Colofon
Title:
Handbook for a safe and healthy school
Text:
Adrianus (Ton) Vlugman and Johanna Lakhisaran
Editor
Adrianus (Ton) Vlugman
Photo’s
Adrianus (Ton) Vlugman and Johanna Lakhisaran
Drawings:
Adrianus (Ton) Vlugman
Layout:
Adrianus (Ton) Vlugman
Cover:
Adrianus (Ton) Vlugman
Printer:
1ste Edition
Leo Victor
May 2005
Original Title:
Handboek voor een veilige en gezonde school
Translation
from Dutch:
Patricia van Aerde-Milzink
©
Pan American Health Organization/World Health Organization
P.O. Box 1863, Paramaribo, Suriname
Tel (597) 471-676
1.Healthy Schools- Health Promoting Schools
I.Vlugman, A. II.Lakhisaran, J.
ISBN 99914-661-6-9
The contents or part of the contents of this document can be used and copied freely for non commercial purposes only and
with reference to the Pan American Health Organization / World Health Organization, Suriname Office
Table of Contents
Table of Contents
i
Preface
ii
Acknowledgement
iv
Introduction
v
1. Safe drinking water and sanitary facilities
1
2. Waste management
10
3. Air quality and ventilation
22
4. Safety and aesthetics
25
5. Grounds and surroundings
30
6. Vector control
32
7. Personal and food hygiene
38
8. Sustainability
43
Annexes
I
The 30 criteria of the National School Competition: ”improve your school”
II List with organizations
III List of references
Handbook for a safe and healthy school
i
Preface
The concept of health promoting schools is based on a social health model. This model
approaches the whole of the school environment with emphasis on the individual. The heart
of this model is the young person, who is viewed as a human being intertwined in a dynamic
environment and community. The school is the center of this dynamic environment in a
community with several different actors: pupils, teachers, other personnel, parents, private
sector (also partly being represented by the parents), churches, service groups and the
government.
Schools are centers for personal and community development and have to provide a
conducive and supportive environment for a health behavior and lifestyle. Schools also
provide a clear and controllable environment for health education and promotion. A safe and
healthy school has a positive impact on the health of its pupils as well as teachers and other
personnel and will improve the academic and physical development of the child and make
them better parents when they grow up.
This handbook is in the first place written for headmasters, teachers, parents and all others
who are involved in and carry responsibilities at the school. This book aims to increase their
awareness on the need for safe and healthy schools, and to provide guidelines to reduce the
dangers to safety and health at the schools. This book also contributes to the sustainability
of the management of the many schools that have been build and renovated in the towns
and villages throughout the country.
The guidelines in this manual are based on literature surveys and practical experiences from
drinkingwater and sanitation projects at schools during the period 2000 - 2005 and the
National School Competition: “improve your school”. It provides information, guidelines for
action to improve healthy and safe conditions at schools and thus contributing to the health
of the pupils, teachers and all who spend prolonged periods at school.
Handbook for a safe and healthy school
ii
The executed projects all followed community based approaches and filled many of the
members of the community with pride for the achieved improvements at their school. Many
communities feel empowered and will continue to maintain the facilities and to sustain the
momentum of improvements always required in their school environment. The winning
schools of the national school competition have organized open days to invited neighboring
schools to follow their example.
The school improvement projects on which this manual is based have been facilitated and
supported by the Ministry of Education and Development and the department of Basic Life
Skills, the Ministry of Health and the Bureau of Public Health, The “Inter-American Water Day
Committee” and the “Health Promoting Schools Committee” in collaboration with the Pan
American Health Organization.
Minister Sandriman (r), Minister
Khudabux (m) and Dr. Alleyne (l),
former Director of PAHO, with Smoke
free school certificate for OS Helena
Christina, Wanica, February 2002.
__________________________
Walter Sandriman
Minister of Education and
Community Development
Handbook for a safe and healthy school
___________________________
Rakieb Khudabux
Minister of Health
iii
Acknowledgement
PAHO wishes to express its gratitude to all collaborators of the school teams fort their hard
work and energy. Without their dedication the successful completion of the projects would
not have been possible. Especially the head masters performed a guiding and leading role in
the initiation and execution of the projects.
PAHO thanks the members of the “Health Promoting Schools Committee” of the Ministry of
Education and Community Development and the Ministry of Health, and the members of the
“Inter-American Waterday Committee” for their technical support to the projects as well as
members of the jury for the National School competition. In alphabetic order: Armand
Amatali (Ministry of Public Works and Traffic), Maaltie Ashim Sardjoe (Regional Health
Services), Edmond Blufpand (Surinam Water Company NV), Hildegard Illis (Ministry of
Education and Community Development), Jetty Rosheuvel (Surinam Water Company NV),
Moedio Tirtotaroeno (SURALCO), Erwin Tsai Meu Chong and Meryl Zeefuik (Bureau for Public
Health).
We are greatly indebted to Mrs. Liesbeth Venetiaan, who with her charismatic personality
launched the National School Competition and guided to project to a successful completion.
The authors are grateful for the great interest from several service clubs and the private
sector for their active participation and support to the projects at the schools.
Special thanks are addressed to the RBTT Bank, Suriname, for their financial support to print
this edition of this manual in accordance with their 2004 Public Relations Theme: Youth,
Health and the Environment.
Handbook for a safe and healthy school
iv
Introduction
This manual provides specific guidelines for safe and healthy schools in Suriname and aims at
policy makers, school management and boards, headmasters and teachers and guides their
attention to specific environmental health related problem areas and offers appropriate
solutions for school environments.
This manual contains the experiences of several projects executed in the period 2000-2005,
which aimed to improve environmental health conditions at schools. These projects included
improvement of the drinking water supply and sanitary facilities, expansion of the school
curriculum to include basic personal and food hygiene education, the 100-smoke-free
schools project as part of PAHO’s centennial celebration, and the National School
Competition: improve your school” to improve the safety and environmental health
conditions at school.
The strategy of all these projects was to increase the awareness on the relation between
health, hygiene and the environment, the integration of hygiene and environmental aspects
in the management of the school and to stimulate the school to work together with the
parents and the community to make improvements at the school.
Launching, milestones and finalization of the projects was always celebrated at
corresponding internationally celebrated days, such as World Water Day, Inter-American
Water Day, World Health Day, World Environment Day. By doing so we were able not only
to highlight the importance of the specific theme of that year, but also show specific
solutions and approaches to solutions to the community in Suriname.
We wish to stress that the role of the principal at the school is paramount to the success of
any activity or project at a school. Projects are not possible without his or her leadership and
dedication as well as the dedication of the teachers, other staff and the PTA’s. Special
attention must be paid to these factors in identifying projects at schools and to stimulate,
encourage and empower active participation in all aspects of the project of dedicated
teachers and parents.
Handbook for a safe and healthy school
v
This manual is divided into 8 chapters. Chapter 1 to 5 discuss the physical aspects of the
facilities at schools and their relation to health and deal with 1. Safe drinkingwater and
sanitary facilities; 2. Waste management; 3. Air quality and ventilation; 4. Safety and
aesthetics; 5. Grounds and surroundings.
Chapter 6 to 8 discuss specific activities, plans and strategies in relation to improvements to
control vector proliferation, personal and food hygiene and increase sustainability of the
improved environment at the school.
Each chapter provides background and specific information in relation to health and provides
guidelines for action. We also included pictures of actual facilities and situations at schools in
Suriname.
Our experience from the school projects in Suriname over the last five years shows that
significant improvements are possible with a relative low budget through good collaboration
with the school community, government, NGO’s and the private sector.
It also indicated the importance to adjust the curricula at schools, as well as that at teachers
colleges, to include basic concepts of hygiene education and health promotion. Such
improvements have been realized in collaboration with the Ministry of Education and
Community Development and the Ministry of Health
This book also highlights the commitment and participation of students in health and
environmental health issues and activities at school. We advice all teachers to stimulate,
encourage and actively support the establishment and functioning of student health,
environmental and safety clubs. Annex 2 and 3 include contact and email addresses where
information can be found in support of child based and oriented approaches to education.
relevant subjects
Handbook for a safe and healthy school
vi
1.
Safe drinking water and sanitary facilities
Background information
The World Health Organization has established guidelines for the quality of drinking water
and is clearly states that safe drinking water is free of pathogens. Safe drinking water is
clear, free of offensive odor and has no taste.
The freshwater sources for dinking water available to human beings are rainwater,
groundwater, rivers and creeks, lakes and other reservoirs, with a preference for
groundwater as this water is generally better in quality. The Suriname Water Company
(SWM) and the Department for Water Supply (DWV) of the Ministry of Natural Resources,
are responsible for the public water supply in Suriname.
Much importance is placed on the water quality en adequate supply of safe water. All
schools should have an uninterrupted supply of safe water for drinking food preparation,
flushing toilets, washing hands and general cleanliness of the facilities. Unfortunately not all
schools have access to such supply. Sometimes water containers can store water to
accommodate time periods of no supply facilities. Water storage containers should have a
capacity of about three days.
Health aspects
Water purification is the process by which particulate matter, color, turbidity and pathogens
are removed from the water as such matter can harm the health of the people.
