differs according to individual differences between and among children. No treatment is called for a child who wets the bed till six or seven and using force on the child to control could lead to disastrous results because it could create a severe guilt comp