4.1 Unit One - OUR HEALTH

A clear understanding of health and how children perceive health and illness is very important for the student teachers. Therefore, student teachers should realise and appreciate that health is influenced by self awareness, beliefs, myths, attitudes, environment and finally the action taken by the individual, family and community as a whole.

Teachers are the custodians of our children in the 6 to 14 years age bracket at a time when they are amenable to change, and therefore, they should have a clear understanding of health at the earliest opportunity.

UNIT OBJECTIVES

By the end of the unit, students should be able to:

1. Describe and list the ways children perceive health and illness.

2. Identify and explain life skills that promote health.

3. Explain children’s rights concerning health.

4. Explain how children’s mental development affect their learning of health concepts.

5. Explain the concept of health and health education and how it can be promoted.

6. List various types of environment and describe their effects on health.

7. Describe different problems that may affect proper growth and development of a person at various stages.

8. explain the role of the individual, family, and community in the promotion of health.

TOPIC ONE

CONCEPT OF HEALTH AND LIFE SKILLS

Objectives

By the end of the topic, student teachers should be able to:

1. Learn and work with their fellow students on common tasks on a basis of mutual understanding and team work.

2. Explain the meaning of health in relation to the individual, family and community.

3. Adopt and demonstrate healthy behaviours.

ACTIVITY ONE

GETTING TO KNOW ONE ANOTHER

Life Skills to be developed

Friendship formation, interpersonal relationship, effective communication.

Time: 40 minutes

Materials

Large sheets of paper, markers, pieces of cards with halves of towns in Uganda printed on them.

Procedure

1. Ask each student to pick one card which contains half the name of a town and tell them to find the person with the card with the other half of the name.

2. Each student sits with his/her partner. They tell each other the information about themselves:

· Name
· Age
· Place of Origin

· Favourite Musician
· Biggest Dislike

3. 3 pairs join together to form a group. Each member of the pair introduces her/his partner to the rest of the group.

4. Each group draws its own shield as demonstrated by the tutor on a large sheet of paper with a name and motto. Inside, the shield is divided into four parts:

(i) Names of student in the group,
(ii) Reasons for joining the teacher’s education.
(iii) Concerns, hopes and fears of the group and
(iv) Ground rules for effective class interaction.

5. Each group put up its shield on the wall and explains to the rest.

6. In plenary, discuss the importance of the activity bringing out the life skills such as friendship formation, interpersonal relationships and effective communication.

Learning Points

· This first session is an introductory lesson which aims at building up the students’ knowledge of and trust in one other as an essential pre requisite to later interaction throughout the year. It also introduces from the start the participatory nature of the course.

· It is important to know each other so that you work together effectively.

· Knowing each other helps to improve relationships by appreciating other peoples’ ideas, concerns, hopes and fears.

· Effective communication promotes good relationships.

Hints

· Prepare cards of different towns in Uganda before the activity. Cut the cards inhalf.
· Cards should be of the same size.
· Draw a sample of the shield as shown below:

Figure

Extension Activity

1. Encourage student teachers to continue learning about one another outside the class.

ACTIVITY TWO

WHO IS HEALTHY?

Life Skills to be developed

Self awareness, decision making, critical thinking.

Materials

Handouts containing pictures and descriptions of the four characters, case studies.

Time: 40 minutes

Procedure

1. The students are divided randomly into groups of 8 students.

2. In groups they discuss the four characters shown in the pictures using the questions below:

(i) Who is more healthy and why?
(ii) How could each character improve her/his health?
(iii) What factors lie within the control of each character and what factors do not?

3. Groups present their answers to the whole class for discussion

Learning Points: Some definitions of Health.

· Health is a complete state of physical, mental and social well-being and not simply the absence of disease or infirmity. (WHO, 1964).

· Our bodies are very complicated structures made of many parts each with its job. As long as each part performs its job correctly, at the right time, we are healthy. School Health Text (1984).

· A process of adaptation.... the ability to adapt to changing environments, to growing up and ageing, to healing when damaged, to suffering and to the peaceful expectation of death. Illich (1976).

Hint

· The aim of the first activity is to evaluate the perspectives from which me students view health in its broadest sense and to use the examples to build on that knowledge. Therefore, the tutor should bring out issues of mental, social and spiritual health if the students fail to do so.