Rain water collection tanks and
washbasins, Thomas Moreschool,
Washabo, Sipaliwini
Disinfection is a process normally used in the water purification process for the killing of
pathogens, e.g. bacteria, viruses, and other micro-organisms that would otherwise endanger
the health of those who drink the water. Disinfection using chlorine give the best guarantee
for safe drinking water, however, water disinfection is not a standard practice in Suriname.
The water delivered by the SWM and the DWV is regularly tested by the Central Laboratory
of the Bureau of Public Heath. If the water from the pipe has a suspicious color, always
report this to the BOG. Sometimes people break open water mains to get to the water. This
is stealing and rejectable behaviour as this will allow contamination to enter the system and
Handbook for a safe and healthy school
1
disrupts the supply of water to other people. In such situations it will be necessary to boil
the water before drinking.
Table 1 below lists diseases that could be spread by drinking unsafe water:
Table 1: Water related diseases
from unsafe drinking water
Cholera
Hepatitis
Diarrheas
Polio
Dysentery
Ascaris
Typhus
Whipworm
poor personal hygiene
Scabies
Typhus
Trachoma
Lice born disease
Leishmaniasis
from swimming and bathing in unsafe water
Bilharzia
Guinea worm
Regular handwashing is important to
prevent diseases, OS Helena Christina,
Wanica.
diseases spread by insects breeding in water:
Malaria
Dengue
Yellow Fever
Filariasis
Source: Adapted from Satterthwaite, David et al. The
environment for Children. United Nation Children’s Fund and
Earth scan, News York , 1996
Handbook for a safe and healthy school
2
Guidelines for actions
Use self closing stop cocks. These kinds of taps significantly lessen water consumption as
much less water is wasted. These taps in question are indeed more expensive to
purchase, but they are worth every dollar, especially if a water tank is used and latter is
often empty (and the booster water pump then burns out).
Promote personal hygiene and behavioral change among the pupils, parents and
teachers, including the washing of hands as a simple, but effective manner to interrupt
the transmission route of germs from hand to mouth.
Teach children and teachers how to deal with drinking water, how to store drinking
water and how to protect water sources in a proper manner.
Drinking-water tanks and all other drinking-water containers have to be inspected and
cleaned regularly. The inspection has to be performed monthly, while the cleaning has to
be done at least thrice a year.
Water-storage tanks must always be provided with a properly closing lid secured with a
lock. This is to prevent animals, dirt or other waste from getting into the tank accidentally
and of course to prevent any illegal access.
In case the principal suspects that the drinking water of the school is polluted, he should
immediately advise his pupils and other personnel to bring along drinking water from
home, until the water at school is safe again for them to drink.
The principal should immediately report such an incident to the BOG (Bureau for Public
Health Care). He should
o report unhygienic conditions of the water tanks to the head of the Technical
Department of the Ministry of Education and Community Development;
o ask to take water samples in order to have the drinking water at the school analyzed.
Participate in the celebration of international days such as World Water Day and the
Inter-American Water Day and involve the water issues at school at these occasions.
Girl drinks water from self closing drop
tap, OS Latour, Paramaribo.
Guidelines as to how to clean the drinking-water tank
1. Empty the tank.
2. Thoroughly scrub and wash the inside of the tank.
3. Rinse and remove all dirt.
4. Fill the tank with water and add 250 ml of bleach (ordinary household bleach is OK)
Handbook for a safe and healthy school
3
5. Leave the tank like this for 24 hours (do not use the water).
6. Drain the tank of the chlorinated water.
7. Refill the tank with safe drinking water.
Guidelines to protect the water well against pollution
The principle of a protected water well is that the groundwater is hermetically sealed
from environmental pollution. Page 9 indicates a schematic drawing of and guidelines for
protected water wells.
Regularly inspect the well for cracks in the cover, the raised edge of the well head or in
the concrete floor.
Repair cracks and holes with grout.
If no pump is available and a bucket has to be used, please remember that the bucket
and the rope cause dirt and bacteria to enter the well. This would infringe the principle of
protected water wells.
Do not leave the bucket and the rope lying around, but put them on top of the well to
dry out if they are not being used.
Sanitation
Appropriate sanitary facilities meet a primary need of pupils and teachers and contribute to a
clean and hygienic environment. A lack of proper toilets drops school attendance, especially
among girls. Urinary tract infections also happen to occur more often among girls if they are
forced to delay going to the bathroom as there is no toilet, or because latter is too dirty to
be used by them.
Good and clean toilet, OS Apoera,
Sipaliwini
Proper sanitation is characterized as follows:
Toilets at school must be robust as they are used often. Constructing tiled urinal walls are
much less subject to damage than individual pissoirs. Page 7 shows an example of a
good urinal wall.
Be sure that the drainage system functions properly (for example: no leaks in the sewer
and septic tank and stench formation);
Be sure that the sewage drain is in an excellent state of repair, has a good slope so that
no stagnant water is created and that the sewer discharges in an acceptable open drain;
Handbook for a safe and healthy school
4
Ensure that the sanitary facilities are properly used and that the floors, the walls and the
ceiling are regularly cleaned and maintained.
The toilet facilities
Provide toilet facilities, inclusive of urinal walls for boys, that are constructed in such
manner that easy and proper cleaning is facilitated. We strongly recommended tiled walls
and floors, because they can be kept clean much easier and thus promote hygienic
conditions.
Provide adequate hand washing facilities in the bathrooms
See to it that the bathrooms are well-ventilated and that the air flows into the open air;
and not into working areas or class rooms and especially not in areas where food is
consumed.
See to it that toilet rooms are properly cleaned on a daily basis.
Ensure that there is a waste bin in the toilet rooms.
Regular sanitary inspections will be necessary to guarantee the desirable level for
environmental and sanitary facilities. If necessary expansion or maintenance is necessary, it is
recommended to perform these during the holidays or during the dry seasons.
Boy uses wall urinal, Clarkeschool,
Wanica.
Principals must be aware that pupils have different backgrounds, socio-economically,
ethnically and as far as culture is concerned. In this respect Suriname is a very diverse
country and in many cultures it is customary for people to open their bowels while squatting.
This is one of the most natural and also very hygienic manner of bowel movement. The
seatless squatting toilet is used by many families in Suriname and also many companies have
this type of toilet for their personnel. Schools could also contribute to accepting the cultural
diversity by placing squatting toilets if the cultural custom requires such.
Pupils (mostly young) are often not familiar with the right use of the flush toilet as indicated
on page 4. If it is not possible to place squatting toilets, it is essential for teachers to give
these pupils orientation lessons and guidance as to how to treat and use such sanitary
facilities.
Handbook for a safe and healthy school
5
At schools where there is no running water supply, as e.g. in the interior, the flush toilet is
not practical and thus not suitable. A ventilated pit-latrine is a very good alternative of a
waterless and hygienic toilet and provided that it is properly built and used, there will be no
more complaints about stench and flies. In chapter 2 the technical aspects of this latrine are
discussed.
During the hygiene classes that PAHO conducted at schools, it turned out that most female
and male teachers never visited the toilet of the pupils. We strongly recommend that the
teachers do regularly visit the students’ toilets and even use these. This always results in a
diminished misuse and vandalism, and cleaner toilets.
Guidelines for action:
A proper use of the toilet is truly emphasized:
See to it that the toilet and/or the urinals are used in a proper and hygienic manner.
Use toilet tissue or water and flush after each use.
See to it that there are waste bins for sanitary napkins in the toilet rooms for the girls.
Clean the toilet after each spill.
Report any non-functioning of the facilities to the principal or the teacher.
Each toilet room must be provided with taps, washbasins and soap for users to wash
their hands. Towels are not really necessary, as they become dirty very quickly and can
transmit diseases if they are not changed often enough.
See to it that everyone washes his or her hands with soap after each visit to the toilet.
Facilities for hand-washing remain essential, even if there is no running water. E.g. place
special hand-wash tubs near the toilets that are filled with buckets of water from the
river. A good drainage of spills is again essential.
Pupils and chairperson of PTA place the
first stone for the new sanitary
facilities, OS Tamanredjo, Commewijne
Above-mentioned aspects all relate to building responsibilities that each child must develop
for his or her personal hygiene and for public health.
Handbook for a safe and healthy school
6
Drawing 1: Tiled urinal wall with self closing push taps.
Urinal wall with sprinklers, slanted
splash edge and space for feet,
OS Helena Christina, Wanica.
The extra space for the feet will allow the user to get closer to the center of the drain gutter and reduces
the amount of spilled and splashed urine. The slanted splash edge prevents splashing of urine against legs
and trousers.
Table 2: Minimum number of sanitary facilities and taps at schools
Urinals
50 cm of urinal wall per 50 Boys
WC's
1 per 50 Boys
1 per 25 girls
Water faucets
1 per 50 pupils
Handbook for a safe and healthy school
7
Drawing 2: Yard tap with self closing drop taps and proper drainage.
Improved water facilities at the school
yard, OS Helena Christina, Wanica.
Unhygienic drainage at the pipe before
the improvements shown above.
Handbook for a safe and healthy school
8
Drawing 3: Protected shallow well
Pupils inspect a borehole of their new
water well before submersible pump is
installed, OS Tamanredjo, Commewijne
A protected shallow well is provided with:
1. an elevated well head with sealed lid
2. an electrical or hand pump
3. sealed casing (mostly concrete rings or masonry)
4. a concrete apron, draining rain and spilled water away from the well to a drain pit at least 10
meter from the well casing.
