I have two (clean) hands

MANILA, Philippines - Proper hand washing and tooth brushing are two of the simplest but most effective ways to maintain good health, thus the Department of Education (DepEd) and local government units (LGUs) have been implementing the Essential Health Care Program (EHCP), which targets about two million children in public elementary schools.

EHCP entails daily supervised hand washing with soap and tooth brushing with fluoride toothpaste, as well as bi-annual deworming. Implementing the program side by side with the DepEd and the LGUs is Fit for School (FIT), a Philippine non-government organization (NGO) that was founded in Cagayan de Oro in 2009.

While LGUs finance the program and the DepEd manages the daily implementation of the EHCP, FIT provides training to LGU and DepEd personnel, develops new tools and strategies to facilitate the program’s implementation such as manuals with guidelines and recommendations, shares the best practices for group washing facilities, helps monitor the coverage and quality of the project and researches the impact on the health and education of children beneficiaries.

The complete EHP Package for washing hands and brushing teeth.

According to Alexander Schratz, executive director of Fit for School Inc., their organization was established by a group of people from the Philippines, Germany and the Netherlands led by Dr. Bella Monse who had been working at DepEd when the EHCP was developed.

FIT’s trustees include representatives from the academe (University of the Philippines-National Institute of Health, Xavier University, Nijmegen University), Philippine Health Insurance Corporation (PhilHealth), the League of Provinces of the Philippines, an NGO (German Doctors) and the German Development Cooperation (GIZ).

Schratz says that from 100,000 children from 16 provinces in 2008, they are now targeting two million children throughout the Philippines, from Ilocos Norte all the way to Sarangani.

“The status of children’s health is alarming. Almost all first-graders (97 percent) have dental caries, which causes pain and suffering and is the number one reason for absenteeism,” Schratz says.

This is how I brush my teeth.

“Moreover, 67 percent of children suffer from intestinal worms that are transmitted because of bad hygiene practices and poor sanitation. These worms rob children of nutrients and energy, contributing to the fact that 33 percent of children are malnourished. In many provinces, diarrhea is the main reason for child hospitalization and mortality. Despite commendable efforts, there just aren’t enough resources available to treat this dire public health situation.”

“Quality health care should really be focused on prevention. As one governor said during an EHCP launch, ‘The quality of health care is not measured by the number of hospital beds and doctors, but by the number of children that do not need to go to the hospital’,” he adds.

Schratz says preventive interventions, such as hand washing with soap, tooth brushing with fluoride toothpaste and deworming, have proven to be very affordable and very effective. The complete package of the EHCP (soap and toothbrush) costs LGUs only P25 per child per year. And a scientific research project on EHCP by DepEd, GIZ and FIT in northern Mindanao showed that these interventions contributed to lower malnutrition (20 percent) and reduced increments in oral infections (40 percent).

The tippy tap, a simple devise for hand washing. A container filled with water with a small hole on the cap is tipped over to provide water for hand washing.

Children who received the EHCP also had 50 percent lower rates of intestinal worm infections and 30 percent fewer days of absenteeism, he says.

“The EHCP is unique in that it’s the largest hand washing program in the developing world that is funded with government resources. This is due to the unique features of the Fit for School approach, which calls for the following: channeling funding from public and private donors through an NGO that focuses exclusively on capacity development as well as monitoring and evaluation; giving full ownership and responsibility in terms of sustaining funding and implementation of the program to government agencies (DepEd, LGUs); supporting and facilitating effective intersectoral collaboration between DepEd and the LGUs; and empowering school communities (school heads, teachers, parents, barangays) through templates for school-based management of the program,” Schratz says.

FIT’s head office is in Cagayan De Oro, but they also have several offices in Manila and Cotabato as well as field offices in various schools nationwide.

Children are also given bi-annual deworming to keep them healthy.

Aside from the DepEd and the LGUs, Schratz says the credit goes to GTZ and the GlaxoSmithKline Foundation for the founding and initial growth of FIT.

At present, they are also partnering with UNICEF, AusAID and the Danish NGO TUG. “The support of such prestigious partners is proof of our successful work so far,” Schratz says.

But the best proof is the growing number of healthier children in schools throughout the country.

To know more about the program, visit www.fitforschool.ph