Extension Activity

1. Ask students to work in their groups to define health and what is needed in order to maintain good health.

Picture 1: Mr Kizito: He is a fat man, obviously rich wearing expensive clothes. Although he is fairly old, a young woman is hanging on to his arm.

Description: Mr Kizito is 45 years old and he works in a parastatal. He is rich and lives with his family in a big house he has built just outside Kampala. In the morning he has no breakfast but when he gets to work he orders some well salted mchomo which he eats while he reads the newspaper. In the afternoon he usually has a leg of chicken and one beer. In the evening he drops into the local bar for ‘a few beers’ and discussion before going home. Sometimes he takes another girl but he insists on wearing a condom. On Sundays he goes to church and tries to stay with his family the whole day. At work, Mr Kizito is not popular because he always like to command the other workers. He has even been known to hit one of them.

Picture 2: Mrs Kaggwa: She is a peasant woman wearing a long colourless dress and a headscarf. She is not wearing shoes.

Description: Her husband was killed during the liberation war. She has a small farm of bananas, sweetpotatoes, beans and green vegetables. She has four children who alt go to school. Although Mrs Kaggwa works very hard, the children have a sweetpotato before going to school and then the main meal is in the evening. In the middle of the day they cannot eat.

The family eats green vegetables every day but Mrs Kaggwa keeps a few hens so that they can eat chicken on Sundays after going to church. She feels very lonely and abandoned without her husband. She gets her strength from her faith in God and her faith in her children who are all doing well at school.

Picture 3: Mr Okello. About thirty years old, well dressed and thin.

Description: He is the LC1 in his village. He used to work hard for the village but he has changed recently, since he believes that he has not received recognition for all the hard work he does. So he has taken to pocketing some of the village contributions for himself. He doesn’t drink but, ever since he was in the liberation war he has been smoking 20 cigarettes a day. Recently he divorced his wife and married a young girl in the village.

Picture 4: Martina: She is dressed in a secondary school uniform. She looks very smart.

Description: Martina is in S3. She is one of the best students in the class and everyone expects her to go to high school. She hates boys and refuses to go to any dances or other social activities. She spends all her time with the books. Maybe one reason why she hates boys is that she has a twisted leg which makes her feel that she looks ugly and so she is afraid that all the boys are laughing at her.

Picture 1

Picture 2

Picture 3

Picture 4

ACTIVITY THREE

HOW DO I REMAIN HEALTHY?

Life Skills to be developed

Self awareness, decision making, creative thinking.

Materials

Case studies for role plays, large sheets of paper, markers.

Time: 40 minutes

Procedure

1. Students brainstorm on all the factors in the physical and social environment that affect health.

2. In the same groups as in activity two above, students analyse which factors lie outside their control (NC), which they can partly control (PC) and which they have a great amount of control over (LC)

3. Tutor explains that life skills are those skills that enable individuals to have more control over their health and their lives

4. In groups, students prepare role plays on the following situations (one role play for each group).

(i) Paulina is in S2. She was Richard’s girlfriend for one year before agreeing to have sex with him when she realised that Richard was going out with one of her friends. Now she is pregnant with Richard’s baby. He is in S4. She goes to confront him.

(ii) Kato has been rejected by his girl friend, Rose, because he drinks too much. As a result, he starts drinking even more. He meets Rose on the road and tries to convince her forcibly to come back to him.

(iii) Mariamu is in S3. She comes from a poor family and has been going to discos every weekend in the hope of finding men to give her money. Her best lover was a 45 year old manager. She meets him on the street and he is very thin and obviously very ill.

(iv) Atieno left school in P7 to get married to a rich young man in the village who paid a big bride price to her father. She was soon pregnant. On her last visit to the clinic she was told that because she is still very young, she is in danger of losing her baby. She goes home to tell her husband (and her/his parents)

5. For each of these role plays, the students should discuss the following:

(i) What are the health or health related problems outlined?

(ii) To what extent are the problems caused by the situations in which they live?

(iii) What measures could they have taken to avoid their problems?

(iv) What life skills will be needed by each of the characters in order to improve their health and/or behaviour.

Learning Points

· A health problem is the actual illness e.g. malaria.

· A health related problem is an adverse/undesirable situation, which is not prevented or dealt with effectively will lead to actual illness e.g. in an under-five child, shortage of an adequate balanced diet is a health related problem.

Hint

· Each role play should not be more than 5 minutes. The aim is to start the students thinking themselves into the situations, not produce full dramas.

