Gujarat is experimenting with peer-pressure of a different kind in its schools. To spread awareness about health, nutrition and hygiene among schoolchildren, the state health department has mooted the creation of bal (child) doctors. For every 30 students in a school, there will be one bal doctor, who will remind schoolmates to wash hands before and after meals, take iron supplements (for those who are anaemic), administer first aid and give ORS to those having diarrhoea or vomiting. Bal doctors will be trained in these functions and a nodal teacher will be appointed to supervise their functioning. They will also be given stethoscopes and white aprons, quite like the ones real doctors use. As long as the aim is to create awareness and administer first-aid or ORS, the initiative is a welcome one. Peer behaviour has a lasting imprint on children, and if bal doctors are able to get their schoolmates to adopt hygienic habits, it would be a big win for public health.
Where it becomes a tad worrying is that the programme, as reported by Times of India, also allows bal doctors to prescribe and hand out ayurvedic medicines for minor ailments. To be sure, they are likely to be trained in this, particularly recognising symptoms, and it would happen under the supervision of the nodal teacher. Also, ayurvedic medicines are believed to be hypoallergenic and free of side-effects. But the fact is that these bal doctors are, at the end of the day, children, and allowing them to diagnose and prescribe medicines—even if these are ayurvedic ones—is a fraught proposition.
First, many rare and potentially life-threatening diseases share symptoms with common and minor ones—distinguishing between the two takes medical expertise, aided by diagnostic tests. It could mean a loss of crucial treatment time if a patient, unaware of what she is really suffering from, relies on the bal doctor’s prescription even for a few days. Second, such latitude—prescribing medication to fellow students—could lay the foundation for harmful behaviour such as self-medication. The bal doctor programme could have many positives; it would be for the best to do away with prescription functions and retain just the driving awareness ones.