Editorial: should medicines be kept away from children? African considerations.

Abstract

Medicines often carry a warning: Keep away from children . Who are these children? How old are they? The warning assumes that children do not know the difference between a sweet and a pill, or between lemonade and medicinal syrup. It assumes that children’s knowledge and responsibilities are, and ought to be, different from those of adults, based upon a concept of childhood as fundamentally different from adulthood, and of medicine as a domain of experts (Geissler et al. 2001). This concept is historically and geographically specific, originating in 19th century Europe, and its validity cannot be assumed to hold true for, say, rural Africa at the beginning of the 21st century. Children in rural African households may have a low position in the domestic hierarchy, but they participate in most activities and are given considerable responsibilities early in life. In this sense, rural African children are far more adult than children of the same age group in Europe. Their status as a child is marked by more peripheral participation in vital daily activities, but not by exclusion from them (Weisner et al. 1997). They do important work in the house, such as looking after younger brothers and sisters, fetching water or firewood, and cooking. They know how to behave and can keep secrets like adults. They also participate in the collection and preparation of herbal medicines and are sent to buy pharmaceuticals (Sternberg et al. 2000; Prince & Geissler 2001; Prince et al. 2001). Handling medicines is a sign of being a responsible person at a young age, and it underlines the fact that medicine and treatment are not seen as an exclusively expert domain, but as a field of practice to which all responsible persons, including children, can contribute.