Do children get the attention they deserve?
Dec 01, 2009
ROBERT'S face has dark spots. He is a typical teenager walking with a swagger, except that he is weary of answering questions about his skin condition. Robert is one of the several students born with HIV who loves school, but is not consistent due to the
HIV IN SCHOOLS
A UNAIDS report puts the number of children living with HIV in Uganda at 150,000
By Susan Muyiyi
Robert’s face has dark spots. He is a typical teenager walking with a swagger, except that he is weary of answering questions about his skin condition. Robert is one of the several students born with HIV who loves school, but is not consistent due to the occasional long spells of sickness.
With the mother-to-child transmission still the second-leading route of HIV transmission, more children living with HIV/AIDS are likely to be enrolled in several schools in Uganda.
A UNAIDS 2008 global report puts the number of children aged, 0 to 14 years, and living with HIV in Uganda at about 150,000. Every year, 30,000 babies are born with the HIV virus.
Dr. Sabrina Bakeera-Kitaka, a specialist in paediatric infectious diseases and the head of the adolescent programmes at the Pediatric Infectious Diseases Clinic at Mulago Hospital, says children in boarding schools face serious challenges, many of which arise from the fear of disclosing their status to peers. This makes drug adherence difficult because the children cannot freely take their drugs from the dinning room or dormitory.
“We often prescribe medicines for a month. So, having the children in boarding schools request for sick offs may be a problem because some school authorities are not compassionate to the infected children. The adolescents and children at the Baylor-Uganda clinic have shared nasty stories,†she says.
Bakeera adds that many schools employ only one nurse, who may not be skilled at providing care for HIV infected children. This creates a great challenge in handling opportunist infections. Some children are discriminated against and stigmatised.
For many years, HIV/AIDS education has not been a component of the national school curriculum. Hundreds of schools still use textbooks published before the HIV/AIDS pandemic, hence much of the available information on prevention and treatment is not only inadequate, but also non-existent.
After recognising this information gap, President Yoweri Museveni instigated a national initiative in 2003, seeking to make HIV/AIDS an integral part of primary and secondary education.
In 2004, this programme, the Presidential Initiative on the AIDS Strategy for Communication to the Youth, was implemented in all primary schools countrywide. The programme began at primary level and was to be integrated into five examinable subjects at secondary school level. However, the actual integration has been slow. According to a UNESCO report titled, ‘Planning for Education in the Context of HIV/AIDS’, the slow progress was due to outdated textbooks, inadequately trained teachers and administrators and sensitive cultural issues that prohibited sex education discussions and safe sex practices in schools.
Yusuf Nsubuga, the acting director of basic and secondary education and the HIV/AIDS sector coordinator in the education ministry, says HIV/AIDS has led to increased school drop outs.
“Absenteeism is high in some schools. Many female students have been reported to stay home to take care of their ill parents,†he says.
The ministry has developed an HIV/AIDS policy to counter some of the problems children face while at school. The 2006 national policy guidelines on HIV/AIDS point out that schools are to be supported to put youth-friendly health services in place. Remedial classes for students to make sure that they catch up with their colleagues are also permitted.
Nsubuga says the education ministry works closely with that of health to coordinate youth friendly services in schools.
He says the implementation of these services occurs at different levels and there are many factors that affect it.
“Not all schools have implemented these services. Some move faster than others. The ministry’s role is to set and disseminate the policy to schools,†he says.
A key highlight in this HIV/AIDS policy emphasises shared confidentiality between parents and school heads to enable schools provide special care and treatment to the children, should need arise, Nsubuga explains.
However, some head teachers have not found the approach applicable.
Nsubuga acknowledges the hurdle of uncooperative parents and suggests that the age of consent be lowered to 16 to enable voluntary counselling and testing.
“Before a child is 18, you need their parents’ permission to have them tested.
“Young people should be empowered to deal with their own diagnosis and living positively.
