“It is a little past 4pm and most of the pupils have already been sent back home from school while a few others are still playing in the compound waiting to be picked up by their parents. I am in class marking some of my pupils’ work when one of the girls comes screaming! ‘Teacher! Come and see Maurine! She has fallen down in the compound!” Sarah Nalujja, a teacher at St Paul’s Primary School in Mityana District, remembers the first time she found out one of her pupils was epileptic.
Surprised and shocked, but more than anything scared, Nalujja hurriedly ran outside to the child. “I thought it was just a bad fall but it was not,” she recalls.
The little girl lay on the ground surrounded by fellow pupils who had come mostly to spectate. Her small body was being overcome by uncontrollable seizures, her jaws were locked together as saliva ran down her cheeks.
Her dress was already damp from the urine that had escaped her body.
Ordinarily, Nalujja would not have known what to do, but she had a relative with the same condition. With this knowledge, she was able to save the day.
“First, I knew I needed to separate her jaws so she does not bite into her tongue. She needed fresh air, so I had to clear other people out of the way and make her lie on her side,” Nalujja says noting that the parents of the pupil had never reported this medical condition to the school.
Children spend most of their time at school, especially those in upper primary classes.
On average pupils spend roughly between six to 10 hours of their day time at school.
Hassan Ssenkumba, the deputy head teacher of Masajja Primary School, says children with chronic health conditions can perform as well as other children if their needs are addressed.
He adds that whereas there is no shame in sending such children to school, it is important that parents not only confide in the administration about their medical conditions but also keep in constant touch with the school about the same.
But to offer a supportive environment, both parents and the school community ought to be a team.
Hairah Namala, a mother of three, has an asthmatic seven-year-old in Primary Two, at a nearby school in Namugongo.
She says parents of children with chronic illnesses must be careful about the schools where they enrol their children and whether they are willing to have a caring hand for such a child.
“I opened up to the school about her condition right from when it was diagnosed in kindergarten. And further still, when she was joining primary section, I went to the school administration and told them all the details of her medical condition accompanied with the necessary documentations,” Namala affirms.
She adds that she also explained what her daughter reacts to when her health is not so good, as well as her health management needs.
“I had to ensure that the school had a medical facility and personnel that could handle those cases,” she says.
Luckily, the administration was willing to take her child in. Namala shares that she also tries to keep the school constantly informed about her daughter’s health.
“For example when the weather is extremely cold, I cannot send her to school. In such a case, I have to let the school know; and they are understanding,” she adds.
Communication is key
Similarly, Ssenkumba emphasises that in some cases, depending on the illness, parents may have to write a detailed explanation of the student’s health needs at school.
“For example medication that can be administered, or that which should not be. Things the child should not be exposed to, especially in case of allergies, emergency treatment or procedures so that the school can handle the student’s emergency cases,” he says. These, he adds, should be endorsed by a professional health provider or doctor.
Doreen Oketch, a mother of a 14-year-old Senior One girl living with sickle cell disease, says communication between the school and the parents is crucial.
“I always communicate important changes in her health and her health status at any given time to the school. I communicate any changes in treatment that the school should know about,” she says.
Furthermore, in case there is medication that the girl has to take during school time, Oketch ensures she shares some of them with the school nurse, even when her daughter carries her own to school.
“This I do because I want to avoid situations of her missing her dose at any one time because she lost the medicine or left it at home. I can always be sure that there is some at the school clinic,” she says.
And for a child who cannot supervise themselves to take their medication on time, the parent then needs to forge a way with the school so that they ensure the child does not miss their medication. This is a routine that can be developed.
Proscovia Namaganda, a school nurse at Bright Stars Primary School, Mutungo, advises parents to be as reachable as possible.
“Make sure you provide the school with a way of contacting you or another person responsible at all times just in case there is an emergency. This can include providing all your contact details and numbers. Sometimes, there are emergencies and the school cannot reach the parent, their phones are switched off for hours and yet at times the school does not even have prior knowledge about the child’s health,” she says.
Furthermore, she encourages parents to teach children with chronic illnesses some self-care skills so that they can either avoid their triggers or handle some of their health needs.
“Some parents keep children’s conditions a secret from them. However, a parent should be able to explain to their child in a simple way that they are for example HIV-positive and need to take medication the way it is prescribed,” she advises.
“For other ailments, the parent can induct their child on how to take care of themselves without the help of an adult. Tell them telltale signs that show they are getting an attack and what they need to do in such a case, advise them on physical activities they must avoid in accordance to recommendations by doctors,” says Namaganda.
What schools need to do?
As for the school, Remigius Butale, the deputy head teacher of Little Royals Primary School, says while admitting pupils, parents must be asked to fill a medical form from what the school can use to identify pupils with chronic illness and those that need to be given some extra attention.
“Normally, we invite such parents for further discussions about their children and whenever we feel that the medical situation is complicated and requires a lot of supervision we recommend special schools for such children,” Butale says.
After taking note of that, the respective class teachers as well as the school medical personnel are informed so that they keep a keen eye on such students, but at the same time, keep that information as confidential as possible.
He, however, notes that sometimes, parents are not forthcoming about some chronic diseases. “For example, some parents shy away from confiding in the school that their child has HIVAids or epilepsy for example, thinking that their child will be stigmatised.”
some of the chronic diseases: Multiple Sclerosis, mood disorders, HIV, heart disease, asthma, sickle cell disease, epilepsy, diabetes, allergies.
First aid for asthma
•Sit the child upright.
•Tell them to take long, deep breaths. This helps to slow down their breathing and prevents hyperventilation.
•Tell them to stay calm.
•Get them away from the trigger.
•Seek emergency medical help.
Take note of the dos
•Make sure you provide the school with a way of contacting you or another responsible person at all times in case of an emergency.
•As a parent you should be able to explain to your child the condition they have and why they need to take their medication.
•Tell the children tale tell signs of getting an attack and what they need to do in such a case.
•Advise them on the physical activities they must avoid in accordance to recommendations by doctors.
•In case there is medication the child has to take during school time, ensure the school nurse has some as well as the child.