5. a fence and lockable gate to control access to the well and ward off stray animals.
6. at last a 30 m distance from any septic tank of latrine.
7. at least a 100 m distance form any storage of dangerous chemicals (e.g. pesticides).
Handbook for a safe and healthy school
9
2.
Waste management
Background
Many of the health aspects in this instruction manual concern waste. Liquid and solid waste
can constitute a health risk factor at school if these are not disposed of in a responsible
manner. Different measures and interventions are necessary for different kinds of waste,
mostly focused on the prevention of illnesses, physical diseases and accidents.
Waste is stored for a shorter or longer period of time before it is treated, processed and
made harmless. If the waste still has a useful residual value, it may be reused, e.g. a glass
bottle or jar can be filled again. Other waste can sometimes be recycled, if it is again
processed in a manufacturing process. The glass of a broken bottle can be melted to a new
bottle in a glass factory. Composting is also a form of recycling.
Liquid waste
Providing a school with running water is only half the job done. Most piped water that
enters a school, leaves the school as wastewater. Water is not only used to drink and to
cook, but is also a means to transport waste. Wash water removes the dirt from your body
and from the kitchen, the toilet flushes the water and drains the faeces to, if this is done
properly, a septic tank, the rainwater rinses all the dirt from the roof and the school yard to a
ditch.
Clean, accessible and maintainable
septic tank, OS Bacovendam, Nickerie
(A rectangular tank is better)
The septic tank
A septic tank is a water-tight underground tank that collects the flush water from the toilets
and in which chambers solid matter settles. Drawing 4, page 19, shows a cross-section of a
standard septic tank. Good septic tanks are rectangular and elongated and not round as the
ones in Suriname usually are. In time, mostly some years, the sludge has to be removed from
the tank. In Suriname, waste from septic tanks and other sewer waste are not treated as
yet, but unfortunately discharged into the Suriname river.
Improved ventilated pit (VIP) latrine
The conventional latrine, often called toilet in Suriname, creates much nuisance due to the
stench and is a breeding ground for vermin. These disadvantages can be prevented by
Handbook for a safe and healthy school
10
building an improved ventilated latrine. Adjacent to this text, you can see an improved
ventilated latrine in the process of being built; the roof and the door still have to be placed.
Technical details are included in drawing 5 on page 20. Also check the hygienic squatting
floor as discussed in the previous chapter.
Health aspects
Most water that is used at schools, leaves the schoolyard as waste water. Wastewater with
faeces from human-beings (and animals), contains many germs, as indicated in the table
below.
Table 3: Faecal matter – A very dangerous pollutant
One gram of human faeces can contains
10,000,000 viruses
1,000,000 bacteria
1,000 parasitic cysts
100 parasite eggs
The wastewater of septic tanks contains many bacteria and germs and consequently this
water is contagious. Most of the time, this wastewater is discharged in trenches and creeks
and contact with water in these creeks constitutes a health-risk. Discharging wastewater
from
septic tanks on the schoolyard or leaking septic tanks can have very adverse
consequences for the health of the pupils and the teachers. Table 4 indicates specific
diseases that are spread by contaminated drinking or surface water (puddles, ponds,
trenches, creeks, rivers and lakes).
VIP latrine under construction with
hygienic squatting floor. The roof and
door await installation, Baha’i School
Bufrukule, Sipaliwini.
Guidelines for actions:
See to it that the toilet drain and the septic tank do not leak. Be alert for moist spots (in
the dry season), as these most of the time reveal that there is a leak somewhere. It must
at all times be prevented that toilet discharge and wastewater from the septic tank enter
the schoolyard. The water that overflows from the septic tank must be discharged either
in a seepage pit or to a ditch or creek outside the schoolyard.
Handbook for a safe and healthy school
11
Do not build a septic tank within 30 meter-distance of drinking-water wells and repair
any observed leaks; also fill all cracks and holes in a septic tank with grout.
See to it that the vent pipe remains open. It must be possible for gasses to escape from
the septic tank, otherwise they can enter the toilet room through the toilet bowl.
Use environmental-friendly detergents for the toilets, as chlorine and other aggressive
chemicals interrupt the decomposition process in the septic tank.
Regularly inspect whether the septic tank has to be pumped out.
Remove all high weeds around the septic tank to allow for proper inspection.
Table 4: Diseases related to faecal matter
Diseases spread by faecally contaminated drinking water or food
Cholera
Typhus
Ascaris
Diarrheas
Hepatitis
Dysentery
Polio
Whipworm
Diseases spread by faecally contaminated surface water
Worm infections
Leptospirosis
Bilharzia.
Diseases spread by mosquitoes breeding in septic tanks
Parents construct a drainage system for
wastewater of water fountains at
school yard, OS 1 Tamanredjo,
Commewijne.
Filariasis (elephantitis)
Drainage
Each school has to be provided with a good system to be able to drain water from the
washbasins and drinking taps, as well as the rainwater, in a proper manner. Especially in the
rainy season, heavy showers may not only make school attendance difficult, but rainwater
can also constitute a health-risk. Drawing 2 on page 8 shows an example of a tap on the
schoolyard with a proper drainage.
Handbook for a safe and healthy school
12
Health aspects
Water pools can be the cause of true epidemics. Many worm infections are contracted by
water and mud puddles near water taps. If the rainwater cannot drain properly, it also
happens that children often have to wade through the dirty water. In this manner they can
contract worm infections. Leptospirosis is transmitted in this manner. Children often take off
their shoes or sandals to save these from the water. Unfortunately it often happens that they
cut their soles or lower legs on sharp objects that are under the water surface.
Water drains are also favorite breeding sites for the Dengue mosquito and that is why these
should all be well-sealed. As a matter of fact, the dengue mosquito breeds in anything that
contains rainwater (read more about this subject in chapter 6).
Guidelines for action
Repair leaking taps and prevent puddles.
Ensure that the drains are covered and sealed so that mosquitoes cannot breed therein.
Inspect the water drainage and eliminate any blockage.
Regularly clean gutters and remove piled up leaves (mosquitoes also like to breed in
gutters).
Do not walk bare-footed through flooded areas. Use boots!!
Boy cleans drainage pit, OS Latour,
Paramaribo.
Solid waste
Solid waste at schools mainly consists of food waste, plastic bottles and bags, old
copybooks and writing paper, other paper, packaging material and garden waste. Some
schools also have chemical waste from the physics and chemistry classroom. Old and
damaged school furniture and building material can also often be found on the schoolyard.
This waste has to be removed, collected and stored in a responsible manner, to be
transported or processed later on. There are various methods to remove and treat waste,
and these all depend on the kind of waste involved. Important aspects are reducing waste,
storing and transporting waste properly, reuse and recycling of waste.
Handbook for a safe and healthy school
13
Health aspects
Irresponsible dumping and not collecting garbage from neighborhoods and schools can
create health problems and result in the spread of diseases. It will soon lead to problems
such as stench, the breeding of flies, rats, cockroaches, mosquitoes and other vermin. This
vermin is also called vector and this term and the control thereof is described in chapter 6.
These animals can transmit many different kinds of diseases:
Table 5: Diseases spread by vectors related to waste
Diarrheas
Toxoplasmosis
Dysentery
Leptospirosis
Typhus
Filariasis (elephantitis)
Yellow Fever
Dengue Fever
Note: damaged school furniture and construction material, lying freely around the
schoolyard, can also cause bad accidents.
In Suriname much waste is simply burned along the streets and in the yard. Burning waste
creates much air-pollution, is bad for our health and many pupils are bothered by the smoke
if waste is burned in the surrounding. At schools the waste is also often burned. Burning
waste is strongly discouraged, due to aforesaid air-pollution and health problems. In the next
chapter about the quality of air, we will elaborate on this subject matter. We advise to bury
the waste that cannot be recycled or reused and is not collected.
Waste bin in the corridor during
breaks, OS Paradise, Nickerie
The dustbin
Each classroom must be provided with a dustbin or bucket, in which a plastic waste bin-bag
is placed, to make the removal and storage of the waste easier. Each dustbin must have a
well-closing cover to minimize contact with flies and other animals. The waste from the
classrooms must be removed daily, be properly tied off and stored and thereafter removed
from the schoolyard.
The schoolyard should also be provided with sufficient garbage bins. If not, the pupils may
see to it that the dustbins of their classrooms are placed in the halls during the break to
minimize waste lying around the schoolyard. Pupils and Eco Clubs may fulfill an active role to
that effect.
Handbook for a safe and healthy school
14
Guidelines for actions
See to it that there are enough dustbins and garbage cans at school and empty these
regularly.
Ensure the waste is collected at least twice per week. If the waste is not collected, bury it.
Never burn waste on the schoolyard.
Select damaged school furniture that can be repaired and store it separately.
Collect and remove from the schoolyard all waste that is not usable anymore, such as
irreparable school furniture, broken containers and dustbins and waste from construction
activities.
Involve the schoolchildren in waste-related chores, not as a punishment, but as part of
the development of their sense of responsibility for the community.
Involve the school in recycling projects (PET, glass and composting).
Set up projects for waste reduction.
Prevention, reduction and processing of waste
The school has the option to choose the methods to prevent, reduce and process waste at
school and to include the participation of the pupils (reduce, reuse, recycle programs) as part
of the curriculum.
