A School in Need
At St John’s, students have to face in opposite directions to hear their teachers, as there are no wall divisions for separate classrooms. Though uniforms are required, very few are able to afford them. In the face of such lack, we are compelled to help, beginning with assessing their health.
Global Outreach Developments International’s property in rural Central Uganda is situated next to a public school called St John’s Primary. The school is a typical Ugandan brick structure composed of three classrooms. We were dismayed when we learned that 350 children fill those rooms on a daily basis, with only eight teachers employed at the school. Though the needs of teachers and students in Uganda are immense, G.O.D. Int’l is on a mission to improve this school. One of the ways we are beginning is by assessing the health of all the students enrolled.
In the village where St John’s Primary is located, there is no doctor, no nurse, no reliable health care facility. Health care is inaccessible, due to both the distance from a health clinic, and the extreme poverty of the residents. The chaotic environment of this area can make even the smallest wound a dangerous threat for the students. Most children walk barefoot daily to and from school on rocky roads littered with animal feces, trash, and broken glass. Children as young as five years old work in their family gardens without safety equipment or age-appropriate tools, and they are often injured.
Assessing their Health
Miller works with Henry, one of the new trainees, to complete this young boy’s assessment. Henry is now able to perform assessments on his own, as he has been trained in taking vital signs, as well as knowing what health issues to look for.
The health assessments we are performing will give us insight into both the overall health issues of the school and the specific needs of each child. It will also assist us in prioritizing needs and addressing those we can help meet in a timely manner. Each child is being assessed for oral health issues, gastrointestinal function, vision and hearing, possibility of malnutrition, dehydration and stunted growth, skin diseases, and other issues common to the area. For many of these children, this is the first time they have had their blood pressure taken, their vision and hearing screened, or experienced this type of care.
On the first day of the health assessments, Jordan Miller, a G.O.D. Int’l health care worker, along with a visiting nursing student and a few translators, were able to examine just twelve of the 325 students at St John’s. She quickly realized the necessity of empowering the young people we work with in Uganda, fluent in both the language and the culture, to help complete these exams. She organized a training session, through which we gained eight assistants, capable of taking vitals signs and health histories, and they joined her in the health assessments. This team worked together to perform the health care exams more effectively. This was not only of benefit to the students assessed, but also the trainees, as they were being empowered to play a vital part in the health of their local community. The nursing student was amazed by the speed at which they learned the skills necessary for the task. Within days of the training, over 200 health assessments had been completed. Meanwhile, Miller has been researching and working to diagnose some of the more severe health issues they’ve encountered. She and the others are also regularly checking on the children with wounds to ensure healing is taking place.
In the examinations, the team found that 95 percent of the children have poor dental health. In addition, most are malnourished and dehydrated due to inadequate diet. Many of them have a variety of skin diseases related to their nutritional deficiencies. With so many of the health issues due to poor nutrition, we recognized that the children needed a more balanced diet. It was decided to integrate agriculture into their curriculum, helping them to grow their own vegetables that will greatly enhance their nutrition. When Gregg Garner, who was on the ground at the time, announced this plan at a school assembly, there was an uproar of applause and cheers from the students and teachers.
Laura Foster, one of Miller’s teammates, held Apollo while he suffered the pains of a headache from malaria. The loving touch is an important and essential part of treatment. Humanizing care and compassion is often missing in efforts to bring healing. People are not problems to be solved, but persons to be served.
Apollo is one student we have been particularly concerned about. The team learned that he ran away from his home in Kampala because his father was physically abusive, “terrorizing” as he described it. He now lives with an older woman, who is also caring for three other children. He resides up a steep hill an hour’s walk from school. When Apollo was first examined, he had untreated infections on his shin and foot. Miller knew that the possibility of tetanus was a threat, as he hadn’t received any vaccinations. Miller dressed his wounds and gave him antibiotics to treat the infection. She then walked him home to meet his guardian, give her instructions regarding the medication, and assess his living situation. Everyday that followed, Miller checked on Apollo and his wounds. One day, Apollo came to school clenching his head and sobbing. He had a headache, high fever and body aches, and his wound looked worse than the day before. Miller and our team on the ground diagnosed him with tetanus and a possible case of malaria. They took him to a clinic in town where they confirmed the diagnoses and treated him for tetanus and malaria. Two days later, Apollo returned to school healthy and happy.
Assessing School Structures
We recognize that our efforts to improve people’s health require us to do more than just treat wounds and diagnose illnesses. We have to identify the environmental factors that act as detriments to lasting health, and then improvements must also be made to the facility and grounds. When Miller went to assess the hand washing stations at St John’s, she found none. The school has no protocols about hand washing, likely due to no on-site source of water and no place to wash their hands. The school has a water tank that was donated by an non-governmental organization (NGO) a decade ago, but its spout had been broken for some time due to vandalism. In addition, the gutters intended to drain rainwater collected from the roof into the water tank are broken and no longer attached correctly to the cistern. Our cooperatives, themselves expert builders and water system repairmen, repaired the spout and filled it with water. Now, the children don’t have to fetch water from a well off-site while at school, which took significant time away from them learning in the classroom. Having a water source on-site will enable them to be consistent and thorough in hand washing throughout the day, which will help prevent diarrhea and other bacterial diseases.
Moving Forward
Teachers in Miller’s class practice their new skills on infant models. In Uganda where emergency care is scarce, serious accidents typically end in death. Knowing what to do in emergency situations can significantly change people’s outcomes.
Miller did a basic health seminar with the local school teachers, which included CPR and the Heimlich Maneuver. She is doing another training seminar with the assessment team to teach them more about patient assessment and treatment. In addition, she’s creating and organizing a medical record system, including health incident reports, and making a basic first aid box for them.
As people of God, we’re responsible to love our neighbors. In rural Central Uganda, our neighbors are the children attending St John’s Primary. Our efforts and resources couldn’t be more well spent.
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