Kimiko Enomoto writes:

Although we have improvement in worldwide life expectancy, and progress in medical science, we still have various problems with respect to world health. Especially in adolescence, there are complex problems. They are not only medical problems, but also tightly connected to social issues. Characteristic of adolescents, they have almost matured physically, but not mentally. They tend to behave like adults without thinking whether it is good or bad, and are strongly influenced by adults. This means that they establish some behavior patterns which are not always good and which can reflect larger social problems as well as public health problems.

Problems of adolescents' health mainly result from bad behavior patterns. They have strong desires to have sexual relationships, but generally they lack knowledge about their bodies. This causes unwanted pregnancy and increasing infections of STD, HIV and AIDS, and these problems occur much more among adolescents than in other age groups, especially with adolescent girls in developing countries. And teenage pregnancy carries higher rates of death than adult pregnancy as well as longer term complications.

Another the big problems for adolescents' health is addiction; they start smoking, drinking and using drugs when they are teenagers. Especially street children do so, children who are growing in large numbers, as many as 100 million, and these young people of the streets are at greater risk of malnutrition and infectious diseases, including STD, HIV and AIDS.

To solve these problems, what can we do as members of the Japanese medical community? There are three ways to approach the problems, I think. First, we can make the full use of Japanese medical science, and try to develop new medicines for STD, especially for HIV and AIDS. But developing medicines isn't enough. This can only be treatment of their physical diseases. As written above, problems are strongly related to their life style based on social influences and diseases. So to approach the problems, second, we must educate adolescents, give them information about their bodies and about how dangerous their life styles are: sex, smoking, drinking and using drugs. We do not inhibit sex and other habits, but teach them how they can protect their bodies, then let them decide what to do.

A third approach is most important: we people in medicine ourselves must act as good role models for them. Most adolescents who have bad habits lack education, chances to go to school, etc. For them, adults around them who have bad habits are their models and their whole world. Adolescents are matured physically, but not mentally. In order to help their mental maturation and identify who they are, they need adults as their models. So we have to be models as adults without practicing bad habits, by just behaving as usual, to let them know about other life styles and their merit and to let them know that people can be healthy without bad habits.

And finally, we should work on not only adolescents but also native doctors and nurses to help adolescents in their own countries, because in most cases, we, members of the Japanese medical community, cannot stay and join the effort for a long time. And adolescents can identify adults from their own countries more easily than adults from foreign countries. So we must educate native medical staff and let them know what they should do regarding not only medical treatment but also education of their adolescents and providing role models. Their behaviors, working with special knowledge and living without bad habits, can let adolescents think why these adults seem to be happy without smoking, drugs, and drinking and staying healthy, and also let them notice how their own bad habits are bad for their health.

Education is by far the most important step for their future, that is, having jobs they want and living in a healthy way.

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