Certain waste stream may be prevented by excluding them for use. Waste consists for the
greater part of packaging material and the use thereof may be reduced if pupils use plastic
lunch boxes and drinking cups with a cover that they can take back home again. Deciding
not to use disposable articles, such as plastic cutlery, styrofoam cups and plates, will also
contribute to reducing the waste that has to be removed. This has to be weighted against
the fact that reusable cutlery and plates have to be washed.
Members of the ECO Club give the
example: waste in the waste bin,
OS Bacovendam, Nickerie.
Recycling
Recycling is the process by which a waste product goes through a manufacturing process to
become a similar product or to be transformed into another product.
A glass bottle that is recycled, goes back to the glass factory where the glass is melted again
to produce another glass bottle. (A glass bottle that goes back to the factory to be washed
and filled again is being reused, this is not recycling).
Handbook for a safe and healthy school
15
Some kinds of plastics are melted to other plastic utensils. PET bottles cannot be reused for
drinks, but can be recycled. In Suriname PET waste bottles are shredding and these shreds
are added to cement mixture to make new building blocks. Research has shown that such
bricks with PET shreds are even stronger than normal building bricks.
For the recycling to be successful, at all times separate recycle containers must be placed for
the product that is to be recycled, in addition to the normal garbage bins. This is necessary
to prevent normal waste from being put in the recycle bin.
Guidelines for action:
The school can actively participate in the reuse and recycling of waste
Encourage pupils to collect glass jars and bottles for reuse. A company in Suriname gives
a remuneration for usable jars and bottles.
Encourage the school to join the PET recycling programs. Lucrative prizes are available for
schools that return the most PET bottles.
Always place bins for normal waste next to recycle bins.
Involve pupils in helping to keep clean the classrooms, the schoolyard, the pavements
and the drainage system of the school.
Participate with the school in national and global clean up activities (such as Clean Up the
World).
Pay attention to the waste problems at school on world anti-pollution day.
Encourage pupils to set up Eco Clubs and promote membership.
PET in the recycle bin. These students
participate in the national PET recycling
campaign and compete for lucrative
prices, OS Drambrandersgracht,
Paramaribo.
Composting
Composting is one of the oldest forms of recycling. A successful compost heap consists of
organic waste, moisture, oxygen and micro-organisms. Compost is very fertile soil that is very
suitable to cultivate all kinds of crops, inclusive of vegetables and flowers. Composting can
be part of the biology or physics class.
At school one can start to teach the pupils this process, as there often is sufficient waste at
school that is suitable for composting. A complaint that is often heard is that compost heaps
smell, but this is the result of incorrect treatment. Rats and flies are only attracted to a
Handbook for a safe and healthy school
16
compost heap if meat and fish leftovers are put on it. So NEVER put meat and fish on the
compost heap. Table 6 indicates simple guidelines to put up and maintain a compost heap.
Table 6: Composting, guidelines and troubleshooting checklist
Ingredients for composting
The compost pile
Leaves
1. Choose a location in the shade
Egg shells
2. Always start with a layer of twigs to promote aeration
Grass
and drainage of water
Straw
3. Make alternating layers of ripe compost and fresh
Dry leaves and dead flowers
Material
Fruit and green kitchen waste
4. Maintain a layer thickness of 2-3 inches
Paper and carton
5. Wet if material is dry
6. Turn pile over every two weeks to enhance supply of
Sawdust
oxygen and mixing of micro-organisms
Ashes of burned wood
7. Maintain adequate moisture content in pile
Problems with compost
Problem
Cause
Solution
Compost too dry
Moisten the pile
Turn over the pile and loosen
Process is very slow
too little oxygen
material
Too large chunks of waste
Mulch or cut large parts
Pile too wet
Add dry materials
Unpleasant odor
Poor mixing
Turn over pile
Too much green waste
Add sawdust (carbon)
Ammonia odor
Keep meat and fish out of
Flies and rats
Meat and fish leftovers in compost
compost, give to cat/dog or burry
NOTA BENE: always use gloves when working with compost pile and in garden and always
wash your hands afterwards
Handbook for a safe and healthy school
Waste bin next to recycle bin at
Lyceum 2, Paramaribo.
17
Incineration
Waste is often burned at school and the smoldering heaps of waste, creates an odor
nuisance and the smoke also constitutes a health-risk. Try to prevent burning as far as
possible. See to it that the collection service indeed collects the waste. In cases where there
is no collection service, the waste can be reduced by aforesaid practice of “reduce, reuse and
recycle”.
If it is still decided to burn the waste, it is important to do this as properly as possible. A
simple incinerator is indicated in drawing 6 on page 21. This in basically a rectangular
container of fireproof bricks with an opening at the bottom and a grate on which the waste
is placed with the combustible material. The opening at the bottom is paramount and
ensures a proper air supply. This air supply is essential for complete incineration at high
temperatures, with consequently less smoke being generated and also less odor nuisance.
An inclined floor simplifies removing the ash. The ash and other non-combustible residues
must be buried.
Pupils with collected wastes during the
Clean Up the World Campaign 2003,
OS Latour, Paramaribo
Handbook for a safe and healthy school
18
Drawing 4: The rectangular septic tank
Leaking septic tank next to shallow
drink water wells at school in Wanica.
A rectangular tank is better than a
round one and must have a minimal
distance of 30 m to water wells.
The septic tank is a rectangular, water-proof container, consisting of minimally two chambers, the
first being twice as large as second one. The tank has a length to width ratio of 3 :1 and is
normally 90 – 120 cm deep. The dimensions depend on the amount of toilets connected to the
system. In the two compartments, the heavier waste settles on the bottom (sludge) and the lighter
waste forms a floating layer on the water (scum). The waste water from the septic tank is not
entirely purified and still contains many pollutions and bacteria and must for that reason be
connected to seepage pits or to the public sewer for further treatment. The sludge contains
bacteria that slowly degrade the waste. These bacteria produce gasses that must be able to
escape through a vent pipe. Despite the biological degradation by bacteria, the indigestible matter
slowly accumulates in the septic tank and must be removed after a number of years.
Handbook for a safe and healthy school
19
Drawing 5: Ventilated Improved Pit (VIP) Latrine
A vent pipe, painted black, is
placed behind or next to the
latrine
in
the
sun.
Consequently this pipe and
the air in the pipe heats up
and the air rises. So a
chimney-effect is created as
the rising air pulls out the
stench from the pit. As a
result, the air in the toilet
remains fresh.
It is important, however, that
the floor slab hermetically
seals the pit, otherwise
“false” air is drawn in and
the principle does not work
anymore. Also ensure that
there is enough sunshine on
the vent pipe and that it is
not overshadowed by trees
and shrubs.
Placing a board on the oval
hole if the toilet is not in use
and screening the top of the
pipe prevents flies from
flying in and out of the pit.
Ensure good drainage, so
that rainwater does not run
into the pit. If the pit is full, it
must be covered and a new
one must be dug.
Digging the pit for the VIP is very
laborious, Baha’i School, Bufrukule,
Sipaliwini.
Sealing the squatting floor to the pit
with grout, Baha’i School, Bufrukule,
Sipaliwini
Handbook for a safe and healthy school
20
Drawing 6: Simple incinerator
This simple incinerator is
constructed of fireproof bricks
and has a grate above the air
supply
at
the
bottom.
Sometimes it is necessary to add
additional combustible material
in case the waste is wet. Ensure
that this incinerator is situated
leeward of the school and other
buildings. The smoke of the
incineration is very bad for one’s
health.
Handbook for a safe and healthy school
Dumping of waste and open
incineration in the school yard sets a
poor example and it bad for the health
of the pupils, teachers and the wider
community, Sipaliwini.
21
3.
Air quality and ventilation
Background information
The guidelines of the World Health Organization for safe indoor and outdoor air quality
apply globally.
The aspects of air quality should be sufficiently taken into consideration during the planning
phase and during the construction of the school. Children inhale an average of 10 liters of air
per minute or 3.6 m3 during the six hours they spend on average at school per day. The air
they inhale at school and in the classroom should therefore be free of pollution.
There is a strong correlation between air-pollution and respiratory illnesses. Exposure to air
pollution during childhood, when children are in their growing stage, has lifelong adverse
effects on their health. Research unfortunately shows that pupils at schools are still far too
often exposed to dust, tobacco smoke (there are even teachers who smoke in class), smoke
from the burning of household and urban waste, traffic exhaust gasses and other air
pollution from industries nearby.
Health aspects
The WHO strongly recommends that schools and the schoolyards are designated no-smoking
areas. Inhaling tobacco smoke does not only cause serious health problems for the smoker,
but also for non-smokers, who inhale other people’s tobacco smoke (so called secondhand
or passive smoking).
Proper ventilation is important for fresh
air and optimal concentration during
classes, Clarkeschool, Wanica.
Symptoms associated with poor air quality in classrooms and other areas
Acute effects:
•
Headache and dizziness
•
Shortness of breath
•
Wheezy breathing and coughing
•
Fatigue
•
Decreased lung function
•
Coughing and sneezing
•
Asthmatic attacks
•
Eye and nose irritation
•
Infections of the respiratory tract
Potential chronic effects:
•
Decreased immunity
Handbook for a safe and healthy school
22
•
•
•
Chronic respiratory tract and lung diseases
Aggravation of asthma
Cancer
Poor air quality in classrooms and other areas often leads to an increase of asthma and
allergies, infections and diseases of the respiratory tract and it affects the concentration of
the pupils and diminishes their brain capacity and memory.