Extension Activity

1. Groups develop plays around the situations they role played, for later presentation to the class/college/community.

TOPIC TWO

FACTORS INFLUENCING HEALTH: GENDER AND ENVIRONMENT

Objectives

By the end of the topic, students should be able to:

1. Analyse differences in health problems facing men and women and the reasons for them.

2. Analyse their own feelings in relation to gender roles and how they are changing/may change.

3. Identify ways in which current imbalances can be addressed in their own lives.

4. Explain how the environment influences health.

5. Identify and adopt life skills for confronting and coping with external influences on health.

ACTIVITY ONE

WHO IS MORE AFFECTED?

Life Skills to be developed

Self awareness, creative thinking, empathy.

Materials

Questionnaires, large sheets of paper, markers, handouts.

Time: 30 minutes

Procedure

1. Hand out the following questionnaire. Each student places their answer on a scale of 1 -5. 5 means that they fully agree and 1 means that they don’t agree at all.

WHAT DO YOU THINK?

(i) Boys are stronger than girls.	1	2	3	4	5
(ii) Cooking is a girl’s job.	1	2	3	4	5
(iii) Girls don’t have time to study because of all their chores.	1	2	3	4	5
(iv) Girls wake up before boys.	1	2	3	4	5
(v) At school, girls do more work than boys.	1	2	3	4	5
(vi) Boys are more intelligent than girls.	1	2	3	4	$

“Girls don’t have time to study because of all their chores”

“Boys are stronger than girls”

2. Each person shows her/his answers to her/his neighbour and discusses it with her/him.

3. Students divide into groups according to sex and write down the different activities they do:

· on schooldays
· at weekends
· in the holidays

4. Each group presents a list of what each does.

5. Tutor asks the followingup questions.

(i) What do we learn from these lists?
(ii) What does it tell us about the health of boys and girls?
(iii) The Convention on the Rights of the Child, it states that:

States should ensure that no child is discriminated against on the basis of status, ethnic origin, religion, sex etc. (Article 2)

How is this relevant to the above discussion?

Learning Points

· In Uganda, men are generally considered heads of families and decision making is largely dominated by them.

· There are gender disparities in access to education, economic opportunities and health care in the country.

· There is bias in favour of education for boys coupled with issues of early pregnancy resulting in the high drop-out rate of girls from school.

· There are imbalances in employment by sector and sex. Within the agriculture sector, women are the major food producers.

· Women perform most of the household chores and are concentrated in low paying jobs.

· As a basic human right, there is need to improve women status, raise the level of income of individuals and family.

· People are born female or male, but learn to be girls or boys who grow into women and men.

· They are taught what the appropriate behaviour and attitudes, role and activities are for them, and how they should relate to other people. This learned behaviour is what makes up gender identity and determines gender roles

Hint

· Gender issues are sensitive and therefore the ground rules should be strictly observed in order to ensure that it is not just a fight between the boys and the girls.

Extension Activities

1. Ask students to identify the gender issues that affect the health of an individual, family and community.

2. Ask students to suggest types of communication activity which promote the behaviour change towards healthy living.

ACTIVITY TWO

ROLE PLAY: MRS BYAKIKA IS LATE

Life Skills to be developed

Empathy, problem solving, critical thinking.

Materials

Large sheets of paper, markers.

Time: 40 minutes

Procedure

1. Prepare a few students to do the role play before the class

2. Ask the students to do the role play.

Mr Byakika is busy cleaning the house. He is carrying a baby on his back and a small child is pulling at his legs wanting something. He is obviously tired but dinner is also cooking on the fire. He talks about his problems as he works, that there may not be enough food when his wife comes home from work in the council. After his situation is made clear, his wife returns. She is a little drunk and is angry that dinner is not ready. The children hide behind their father.

3. Students discuss in groups the following questions:

(i) What do you think about this situation?
(ii) How did you feel when you were watching the role play? Why?
(iii) What do our feelings show about how we view roles of men and women in society?
(iv) If the role play were the other way round, would we have felt differently? Why?

Learning Points

· Gender describes those characteristics of men and women which are socially determined in contrast to those which are biologically determined.

· The distinction between sex and gender is made to emphasise that most of the so-called differences in roles are socially determined.

· Many of the students’ reactions come from the way they have been socialised which leads to an unconscious gender stereotyping

· Many aspects of division of labour change from one place to another and one time to another. For example, men do cook when it is paid employment or the food is not regarded as traditional (such as roast meat and chips).

