New Delhi : Ahead of the environment summit in Paris, Environment Minister Prakash Javadekar said the developed countries should come out with “more reasonable proposals” to fight climate change.
“India has pledged for an ambitious action plan to fight climate change. We hope for an equitable and just climate agreement in Paris, but the developed world will have to come out with more reasonable proposals,” he said during an online discussion with experts and citizens on ‘MyGov’ platform.
The minister referred to French President Francois Hollande’s statement that unless the developed world committed more finance and technological support, the Paris meeting could be a failure.
“I think, with this warning, coming from the French president, who is the host, the developed world will come out with more reasonable proposals,” he added.
Meanwhile, the minister also invited suggestions from people on various issues related to the environment.
Javadekar also announced that the best ideas would be awarded with a cash prize and a visit to a wildlife sanctuary.
The modalities of the contest would be announced on ‘MyGov’ platform soon, he said.
On October 2, India in its climate action plan pledged to cut emission intensity by 33-35 percent over the next 15 years.
The action plans of different countries would serve as the basis of negotiating an agreement, applicable to all countries, with an aim of keeping global warming below two degrees Celsius during the crucial 21st meeting of the Conference of Parties on Climate Change due in Paris, France, from November 30 to December 11.
Deliberate self harm (DSH), also known as self injury is the act of intentionally inflicting damage to the body
It has become a common practice among children and teenagers across the globe
DSH among teenagers can be attributed to lifestyle and technology changes, peer pressure and lack of support
Australia, September 1, 2017: Dr. Rajeev Nagpal expresses his opinion on the dangerous practice of self-harm increasingly affecting children and young adults across the world.
What is Deliberate Self-Harm (DSH)?
Self-harm is described as an expression of situational crisis or personal distress which leads to harming oneself. NICE clinical guidelines from the UK have defined it as self-poisoning or injury, irrespective of the apparent purpose of the act.
Deliberate Self Harm (DSH) is not a clinical condition but a response to a stressful situation in the life of a young child or adolescent. It can occur after long term stress like abuse or domestic violence or after an acute single event like the loss of a near one or failure in examinations. It is primarily a coping mechanism in which they try to release tension by trying to self-harm.
Already there are reports of Indian children losing their life after playing games like the blue whale challenge on the internet. It is time for the general population, including the parents of young children to understand the issues of this very complex condition called deliberate self-harm.
Public Health Issue
In recent years DSH has become a major public health issue in most developed countries. However, although less reported, this problem is a major under-recognized epidemic in low and middle –income countries like India, Nepal.
According to a retrospective study conducted at the Emergency department of CMC, Vellore, India from Jan 2011 to Dec 2013, among the total 1228 patients who were admitted, consumption of pesticides was the most common cause of DSH in men. Consumption of plant poisoning and drug overdose was more common in women.The study involved all population, therefore, the actual number of pediatric population was difficult to ascertain.
Other international studies have also revealed that adolescents, who experienced anxiety or low mood, were six times more at risk of self-harm in young adulthood compared to those without depression or anxiety disorders.
Approximately a million lives are lost to suicide annually, worldwide.
Deliberate self-harm (DSH) is the single most important risk factor for suicide and is associated with huge health service resource utilization. Deliberate self-poisoning in children continues to remain a significant part of the workload of emergency departments, especially in adolescents, even though fewer children need admission now as compared with earlier decades.
Presentation of DSH
Many young adults find it difficult to express their feelings. Some examples of self-harm behavior are:
Self-cutting or scratching
Burning or scalding
Poisoning with drugs like paracetamol, anti-depressants
Relatively little information is available about the characteristics and long-term outcome of children and adolescents aged under 15 years who present to general hospitals because of deliberate self-harm (DSH).
Depressive disorders in pediatrics fall in ranges from mood changes in response to persistent mood change accompanied by suicidal ideation or intent.
The difficulties faced by adolescents are getting more complex with lifestyle and technology changes globally. Peer pressure along with family expectations can aggravate this sense of worthlessness.
Lack of support networks can lead them to opt for impulsive self-harm mechanisms like poisoning. Intentional overdose to commonly implicated drugs like Paracetamol in the UK, or organo- phosphorous compounds in Nepal and is a cause of grave concern.
How to Deal with this Issue
As young children are unable to deal very well with emotional stresses, they will need a supportive team to help them in understanding their feelings and the possible outcomes from them.
This requires a multidisciplinary team approach.
Understanding the issues by holding awareness sessions of this condition in schools and other organizations
Creating referral pathways that all school staff are aware of
Confidential telephone lines /NGOs dealing with mental health of adolescent’s
Government policies and procedures for treatment of acute cases in Accident and Emergency departments
Provision of developing CAMHS(Child and adolescent mental health services ) like services at state level in Indian government hospitals.
Increased research particularly in pediatrics and adolescent’s needs to be conducted at state and national level.
DSH is an under-recognized, major public health problem in low and middle-income countries. National level medical protocols and increasing the awareness amongst the public and agencies dealing with such conditions can be the first step in saving millions of lives from the untimely death of the most vulnerable yet productive younger sections of the society.
Dr. Rajeev Nagpal is a Pediatrician and MHID (Masters OF Health and International Development-Flinders University, Adelaide, Australia)
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