School Health Clubs
Students
teaching students in rural Nepal
A
project by the HEAR Nepal association
(Represented
by Sten Linnander, StenLinnander@gmail.com)
Just a few days after arriving
in Kathmandu, I was accosted by a young man on the street with the word
“Namaste.” Thus began a new project for me. The man, whose name is Madhav
Joshi, had an idea about
how to overcome the serious health situation in the poorer parts of Nepal that
to me was so convincing that I just couldn’t say no. And he asked me if I could
help him kickstart his pilot project.
The future is our children.
But what children in Nepal learn about health in school, if anything, tends to
go in one ear and out the other. Instead, so Madhav’s reasoning, you must get
the students involved and motivate them. He thus had the idea to create what he
calls “School Health Clubs,” one in every school, consisting of 10 students,
with an equal number of girls and boys. The members of the Health Clubs were to
undergo 40 hours of intense training regarding various health issues and then,
during an hour a week for the rest of the year, pass on what they have learned
to the other students.
The
health situation in Nepal
Financially speaking, Nepal is
one of the poorest countries on earth. Especially the rural population suffers
from many health problems, many of which are due to a lack of knowledge about
health issues.
Let us take the example of anemia:
About half the population of Nepal is anemic. If pregnant women are anemic,
their children tend to have impaired growth and cognitive disorders. If
students are anemic, they either do not come to school at all or they sit
around unconcentrated and vacant. There can be several reasons for anemia, but
a main reason is hookworm.
Life cycle of the hookworm
Hookworms lay
their eggs in the intestines of humans, the eggs are passed out in feces, the
larvae hatch and feed off bacteria in the feces. They then enter the soil and
wait for a suitable host. Through skin contact with humans, the larvae bore
their way into the body, usually through the feet. Once inside the body, they
migrate through the bloodstream to the lungs. There they get coughed up and
swallowed, passing down the esophagus ultimately entering the intestine, where
the larvae mature into adult worms. The worms and the larvae suck up great
amounts of blood from the walls of the intestines, leaving those afflicted
anemic.
26% of the households in Nepal have “open toilets,” i.e. the
people defecate in the open fields. Since they usually walk around barefoot,
the hookworm larvae can enter the body through the feet. Here, only education
can help. But old traditions are tenacious. In many cases, the families have
installed toilets inside, but out of tradition and habit they still go out into
the fields. The children, once they have understood the workings of the
hookworm, can share their knowledge at home.
A second example: 50% of the
population suffers under malnutrition. This is due to poor nutrition, but even
more it is due to diarrhea and dysentery, which, in turn, are caused by bad
hygiene as well as worm infestation. Again, most of this can be changed through
education.
Other important health
problems are respiratory tract infections, Hepatitis A and B, STD’s and issues
around hygiene, especially for women around menstruation. Many girls stay away
from schools for a week every month for their “week of shame,” because they
neither know of nor have any sanitary napkins. In addition, in Western Nepal
many women are not allowed to live in the house when they have their period.
Instead, they have to stay in a little shed, without any comforts, often in the
cold. Last year four women died of snake bites; the snakes had crawled into the
sheds. A woman who is on her period is not allowed to drink any milk because
the cow would then die, plants die if she touches them and if she touches
others, especially shamans, they will get severely ill. Again, constant
education is needed.
The
Organization
The project is conducted by the registered Nepalese
non-profit organization HEAR (Health, Education, Awareness and Rights). This organization
has tested and, when necessary, treated students in 800 schools in the
Kathmandu Valley over ten years. Severe cases have been referred to hospital.
The organization consists exclusively of Nepalese people and they employ staff
for their projects on a temporary basis, as needed.
The head of HEAR Nepal is Madhav Joshi, a paramedic
and laboratory technician from Western Nepal:
The process
HEAR Nepal will visit, survey and evaluate 25
government schools in the Kathmandu Valley. Five of them will be selected for
the pilot project. Although the overall project will be focused on rural Nepal,
the pilot project with the five schools will be conducted in the Kathmandu
Valley, to make easy access and better monitoring possible.
