That was the belief of an 18th century London physician named George Armstrong, although he said it this way: “But certain it is that the human species can only be preserved by taking proper care of the infant race.”
Dr. Armstrong, who devoted his life to the care of children, to learning about them and documenting their illnesses and their behavior and development, is considered one of the parents of pediatrics. For that reason, every year at the Pediatric Academic Societies (PAS) meeting a lecture is given in his honor. This year, the PAS meeting was in Boston and the lecture was given by Boston Children’s Hospital’s own Judy Palfrey, MD. Palfrey, who has been the president of both the Academic Pediatric Association and the American Academy of Pediatrics, is the T.Berry Brazelton Professor of Pediatrics at Harvard Medical School and the director of the International Pediatric Center at Boston Children’s.
In Armstrong’s time, one in two children died—and medicine, as Palfrey pointed out, had not much more than leeches to offer. But Armstrong did some remarkable things. He started a clinic that cared for 35,000 children. He kept careful records, some of the earliest examples of population data and quality improvement. He built collaborations with influential people, even did outreach to the Queen, in his attempts to get children what they needed. He understood, long before most, that advocacy is crucial for health—especially the health of children, who can’t advocate for themselves.
What, Palfrey said, would Armstrong think of the 21st century? Obviously, we’ve had tremendous progress in medicine. Antibiotics alone have saved millions of lives. The technology is amazing. But although many more survive now than did in the 18thcentury, that doesn’t mean all is well for children. Many still die from preventable illness—because of poor sanitation, poor access to care, or even vaccine refusal. We have a prematurity rate of 12.2 percent, and a teen pregnancy rate of 34 per 1000. As many as nine children die each day from gun injuries. Fifteen percent of children have special health care needs—and 20 percent have a mental health condition. We are in the midst of a childhood obesity epidemic. And we have unconscionable disparities: a black infant boy born today can count on a life that is five to seven years shorter than the white infant born in the hospital room next to his.
“Doctors, nurses, researchers, teachers, legislators, parents, grandparents, community leaders…we have a veritable army.”
Makes the survival of humanity look a little dicey. It’s easy to feel pessimistic, even.
But Palfrey isn’t pessimistic—because advocacy is alive and well and working all over the world. Right here at Boston Children’s we have people who are making a difference. Like Gary Fleisher, MD, who was one of the first to respond to the Haitian earthquake. Or Joanne Cox, MD, whose Young Parents Program supports teen moms. Or Mark Schuster, MD, PhD, whose work with the Los Angeles Unified Public School System helped fuel legislative change and bring healthier food to schoolchildren. The Pediatric Academic Societies meeting was filled with more examples of ways that people are working to improve the lives of children.
This, Palfrey said, is what would amaze Armstrong the most if he could see us now. Doctors, nurses, researchers, teachers, legislators, parents, grandparents, community leaders…we have a veritable army. And we need one.
Advocacy works best, Palfrey said, when we all work together. And what better reason than to do it for children, she said, “who bring light into our lives and hope into our world.”
Together, we have real power. Together, we can take care of children—and ensure the survival of humanity.