Sources of air pollution in classrooms
Contaminated outside air (e.g. by: running engines of school buses and other
vehicles, emissions from factories, the burning of household, school and other waste,
the spraying of agricultural acreages).
Dusty and moldy floor covering.
Tobacco smoke.
From commercial products (e.g.: paint, cleaning agents, pesticides, air-fresheners).
Vapors from school appliances and equipment (e.g. laboratory chemicals, photo and
art necessities, copy and printing equipment, ink and markers).
Gasses from septic tanks, ditches and swamps.
Smoking at schools
Everyone knows that smoking is an addiction and that it is very bad for our health. Smoking
addiction starts in teenage years and schools play a crucial part in preventing young people
from becoming addicted. One of the strategies to prevent smoke addiction is to proclaim a
ban on smoking at schools. The 100 smoke-free schools project clearly showed that there is
a great need for smoke-free schools. Most teachers and the majority of the pupils do not
smoke and are bothered by the smoke from others. It has been shown that those who
smoke, do wish very much to stop, but find this difficult because of their addiction. A smokefree school initiative stimulates smoking teachers to smoke less or even to kick the habit. It
also encourages the children and the non-smoking teachers to claim their right to clean air.
The 100 smoke-free schools project has shown that 15% of the smoking teachers entirely
stopped smoking as a result of the smoking ban at school.
Handbook for a safe and healthy school
Boy sticks no-smoking sticker on wall
in class room, OS Helena Christina,
Wanica.
23
Guidelines for actions
Enable education and information to pupils, teachers and parents about air quality and the
ventilation of rooms.
The principal is strongly recommended to make the school smoke-free:
o Introduce a ban on smoking for all classrooms, offices and other rooms, such as
the toilets, storage rooms and the schoolyard.
o No-smoking stickers must be clearly visible on walls and doors and also at the
gate of the school.
o Declare smoking an unacceptable habit at school: the school management,
teachers, and the pupils may approach each smoker about their smoking behavior
and tell them that they are creating a nuisance.
School management and patens should encourage school bus drivers not to let their
engine run for prolonged periods when they are waiting.
The principal will have to see to it that garbage and waste is not burned at the school
yard but removed from the school.
Ensure that pest control (termites en other insects), when necessary, will be performed
during holidays, so that pupils and personnel are not or minimally exposed to chemicals.
With regards to maintenance work we recommend to use water-based paints.
Reduce the use of air-fresheners and deodorants and if used, ensure sufficient ventilation.
Smoking is bad for your health and
children must be exposed to healthy
lifestyles: Do not Smoke!,
OS Bacoverdam, Nickerie
Illumination
Good illumination and light-colored walls in the classroom are important, not only to
improve visibility and a fresh appearance of the classroom, but also for the personal safety
and a better state of mind of the children and the teachers.
Handbook for a safe and healthy school
24
4.
Safety and aesthetics
Background information
Safety starts at the entrance to the school, the school yard and the building. Some school
buildings are very old, other schools are fortunate enough that their accommodation is
maintained and equipped in a proper manner. Safety of the accommodation is the first
principle to avoid accidents and second principle is the behavior of the persons at the school.
As many accidents happen at school and on the road in front of the school, good
agreements with the school-team and the pupils are indispensable. Accidents at school
happen at the entrance gate of the school, in the halls, on the stairs, in the classrooms, on
the schoolyard, in the toilet, during physical education and on and around game equipment.
The safety rules are part of the school regulations and all parties will have to observe these.
Well-maintained and safe school furniture
The school must provide well-maintained and safe school furniture, including:
a. a level desk and chair that are adjusted to the height of the pupil with a smooth and
well-finished surface and adjusted back and without splinters;
b. if the legs of the desk and chairs are made with metal tubes ensure that plastic caps are
provided to prevent the goose pimple causing screeching noise when the desk or chair is
moved.
A fire extinguisher and knowing how
to use it in case of fire can prevent
much harm and damage,
OS Bacovendam, Nickerie.
Operational and tested fire-extinguishers
Many of our schools are erected in wood and every wing should have a fire-extinguisher
available. An emergency plan must also be drawn up and teams must be trained in what
actions to take in case of fire and how to evacuate the school building. It is also important
that persons are trained in extinguishing a beginning fire with the available equipment.
Information on this subject matter can always be obtained from the local fire brigade.
First-aid kit
The principal and the teachers are the first who will have to render assistance in case of
accidents. A well-provided first-aid kit is necessary at schools. This kit must be stored at an
Handbook for a safe and healthy school
25
accessible and safe place and be provided with an overview of the content inclusive of the
expiration date. A checklist for the content of the kit has been added at the end of this
chapter.
On the occasion of the 100th-anniversary of Rotary International, the Rotary clubs in
Suriname donated a fire-extinguisher and a well-provided First-Aid Kit to all schools in
Suriname. In addition two teachers of each school will receive first-responder training.
Safe play surrounding
The schoolyard is a playground for all pupils at school, both during and outside school hours.
Many pupils are very active on the schoolyard and the risk of stumbling and colliding
increases there. The schoolyard must thus be a safe place to play. There should not be any
dangerous obstructions, sharp objects and holes on or in the schoolyard. When construction
(e.g. renovations) is going on at school during active school hours, additional safety
measures will have to be put in place (e.g. cover trenches).
Traffic safety
Due to the increase in traffic, schoolchildren are ever more the victim of traffic accidents,
while on route to or from school, by foot, bike or in the bus. Crossing the street is often a
very dangerous undertaking. Accidents can be avoided by simple precautions and measures.
The pedestrian crosswalk, traffic signs and speed bumps
School along a busy road must be provided with a clearly visible pedestrian crosswalk and
traffic signs, so that approaching traffic can be signaled from a distance that they are
approaching a school.
Installing speed bumps on the street near the school is a manner to slow down the traffic
around the school and to focus the attention of the drivers on the presence of the school.
Such bumps are very effective in preventing dangerous driving and accidents.
Traffic wardens and a pedestrian
crossing are essential for the safety of
students entering and leaving school,
OS Petunia, Paramaribo
Traffic Wardens
The traffic police carry out a school program in which pupils are trained to become traffic
wardens. These wardens play a very important role regarding the safety at school.
Handbook for a safe and healthy school
26
They are trained by the traffic police to assist their fellow pupils in crossing the street and this
under the supervision of parents or teachers. As a result they do not only decrease the risk
for accidents, but also increase the awareness with regard to safety.
Absence of traffic noise
Many schools that once were in a quiet neighborhood are now affected by the increasing
traffic noise. Noise can be very disturbing for the pupils as well as the teachers. The absence
of noise is not only important for the concentration of both the teachers and the pupils, but
also for their peace of mind and mental well-being.
Health aspects
Children can be maimed for life or even die as the result of an accident. The biggest risk for
accidents is on their way to and from school. So children must learn the principles of good
traffic safety. It is necessary that children are taught to take the shortest cut between home
and school.
Guidelines for actions
In order to improve the safety in and around his or her school, the principal should seize
every possible support.
Encourage your teachers to take first-responder training; it is recommended that at least
two persons, e.g. the physical education and the pre-school teacher are trained.
In cooperation with parents, experts, teachers and pupils, a safety plan for the school
should be drawn up.
A safe and comfortably shaded school
yard, OS Apoera, Sipaliwini.
Tips for drawing up the safety plan:
1. Inspect the accommodation while children are present, then you will notice the risks
sooner.
2. For a better perspective, kneel down or stoop to experience the world of the pupils as
realistically as possible.
3. Do not assess from a distance but test out things (is this edge sharp, is the floor slippery,
is the game equipment solid enough to hold the weight and movements of children,
etc.).
Handbook for a safe and healthy school
27
4. Listen to the experience of the pupils.
Well-maintained and safe school furniture
1. The Technical Services Department of the Ministry of Education and Community
Development provides new and repairs damaged furniture at schools.
2. Involve the parents in repairing the damaged school furniture.
3. During the silly season pupils can clean, sand and varnish their tables and chairs under
supervision.
Operational fire-extinguishers
1. All schools should have access to a working fire-extinguisher. Have yourself expertly
informed by the local fire brigade about placing and using this equipment at your school.
If necessary, acquire more extinguishers.
2. See to it that a team of teachers is trained in the use of the fire-extinguishers.
3. See to it that there is a reliable checking and refilling schedule.
4. Observe the requirements set by the fire brigade.
First-aid kit
1. Assign someone to take care of the content of the first-aid kit.
2. Use a checklist to maintain the contents of the kit and keep this list in the kit.
During construction at school, cover
trenches to prevent children from
falling in. Thomas Moreschool,
Washabo, Sipaliwini.
Safe playing area
1. Ensure that clear house rules have been established and are clearly displayed.
2. Regularly inspect the schoolyard, also behind the buildings and the shrubbery.
3. Draw up a schedule for the yard surveillance service of teachers.
4. Make it obligatory to report accidents and calamities.
5. Stimulate social control as part of the code of conduct at school.
Traffic safety
1. If a pedestrian crossing is required but not available, submit an application for such with
accompanying traffic signs.