Stigma in schools ranges from outright teasing to giving too much attention.
Nuru Nabbumba a counsellor at the Straight Talk Foundation, says teasing and stigma in schools is caused by an information gap.
She says children living with HIV should be treated like any other since extraordinary attention isolates them, leading to stigma.
“I came across a 14-year-old girl who had to change schools three times because she was being stigmatised. Whenever her peers would see her taking drugs, they would call her a moving coffin,’ Nabbumba says.
Bakeera says the education and health ministries should work together to promote care, treatment and prevention of HIV. “A big number of children in boarding section may miss out on all the three,†Bakeera notes.
To avoid stigma, Nsubuga says, the ministry has embarked on training teachers to internalise the policy and be able to use it.
Although schools are not yet equipped to handle all the issues that arise from dealing with children living with HIV/AIDS, other health institutes lend a helping hand.
Preparing the next generation of teachers is another daunting task since the current teacher training syllabi rely on outdated materials and information.
According to a report titled Evaluating HIV/AIDS education programmes in Ugandan secondary schools, published in Development in Practice Journal, (Volume 17), teacher training institutions are beginning to reverse this trend. The report cites Kyambogo University as having run mini HIV/AIDS seminars with student teachers for the past couple of years.
The Joint Clinical Research Centre, Pediatric Infectious Disease Institute, Mild May pediatric Care Centre, Mulago Teen’s Club, Baylor School of Medicine and the Makerere University-Johns Hopkins University Research Collaboration, have established forums for children to express themselves freely through drama and emotional support.
The 2006 education management information system puts enrollment of pupils and students in primary and secondary schools at 7,33,150. All these students spend a considerable amount of time in school, presenting an appropriate opportunity for behavioural change interventions to prevent new infections.
Although the awareness on HIV/AIDS is high, behavioural change such as adoption of abstinence as an HIV preventive strategy, remains limited. The Straight Talk Foundation has, for the last 10 years, supplied free material on sexual and reproductive health to a number of schools.
A lot has been done, but the road ahead is far from smooth. It is a challenging battle which might take decades to win.
Additional reporting by Jamesa Wagwau
A UNAIDS report puts the number of children living with HIV in Uganda at 150,000
By Susan Muyiyi
Robert’s face has dark spots. He is a typical teenager walking with a swagger, except that he is weary of answering questions about his skin condition. Robert is one of the several students born with HIV who loves school, but is not consistent due to the occasional long spells of sickness.
With the mother-to-child transmission still the second-leading route of HIV transmission, more children living with HIV/AIDS are likely to be enrolled in several schools in Uganda.
A UNAIDS 2008 global report puts the number of children aged, 0 to 14 years, and living with HIV in Uganda at about 150,000. Every year, 30,000 babies are born with the HIV virus.
Dr. Sabrina Bakeera-Kitaka, a specialist in paediatric infectious diseases and the head of the adolescent programmes at the Pediatric Infectious Diseases Clinic at Mulago Hospital, says children in boarding schools face serious challenges, many of which arise from the fear of disclosing their status to peers. This makes drug adherence difficult because the children cannot freely take their drugs from the dinning room or dormitory.
“We often prescribe medicines for a month. So, having the children in boarding schools request for sick offs may be a problem because some school authorities are not compassionate to the infected children. The adolescents and children at the Baylor-Uganda clinic have shared nasty stories,†she says.
Bakeera adds that many schools employ only one nurse, who may not be skilled at providing care for HIV infected children. This creates a great challenge in handling opportunist infections. Some children are discriminated against and stigmatised.
For many years, HIV/AIDS education has not been a component of the national school curriculum. Hundreds of schools still use textbooks published before the HIV/AIDS pandemic, hence much of the available information on prevention and treatment is not only inadequate, but also non-existent.
After recognising this information gap, President Yoweri Museveni instigated a national initiative in 2003, seeking to make HIV/AIDS an integral part of primary and secondary education.
