Sierra Leone The use of teachers in Primary

Sierra Leone The use of teachers in Primary Health Care Education

Introduction - 1 n n Introduction ‘No child in the world will go to bed hungry by the year 2000. ’ This was one of the closing statements of the Food Security Conference in Rome in 1974. According to the United Nations Development Programme, hunger now prevails among at least a quarter of the world’s inhabitants. Every day there are 30, 000 – 40, 000 child deaths in the world and most of these are from diseases related to poverty. This means that there are 12 to 14 million-child deaths associated with hunger each year.

Introduction - 2 n The well-known phrase ‘Health for all by the year 2000’ was first heard at the United Nations Alma Ata conference in 1978. Alas, its aims were never realised and so as you read this Introduction it is time for us to examine both why the target was not reached and what can be done to try and make some serious reductions in this tragic waste of human life. Such statements fall easily from the lips of politicians and planners but what is the reality against which they must be put in context? According to the World Bank almost 65% of the inhabitants of Africa live in ‘absolute poverty’, a term used by the former World Bank President Robert Mac. Namara to describe a condition of total deprivation of the minimum living conditions essential for human dignity.

Introduction - 3 n We are familiar with such terms as the ‘Debt Trap’ and other causes of morbidity and mortality amongst children and women – the most vulnerable groups. This ‘pathology of poverty’ in the Third World is associated with increased scarcity of resources, more hunger, and increasing death rates. The poverty gap has increased by 30% over the past decade. We are also aware of the problems caused by aids, the enforced reductions in public expenditure on health and welfare and the shrinking education budgets that many countries now battle with

Introduction - 4 n n So, how can teachers attempt to do something positive to improve the quality of life of those they will teach and that of their families and communities? Well, let’s look at two simple statements. there are more teachers that doctors there are more pupils than patients Simple statements yes but they offer a base from which to build programmes that allow those most at risk from serious and life threatening disease to begin to do something positive to help them. In modern political terms people need to be ‘empowered’ or offered the knowledge to ‘enable’ them to begin an active campaign to improve the living conditions for the most vulnerable members of society.

Introduction - 5 n n n Let’s look again in more detail at the two statements. Teachers meet with the young and build a trusting relationship through which knowledge and its application are passed. Why not incorporate in normal timetables/curriculum’s simple advice on the major diseases that cause so much of the poverty that is evident in Africa? This can be done in interesting ways that encourage participation and a desire to spread the information. Lessons can centre on outward signs of possible illness, ways of reducing the risk of catching such diseases and effective proposals for helping those who already have an illness. Greater awareness may also reduce prejudice and misunderstanding. Access to life saving information need not be the privilege of those fortunate to live near to better -stocked medical centres.

Introduction - 6 n n The second statement noted that more pupils exist than patients. So, once again here is a perfect opportunity to allow the young to be pioneers within their own communities in the spreading of health messages that offer a positive input to communal life. None of this needs to be sophisticated. Indeed, the more basic the message the greater the chance of acceptance. Young people can be ‘peer educators’ to their own age group and ‘information providers’ to their wider community. Such programmes do not require vast sums of money and yet individuals can be made to feel involved and valued.

Introduction - 7 n Evidence of the impact on both individual and community health standards can be gathered from many different locations. An example is that of Nicaragua, where successive Structural Adjustment Programmes seriously reduced the fabric of the health and education facilities. A more ‘upside down approach’, in which simple primary health information was given to young people has now been introduced in some regions and the levels of malnutrition and infant mortality is beginning to drop – though only by a little. In India the ‘bottom upwards’ approach adopted in Vellore, South India has also paid visible dividends in increased child welfare and better treatment for women.

Introduction - 8 n n In this course we will be concentrating on many of the diseases most prevalent in West Africa and producing simple and effective teaching materials. We will be including materials on each disease, community and individual reactions and possible life style changes that could help in the fight against the killer diseases. Each disease will be given adequate coverage to allow teachers and others who work with the young to offer positive, enabling instruction that will empower the next generation to make a significant contribution to the health of both themselves and their communities.

Objectives n n n There are more teachers than doctors and more students than patients, so we need to inform young people of the dangers they face. Young people can then act as: Peer educators and inform those not fortunate to go to school Community educators, so giving positive externalities and reducing the health problems faced by their families and communities. Shapers of community reactions to those parts of life than cause health problems As teachers we can ‘educate’ the young to have long and lasting influences on their families and communities.

Basic Course Structure n n n Getting to know the body Getting to know the environment Serious diseases – symptoms, reactions, preventative actions and helping those with these diseases More minor illnesses and life style decisions Links to information

The manual – once prepared n n n An Introduction to the Manual of Teaching Materials Alas, only a minority of the world’s population have direct access to basic medical assistance can be a worrying one – indeed it may end in the need being totally ignored. This manual is the result of several years work in various parts of the developing world. It represents a small, but hopefully useful contribution to the level of health awareness afforded to the younger members of communities. By providing accurate, yet easily understood health information to young people, it is hoped that they can act as effective messengers to both their peers and other members of the communities within which they live.

Manual once prepared - 2 n The language and style of presentation used is not technical, but is chosen to be of interest to young people. Diagrams etc. have been selected to allow non-medical personnel (especially teachers) to feel confident in discussing health issues with the young people for whom they are responsible. Let us hope that better informed young people will be less at risk from illness and will be capable of providing others with essential pieces of lifestyle information. If this is achieved then individuals and communities will be less vulnerable and will be in the position to engage in more meaningful dialogue with those in authority. For if these people who make the life enhancing decisions that directly affect the lives of those for whom these materials are intended.

The manual once produced - 3 Anyone is welcome to reprint/translate as they wish any of the materials contained in the manual. The format of this manual allows for materials to be incorporated as they become available

Working in the Community n n n n Community based projects platforms, notice boards, maps, education classes, keeping records, developing a common health policy

Working in the Community - 2 n n n Family-based projects covering standing water safe places to wash and bathe covering windows burning rubbish

School based Projects n In the classroom School-based projects looking after siblings diets farms cleaning burning rubbish placing of toilets safe places to wash, draw water and bathe

School based Projects n n In-class projects experiments learning to help the disabled using school as a community asset

Other Projects n n n Other possible projects keeping records of height and weight keeping health records noting dates of clinics mapping local amenities and danger spots developing community reactions to problems

Other Projects n n n n Some other ideas games posters competitions radio broadcasts including local traditions diet based games (Sri Lanka)

Where to go n n n www. johnbirchall-economist. com/ Primary Health Care The teaching booklet that will emerge post this session Email: john_birchall@bsc. biblio. net