Handbook for a safe and healthy school
28
2. Seek collaboration with the traffic police and the neighborhood to examine which
measures can be taken to reduce traffic, speed and noise around the school by diverting
traffic during active school hours (local traffic only) and placing speed bumps.
3. Encourage pupils to become traffic wardens and join the training program of the traffic
police.
4. Ask for support of parents to supervise the children crossing the street.
5. Promote active participation of parents and school-bus drivers as to safe transportation
of pupils (making safety belts compulsory, also on the backseat).
6. Promote the wearing of safety helmets for cyclists.
Table 7: CHECKLIST ---- First Aid Kit
Contents
Remarks
Plasters, bandages
Different sizes, gauss, plasters
Tape
Different sizes, 1 cm to 2½ cm
Dressing strips
Sterile gauss
Dressing gauss
cotton wool and cotton swaps
Triangular Bandage
to support and relax injured arm
Safety pins
Sharp pair of scissors
Disinfection liquid (alcohol)
for superficial wounds
Tweezers
to remove splinters
Latex gloves
Pen, paper and writing pads
also add alarm number on or in the kit
This list
use this list as check list
Handbook for a safe and healthy school
A first aid kit and teachers with first
responder training can save lives,
OS Bacovendam, Nickerie.
The first aid kit as part of Rotary’s
Centennial School Safety Project to all
schools in Suriname.
29
5.
Grounds and surroundings
Background
Trees are ancient symbols of life; they provide oxygen, fruits and shade. Many school yards
in Suriname have been planted trees to provide shade and fruit. Such trees provide a cool
place during sunny and hot periods of the breaks. They also contribute to the tranquility and
the appearance of the school. It does not take much time to plant a tree in a carefully
selected space, but it is almost impossible to move a fully-grown tree if it turns out that it is
in the wrong place.
Health aspects
A beautifully landscaped and well-maintained garden contributes to the good state of mind
of the pupils and the teachers. This aspect is often neglected or receives very little attention.
Furthermore a living green fence contributes very much to the attractiveness of the school
and is also very functional in trapping windblown dust, dirt and fumes from passing traffic. A
very dense hedge also functions as a sound-barrier.
Trees are bearers of fruits and are indispensable in the educational values for the children.
For the safety at schools, fruit trees have some disadvantages when they bear fruits:
1. Falling fruits on children playing under the tree.
2. The throwing of sticks and stones to collect the fruits.
3. Children climbing into the trees and possibly falling out.
4. More wasps and bees.
Boy waters seedlings for new hedge,
OS Tamanredjo, Commewijne.
Guidelines for actions
Pay attention to the following before planting a tree.
Make a map with the layout of the school surroundings.
Include on the map the layout of the sewerage system, the drinking water supply system
and the telephone lines.
Examine whether expansion of the school is planned in the near future on open spots on
the layout.
Employ a gardener
Handbook for a safe and healthy school
30
Involve the children in the planting of the trees and its maintenance as part of their
biology class.
The planting of a tree:
Dig a hole of 30 cm deep and a diameter of 30cm.
Put a support stick in the hole together with some compost.
Place the tree with root cap in the hole and fill the hole with water.
After the water has been absorbed, fill the hole with compost and gently stamp the soil.
Tie the plant with a ribbon to the support stick.
Place a protective fence around the plant.
Water the tree every day, preferably in the early morning.
In a few month the seedlings grow into
a hedge to protect the school against
dust, traffic fumes and noise,
OS Tamanredjo, Commewijne
Well maintained and cared for school surroundings. OS Bacovendam, Nickerie
Handbook for a safe and healthy school
31
6.
Vector control
Background information
Above we discussed diseases that can be transmitted via animals. Animals that do not cause
the disease themselves, but transmit to human-beings the pathogen (the disease causing
organism), are called “vectors”. Mosquitoes, rats, lice, cockroaches are some of the animals
that are called vectors. Vector control implies strategies and measures to control the
population of specific vectors, including removal of breeding grounds and the hiding places,
isolating their food source (which often is our food), killing the vectors in order to prevent
and protect human-beings against contact with these vectors.
Health aspects
The school is a place where many people come together and infectious diseases could under
such conditions easily be spread by vectors. Table 8 below indicates several diseases and the
vector responsible for its transmission.
A sealed drainage pit prevents the
Dengue mosquito from breeding,
Fatima School, Paramaribo
Table 8: Vector related diseases and infection route
Disease
Dengue
Yellow Fever
Filariasis
Malaria
Vector
Aedes Aegypti mosquito
Aedes Aegypti mosquito
culex mosquito
Rat, pig, dog, cat, mouse,
cattle, sheep (via urine)
Anopheles mosquito
Scabies
Sarcoptes scabiel mite
Rabies
Dogs, rats, bats
Pediculus humanus capitis
Headlice
Cat
Leptospirosis
Pediculosis
Toxoplasmosis
Infection route
Bite of infected mosquito
Bite of infected mosquito
Bite of infected mosquito
thru contaminated food and water, wading in
contaminated water
Bite of infected mosquito
Scabies is very contagious, especially in highly
congested situations (like schools)
Bite by infected dog, rat or bat
Contact with infected person, their clothing
or bedlinnen
Contact with cat faeces
An open pit is an ideal breeding site
for Dengue mosquitoes.
Handbook for a safe and healthy school
32
The animals listed in above table can transmit contagious diseases and consequently do not
belong at all at schools. It is therefore very important that the school environment is clean
and absent of vectors such as dogs, cats, bats, rats, mice and mosquitoes. The school
buildings and yard should not provide shelter, food and breeding grounds for these animals.
Stray cattle, horses, sheep, goats and pigs are not permitted either.
Guidelines for actions:
The vector-control program in Suriname is implemented by the vector control department of
the Bureau for Public Health of the Ministry of Health. This implies cleaning the removal of
breeding grounds, educating the community, killing vectors by means of spraying chemicals
and placing poisons, enforcing the anti-litter regulations. There are also many private
enterprises that render vector control services.
Schools can provide an important contribution to public health by educating the children on
the dangers of vector related diseases, implementing preventive measures and being an
example of safe, sanitary and clean environments, free of breeding and hiding places of
vermin.
The mosquito
There are different kinds of mosquitoes, but they all breed in water. The female mosquito
feeds itself with the blood of an infected person. By stinging another person, this female
mosquito can transmit this disease and infect this other person.
The Aedes Aegypti mosquito solely breeds in clean still water around schools and your
home. It is the vector for the viruses that cause Dengue and Yellow Fever. Dengue is causing
increasingly more victims in Suriname and our region.
The Culex mosquito breeds in dirty waste water, preferably in septic tanks. This mosquito is
the vector for the pathogen of Filariasis (Elephantitis). Fortunately, as a result of vigilant
efforts in the nineteen sixties by the Bureau of Public Health, especially the late Dr. Oostburg,
Suriname is currently free from Filariasis. However, we must remain vigilant as this disease
still occurs a lot in our neighboring country Guyana.
Handbook for a safe and healthy school
33
The Anopheles mosquito breeds in rivers and creeks and also in brackish water and swamps.
It is the vector for the malaria parasite. Malaria is still causing many victims in the interior of
Suriname and people who have traveled there. Fortunately it is possible to quickly determine
whether a person has malaria and there are adequate medicines are readily available.
Guidelines for actions:
One of the main rules in regard to prevent mosquito borne diseases is to prevent these
mosquitoes from biting you and to prevent breeding opportunities.
Seal rainwater drain pit at school to prevent breeding grounds for the Dengue mosquito.
For more details and information about Dengue, its prevention check our website:
http://www.paho.org/English/HCP/HCT/feti-dengue.htm. From this site you can download
the posters and flyers used in this chapter.
The Culex mosquito likes breeding in dirty waste water, including septic tanks. Therefore
you have to inspect septic tanks on cracks and holes and fill these with grout. You should
also prevent waste water from entering the schoolyard.
It is difficult to combat the malaria mosquito, because it lives in an extensive area. If you
live or visit in the interior, sleep under a mosquito net. When you get headaches and
fevers, immediately consult a doctor for a malaria test.
Lice
Head lice often occur among children at school and when not quickly attended to can
quickly spread among the children at school. In serious cases the lice can also be seen in the
eyebrows and the lashes.
Guidelines for action:
Prevent the spread of lice by washing the hair at least once a week with soap or
shampoo.
In case of lice, consult the physician and use the medication as prescribed.
Handbook for a safe and healthy school
34
Rats and mice
If rats are living at school, they are mostly attracted by leftover food and they find good
breeding grounds. Once there is a food stock (mostly garbage), water and a good breeding
ground, rats can reproduce at a very high rate.
Guidelines for action:
Improve the sanitation in at around the school.
Clean all food sources: do not leave food open, close garbage bins well and forbid
littering of food on the schoolyard.
Prevent breeding in unkempt storerooms, by storing items and goods properly and
orderly. Keep the edges of the school-buildings without weed.
Ensure a proper removal of all waste and garbage as described in chapter 2.
Buildings can be made rat-free by preventing access, close cracks in doors and walls,
keep windows closed and repair broken glass, remove braches overhanging on the roof
and gutters (rats and mice might get access through the roof).
Place rattraps or rat poison.
In case of a plague you can turn for help to the Vector Control Department of the Bureau
for Public Health.
