Kumaragara: Children Ward (Room), Ayurvedic Perspective

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Children were considered with high accord in the ancient times and every bit of their needs and necessities were handled with precision and sense of responsibility, care and affection. Every minute aspect of handling the newly born child, infants, toddlers or grown up kids were well planned and skillfully implemented. The method in which these delicate things were handled with a blend of perfectness is highly appreciable. 

The concept of Kumaragara or children’s ward (children’s room) detailed in the Ayurvedic treatises stands as a proof of exemplary pediatric management in the ancient days. The engineering of these special wards for children, the necessary things and amenities with which it should be equipped, the arrangement of different things, the attendance of nursing staff etc are explained in detail in Ayurvedic texts.

Kumaragara
अथो अनन्तरं कुमारागार विधिं अनुव्याख्यास्यामः – वास्तु विध्या कुशलः प्रशस्तं रम्यं अतमस्कं निवातं प्रवात एक देशं दृढम् अपगत श्वापदपश दंष्ट्रि मूषिक पतङ्ग सुविभक्त सलिल उलूखल मूत्र वर्चः स्थान स्नान भूमि महानसं ऋतु सुखं यथ ऋतु शयन आसन स्तरण सम्पन्नं कुर्यात्, तथा सुविहित रक्षा विधान बलि मङ्गल होम प्रायश्चित्तं शुचि वृद्ध वैध्य अनुरक्त जन सम्पूर्णम्। इति कुमारागार विधिः। (च.शा.८/५९)

प्रशस्त वास्तु शरणं सज्ज उपकरणं शुचि।
निर्वातं च प्रवातं च वृद्ध स्त्री वैध्य सेवितम्॥
निर्मत्कुण आखु मशकम् अतमस्कं च शस्यते॥(अ.सं.उ.१/३५)

Salient features of Kumaaragara –
Vastu vidhya kushala nirmita / Prashasta vaastu sharanam – The Kumaragara should be built under the guidance and supervision of Vastu vidhya kushalas i.e. architecture engineers knowing directions and placements of rooms, doors, windows, things, essentials in precision and in relation with astronomical concurrence.

Prashastam – The Kumaragara should be built in an auspicious place in an auspicious time and should include auspicious and wholesome things well equipped within the ward

Ramyam – The ward should be beautiful and attractive
Atamaskam – The child’s room should be devoid of darkness, it should be illuminated. It should be constructed in such a way that it provides adequate entry of the Sun’s light

Nirvatam, Pravata Eka Desham – The room should be devoid of heavy breeze, but the room should be sufficiently aerated so as to be sufficient for the child. Care should be taken so as to the air coming into the room should not be directly coming into contact with the child. The doors and windows should be built with such care and precision.

Sajja upakaranam – The ward should be well equipped with all essential things and staff needed for the child and child care. Each and everything should be placed in places meant for them, cleanly arranged. Everything should suit the need and taste of the child.

Shuchi – The ward should be clean
Drudham – Construction of the ward should be strong and stable
Apagata Shwaa aadi – Devoid of dogs, insects, flies, butterflies, mosquitoes’, rats etc. The construction should be protected from entry of animals like dogs, cats or any other dangerous and wild animals which could scare or harm the child.

Suvibhakta – The ward should be well classified and demarcated with specific places, shelves and rooms meant for specific things.
Kreeda Bhumi evam Kreedanaka – Play ground and toys are life of the child. The child learns and explores while playing. Playing keeps the child physically and mentally engaged and healthy, it also provides the essential exercise to the child. Therefore a separate room with an even surface which forms the playground for the child should be in-built within the kumaragara. The kumaragara should be well equipped with various sorts of toys which are pleasing and amusing to the child and at the same time doesn’t harm the child.

Salila, ulookhala sthaana – Separate spaces or places should be reserved for placing water (tank or water filled vessels or pots), mortar and pestle etc

Mootra Varcha Sthaana, Snana bhumi, Mahanasa – Separate rooms should be constructed for toilet purposes (voiding urine and stools), for bathing the child (bathroom) and for cooking purposes (kitchen)

Rutu Sukham – The ward should be built and arranged in accordance with the season, i.e. the comforts should be according to the season (and should be altered with every coming season, accordingly)

Yatha Rutu shayana, aasana, starana sampannam – The cot, bedding, seating etc arrangements should be according to the seasonal changes. The necessary changes should be made with respect to these things as and when the season changes so as to make it seasonally comfortable and compatible to the child.

