Colombo, October 21 (Sunday Observer): WHO’s regional champion for autism in South Asia Dr Saima Wazed Hossain says autism has reached alarming numbers worldwide, and that it may reach epidemic proportions in Sri Lanka. But the causes of autism are still unclear, she adds.
Dr Saima Wazed Hossain, a Specialist in School Psychology and the daughter of the Prime Minister of Bangladesh, Sheikh Hasina was in Sri Lanka recently to take part in a health seminar.
An expert on neuro-developmental disorders and mental health and an accomplished speaker, her efforts have led to international awareness, policy and program changes, and the adoption of three international resolutions at the United Nations and World Health Organization.
She is currently the Chairperson of the Bangladesh National Advisory Committee for Autism and Neuro developmental Disorders as well as a Member of the World Health Organisation’s Expert Advisory Panel on Mental Health.
Dr. Wazed Hossain is also the chairperson of Shuchona Foundation – a not-for-profit advocacy, research and capacity-building organisation based in Dhaka. Shuchona has partnered with various Bangladeshi ministries to provide low cost high impact training and awareness programmes for parents, caregivers, health workers and educators.
Excerpts of the interview:
SO: Reports in health journals caution that Autism is reaching epidemic proportions in Sri Lanka. How true is this claim?
SWH: It is an increasing number all over the world, not just in Sri Lanka. We do not know for certain the reasons behind the alarmingly high numbers. It is believed, awareness and better diagnostic mechanisms are exposing more and more numbers that would not have come to light otherwise.
No specific cause has been established for the rise. It takes time to know if there is a connection to our changing lifestyle, if something related is causing this genetic mutation to effect. Autism has no socio economic differences, rural – urban differences, it has nothing to do with education.
One study looked at how much the high levels of the banned insecticide DDT in the blood stream is affecting newborns. DDT can be inherited from your parents and their parents. It is then passed on to your child. That’s very scary. Although parents are careful with food, the chemical can be inherited from earlier generations, because it stays in your system. But again, there is no conclusive research.
Researchers also try to find if there is a relationship between the cosmetics and preserved or processed food and Autism. The increase is universal, it is not distinctive to any specific country. We see an increase in Autism cases worldwide.
SO: Do you think childhood vaccinations may have contributed to the increase in numbers?
SWH: In one study it was said there was a link to childhood vaccinations and Autism, but now it has been debunked. No matter what respectful research they do, this theory has been disproved, the findings were boycotted.
When research is conducted, sponsors play a key role. It is almost like saying find this result for me, hence it is difficult to know if the results are accurate until another independent research, without a third party sponsoring, is carried out to confirm the outcome of the former study.
A lot of people still talk about this research, but no one so far has replicated this study of relationship of childhood vaccinations to Autism.
Autism is linked to your immune system. There are several types of the disease. In most early diagnosed cases, the child starts showing symptoms around the time of the MMR vaccine.
That is when social and emotional development is manifested. So this claim of childhood vaccines having a link to the disease was very easy to latch on to.
Immune systems are important to stay healthy, vaccinations are important to stay healthy. Nevertheless, it will be important to look at how vaccinations are preserved, what age are they really needed – it should not be given at the health systems’, insurance companies’, pharmaceutical companies’ or doctors’ behest or convenience.
It should be based on the health of the child, the vaccinations are put together so that there are fewer shots and are less costly, and perhaps it can be divided and given not at too young an age.
The WHO approved vaccinations do not cause Autism in children. It has actually been proven.
SO: What are the common issues to Bangladesh and Sri Lanka re mental health?
SWH: In the school I visited all the children looked like Bangladeshi to me. That was a startling similarity. There has to be truth to the legend that King Vijaya came from the region of India where now Bangladesh is.
With regard to mental health, there are cultural similarities, hence the challenges and stigma that exist are common to both. The advantages you have are your health professionals – the psychologists and psychiatrists here, who are highly competent.
SO: Did you identify any gaps where perhaps the state officials are failing when trying to address challenges in the mental health sector?
SWH: The gaps are everywhere in the world, mental health is a challenging and complex issue. Sri Lanka is lucky to have competent experts. What was wonderful to see is the motivation of the experts.
And I think the gaps are not for me to identify. You should get the parents’ perspective, it is like a chef cooking a delicious meal and never knowing how his client feels about it. For example parents know the best for their children.
I visited a college which incorporates autistic children with ordinary children. They help other parents learn those techniques, it is not a place where evidence based intervention is used like in a health clinic but it’s about how to interact and learn from experiences of each other.
Ultimately, the idea is to have an independent, productive person.
In this part of the world we value education and achievement so much we don’t want to see any weakness. I grew up with that stigma, I was not good in math, and that was seen as a handicap. Among family members who excelled in math I felt like a failure.
The cultural expectations are common to Bangladesh, Sri Lanka and most other countries in this region.
SO: Where should you start addressing this issue?
SWH: The children are where we should start with, we must create awareness on acceptance and compassion among children. Then you will have children going home and teaching their parents about those values.
When I was working in the US as an early career psychologist, my daughter came home one day from kindergarten and said you know mum not everyone in my class are walking with their feet. I thought she was talking about kids crawling and playing. But she said, mum some children need wheelchairs. I later learned it was an inclusive classroom.
Through such learning we all get to benefit. She learned early to accept differences, feel when someone is feeling left out. Coming after school one day she said, “I made this lonely child smile today.”
We can teach children the skills, reading and math but not how to be kind. So inclusiveness is very important, especially, for countries like Sri Lanka and Bangladesh where we’ve had so much of strife, everyone has experiences of pain.