ACE

Naupang doctor ka nih angin OPD-a naupang entir tur an rawn hruai zingah, laina hnaite laka khuaikhem tawk hmuh tur an awm ṭhin a. Nu mangang tak tak, mualpho hlau bawk si leh pa, chhungte mitmei ven avanga fate thlavang hauh ngam lo, fate hma lam hun dawn loa pawi khawihtu report ngam lo hmuh chang hian rilru a na a. Khang naupang, taksa leh rilrua hliam tuarte kha engtin nge an awm zel ang aw tihte ka ngaihtuah fo ṭhin.

Kan ram dinhmun kan thlir chuan zu leh ruihhloin min run nasa a, nupa inṭhenna leh mipat-hmeichhiat hman khawlohna a pung zel a. HIV/AIDS vei an pung a, jail, de-addiction center leh Home a khat reng a. Kum 10 vel kal ta aṭang phei kha chuan Non-Communicable Diseases (inkaichhawn theih loh natna), cancer, zunthlum, BP sang, lung natna, stroke leh rilru lam natna chi hrang hrang a hluar sawt hle bawk.

Kum 1990 chho aṭang tawhin sawrkar, khawtlang, NGO, mimal ṭhahnemngai leh Kohhran ngei pawhin do leh tihrem tumin sum, hun leh tha nasa tak an seng a. Mahse, kiam zai reng an rel si lo, kan pung zel zawk a. Eng nge a chhan ni ang? Kan ral rel danah hian hriat hmaih kan nei em ni? Kan ral rel dan hi thlak a ngai em ni?

ACE Study

ACEs (Adverse Childhood Experiences) awmzia chu, miin, an naupan laia (0-18 years) taksa leh rilru lama thil ṭha lo, an hma lam huna an taksa, rilru leh nungchang thlenga nghawng pawi thei, tawnhriat an neihte hi tiin a sawi theih awm e. ACE chungchang zirchianna hi, CDC (Centre for Disease Control & Prevention) USA leh Kaiser Permanente te ṭangkawpin 1995-1997 chhung khan an nei a. Zirchiannaah hian puitling 17000, eizawnna ṭha pangngai nei (middle class), mi ngo, health insurance neite an tel a ni.

Dr Nadine Burke-Harris, paediatrician, Surgeon General of California lo ni tawh chuan, “ACE Study ka hmuh ni aṭangin ka damlo en dan leh ka eizawnna a danglam a. He zirchianna hi mi zawng zawngin an hriat vek a ṭul a ni,” tiin ACE study pawimawhzia a sawi a ni.

He zirchiannaa telte hnenah hian a hnuaia thil chi sawm hi an naupan laia an tawh leh tawh loh an zawt a –

A. Tihnawmnahna (Abuse)

1) Taksa lamah

2) Rilru leh thinlung lamah

3) Mipat-hmeichhiatna lamah

B. Ngaihsak lohna (Neglect)

4) Taksa lamah

5) Rilru leh thinlung lamah

C. Chhungkaw kalphung dik lo (Household Dysfunction)

6) Rilru lam natna nei awm

7) Nute chunga tharum thawhna thleng

8) Nupa inṭhen emaw, awm hrang

9) Chhungkaw zinga mi lung ina tang awm

10) Ruihhlo hman sualna

Heng 10 zinga mi hi an chunga thleng a awm chuan, pakhatah ACE score point pakhat zel pek an ni. Zirchianna aṭanga an hmuh chhuahte chu –

1. ACEs hi a lo hluar hle a. Mi 17000 zinga 67% in ACE score pakhat tal an nei a, 12.5% (1/8th) chuan ACE score 4 emaw, a aia tam an nei a. Mi 28% chuan taksa lama tihduhdahna an tuar a, 21% chuan mipat-hmeichhiatna lama tihduhdahna an tawk tih an sawi.

2. Miin ACE score an neih tam poh leh an hriselna dinhmun a ṭha lo a, ACE score nei lote aiin an dam hun chhung pawh a tawi. ACE score 4 emaw, a aia tam nei chu, a nei ve lote aiin chuap natna benvawn (COPD) neih theihna a let hnih leh a chanve, depression neih theihna a let li leh a chanve leh, mahni intihhlum theihna a let sawmpahnihin an nei sang a ni. ACE score 7 emaw, a aia tam nei phei chuan a nei lote aiin chuap cancer neih theihna chance let thum leh, lung natna (Ischaemic Heart Disease) neihna chance let thum leh chanve a sang an nei a ni.

UK-a zirchiannaa an hmuh chhuah-ah chuan, ACE score 4 aia tam neite chu nei ve lote aiin –

1. Meizial zuk chin theihna a let thumin a tam

2. Kum 16 hmaa sex hman theihna a let ngain a tam

3. Zu in chhin theihna a let sarihin a tam

4. Ruihhloa inchiu theihna a let sawmin a tam

5. Jail-a tan theihna a let sawmpakhat-in a tam a

6. Intihhlum tum hi a let sawmpahnih-in a tam.

ACE-te hi rim tawngna hlauhawm (toxic stress) thlentu pawimawh tak a ni a. Harsatna emaw, hlauhna kan tawhin, kan taksain hmachhawn turin stress hormones hrang hrang – adrenaline, cortisol te a pe chhuak a. Mahse, heng harsatnate hi a thil tawn fo a lo nih chuan, a taksa chu a lo rim tawng (toxic stress) ṭhin a. Chu chuan naupang thluak leh taksa la insiam mekah nghawng neiin, a thluak insiam dan (brain architecture) a tidanglam ṭhin. Chuvangin, naupan laia thil ṭha lo tawn tam hian thluak leh taksa ṭhan dan pangngai a tidanglam a, hormone leh immune system-te tidanglamin, an DNA awm dan thlengin a tidanglam thei a ni.