· Women and men must be given equal opportunity at all levels of health and development activities because it is both a matter of justice and a recipe for faster development.

Hints to Tutor

· Gender roles are very sensitive and therefore ground rules should be strictly observed.

· Avoid reinforcing stereotypes of men and women

· Be aware of your own, as well as your students’ assumptions about gender.

Extension Activities

1. Students read the dialogue from the beginning of The Special Gift:

IN THE COUNTRYSIDE NEAR A SMALL TOWN IN AFRICA THE HOT MID-DAY SUN 15 BURNING FIERCELY. WOMEN AND GIRLS ARE GATHERING NEEDED FIREWOOD. SARA AND HER FRIEND AMINA. TWO SCHOOL GIRLS, HAVE COLLECTED AS MUCH FIREWOOD AS THEY CAN FIND AND ARE HEADED FOR HOME WHERE MORE WORK AWAITS THEM. SARA’S PET MONKEY, ZINGO, IS ALSO GATHERING WOOD TO HELP SARA.

Figure

Figure

Figure

Figure

2. In groups, discuss how Sara and Amina could convince their relatives to allow them more time for homework.

3 Role play the discussions.

4. Plenary discussion:

(i) How did you feel trying to convince your mother/uncle?

(ii) How easy is it to do so? Why? What other methods could they have used to convince their relatives? (e.g. calling in another adult, the teacher etc.)

ACTIVITY THREE

HOW ENVIRONMENT AFFECTS HEALTH

Life Skills to be developed

Self awareness, interpersonal relationships, problem solving.

Materials

Large sheets of paper, markers, portable boards, chalk.

Time: 40 minutes

Procedure

1. Divide the students into six groups.

2. Each group answers the following questions.

(i) What are the physical environmental factors that can adversely affect health?
(ii) How do these factors affect health?
(iii) How can children participate in minimising these factors?
(iv) What are the social environmental factors that can adversely affect health?
(v) How do these factors affect health?
(vi) What is the role of children, the school and the family in minimising these factors?

3. Each group writes down their answers on large sheets of paper for presentation to plenary.

4. Each group chooses one of the factors and prepares a tableau to depict both the factor and how children can participate in minimising the factor.

Learning Points

· This activity is intended to remind students that the environment plays a major role in determining the quality of health. Improving the environment should improve the health of those who live in it.

· The increasing population and demand for natural resources has led to a marked destruction of the environment especially the forest cover.

· The environment influences the individual from conception to death.

· Air pollution strikes the young more harshly than the old, affecting their respiratory system.

· Active participation of the individual, family, school and community is required in the promotion and maintenance of a healthy environment.

· Some diseases/conditions have hereditary/congenital bearing.

Hints

· Guide the students to explain what Health Education is in relation to environment.

· Emphasize that Health Education should be integrated with everything that we do because basically all that we do is for sustaining life; which can only happen if we promote health.

· The groups discussing biological factors should come up with among others, how they affect health.

· The group discussing social factors should come with amongh other dindings behavioural factors such as knowledge, attitudes, beliefs, adversely affect health.

Extension Activities

1. Ask students to visit various communities to find out the following:

(i) Their water source

(ii) Health facilities in terms of types, use/attendance and common illnesses

Protected spring

Piped water source

2. Ask students to visit primary schools look into the conditions of:

(i) sanitation and water sources.
(ii) buildings.
(iii) feeding.
(iv) school health services.
(v) common illnesses.

TOPIC FOUR

HEALTH AND THE SCHOOL

Objectives

By the end of the topic the students should be able to:

1. Explain what a health promoting school is and how it affects the pupils and teachers who attend it.

2. Analyse schools and colleges from the perspective of a health promoting school and identify problems which need to be addressed.

3. Identify behaviours which they as teachers should have in order to facilitate a health promoting school.

4. Prepare materials for use in class that build on the knowledge the pupils already have.

5. Explain the Sara Communication Initiative and how it relates to them as future teachers.

6. Explain the role of the individual, family, school and community in the promotion of health.

ACTIVITY ONE

GETTING TO KNOW YOUR CLASS

Life Skills to be developed

Self awareness, decision making, creative thinking, problem solving.

Materials

Pictures of Ms Matata, Sara, Amina and Juma, brochure on Sara Communication Initiative.