After that, a survey of the five schools will be
conducted by outside health professionals to determine base values. At the end
of the school year a second survey will be carried out and the results will be
compared so as to document successes and failures that are then used as a basis
for improvements. This will on one hand deal with the schools themselves, such
as the condition of the sanitary facilities, how often they are cleaned and if
there is access to clean drinking water. On the other hand, a focus will be
placed on the students’ health issues and their situation at home, to what
extent preventive health education is provided and how many students are absent
at a given time and why.
Subsequently, the Director and the teachers, with the
participation of the students, select ten students per school to become
members of the Health Club. They must fulfill certain criteria: There should be
equal numbers of girls and boys from grades 8 to 12, they are to be among the
best in their class – and must seldom be absent. It is also important that they have
the unequivocal desire to be part of the Health Clubs and that they are willing
to commit to it fully.
The members of the Health Clubs in the five schools undergo 40 hours of intense training regarding health issues. The
training is conducted by a medical doctor and three paramedics/nurses.
This training begins right after the important annual tests, so that their
normal studies are impacted as little as possible. The members receive
educational material to be able to pass on their knowledge, and every Health
Club also gets a comprehensive First Aid Kit, which also contains
non-prescription medicine for the most common ailments. If there is a school
nurse, the members of the Health Club are something like their assistants.
After that the Health Clubs organize the health
examinations of all students in their schools. This examination will be
conducted by a team from HEAR Nepal, consisting of a medical doctor and three
laboratory technicians/nurses. Test samples of stool, urine and blood are
collected and are tested for anemia, worms, hemoglobin values, etc. The
students’ blood groups are also determined. Any illnesses are treated with
medicine and difficult cases are referred to hospital. The parents are invited
to these health tests, in order to get to know them and to include them in the
project.
The training of the other students by the Health Clubs
is organized and is monitored and supervised regularly during the rest of the
year. Educational material is made available.
The Health Clubs also fulfill other tasks, such as
being contact persons for basic health issues in the entire community. They are
also to be available to administer first aid, especially around the many
festivals that are celebrated. It can be expected that the desire to continue
to study and work within the health sector will be awakened in many Health Club
members.
About the finances of the pilot project
The
project is to begin in January 2017. For the first year the project needs
€
14,300 or $ 15,700. This is constituted approximately as
follows:
Staff: US $
Full-time:
Project coordinator.............................................................. 2,800
Part time: 1 medical doctor, 3 paramedical staff/nurses,
3 health instructors (Bachelors of Public Health), 3
laboratory
technicians, 1 accountant, 1 office assistant,
altogether..................... 4,900
Miscellaneous
Office rent and transportation.............................................................. 1,900
Educational and medical material........................................................ 1,400
Medicine, First Aid kits, chemicals, etc................................................... 800
Baseline survey, undertaken by
independent health researchers.......... 500
End line survey, social auditing,
documentation.................................. 1,900
Miscellaneous, unforeseen 10%........................................................ 1,500
Total............ $ 15.700
HEAR Nepal is contributing medical
material, such as microscopes, calorimeters, containers, chemicals, etc. as
well as educational material and many voluntary work hours, altogether valued
at € 5,300.
A donor, who wishes to remain
anonymous, has agreed to put up half the needed sum, i.e. $ 7,850, but only on the condition
that we are able to raise the other half, i.e. $ 7,850. Time is short, since the project is to start in January 2017.
I am
looking for 100 persons
who are willing to donate $ 75 or 75 Euro each for this project to
take off. All donors will be listed online either with your name
or as an anonymous donor. Every donor will receive quarterly reports on the
progress of the project, with photos and detailed specifications of how the
money is being used.
Payment methods:
Credit card: Go to https://www.indiegogo.com/projects/bringing-health-to-rural-nepal-through-schools-education#/ and go from there.
Bank transfer:
Account holder: Sten Linnander
Bank: Commerzbank Frankfurt
Bank No.: 50040048
Account No.: 140144700
IBAN:
DE30500400480140144700
BIC/SWIFT: COBADEFF950
Reference: School Health Clubs
I thank you in the name of HEAR Nepal and myself:
Lakshmi Joshi, MD (medical advisor of the project), Madhav Joshi and
myself
Namaste,
Sten
