When Zindagi Trust took over school management, many students were malnourished and found it difficult to concentrate in class. Younger students would often pass out early in the day, rendering them unable to follow the day’s instruction. As the winter progressed, many students had torn or chapped skin and lips, rashes and other skin infections. Overall hygiene was also poor, with many students showing up with un-brushed hair, dirty or overgrown nails, untidy uniforms and dirty shoes.
Poor oral health and hygiene was widespread. Several young students had ruined teeth thanks to addictions to ghutka/paan. Cavities were also quite prevalent and most of these students came from families where there was no concept of dental checkups. Several students also had serious eye infections which prevented them from participating fully in their classes.


Health Room: Medicines, Doctor, Nurse
A Health Room was introduced in the main building where a full-time volunteer doctor, and later a full-time nurse attended to any sick students. The health room was stocked with basic medicines such as painkillers, fever reducers, anti-allergy medicine, etc. This was sponsored by a pharmaceutical company and an individual donor. Students and their parents were informed about this facility and encouraged to visit whenever they had a health issue.

On average, 40-50 students came to see the doctor every day with a variety of ailments from weakness and headaches to skin infections. Any child who fainted in assembly or class was taken to the health room and given milk.


Special Clinics and Awareness Drives
Students who were diagnosed with issues that could not be treated by the school doctor/nurse were referred to specialists and their parents were asked to take them there. Arrangements were also made to provide free eye clinics, dental checkups and treatment.

Transport was arranged to take a set of students identified by the nurse as needing further eye treatment to the Bhamba Eye Clinic where they got free treatment and were given prescriptions for eye drops etc. as needed.

A basic dental hygiene awareness talk and checkup at the school was organized with the help of volunteers from Fatima Jinnah Dental College. Students needing further treatment such as extractions, fillings, cleanings for extreme cases of ghutka-paan-ruined teeth were taken to the Fatima Jinnah Dental College and helped free of cost thanks to the city mayor at the time. Dental kits with toothbrushes and toothpaste (donated by the Karachi Medical and Dental Association) were distributed to the students who were given oral hygiene awareness sessions where the school doctor and nurse taught them how to brush.


General Hygiene
Students with poor overall hygiene were identified by the teachers and taken aside by the school doctor/nurse who used a hygiene kit (with nail trimmers, hairbrush, Vaseline, shoe polish etc.) to tidy them up and give them pointers on cleanliness and presentation in general. Letters were also sent to the parents of such students to encourage them to take an interest in the cleanliness and appearance of their children.


Nutrition Support Programme
A Breakfast Programme was started for Kindergarten students, where the young children were given fortified milk and a breakfast of either eggs, noodles or fruits (depending upon the season) so that they could get some nutritious fuel for the day. The programme has brought about a heartening improvement in the development and health of our young students. The nurse in the Health Room reports that she hardly sees any complaints from KG students now. This shows the impact of the programme – given how many of them would have to be taken to the health room every day, fainting from weakness or malnutrition.


Serious Health Issues
Students with more serious health issues were provided with help as needed, on a one-by-one basis. E.g. one student was diagnosed with TB and was sent for treatment to Aga Khan University Hospital (AKUH) funded by an individual donor to the Trust. Another student who had a lump in her breast was sponsored and sent to AKUH for diagnosis and treatment.


Thinking Big: Health Inusrance
Health Insurance was provided to all students in partnership with Naya Jeevan – each enrolled student was given a health insurance card. Parents and students were educated on the details of the insurance programme and how to avail it when needed.


Reform in government schools, which typically serve impoverished communities, can not be treated in isolation. If students are not healthy enough to concentrate or stay awake in class, the best curriculum and teachers in the world cannot help them.

Given that background, Zindagi Trust recommends the following simple steps to be followed at Fatima Jinnah School – as well as in all government schools – to improve the basic health, hygiene and nutrition of the students in order to get them to a baseline level of readiness for academics:

- A bi-monthly basic medical checkup for all the students of the school organized during school hours
- Teachers and Administrators made aware to be on the lookout for students with health issues
- Health Awareness Drives to be organized, specially to create awareness about topical diseases like dengue fever
- Subsidized health insurance should be provided to students of schools in impoverished communities

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