by Kresge Foundation Staff
Detroit pediatrician, Dr. Nakia Williams, discusses the importance of treating the whole child and not just the illness.
Internalized stress can exacerbate certain health conditions, like asthma (a prevalent condition in Detroit), and lead to behavioral issues. One problem can quickly become many.
Williams shares those observations as a member of the Hope Starts Here Family Well-being Strategy Team. Launched in 2016, Hope Starts Here is a joint community-engagement project of the W.K. Kellogg Foundation and the Kresge Foundation aimed at helping all Detroit children reach their full potential. The strategy teams create ideas and solutions for the program’s 10-year framework. The ultimate goal is the make Detroit a city that puts children and families first by 2027.
There are challenges.
According to Dr. Williams, it’s harder than ever to be a parent as they juggle careers and child care, especially with the over-abundance of conflicting information. It can be hard to know when to protect your child and when to encourage them to explore this fast-paced world. But, she hopes parents aren’t afraid to ask for advice, especially from their child’s doctor.
The alarm sounds at 5:45 a.m. for Nakia Williams, a pediatrician and mother of two.
Williams, 38, says that it’s important she makes time for her morning Bible devotion and prayer. This helps her to reflect and recharge. “Working with so many people and addressing their needs can be challenging,” she says.
But before heading off to a packed day at the clinic to see children and concerned parents, she has her own children to attend to – 2-year old son, Zion, and 13-year-old step-daughter, Zoe, whom she likes to refer to as her “bonus child.”
Williams tries to drop her son off at daycare most days and is grateful to have found a place she trusts. “Sometimes Zion wants extra hugs and kisses and, for the most part, I’ll stay for a while to make sure he’s comfortable. I know he’s going to be there for ten hours until I return,” says Williams.
She was a small child herself when she first started entertaining the idea of becoming a doctor. “My mother reminded me that I was 3.” But it would be some years later before she realized her desire to become a pediatrician.
“When I was in medical school, I did not like pediatrics,” she says. But as she went through rotations in Flint, her feelings changed. She watched as pediatricians inquired about the whole child and not just the illness. “They wanted to know the whole picture. I thought I can do that. I don’t have to be the smartest person in the world, but I can be a people person.”
She is continually impressed by the selfless way children look at the world. When she was at Children’s Hospital of Michigan, she says that the terminally ill patients were always more concerned about the well-being of others after they were gone.
“Children are amazing patients to take care of. They say ‘Someone take care of my Mommy.’ They are always worried about someone else. Isn’t that an awesome example to live by?”
How One Problem Can Become Many
In her practice, Williams says the most common reasons for visits are check-ups, skin issues, such as eczema and insect bites, and respiratory-related ailments – colds, coughs and asthma. Respiratory issues can be exacerbated by living in Detroit. The rate of asthma-related ER visits for children in Detroit is about twice that for the rest of Michigan.
Most of her patients are under the age of five, the importance of which does not escape her. “Most a child’s brain development occurs in the first five years. The child is learning more things at this point than perhaps any other time in their life,” she says.
Williams was one of more than 18,000 Detroit parents, caregivers, educators and community member who provided input, ideas and feedback for the in many ways, from a citywide parent survey to over 125 listening sessions.
We listened and learned from more than 18,000.
Treating children during such a pivotal point in their lives, Williams tries to emulate the pediatricians she watched in medical school and treat the whole child. This means understanding their routines and family dynamic. She shares in their worries, as well as in their happiness and victories. She says, “They become like family.”
“As a pediatrician, I have the privilege of partnering with parents to help to raise a multitude of children.” But she says there are many obstacles. She sees toddlers who aren’t getting enough sleep due to parents’ busy work schedules and parents who are overly stressed. She is often asked about job openings and WIC (Women, Infants, and Children, nutrition and food services), as well as counseling options for children when a family is broken up by death, divorce or protective services.
“These are very real concerns that have to be addressed in some way because the children start to exhibit symptoms of increased stress-related illness, which can include asthma.” This can lead to increased absence at school and behavioral problems.
She often works together with parents to stop problems from snowballing. Even a mild speech delay, if untreated, can lead to delays in potty-training. It can lead to a child starting school with additional delays and adversely affect their education.
“When children are delayed in their education, they can experience psychological challenges presenting as aggressive [or] depressed behavior with origins unbeknownst to the child,” cautions Williams. She says she sees a fair amount of behavioral problems in her patient population.
She mentions the children’s literacy bill Governor Snyder signed last fall. Children who aren’t proficient in reading by third grade would be held back. But Williams says issues start long before that. “Children don’t start becoming behind in literacy in the third grade though; it starts early and they fail to catch up.”
A Different Kind of Medicine
Williams believes that the doctor’s office should be a one-stop shop for all of a parent’s concerns and should include social workers. She says such a multifaceted model would likely be time- and money-saving. “I could [also] spend more time dealing with the direct health needs of the patients.”
But Williams is amassing quite the stockpile of information herself and often reaches out directly to children’s schools to learn how they are progressing between visits. She teaches her medical students and residents to do the same: “They are learning a different kind of medicine at our clinic. We are not only addressing bread-and-butter pediatrics but dealing with social issues that affect our patients.”
Families today are under an inordinate amount of strain, but Williams is hopeful. She thinks we are reaching a critical point in Detroit. She sees more opportunities for early childhood education and intervention in the city. “There are several dedicated individuals and funding resources that are committed to helping. Now is our time to act.”
With all of the conflicting information out there, Williams thinks that being a parent is harder than ever. She urges parents to take the time to appreciate their children, forming support groups if needed. Being able to take a break helps us to become better parents. “Don’t be afraid to ask questions ([of the] non-judgmental sources you trust (like pediatricians).
“Love your children. Enjoy your children. Read to your children. Sing with your children. Expose them to the world.”
To learn more about Hope Starts Here please click here.