The answer is folic acid!

The problem in our part of the world is that the message has still not gone across the board


Raja Khalid Shabbir October 30, 2022
The writer is a doctor based in Islamabad. He tweets @drkhalidshab

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A phone call woke me up. I was too startled to notice the time but it was still dark outside. It was my barber. He asked me to see his pregnant wife’s ultrasound report which he had sent on my phone. By the time I had finished reading the report the sleepiness in me had been replaced by deep sorrow. The ultrasound revealed a pregnancy of four months with the baby’s brain failing to develop, a condition known as anencephaly.

I called back my barber and asked him if his wife ever took folic acid tablets before or during her pregnancy. I was not surprised to get the answer in negative. I later found out that he took his wife to a nearby hospital where his wife spent three days in the gynaecology ward and where they unfortunately lost the baby inside the mother. A fate, unfortunately, shared by thousands of other parents in our country. Folate is a naturally occurring vitamin in certain food products.

It is also known as vitamin B-9. Folic acid is its synthetic form and has a wide range of benefits. It plays a role in the prevention of anaemia, at the microscopic level it is involved in the repair of DNA, and of course during early fetal life it plays a crucial part in development especially with regard to the brain and spinal cord. Because of its health benefits the Food and Drug Administration (FDA) has made it mandatory for manufacturers to make folic acid a part of bread, rice and cereals across America.

Every day in the outpatient department we tend to babies who are born with abnormal swellings at the back, anywhere along the length of the spine. These swellings are jumbled-up masses of undeveloped nervous tissue. Again, this is simply because of folic acid deficiency during pregnancy. These babies usually have no power in their legs because of an underdeveloped spinal cord. The look of disbelief and horror on the parent’s face is something which doctors can never forget when they tell them that their baby will never be able to walk.

Folic acid intake needs to be started by women three months prior to getting pregnant. The tablets need to be continued during the first trimester (first three months) of pregnancy. These are golden bullets full of life and devoid of any harm. Folic acid is readily available across Pakistan and that too for as low as sixty rupees (0.25 cents). This amount is sufficient to get a three month long supply of folic acid tablets. The problem in our part of the world is that the message has still not gone across the board. We are living in the era of advanced technology and gadgets.

A single click or button can open up a multiverse of information. Unfortunately our people are getting access to only detrimental material. They are busy with applications which are being banned in developed countries. We need to guide and supervise the type of information which is being distributed. The fact that our masses are unaware of the magic pills which folic acid tablets are is because our health department lacks the intent and has failed to acknowledge it as an issue.

The result of all this are heart wrenching figures. Every 13 out of 1,000 live births have such brain and spinal cord defects. Different studies have quoted more or less similar figures. This is not a new revelation. When will we start guiding our unaware public and change the fate of these unlucky babies

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