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Sunday, August 7, 2011

Being well, doing well: VSO Health Screening at Royal Pride Community Academy

Hungry children find it difficult to learn.  So do sick children and tired children. The links between health, nutrition and learning are well established and universally accepted.

Health screening at Royal Pride.
Much of the work VSO volunteers have been doing at Royal Pride, the small nursery/primary school we have been supporting in the Mutungo slum, has concerned the children’s health.  Those of you who have been reading this blog will know that so far, with the help of friends in the UK, we have managed to make some improvements to the generally damp conditions in which the school operates on its site next to the swamp.   These conditions contribute to the high levels of malaria among the children. The playground is now drier since we provided loads of murram to raise its level, although we are still having problems with the wooden classrooms being flooded whenever it rains. Not only is it difficult for children to learn when they are sitting with their feet in water and mud, but any standing water attracts mosquitos, so a longer-term solution really is needed. Every time the classrooms flood, the classes have to be decanted and all 270 children crowd into the one brick building which stands above the water.

The wooden classroom block.

Muddy classroom floor, after a flood.
One major success has been the harvesting of water from the roof and installation of a water tank so that children can wash their hands after visiting the latrine. You will be pleased to know that the incidence of diarrhoea has gone down by about a half since this improvement was introduced, according to Godfrey, the headteacher.

Using the new water tap.
Another major success has been the school’s achievement of NGO status. This means that it is now an official not-for-profit organisation.  Its status was granted on the basis of its role as a community school focused on the needs of orphans and vulnerable children and their families.  Figures published today indicate that the number of orphans has increased nationally from 11.5% in 1999/2000 to 14.3% in 2009/2010. The 2010 data shows that 2.43 million of the 17.1 million children in Uganda are orphans and about 32,130 children between the ages of 10 and 17 are heading households. (Minister of State for Labour at the launch of the five-year National Strategic Programme Plan of Intervention for orphans and other vulnerable children.) Of the children in Royal Pride, about 70 are orphans and almost all the rest are vulnerable because of poverty, their own and family illness and traumatic events in their childhood. Health promotion is a key aspect of Royal Pride's support to local families. The next step in establishing the official status of the school will be licensing and then registration with the Ministry of Education and Sports. The school has already received its first visits from the local inspectorate.

The motto is a common one, not indicative of any denominational status!
Over time, however, it has become clear that the children have many health issues beyond those caused by poor accommodation and facilities. Food prices have rocketed here – doubled in the last month alone. Hardly any children now bring food with them at lunchtime.  Sometimes food fights break out as some try to grab what the lucky few have brought (usually little more than a couple of pieces of cassava). Almost all the families eat only once a day, and then not much.  They may have cassava, porridge, posho (cornflour) or beans, if they are lucky.  The government says that parents should send their children to school with food for lunch, but that simply means sending many of them to school with their evening meal to eat at lunchtime and then putting them to bed hungry.  Understandably, most parents prefer for the family to eat together at home in the evening. Hungry children find it difficult to concentrate on their work and are more susceptible to disease.

I've got my lunchbox.
VSO volunteers would like to introduce a feeding programme at the school, with the help of supporters back at home. However, before we can plan such an intervention we really need some idea of the main health issues affecting the children, hence this Friday’s health screening sessions.  Fortunately, we have two highly experienced medical professionals among the VSO volunteers, Jean, a nurse and midwife, and Simon, a doctor. Under their leadership, we planned a day of activities which included height and weight measurements, eyesight tests, medical checks and de-worming.

Dr Simon wields the stethoscope under Jean's watchful eye.
Romaine in charge of the scales.
Stuart in charge of the height chart.
The day was highly successful, if exhausting. While some children found it very exciting, for others it was quite overwhelming. Overall, about 170 turned up.  Many were absent because of malaria, so we will try to catch them later.  We still have to go through the results, but by half way through the day Simon had identified about half a dozen children about whom he had some significant concerns, possibly relating to HIV, repeated bouts of malaria, TB or other serious illnesses.  These children will need to go to local clinics with their families to be tested. Some children may need glasses, which will need to be paid for. We would like the height and weight measurements to be built into the curriculum so that the teachers can keep a track of those who are failing to thrive.  One of our volunteers is donating scales and buying a height measure for this purpose. Although we aim to provide porridge for all the children, as it would be invidious to choose among them, we will probably try to provide dietary supplements for those who are significantly underweight. De-worming is an important aspect of healthcare and needs to be repeated regularly.  Many of the children had swollen stomachs, indicative of the presence of worms.  Worms prevent children absorbing the nutritional benefits of any food they eat.  Simon also checked them for skin diseases, listened to their chests and hearts and looked for any signs of infection.


I'm not so sure about this de-worming business - Godfrey reassures.
Nor am I.

Not so bad, after all.
In addition to all these medical and nutritional interventions, we must continue improving the building.  If we are going to store food in the headteacher’s office, the only room which can be locked, we need to provide a metal door.  Locals have already tried to break in and once they know food is being stored there, the risks will increase. We also need to raise money for a solid concrete foundation for the second building to raise it above the ground so that it doesn’t flood.  That is probably the next priority.  Also important in the longer term is the provision of a second block of latrines.  At the moment the only latrine block is shared among all children, from three to sixteen in age, and is used by both boys and girls.  There are no latrines for staff.

Nice clean latrines at Royal Pride.
Another Next Step is to hold a health information day for parents, probably at the beginning of September.  One of the VSO volunteers outside Kampala is a nutritionist and we would like to provide advice to families on how to increase the nutritional value of easily available local food. Other advice will relate to the prevention of malaria through using bed nets, and how to avoid water-borne diseases.

So, we will be busy over the next few months.  All this work with Royal Pride is on top of volunteers’ everyday jobs.  VSO provides a small amount of money which we have used to buy de-worming tablets, produce health cards and provide other materials for the health screening.  However, Royal Pride is a cluster project, not a mainstream VSO project, so all the improvements to accommodation, any health treatments such as glasses, and the feeding programme need to be provided out of funds raised specifically for that purpose, principally from among our friends and families in our home countries. If you would like to make a contribution to this work and are one of our former work colleagues, please get in touch with Jane Renton.  Other possibilities are to give contributions to any others of our friends or family members whom you might know. Alternatively, email me direct on elisabethritchie@gmail.com and I will let you know how to get money to us.

School staff fill in the cards.

Waiting patiently, health cards in hand.
Our turn next.
Once a teacher, always a teacher.  Tommy in full flow under the awning.


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