Suvihita Raksha Vidhana Bali Mangala Homa Praschitam – The ward should be the one in which the raksha vidhanas (protective measures and rituals done for the welfare of the child), Bali (sacrifices or sacrificial rituals), Mangala (auspicious rituals), Homa (fire sacrifices), Prayaschitam (repentance) etc rituals have been religiously or aesthetically performed before bringing the child into the ward. These measures are said to sanctify, purify and sterilize the area and provide protection to the child.

Shuchi Vruddha Vaidhya Anurakta Jana Sampoornan – The ward should have the presence of aged and experienced care-takers or nurses who are also clean, experienced physicians and people who are beloved to the child. Those people also should be affectionate in nature and should be dedicated towards child-care.

Kumaradhara – Male Nurses for the child
अभियुक्तः सदाचारो न अति स्थूलो न लोलुपः।
कुमारधारः कर्तव्यः तत्र आध्यो बाल चित्तवित्॥
अधार्मिकं दुराचारः स्थूलो विकट गामिनम्।
करोति लोलुपो बालं घस्मरत्वेन रोगिणम्॥(अ.सं.उ.१/७१-७२) 

Kumaradhara means those who take care of the child, those who support and nurse the child, keep a watch and attend to all the necessities of the child in the ward. They can be considered as male nurses. Acharya Vaghbhata in his Ashtanga Sangraha tells about the nature and quality of Kumaradhara appointed to take care of the child and assigned a job in the Kumaragara or child ward.
Read related: Ayurvedic Care Of The Neonate: Initial Four Weeks

Characteristic features (qualities) of Kumaradhara or Abhiyukta –
Sadachari – He should be a person who is known to be indulged in good and wholesome deeds. He should be a role model in terms of his lifestyle, character and conduct. He should be noble and pious. These qualities give a surety that the person will take care of the child in the ward and all the needs of the child with utmost care, concern and dedication. He will surely be duty-bounded, prompt and genuine. He will get himself involved in providing selfless love and care towards the child. He might also leave his impression on the child. The child quickly learns and follows the qualities from those people who are nearby and to whom the child is exposed to for maximum time period. This would make the child a sadachari.

Na ati sthoola – The care-taker should not be too fat or over-weight. Being obese, he will obviously be lazy and will not be able to perform his duties properly. He will not be able to dedicate himself in total care of the child. This may prove harmful to the child as the child should be delicately dealt with at that tender age and all the necessities should be taken care of with utmost precision. To do this, an active person should be present in the ward in the form of nurse.

Na ati lolupaha – The nurse should not be greedy. He should have an extremely good control over his senses. If the person is greedy, he will steal everything or most things which belong to the child. The basic facilities and necessities needed for the child will not reach the child and might prove harmful. These people who are greedy are not trust-worthy. They will always have a bad vision on anything the child eats or drinks.

Kartavya Tatpara – The care-taker of the child or male nurse should be duty minded and duty bound. He should not give priority to anything other than taking care of the well-being and welfare of the child. He should be totally dedicated to the assigned job. He should be disciplined and follow the protocol related to ‘child care’ in the ward.

Baala Chittavat – The male nurse should be the one who understands or mastered the virtue of understanding the child’s mentality. The child cannot explain or indicate what it wants and what not. The care-taker assigned for that work should be instinctive and should have a foresight of what the child needs. He should check all the basic necessities and amenities needed for the child and keep them ready. He should be supervising every bit of the child’s need with precision. It is good if he is trained in child psychiatry or the person who is well versed in this field shall be employed. The person employed for child care should know about the wants and needs of the child, tastes of the child, should read the physical and mental signs made by the child and also the emotions displayed by the child and should have a thorough knowledge of the ‘age-wise-needs’ of the child. Only such person will be a perfect plug-in into the job of comprehensive child-care. One who is grounded and tries to be a child along with the child can understand the child better, only he can take good care of the child.

Acharya Vagbhata tells – ‘A care-taker who is adharmika (unethical, doesn’t follow dharma), durachari (person having bad habits, cunning, wicked and crooked), sthula (fat and obese, lazy, lethargic) and vikatagaami (who have bad ways of living) do not satisfy the job profile of male nurse. They will make the kid as they are and influence the child to develop bad habits, bad ways of living, learn bad manners, greedy and diseased. They should always be kept away from the child.’

Just before Finishing –
A playful child in our vicinity sets up a ‘stress-free’ situation. It is important to take care of the child at all stages of development, provide space, time and amenities along with love, care and affection for the child to develop with good physical and mental health. The concept of Kumaragara and Kumaradhara explained in Ayurveda gives us information about the comprehensive pediatric care of the ancient days. It also shows that the child was dealt as a respectful individual and an independent life and all facilities were provided including independent space for comprehensive growth and well-being of the child. This article shares the ancient wisdom of Kumaragara with our readers!!
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