ACE-ten naupang thluak insiam meka nghawng a neih dan tlangpui –

1. Ngaihtuahna pek, thil hriat theihna leh nungchanga harsatna (disorder) neih theihna a ti sang.

2. A thim zawngin thil an thlir a, insum theih lohna (impulsive personality disorder) an nei nasa. Chutih rualin, tha thona, mahni inrin tawkna, dik nia inhriatah pawh huai ngamna an nei tlem.

3. School-a thil zir leh chhiar lamah harsat an nei a, an IQ a hniam a.

4. Rilru lam natna, anxiety leh depression te, natna benvawn dangte an upat hnuah neih theihna a sang.

5. ACE-te hi chhungkuaah a lo lang nawn leh fo ṭhin a ni.

Dr Nadine Burke Harris-i chuan, “ACE-tea chona lian tak chu naupan laia tawnhriat ṭha lote hi chhuan hrang hrangah a rawn lang nawn fo hi a ni. Hei hi a taka tawng ka nih avanga sawi ngam ka ni,” a ti.

ACE hi engtin nge kan hmachhawn ang?

1. Thil awm ngei leh thil thleng mek a ni tih hriat a, pawm. Nu leh pate leh zirtirtute hetiang lam inzirtirna neih tam a pawimawh.

2. Khawtlanga harsatna leh sualna tam tak ṭo bul leh, hriselna leh dam hun chhung nghawng thei pawimawh tak pakhat a ni tih hriat a, ACE titlem tura mi tinin kan mawhphurhna hriat. Dr Robert Bloch, American Academy of Paediatrics-a an President ṭhin chuan, “ACE-te hi a mal laka khawtlang hriselna atana hlauhawm (threat) tak, ngaihsak hlawh lo ber a ni,” a ti hial a ni.

3. Hetiang thil lo tawng tawhten an lo dam leh theih nan, an mamawh hmangaihna pek a, dawh thei taka dawm a, inlaichinna ṭha nei tura puih.

4. Mahni insitna an neih len avangin, an tuina emaw, an thiam leh theih lam zirtir a, mahni inrin tawkna leh hlutna nei tura puih.

5. Stress titlem turin hahchawlhna, taksa sawizawina hun siamsak.

6. An nun chhoh zelna atana pawimawh insawr bing theihna, insiamrem theihna, insum theihna, tum mumal leh ruahmanna neih te zirtir a, chumi tihlawhtling tura fuih leh a ṭul huna puih.

7. Naupan laia thil ṭha lo tawngten ACE nghawng hi an tuar vek kher lo. Chuvangin, chan tawka khua rel anga ngaih tur a ni lo. Dr Nadine Burke Harris-i bawk hian, “Huaisen taka ACE-te kan hmachawn a, mahni leh min pui theitute kan pur chuan, chhuan khatah pawh ACE leh Toxic Stress te hi a zatvein a tih tlem thei ka ring,” a ti a ni.

Kristiante hian ACE lakah engtin nge naupangte kan ven ang?

Lal Isua khan naupangte thlavang a hauh na hle a. Jerusalem nuten an fata Isua hnena an rawn hruai khan zirtirten an lo hnar a. Isua a lungni lo em em a, “Naupang tete ka hnenah han kaltir rawh u, Pathian ram chu hetiang mite ta a ni si a,” a ti a. An mahni a lo kuah a, mal a sawmsak a ni. “Vanramah tu nge ropui ber ang?” tih an zawh pawhin, naupang te ang an nih loh chuan vanramah an lut tawp lo vang, a ti a (Matthaia 18:1-9). Lal Isua khan naupang pakhat pawh titlutu chu, an nghawngah buh rawt sawmna lung awrhtir a, tuifinriata thlak daih pawh an tan a ṭha zawk, a ti hial a ni.

Naupangte nun kawng dik – an kalna awm kawng, an upat hun pawha an thlah loh tur zirtir hi kan mawhphurhna a ni. Hmangaih tak a, “Lalpa thununna leh zilhnaa enkawl,” turin min hrilh bawk a. Heta thununna tih hi hmangaihna nen a, an ṭhatna tur leh an nun siam ṭhatna tur a ni a, ACE-te nen a inang lo. Naupangte chunga thil ṭha lo thlen tirtu ni lo tur leh, thlentir tumtute laka veng a, a tuarte chawmdawl a, ṭanpuitu ni tura ṭan lak a pawimawh hle.

Naupangte chunga ACE thleng tur kan ven a, a lo tlem hian, kan rama naupangte tawrhna leh khawtlanga sualna leh natna tam tak kan titlemin, ṭhang tharte tan seilenna boruak hrisel zawk kan siamsak dawn a ni. Hemi kawngah hian mipuite kan harh chhuah a pawimawhin a hun tawh tak zet. Thil ṭha lo zep a, a tisualtute humtu kan nih loh ngam a pawimawh. Pathianin sual a huat angin, naupang chunga pawi khawihna hi kan huain kan do ngam tur a ni. Tichuan, kan khawtlang hi naupangte selenna atana hmun him a lo ni ang a, chhungkua, ram leh Pathian tana mi ṭangkai niin, an dam chhan an hlen chhuak thei dawn a ni..

Lalpan kan ram tidam leh rawh se!

- Dr Lalmalsawmi Hmar