
| Primary School Physical Environment and Health - WHO Global School Health Initiative (SIDA - WHO, 1997, 96 p.) |
| Appendix A. Case studies |
In many respects, Colombia is typical of Latin American countries. Its basic health and development indicators are among neither the best nor the worst for the region. Infant mortality in 1995 was estimated at 32 deaths per 1000 children. Population growth is 1.66% per year, life expectancy is 69.3 years, and 73% of the population lives in urban areas. A distinguishing characteristic of Latin America is the high proportion of the population living in cities (Argentina 88%, Bolivia 60%, Brazil 78%, Chile 84%, Peru 72%, Venezuela 93%).
The capital of Colombia, Bogotá, is a classic example of a Latin American city which, over the last 30 years, has undergone a dramatic transformation through the large-scale and rapid growth of informal settlements. The oldest and most famous of these is Ciudad Bolívar. With well over a million inhabitants, it has come to be seen as a city in its own right. The Barrio Vista Hermosa is in one of the oldest parts of Ciudad Bolívar and is around 30 years old. It is built on the steep hillsides that surround old Bogotá and, since the Colombian uplands are subject to both earthquakes and sudden torrential rains, buildings on these unstable slopes are at constant risk of disaster. Situated at 3000 m above sea level, the barrio experiences wide differences between night-time and daytime temperatures. The thin mountain air results in an exceptionally harsh, burning sun.
The school of San Rafael was formed by a committee of parents in Barrio Vista Hermosa early in the life of the settlement. In many ways it is typical of an urban school in Latin America. The original school buildings were built by the community and, over the years, the school has spread up the steeply sloping site in a piecemeal way. There are now 19 classrooms. The older ones are of brick with corrugated iron sheets on the roof. More recent ones have concrete-block walls, a prefabricated steel frame and asbestos-cement roofing sheets. Once established, the school was adopted by the Colombian Government. A government health centre has been built on a neighbouring site. The school now has 1400 pupils ranging from 5 to 14 years old. They are taught in two shifts of 700 pupils each, by 22 teachers. Like most schools in Colombia, it does not provide the children with a meal but does have a small school shop selling sweets and the like.
The head teacher, Señora Sophia Ramires, and her staff realized that for a school such as theirs to serve its community it was important first to understand the community. In 1994, at their own initiative, they organized a socio-economic survey of the catchment area. They interviewed 152 families and found that 63% of them had been forced to migrate from other parts of the city because of economic pressures. The remaining 37% were rural peasant families who had come to the city either in search of better work or because they had been forced from their land by the violence that currently afflicts parts of Colombia. The teachers estimated that 46% of the adults could be classified as illiterate and that 30% of the families were living off less than one official minimum wage. Two-thirds of families lived in houses which they had built themselves. Many of these started as simple shacks which had been progressively upgraded over the years.
Despite the relative poverty of the area and the prevalence of self-built houses, the teachers from San Rafael estimated that 95% of their pupils come from homes that have their own water closet (WC). As in most of Latin America, a high priority is placed on having a WC. At the school, there is one WC for the teachers and a further 20 for the pupils. Approximately 30% of these are in some way damaged but the rest are functioning. Some of the taps to the washbasins are broken, but not all. Drinking-water is taken from standpipes. Although the water supply across the district is sporadic, the school has a large elevated water tank which ensures that sufficient water is always available.
Since the health clinic is just next door it is perhaps not surprising that there is no programme of visits from doctors or nurses. The staff of both the school and the health centre reported that the major health problem for children in the area was malnutrition. They reported problems of both eyesight and hearing, and felt that the latter was due to malnutrition. Dental problems caused by too much sugar in the limited diet had also been observed. The school does not have a health education programme. As with all schools in Colombia, a condition for entering the school is a certificate of vaccination.
The school is also typical in its management and maintenance. There are broken windows, damaged furniture and crumbling steps on the steep slopes. Funds for routine maintenance from the government are scarce. On the other hand, external walls are painted with murals and inside there are many posters and notices, indicating a level of care and pride. Also, the level of cleanliness is high. Each family has to pay a small amount each term to help cover the cost of materials. The school compound is surrounded by a high concrete wall and can only be entered through a steel gate that opens into an internal lobby, which is constantly supervised (in Bogotás city-centre schools levels of security are even higher, with bars on the windows and a sense of constant vigilance).
San Rafael is neither an exceptionally innovative school, nor particularly bad. But it illustrates that people on the margin of Latin American urban society are keen to have schools for their children and prepared to invest their time and resources to obtain them.

The school of San Rafael in Bogotá is
built on a steep slope. The long flights of concrete steps are a major
hazard.