Ticks and fleas
A plague of ticks and fleas arises at a school when there are stray dogs, cats, mice and rats.
In case of a serious plague or when these animals are removed without simultaneously
combating fleas and ticks, the pupils can become the carriers or these pathogens.
Guidelines for actions:
In order to prevent a fleas and ticks plague, dogs and cats should not be allowed at
school.
Once there is a fleas or ticks plague, contact the BOG or a pest control company.
Handbook for a safe and healthy school
35
You can download this flyer from our website: http://www.paho.org/English/HCP/HCT/feti-dengue.htm
Handbook for a safe and healthy school
36
You can download this flyer from our website: http://www.paho.org/English/HCP/HCT/feti-dengue.htm
Handbook for a safe and healthy school
37
7.
Personal and food hygiene
Background
Good hygiene – cleanliness of the body – is an important barrier to prevent many infectious
diseases and it promotes a better human health and well-being. As the two words “personal
hygiene” already indicates, it contains measures that an individual must follow for personal
cleanliness in order to improve and maintain conditions for one’s own health. These
measures include good cleansing of the body: regularly washing one’s hands, taking daily
baths, washing one’s hair, proper mouth and teeth care and good skin care, cleaning nails
and cleaning the feet.
Health aspects
Regularly hand washing and daily bathing with soap, clean clothing and footwear prevent
hygiene-related diseases such as diarrheas, scabies, ringworm, trachoma, conjunctivitis and
lice-related typhoid. Washing with soap is an important manner to prevent the spreading of
the very contagious eye disease trachoma. The children’s faces have to be washed regularly.
If a child has contracted trachoma, a special towel or tissue will have to be used to wipe off
the face. This towel may never be used for another child due to the risk of contamination.
Pathogens that occur in food can cause dangerous and sometimes fatal food poisoning. The
most important types of food poisoning are caused by bacteria. The more bacteria one
ingests, the greater the risk of becoming ill. Under certain conditions, warmth and humidity,
and given enough time, bacteria can multiply to enormous numbers. Under the right
circumstances, 1 bacterium can multiply to more than 4 million in only 8 hours. Bacteria
reproduce between 5 and 63 °C, with an optimum around 30-40 °C, but such pathogens
are destroyed at temperatures exceeding 70 degrees Celsius.
Pupils with sandwich donated by
school feeding program,
OS Latour, Paramaribo.
Food poisoning
Germs can contaminate our food from the moment the food is still being grown in the field
until the moment that the food is served on the table. If germs get the chance to survive and
multiply and are not destroyed by the food preparation process, they can cause diseases
after the food is consumed. Sometimes germs are spread to other food, - e.g. through
Handbook for a safe and healthy school
38
kitchen utensils. Symptoms of food poisoning can last several days and include: abdominal
pain, diarrhea (with or without blood), vomiting and fever.
Table 9: Main bacteria causing food poisoning
Bacteria
Could be present in:
Campylobacter
Raw chicken, meat, non pasteurized milk and untreated water
Salmonella
Raw chicken and meat, eggs, unwashed vegetables, non
pasteurized milk and dairy products
E-Coli
Feces of man and animal
Clostridium perfringens
Feces of many animal, is common in soils.
Listeria monocytogenes
In soils, on vegetation, in raw milk, chicken, meat and cheese
Bacillus cereus
In sand and dust, rice dishes, pasta, meat and vegetables
Staphylococcus aureus
On the skin, infected wounds and in the nose
Guidelines for actions
Proper personal hygiene is the key to preventing hygiene and food-related diseases. If we do
not wash our hands, bacteria can remain alive on our hands for many hours. During that
time they can be spread to other things, foodstuff, hands and persons we touch. Regular
hand washing, proper food preparation and storage, cleanliness of kitchen utensils are
important actions against food poisoning.
Student eat their lunch under a tree,
St. Ferdinand School, Para.
Food at school: store food in the right manner
As the content of the lunch box will be at room temperature for quite a while, it is important
that parents take into account a number of facts with regard to the possible development of
microbes in the food. We have to consider which foodstuffs are suited to give our children in
their lunch box, while this food is at the same time nutritious and safe.
There are two kinds of food: a low-risk group (non-perishable) and the high-risk group
(perishable food). The appearance of low-risk food can change and spoil at room
temperature, even with the right treatment, although the chance of illness is rather small.
Examples of such products are: sweet and salted cookies, washed but uncut fruit, packs or
Handbook for a safe and healthy school
39
bottles of juice, dried fruit, etc. On the other hand, high-risk food has a composition which
stimulates the development of bacteria and such food must be stored cold. For example:
chicken and meat dishes, dishes based on mayonnaise and dairy products. Such foodstuffs
run a high risk of spoilage and it is important to keep this food cold during storage. You can
also put a freezer pack in the lunch box to keep the food cool.
Table 10: WHEN DO YOU WASH YOUR HANDS
BEFORE
eating
touching food
preparing food
taking care of the baby
going to school
Always wash your hands with clean water
AFTER
using to bathroom
changing the baby
sneezing and couching
touching waste or the waste bin
gardening, even if you used gloves
stroking and touching of pets
touching raw foodstuff
It is important that children wash their hands before eating. In previous paragraphs we
discussed hand washing facilities at the schools. Parents might wish to give some soap and a
wash cloth or tissue, if the school does not provide soap and tissues in the bathrooms.
Pre-scholers washing their hands
before a meal, OS Bacovendam,
Nickerie.
Teachers should encourage hand washing of their pupils, especially the preschool should be
guided and trained in proper hand washing practices. Remember the old proverb:
“what’s learnt in the cradle lasts till the tomb”
Some practical tips for the preparation of the lunch boxes:
Carefully wash your hands before you start preparing the food.
Ensure that the lunch box is clean.
Use clean kitchen utensils.
Take the food out of the fridge just before the child leaves for school.
Handbook for a safe and healthy school
40
Use small boxes to store the food in the lunch box. Remember to separate raw from
cooked or prepared food.
If the food remains out of the fridge for a long time, we recommend putting a freezer
pack in the lunch box. You can also add a frozen package of juice, which will gradually
defrost but will keep the food cool.
The packaging of the food must be waterproof. Use aluminum foil or a sandwich box.
The lunch box itself can best be made from plastic as this is durable and easy to clean.
Pupils during hand washing classes,
OS Uitkijk, Wanica
Handbook for a safe and healthy school
41
Six steps to
wash your hands:
1) Wet and soap your hands.
2) Rub both hands vigorously.
3) Wash your left hand with your
right hand and alternate to the
other hand and repeat.
4) Rub your fingers over de palms
of your hand.
5) Wash your right thumb with
your left hand, alternate and
repeat.
Also parents and teachers actively
participate in the hand washing
classes, OS Uitkijk, Wanica.
6) Rub your left wrist with your
right hand and alternate and
repeat.
Source: www.medichem.co.uk
Handbook for a safe and healthy school
42
8.
Sustainability
Maintaining a safe and healthy school
In the previous chapters we discussed provisions and activities that contribute to a safe and
healthy school. But in order to remain a safe and healthy school, a number of conditions are
necessary to guaranty that continuity. It requires a continuous effort to keep buildings and
institutions in a good state of repair. Constant attention and a good organization are
necessary to be able to implement school programs and the community activities that are
often planned at facilities of the school.
That is why the National School Competition paid attention to the sustainability of the
improvements introduced and how the school plans its future. It is important that the school
has a plan for its development, the maintenance of the buildings, the surroundings and
greenery, the fence and security. This plan must also indicate who will do the work and how
it will be financed. Support from and cooperation with the community is very important, as
well as the relationship with the Parents’ Committees. How are the children involved in
school activities and the environment, are kids member of ECO Clubs and traffic wardens?
The Jury of the Competition also paid attention to plans and activities to promote the health
of the children, the relationship with the school nurses of the BOG and the RGD, the School
Dental Care Program and other initiatives.
Security is a necessity, Clarkeschool,
Wanica.
Aspect of sustainability: Maintenance
Maintenance of buildings is essential, normal decay will demand continuous repairs. Also
children are very active and there is always something that will break. If there is no regular
maintenance the school will quickly deteriorate. It is also important to hold children liable for
damages caused by their irresponsible behavior or vandalism, not necessarily financially, but
certainly to participate in the repair. Public Schools can contact the Technical Service of the
MINOV.
The foundation “Christian Education in Suriname“ provides an comprehensive maintenance
tool box to each renovated school under its program and a number of people, coordinated
by the headmaster, have assumed responsibility for minor repairs. Often parents are
involved in the maintenance shores.
Handbook for a safe and healthy school
43
Guidelines for actions:
Ensure there is a plan for minor and major repairs. Also identify the persons who will
perform minor repairs. Plan with the government or management organization for the
major repairs and maintenance works.
Keep a well-provided tool box available.
Aspect of sustainability: Security:
Good security in the school has become necessary to guarantee continuity of the teaching
services. The school and its facilities is a valuable investment and theft and vandalism causes
much loss and damage, disrupting the educational process and strongly reducing the
motivation of the teachers and pupils. Schools must therefore be properly secured against
burglary and vandalism. The access control in the school implies that the schoolyard is
provided with an appropriate fence and a lockable gate. The fence may also be a fully-green
dense and thorny hedge. The offices, library, storage rooms and the toilets must be provided
with adequate locks and burglar bars. Each classroom must be provided with one or more
storage cabinets. The Ministry of Education and Community Development provides in night
watchmen for public schools.
