Children Leading The Way to Fight NTDs: Kenya, Bangladesh and more

To become a medical doctor requires years of education, training and internship. But you don’t need to be a doctor to save a life. Performing lifesaving cardiopulmonary resuscitation requires only a tutorial and an instinct to help. Likewise, a student at an elementary school close to The Task Force for Global Health’s headquarters last year saved a classmate who was choking on a piece of apple, using the Heimlich maneuver he learned from YouTube.

In fact, children can be and often are effective promoters of public health with their friends, families and neighbors.

A 2016 article in Health Education Research titled “A Child Is Also A Teacher” studied children in Zambia who were given a  homework assignment of conveying information about handwashing to family members. The study showed that children were enthusiastic – and trusted – sources of information among their families, and that children could also be relied on to build handwashing stations.

Task Force teams have seen many times the valuable ways in which children can lead in promoting public health.

Photo credit: PJ Hooper for The Task Force for Global Health

Stopping Trachoma in Kenya

The Maasai people of East Africa traditionally live on semi-arid lands. In Narok County, Kenya, near the Tanzanian border their main livelihood is herding cattle, and families live in dry, dusty conditions without routine access to water.

Maasai students at Nasarian School there learn the standard subjects of children around the world. They also learn about trachoma, a bacterial eye infection that has blinded or impaired the vision of 1.9 million people in 42 countries, and is the world’s leading cause of blindness, according to the World Health Organization. Flies and poor sanitation can contribute to the spread of trachoma.

“I want to be a person who shows others handwashing, face-washing, and how to use a pit latrine,” said Jennifer, a 12-year-old student at Nasarian School. 

Jennifer is part of a student club started at the school three years ago to educate the  community about how to stop the spread of trachoma. The Task Force’s International Trachoma Initiative (ITI) works with partners in Kenya and many other countries to treat and prevent the condition. The ITI team stewards Pfizer’s donation of Zithromax medicine and partners with ministries of health and other allies to provide complementary services, including raising public health awareness and promoting healthy practices.

At Jennifer’s school, the club meets three times per week and its activities include a trachoma-themed variation on the game snakes and ladders. The school has a large educational poster that, in pictures and words, shows how routine daily activities can transmit trachoma, and how handwashing and using a pit latrine can break the chain of transmission. Club members even learned a catchy song about stopping the spread of trachoma.

“These kids are becoming change agents in their community,” said James Njapit, a teacher at the school. “They go to their parents and ask to build pit latrines.”

Their involvement may also have other, future benefits.

“This is helping me, my community and my family,” said Brian, a member of the club. “Someday I want to be a doctor because I want to help people who are sick.”

Little Doctors in Bangladesh

The Little Doctors program in Bangladesh does not bestow medical or public health degrees on children. The name is a nod to the fact that devoting resources to community-based preventative health care and early detection saves lives – especially in low-resource communities where doctors are not easily accessible. 

Little Doctors equips children to become promoters of personal hygiene, healthy lifestyles and improved immunity through peer education. The Ministry of Health and Family Welfare leads the initiative as part of a nationwide effort to eliminate lymphatic filariasis (elephantiasis) and visceral leishmaniasis and to control soil-transmitted helminths (STH, more commonly known as intestinal worms, which can cause stunting and impair cognitive development)). The Task Force’s Children Without Worms (CWW) program is a long-time partner in Bangladesh’s STH control efforts, engaging with national deworming programs, strengthening partnerships through the STH Coalition, and providing scientific leadership for evidence-based program improvements. 

Little Doctors trains children from third to ninth graders, who then teach their classmates how to avoid infection by improving their personal hygiene with frequent handwashing, avoiding using the toilet barefoot, and avoiding food that has been uncovered and unwashed. Twice each year, the Little Doctors conduct health exams on their classmates, provide deworming tablets, and log their height and weight ( indicators of nutrition-related stunting), as well as eyesight. The Little Doctors also lead educational sessions on health-related days such as World Health Day or Handwashing Day.

Photo credit: Razin Haque

A video produced by the Little Doctors program shows their effectiveness, as well as  the obstacles they can face – including the difficulties for children to challenge authority figures (such as parents or local religious leaders) whose beliefs about curing intestinal ailments may be more informed by cultural traditions than by science. 

Little Doctors was created in 2012. It currently involves an estimated 150,000 schools, with 40 million school-going children being reached  through the Little Doctors program. 

By engaging children as public health agents, governments and their partners can promote healthy, life-saving behavior at a relatively low cost. And perhaps equip some future doctors in the process.

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