Promoting school health in Pakistan
June 2008: The notion of school health promotion is uncommon while debating the existing
situation of schools in Pakistan. It is a common belief that schools are a
nursery for unhygienic food and that they barely provide first aid to the
students within the school setting. But school health promotion, in its true
sense, goes beyond this restricted view.
Let us take a quick
reconnaissance of health promotion in our schools. It would be interesting to
know the percentage of educational institutions here with the facility of a
doctor or a nurse within the premises. Is health education is even a part of
their school curriculum?
Many, if not all, schools today have become the
target market for the corporate world. Academic exercises that were the hallmark
of school culture are now being organised by these business groups under the
heading of "awareness programmes". Visit any school, especially in the urban
areas, and notice the activities which were previously organised by students and
teachers being arranged by these marketers who may in actuality be least
concerned about the promotion of health among the children. Children for them
are the consumers with the schools as the shopping malls.
introduction to Noam Chomsky's Profit Over People, Robert W. Mc Chesney writes:
"Our time represents an era in which business forces are stronger and the more
aggressive faceless organised opposition than ever before."
truly represent these words. The idea that seems to run in these business
companies is that they sell anything and everything in schools.
back to basic health resources in schools, most of the schools do not even have
enough space to support a healthy lifestyle. The bungalow schools do not even
have enough space for proper seating arrangements for the students let alone the
open grounds for physical activities. A majority of the children here experience
school life without actually being involved in any sports. They remain ignorant
of the bliss of happily running around the huge school grounds during recess and
participating in healthy sports competitions. It may sound like a faraway dream
to the bungalow school student. In comparison, the public sector schools may not
fall under the issue of spaciousness but a bigger question for them may be how
to utilise their spacious grounds.
Besides loading up the children with
heavy school bags, a by-product of the modern-educational system, children also
have to carry the additional load water bottles, no matter which school they go
to. No one questions anyone and no one is held accountable for it. It's just
that the parents have lost faith in the drinking water made available at
Food is another important aspect of a healthy school
environment. Hardly any school here encourages the culture of eating home-cooked
meals. Children are rarely encouraged to bring home-made food to classroom or
school parties. The school canteens, not considered a part of school health
promotion, offer all kinds of forbidden junk food usually inaccessible to the
children at home.
Similarly vendors stationed outside the school gates
are allowed to play havoc with the health of our young ones. One wonders whose
responsibility it is to keep an eye on such enterprises outside the educational
A common complaint made by both students and parents alike
is the amount of stress being put on them by the so-called "modern education
system". The children along with their parents have to run from pillar to post
in order to acquire knowledge. The unnecessary rush results in putting everyone
under great stress, so much so that it becomes difficult for children to grapple
with the situation and the inability to manage stress causes sever damage to
their health which may lead to other life-threatening illnesses later on in
If the teachers could be educated about the basic health issues,
they can be the first ones to not only identify the high-risk students but to
also refer them to the right health professionals.
promotion calls for an integrative approach. The few schools that boast of
having the services of nurses and doctors think that health promotion is their
responsibility alone. But in order to approach holistic health promotion, we
must realise that
all school members, including the parents, need to get
involved in making a school one that promotes healthy practices. A school health
nurse could play a vital role in achieving this goal.
According to the
Alma-Ata declaration of 1978: "Schools could indeed provide efficient means of
educating young people ... to build in them a good understanding of what health
means, how to achieve it, and how it contributes to the social and economic
In Pakistan the prevalent notion of health is the absence
of a clinically recognisable disease. However, WHO in 1947 defined health in
terms of total wellbeing and discouraged the conceptualisation of health as
simply the absence of disease. A commonly accepted definition of health given by
the noted epidemiologist Milton Terris is taken as the beginning of the modern
definition of health. "Health," according to him, "is a state of physical,
mental and social wellbeing and the ability to function and not merely the
absence of illness and infirmity."
Neither do we educate our children on
health issues nor do we prioritise keep health promotion in our educational
institutions. There are many ways to bring about a change. It should not,
however, be an issue of scarcity of resources that may cause restrictions in
initiating a change.
Organising health awareness programmes in school can
also bring about a change in the teachers and students' attitude about promoting
health in school. Physical education, regular grooming, counseling and a
friendly attitude in students and teachers are all important ingredients of
school health promotion.
A qualified as well as competent school health
nurse can become a catalyst in promoting a healthy school lifestyle. There is
also a great need to keep a check over what is being sold in the school canteen
and what is on offer outside the school at chutti time.
We also need to
revisit our school curriculum while keeping in mind how health friendly our
schools have become in the recent past. Schools in fact can become the nuclei of
the public healthcare system through which primary prevention may be achieved.
If successful in inculcating healthy habits in our youth, we would eventually be
educating a much larger number of people in society who can go on to become the
ambassadors of a healthy lifestyle. Hence a mass level approach is achievable
via child-to-child and child-to-parent health education models. Children brought
up in a healthy environment can contribute towards a stronger
By Saleema Gulzar (Dawn)
The writer is part of the nursing faculty at a private university hospital in Karachi
"its very important matter to work on it kindly help me as well for the promotion of this ."
Name: dr. a .raza
City, Country: Karachi, Pakistan
"As far i know there is only one organization by the name of Integrated Health Services also called IHS which is providing school health services in Pakistan. There is a dire need for more health institutions and the government to make organized efforst for it. I ve seen the difference in my children in whose school IHS conducts regular health education sessions. "
Name: Ahmed Gulzar
City, Country: Islamabad, Pakistan
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