Guidelines for actions
Regularly inspect the locks and burglar bars and make repairs if necessary.
Seek to join the neighborhood watch in the area.
Ask the police to regularly patrol along the school.
If financially feasible, install an alarm system.
Do not unnecessarily leave money and other valuable items at school during the night
(e.g. the proceeds from fundraising activities).
Members of the PTA and consultant
pose for a picture during construction
of a drain, OS 1 Tamanredjo,
Commewijne.
Aspect of sustainability: Community participation
Schools are an important developmental institution and are often in the centre of a
community. Schools can therefore function as a spear point for the development of the
neighborhood. In all the activities discussed in this manual, the community can play a
supportive role. And with the community we mean society in the broadest sense of the
word:
Handbook for a safe and healthy school
44
1. the government organizations, including the ministry and management organizations,
the relevant ministerial departments, the school nurses, school dental care associations,
school feeding programs, and others;
2. Parents Teacher Associations (PTA’s), community groups, service clubs, and other NonGovernmental Organizations (NGO's).
Establishing a PTA’s
The schools that achieved the best results in the National School Competition were all
schools with very active PTA’s. Such a committee can truly support and vitalize the school.
Parents represent a wide range of professions and skills that may be extremely useful for
school projects and activities. The parents have of course a direct interest in a well
functioning school as such school will be better in the education and development of their
children. Parents are often very critical and can assist in:
Identifying problems and formulating the goals.
Providing knowledge and expertise.
Actively participate in the implementation of improvements at the school.
Disseminate information.
Mobilizing the neighborhood to participate in events.
Seek funds and voluntary contributions to realize the plans.
Parents represent the community around the school. From experience we learned that the
parents are often very proud of their contribution and achievements of their school.
A proud parent of the PTA with his
certificate honoring his participation in
the renovations, OS 1 Tamanredjo,
Commewijne.
Guidelines for actions:
Invite parents and encourage them to join the PTA.
Identify and meet the leaders of the community and service clubs and invite them to visit
the school.
Discuss your plans with the community and the parents in order to involve them in
possible solutions.
Visit community activities in the neighborhood of the school.
Handbook for a safe and healthy school
45
Health promotion
Schools can play a spear point function in community development for the neighborhood
and programs and activities to promote health of youth as part of the school package can
have drastic and sustainable effects on public health. A school that promotes health:
aims at setting a good example of what a healthy school entails and looks like and
how it is managed in a sustainable manner;
brings together health workers, educators, teachers, pupils, parents and community
leaders to jointly discuss health problems and to seek solutions;
has a child-oriented approach to discuss health in an inter-active and participative
manner in the classroom and at school (see ref. 15);
has a good relationship with the school inspector and the ministry of education;
has integrated “basic life skills” programs and has agreements with the school nurses
and the school dental care program;
goes beyond the aspects of healthy environment (as described in this manual), but
also deals with other issues including:
o health education and information;
o health services in cooperation with the neighborhood;
o physical education and recreation;
o the prevention of drug abuse, dealing peer pressure and social support of
students;
maintains a policy and applies measures that increase self-esteem and respect for
others;
aims at improving the health of pupils and school personnel as well as the families
and residents of the neighborhood;
has a health committee to coordinate and monitor the promotion of the health
promoting schools policy, program and activities.
Handbook for a safe and healthy school
Pupils study a ground water map as
part of their curriculum,
OS Tamanredjo, Commewijne.
46
Criteria for the National School Contest:
“Healthy Environments for Children; improve your school”
1
Safe Drinking
Water and
Sanitary Facilities
2
Air Quality and
Ventilation
3
Safety and Noise
4
Greens and
Gardens
5
Waste
management
6
Security
7
Aesthetics
8
Sustainability
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Access to running water during school hours (target one tap/25 students)
Good and clean sanitary facilities
(target 1 toilet(urinal)/25 pupils)
Good functioning septic tanks
Adequate and covered drainage of tap and rain water
Adequate ventilation
No stench nuisance
Well maintained and safe furniture
Fire Extinguishers present
First Aid Kits present
Safe playing environs: absence of obstructions, pits, sharp objects, etc
Pedestrian crossing
Speed bumps
Traffic wardens
Absence of traffic and other noise
Trees and shadow in the school yard
Well maintained greens and flower beds
Hedge for dust and noise control
Absence of litter and waste in bins
Good waste handling and removal from school environs
PET collection point available
Guard service available
Controlled access (fence, hedge and lockable gate)
Lockable doors and burglar bars present
Lockers available
Daily cleaning of facilities and class rooms
State of overall maintenance (paint on walls, ceilings, light, fixtures, doors,
walkways, absence of graffiti, etc)
Plan for Health and Environment
Maintenance Plan (physical, greens, etc)
Health and Environment Committee (incl. PTA, Environmental and Traffic
Wardens)
Handbook for a safe and healthy school
A parent is welding the support of the
new water tower for the school of his
child, OS Tamanredjo, Commewijne.
Annex 1
List with organizations in Suriname:
Bureau voor Openbare Gezondheidzorg in
Suriname (BOG)
Rode Kruislaan 22
telefoon 499 494
I. Fernandes Bottling Company (PET Recycling)
Indira Ghandiweg
telefoon 482 121
email: ifsbot@sr.net
Stichting Regionale Gezondheid Dienst (RGD)
Wanicastraat 188
telefoon 400 771
email: stgrgd@sr.net
Environmental Union Suriname
(De Milieu Bond)
Molenpad 94
telefoon 476 514
Centraal Orgaan voor Ouder Participatie
Dr. Sophie Redmondstraat 172 bv
telefoon 477 713
Stichting voor een Schoon Suriname
Domineestraat/Steenbakkerijstraat/Kersten Mall
telefoon 473 311
Email: svss@sr.net
Stichting Projecten Protestant Christelijk
Onderwijs
Dr. Sophie Redmondstraat 172 bv
telefoon 477 713
email: sdgs@sr.net
Het Surinaams Rode Kruis
Gravenbergstraat 2-4
telefoon 464 780
Bureau voor Alcohol en Drugs (BAD)
Letitia Vriesdelaan 1
telefoon 411 011
email: bad@sr.net
Brandweer Suriname
Verl. Gemenelandsweg
telefoon 474 642
Ministerie van Justitie en Politie
Verkeerspolitie afdeling Educatie
Nieuwe Haven
telefoon 401 025
Pan American Health Organization/
World Health Organization (PAHO/WHO)
Burenstraat 33
telefoon 471 676
Website: http://www.paho.org
Ministerie van Onderwijs en Volksontwikkeling
Technische dienst
Jesserunstraat 13-15
telefoon 472 113
United Nations Children’s Fund (UNICEF)
Herenstraat
telefoon 421 584
email: unicef@cq-link.sr
Handboek voor een veilige en gezonde school
Annex 2
List of References
1 Report on the National School Competition; “improve your school”
PAHO/WHO Suriname – June 2004
2 Report on the closing ceremony of the National School Competition:
“improve your school”
PAHO/WHO, Suriname - June 2004
3 Children’s Environmental Health Country Profile Suriname
PAHO WHO, May 2003
4 Inheriting the World - The Atlas of Children’s Health and Environment
Bruce Gordon, Richard Mackay, Eva Rehfeuss - WHO
5 Children in the new Millennium – Environmental Impacts on Health
UNEP-UNICEF- WHO
6 School’s Environmental Health and Safety Manual - Safe and Healthy
Surroundings,
Ministry of Education, Ministry of Health in collaboration with PAHO/ WHO,
Trinidad and Tobago
7 Proceedings of the first meeting and creation of the Caribbean Network of
Health Promoting Schools - PAHO/WHO
8 Health & Environment – Tools for Effective Decision-Making,
The WHO-UNEP Health and Environment Linkages Initiative ( HELI)
Handbook for a safe and healthy school
Annex 3
9 Information Series on School Health Document 2 – The Physical School
Environment; An important component of a Health Promoting School
WHO, UNESCO,UNICEF, ECD, World Bank, Education International, PCD
10 Food, water and family health – A manual for community educators WHO,
UNDP
11 Environmental Brigade: Workbooks for teachers and students, Working
Group Environmental Brigade (Milieu Brigadiers), Paramaribo 1995
12 Promoting Health Through Schools, The World Health Organization’s Global
School Health initiative, Geneva 1996
13 The Global School Health Initiative.
http://www.who.int/school_youth_health/gshi/en/
14 Healthy Environments for Children Alliances
http://www.who.int/heca/en
15 Children for Health, Children as communicators of facts for life.
http://www.unicef.org/publications/index_4359.html
Photo’s by:
Johanna Lakhisaran made the pictures on pages: 5, 9, 10, 13, 15, 18, 19, 22, 23, 24,
25, 29 top, 30, 31 bottom, 32 top, 39, 40, 41, 42, 44, 46, Annex 1,
Adrianus (Ton) Vlugman made the pictures on pages: iii, 1, 2, 3, 4, 6, 7, 8, 11, 12, 14,
16, 17, 20, 21, 26, 27, 28, 29 bottom, 31 top, 32 bottom, 38, 43, 45, Annex 2.
Handbook for a safe and healthy school
Annex 3