In 2004, this programme, the Presidential Initiative on the AIDS Strategy for Communication to the Youth, was implemented in all primary schools countrywide. The programme began at primary level and was to be integrated into five examinable subjects at secondary school level. However, the actual integration has been slow. According to a UNESCO report titled, ‘Planning for Education in the Context of HIV/AIDS’, the slow progress was due to outdated textbooks, inadequately trained teachers and administrators and sensitive cultural issues that prohibited sex education discussions and safe sex practices in schools.
Yusuf Nsubuga, the acting director of basic and secondary education and the HIV/AIDS sector coordinator in the education ministry, says HIV/AIDS has led to increased school drop outs.
“Absenteeism is high in some schools. Many female students have been reported to stay home to take care of their ill parents,†he says.
The ministry has developed an HIV/AIDS policy to counter some of the problems children face while at school. The 2006 national policy guidelines on HIV/AIDS point out that schools are to be supported to put youth-friendly health services in place. Remedial classes for students to make sure that they catch up with their colleagues are also permitted.
Nsubuga says the education ministry works closely with that of health to coordinate youth friendly services in schools.
He says the implementation of these services occurs at different levels and there are many factors that affect it.
“Not all schools have implemented these services. Some move faster than others. The ministry’s role is to set and disseminate the policy to schools,†he says.
A key highlight in this HIV/AIDS policy emphasises shared confidentiality between parents and school heads to enable schools provide special care and treatment to the children, should need arise, Nsubuga explains.
However, some head teachers have not found the approach applicable.
Nsubuga acknowledges the hurdle of uncooperative parents and suggests that the age of consent be lowered to 16 to enable voluntary counselling and testing.
“Before a child is 18, you need their parents’ permission to have them tested.
“Young people should be empowered to deal with their own diagnosis and living positively.
Stigma in schools ranges from outright teasing to giving too much attention.
Nuru Nabbumba a counsellor at the Straight Talk Foundation, says teasing and stigma in schools is caused by an information gap.
She says children living with HIV should be treated like any other since extraordinary attention isolates them, leading to stigma.
“I came across a 14-year-old girl who had to change schools three times because she was being stigmatised. Whenever her peers would see her taking drugs, they would call her a moving coffin,’ Nabbumba says.
Bakeera says the education and health ministries should work together to promote care, treatment and prevention of HIV. “A big number of children in boarding section may miss out on all the three,†Bakeera notes.
To avoid stigma, Nsubuga says, the ministry has embarked on training teachers to internalise the policy and be able to use it.
Although schools are not yet equipped to handle all the issues that arise from dealing with children living with HIV/AIDS, other health institutes lend a helping hand.
Preparing the next generation of teachers is another daunting task since the current teacher training syllabi rely on outdated materials and information.
According to a report titled Evaluating HIV/AIDS education programmes in Ugandan secondary schools, published in Development in Practice Journal, (Volume 17), teacher training institutions are beginning to reverse this trend. The report cites Kyambogo University as having run mini HIV/AIDS seminars with student teachers for the past couple of years.
The Joint Clinical Research Centre, Pediatric Infectious Disease Institute, Mild May pediatric Care Centre, Mulago Teen’s Club, Baylor School of Medicine and the Makerere University-Johns Hopkins University Research Collaboration, have established forums for children to express themselves freely through drama and emotional support.
The 2006 education management information system puts enrollment of pupils and students in primary and secondary schools at 7,33,150. All these students spend a considerable amount of time in school, presenting an appropriate opportunity for behavioural change interventions to prevent new infections.
Although the awareness on HIV/AIDS is high, behavioural change such as adoption of abstinence as an HIV preventive strategy, remains limited. The Straight Talk Foundation has, for the last 10 years, supplied free material on sexual and reproductive health to a number of schools.
A lot has been done, but the road ahead is far from smooth. It is a challenging battle which might take decades to win.
Additional reporting by Jamesa Wagwau