Monday, March 26, 2007

A Visit to the Consultation Bureau

This morning, Ellie had her first visit to the Consultation Bureau. The Consultation Bureau is an institution here in Holland that looks after children's development and well-being from birth to age four. It is not the same as a pediatrician's office. If the child is sick, he or she visits the family doctor and may be referred on to a specialist at the children's hospital from there. The Consultation Bureau is a well-baby clinic (of sorts). Being a foreign concept to me, I admit that I lived in moderate dread of it until recently. Today's visit wiped out any remaining reservations I might have had. It is truly impressive! Recently, The Netherlands topped a UNICEF list for best countries for children, and I am starting to understand why. I find it amazing that there is a state institution in place to follow infant and toddler development and well-being. Wow.
A little over a week ago, the Consultation Bureau sent a nurse to our home (by appointment beforehand). She came to set up all the initial administrative hoopla (shot records, developmental milestones, etc.). They say this initial visit is done in the home for the convenience of the parents and comfort of the children, but we also suspect it is a good way for them to check out the home environment for red flags. The idea of being inspected had me in a frenzy, but when you think about it, what a brilliant thing! It's not as if the nurse really inspected my home, but you know yourself that you can get a feel for how people live when you enter their homes, even briefly. That home visit is a good way for the state to check the welfare of the child at the start.
Today's visit to the local office was for a well-baby check-up and (alas) immunizations. When we arrived, we were told that one other family was waiting ahead of us, so when we saw them go in, I was asked to strip Ellie down to a clean diaper. The rooms were nice and warm for that purpose. Ellie didn't mind at all. She ran around like a monkey in her nappy, playing in a toy house they had set up and dancing with a doll she found. A staff person took her height and weight measurements, and then Ellie went back to running around naked and free.


When it was our turn, we went into the office and Ellie sat on the large desk, which was heavily padded on one end for a sitting space. The doctor (?--she introduced herself by name not title and she wasn't wearing a lab coat...on the other hand, neither does our family doctor, so I just don't know) handed her some small colored wooden blocks, and then she watched to see what Ellie would do with them. She explained to me that she was going to check Ellie's development through observation. After a few minutes of playing, the doctor (?) offered Ellie a tiny wadded up piece of paper in her open palm. She asked Ellie to take it and put it back; then she moved her palm closer to Ellie's other hand and repeated the process (checking pincer grasp, ability to use both hands equally well, hand-eye coordination, ability to follow simple commands). Then, she put a block back in front of Ellie and handed her another one, asking her to stack it on top. She repeated this one on the other side as well, and then she checked to see if Ellie would lift blocks in both hands at the same time. After that, she got out a soft, colored ball and placed Ellie on the floor. She wanted to check her balance and steadiness while walking and standing. Ellie carried the ball all around. She wasn't interested in throwing it as requested (easy way to check how steady she is when she throws the ball), but she seemed more than steady enough to satisfy. All in all, it was fascinating to me. In the US, I take Ellie to a pediatrician's office that I rave about, and they don't check these things at all. They may ask how she does, but they don't observe it. Ellie just enjoyed playing, so the little tests didn't phase her a bit! Unfortunately, the immunizations at the end did upset her quite a bit, but that's understandable. We may be done with those now until she's four. Hooray!

Finally, since this is labeled a "life in Holland" post, I have to tack on a photo of Ellie at the end of our journey. The Consultation Bureau we will use is about 10 minutes away by bike. We were happy to have beautiful sunny weather for our trip!

5 comments:

Gail Weaver said...

That photo is too cute - it looks as though Ellie is driving the bike.

That's a fascinating post that highlights the approaches that different cultures take towards children, well being, health, etc. I mean, just the idea of a "wellness" visit as opposed to the traditional American "sickness" visit to medical professionals is vastly different, philosophically speaking. For example, just the other day I was mentioning to someone at work that I should make an appointment with my doctor. I was, of course, immediately asked if I am OK, and when I explained that I just wanted to go in for my yearly check-up, I was met with a blank look. In our society, we are generally expected to steer clear of MDs until we suspect that we have a problem. Hmmmmmmm - proactive care vs. reactive treatment ... that really does sum up, in my opinion, one of the reasons why Americans, in general, are developing so many preventable diseases and conditions.

Unknown said...

Gail, both of your points are excellent. Ellie can drive my bike anytime! And, yes, Americans are weird about their approach to health. It's more like they're afraid of death instead of wanting to live a healthy life.

Anonymous said...

For a long time I've held the belief that preventive care would solve so many problems in this country. And I'm surprised that money hungry companies haven't fully figured this idea out that if you catch the small stuff early, it prevents bigger problems in the future thus increasing your productivity.

Ironically enough I know plenty of Americans who feel this way, but unfortunately the way our health care system is set up, a lot of people can't afford to go and get checked out regularly, (myself included.) Then it gets to a point where they don't have a choice because whatever ailment they have has progressed so much now they have to be treated for it.

I hoping that health care is one of the main issues that comes up in the next presidential election. It's something that needs to be addressed, especially given that as baby boomers get older, (not a knock, just a fact as I'm currently dealing with two of those boomers.) our health care system is only going to become more taxed. If it doesn't get dealt with soon, it's going to be a real ugly scene.....

Anonymous said...

Rats, I've done it again. That last long comment was by Azure, apparently the person who doesn't like to put her name on the comments... ARUGH!

Jennifer said...

I'm so pleased this post generated some great commentary! Please keep it up!

As for my two cents on US healthcare, I personally resent the fact that most doctors are far too preoccupied with protecting themselves than providing correct care, as well as the tendency to react only to individual symptoms rather than looking at holistic solutions. The pharmaceutical industry ensures that drugs are quickly and heavily prescribed...is it all necessary? The Consultation Bureau looks after Ellie's total development, not just her daily health. At the very least, the US should provide quality healthcare and wellness for its children! Perhaps if more healthy habits could be established in our youth, the better off adults would be further down the line.