Fix gaps in our healthcare systems now that everyone is learning courtesy of Covid-19


Pupils being 'trained how to use guns' during patriotism session in Uganda. Courtesy photo.

Some schools had a sickbay that offered basic first aid and run by a school nurse or a senior woman teacher.

By James William Mugeni

Iowa, USA – 16, June 2021: Ignorance is a disease whose treatment is a bitter lesson and death. Through death, if at all the dead take lessons!

I have been at the forefront of writing in the media asking those who care to help fix our healthcare system and all kept landing on deaf ears.

I participated in a school health program courtesy of Straight Talk Foundation. This was in the late 1990s and early 2000s majorly on reproductive health program and I wrote an opinion suggesting that government considers attaching a health post in all schools depending on proximity to health services provided in the school surroundings.

Whereas the program was biased to reproductive health, I took keen interest in other aspects of the school standards. Whenever we wanted to see how schools handled menstrual hygiene one would find that most schools ended up with foul smelling latrines as the disposal methods for pads, tampons, presented a big problem.

Then most schools did not have safe water so one easily discovered there was a water and sanitation problem with almost all primary schools although things looked slightly better in secondary schools.

Some schools had a sickbay that offered basic first aid and run by a school nurse or a senior woman teacher.

The girl’s reproductive health problems ranged from painful menstruation to bleeding less than the normal four days to bleeding irregularly, bleeding more than seven days, bleeding due to family planning methods. The most serious problem I found out in schools is girls in need of   referral for safe abortions. These are problems associated with girls, alone.

If one took trouble to look at the other side of the coin, the boys too had multiple problems and the problems in school range from those of general physical health conditions that can affect class performance of students. These included: poorly managed diseases like malaria, skin conditions especial scalp fungal infections.

Since most schools lacked water so water washed diseases were common, body lice and bed bugs. Some schools every chair or desk was home to bed bugs.

Covid-19 has brought out that poor picture of school health that I wrote about one time and everyone ignored. Most nations including the mighty America has taken lessons and considered revamping their primary healthcare systems.

It is one thing pointing fingers at schools as focal points for spreading Covid-19 and it is one thing to think about what to do for schools. Social distance, sanitize, and use of masks are key to managing Covid-19.

For our schools to operate, social distance and sanitize are key words that we need to adopt seriously. Those who are familiar with our schools know that the schools are too congested that schools have moved away from double-decker to triple or more decker-beds.

Most schools just have no water systems. These are issues that must be put into serious considerations besides attaching healthcare workers to be part of school inspections.

As a medical clinical officer, I have hated hospital-based medicine and preferred community based medical practice which rotates around primary healthcare. I cannot even remember how many schools qualified to run a school health program.

Schools being our entry point to life, I made extraordinarily strong recommendations then to have them as areas of primary prevention and now Covid-19 exonerates me.

A school with close to 2,000 students cannot just be under a school nurse whereas other schools teach health science as lessons and these perhaps are medically related, there is need to give schools special considerations as health entry points.

My cadres or medical clinical officers have a silent side of their diploma in clinical medicine and community health that is not active that silent side of their diploma is community health which is basically primary healthcare.

Most of us now consider studying degrees, masters and PhDs but the primary health role of ensuring people eat well, sleep in mosquito nets, get treated for hookworms is neglected as it does not pay to do those basics of medicine. People must be sick for us to gain recognition. Neglecting the clinical officer has consequences one wonders why our hospitals are full?

Medical Clinical officers are a neglected lot yet if they were guns, they are the AK47 of war. I see Uganda grappling with basic health problems and we are very redundant as each of us thinks of finding a hospital to fit in.

Now diseases are in schools why not get attached to schools with a primary role of disease prevention! Health should cease being only in hospital, but community based.

The author is a Medical Clinical Officer/Certified Public Manger

wmungadi@gmail.com


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