Time: 40 minutes

Procedure

1. Groups discuss how they would teach about environment and health to a P7 class.

(i) What do they want to teach the pupils?
(ii) How will they teach it? (i.e. what methods will they use?)

2. Two groups present their answers to the class. Facilitator writes main points on the board.

3. Facilitator presents materials on Sara and her friends.

4. Students read and discuss the following questions in groups.

(i) What picture do you get of these three children?

(ii) What do you think they know about health?

(iii) In the light of having such pupils in your class, would you like to revise the way you would teach your lessons?

(iv) How does Sara contribute to the promotion of Health?

5. Groups revise how they would teach their lessons. Plenary discussion.

6. Facilitator points out that Ms Matata’s class will be the class they will be learning about and interacting with throughout the course, especially Sara and her two friends, Amina and Juma. S/he explains the Sara Communication Initiative and says that, if the students are interested there are stories, comic books etc. S/he also explains that, as they are student teachers, Ms Matata is a good role model in the way she tries to discover and develop her students’ talents by using participatory methodology. That is one reason why Sara and her friends already know so much.

Ms Matata handout

Hello. My name is Ms Matata and I am the class teacher for P7. I am very happy that you have come to join us as trainee teachers for the whole of this year. I am sure you will want to know about the pupils you are going to teach.

Sara handout

Sara is 14 years old. She lives with her mother and younger brothers and sisters in the compound of her uncle who is a farmer. Her father is in town where he is trying to save money to buy a farm and build a house. He sends money home for the education of his children. He is very proud of Sara because she is his first daughter and she is doing so well in school.

Sara wants to be a scientist and she has already shown that she can be. Together with her friends, Amina and Juma, she has built a smokeless stove which has become the model for the whole village because it improves the kitchen environment by reducing the amount of smoke and also reduces the amount of time women and girls have to spend looking for firewood. She says that her aim it to be either a doctor or an animal doctor so that she can help her village in the future.

Amina handout

Amina is an orphan. Both her parents died three years ago and she lives with her sister who works in the local bar. Amina is very good at mathematics but she sometimes get discouraged at school because of her home problems. Recently she decided to go to town to look for a job as a domestic worker but she was cheated by a lorry driver and, if Juma and Sara had not arrived in time to save her, she was in danger of being raped. Since then, she helps Juma’s brother with his accounts for which he helps her with her school fees. At the same time, she has set up a health club, together with Sara in order to discuss how they can best grow up.

Juma handout

Juma lives with his parents and his elder brother Themba who drives a pick up truck. His mother also runs a shop. He is very good at languages and is one of the best footballers in the school. Some students say that he wastes his time playing football but he argues that people who are fit or who have healthy bodies can study better.

Maybe because Juma does not have a sister, he and Sara are like sister and brother and they do most of their homework together. Last year they did a joint project on the jobs done by different members of the family which won first prize at the school.

Learning Points

· It is important to know your class, what they need to learn and how they effectively they should be taught.

· Sara is a good role model for girls.

· Every individual, family, school and community has a role to play in the promotion of Health.

· Environment influences the health situation of the individual, family school and community.

Hint

· In teaching this activity it is important to promote the linkages between health, the environment, life skills and the Sara Communication Initiative.

Extension Activity

1. Ask your students what they want to learn in various topics in Health Education.

ACTIVITY TWO

THE HEALTH PROMOTING SCHOOL

See Section Two of the manual for this activity.

ACTIVITY THREE

WHAT IS IN OUR HEADS?

Life Skills to be developed

Critical thinking, self awareness.

Materials

Picture of an empty head.

Time: 30 minutes

Procedure

1. Draw a picture of an empty head on the blackboard. Discuss what is in that head (e.g. experiences, religion, father’s attitudes, education etc).

2. Ask each student to draw a similar head and write down or draw what is in their heads and where it came from.

3. Students show their heads to one another in groups. An example of what such a drawing may appear is shown.

4. Ask the class:

(i) How can we find out what is in other people’s heads?

(ii) How do you know that you have really found out (eg many people do not like to tell the truth about sensitive issues or ones that they know might regard others to look down on them).

(iii) What is the relevance of this to teaching children about health? How much do they know already? How do we get them to express their real ideas and concerns?

Figure

Learning Points

· Our heads store a lot of information and experiences etc.

· It is important to use appropriate methods to generate students/pupils ideas and experiences for discussion.

· The body needs to be well protected.