Transcript Sierra Leone

Tanzania
The use of teachers in
Primary Health Care
Education
Introduction - 1
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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
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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 MacNamara to describe
a condition of total deprivation of the minimum living
conditions essential for human dignity.
Introduction - 3
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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
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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
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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
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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
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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
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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
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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 can cause health problems
As teachers we can ‘educate’ the young to have
long and lasting influences on their families and
communities.
Basic Course Structure
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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
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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
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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 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
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Community based projects
platforms,
notice boards,
maps,
education classes,
keeping records,
developing a common health policy
Working in the Community - 2
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Family-based projects
covering standing water
safe places to wash and bathe
covering windows
burning rubbish
School based Projects
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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
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In-class projects
experiments
learning to help the disabled
using school as a community asset
Other Projects
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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
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Some other ideas
games
posters
competitions
radio broadcasts
including local traditions
diet based games (Sri Lanka)
Where to go
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www. johnbirchall-economist.com/
Primary Health Care
The teaching booklet that will
emerge post this session
Email: [email protected]