What does health mean to young people? They are active and energetic and rarely lack in physical vitality. So what can health education mean to them and how could it be thought of? Why do we need health education? It is important to
- Provide a sense of what good health is.
- Emphasize health and de-link it from disease.
- Introduce more than one way of looking at the above. This is vital to any learning; to keep an open mind, to understand from more than one perspective.
- Give a child the tools to work with his/her health and well being. Self-help in health was a reality of our culture richly interwoven into daily routines, celebrations etc. Today, self-help is almost non-existent.
- Help children cope with today's media environment and make intelligent choices in life style, for example the type of food they eat.
Health education can play a role in the following areas, which we will look at in turn:
- Knowledge of the body
- Awareness of body mind
- Understanding sex and safety
- Practices for healthy living
- Self Help
- Understanding Change
Knowledge of the Body
It seems important to understand the basic anatomy of the body - what it is made of, and the location and function of the various organs. Otherwise the body becomes a mysterious entity between head and foot! It also has an impact on our attitude to doctors, labs and investigations. Often there is a sense of helplessness born of ignorance!
In understanding the basic structure and working of the body two important perspectives emerge.
It is possible to understand the body in different ways according to different paradigms. For example, in Ayurveda, the basic building blocks are the five elements- water, air, fire, ether, earth and the interrelationships between them. In Chinese medicine, the body is understood as energy flows and balances. It lends richness to a young mind to understand the body in these different paradigms. Understanding that 'How you look is what you see' is a major step in understanding the very nature of thought itself, besides building an openness to different ways of looking at things. It would involve teaching about the human body in terms of western science (three levels can be worked on, for junior, middle and senior students), and also teaching basic structure and function in Ayurveda and Chinese medicine.
When the body is taught in terms of western science, it is necessary to keep the perspective of correlating structure with function. Understanding the human body as a marvel in 'design' lends itself to a multidisciplinary approach as well. For instance levers can be taught using the muscles of the forearm lifting shopping bags!
Awareness of Body-Mind
Invariably, the textbooks of science compare the human body to a machine and there is a complete separation of the mind, feelings and the body. The body is seen as an instrument of action. Except for people who work with the body like dancers, games teachers, etc, this separation continues through life. It seems an important role of a health course to emphasize the 'oneness' of the being, that there is an integrity, connectivity and coherence at all levels that can be explored and experienced. Two perspectives that need introduction are -
- The concept of 'well being' - even people terminally or seriously ill can feel well!
- Understanding that attitudes and feelings have a powerful influence on the body.
There is a wealth of literature available today in these areas. However one has to be careful to separate the obscure and even flawed from the genuine! For a teaching plan, these thoughts would translate into exploratory and coordination exercises -introspective, observational and physical -requiring alertness of mind.
Understanding Sex and Safety
In many homes sex and personal safety (preventing child sexual abuse) are rarely spoken about. Sometimes parents express a certain helplessness in knowing how to speak about this. This places a responsibility on school to deal with these issues. Young people need to have a space for discussion and also to hear sane adult voices. Information in these areas is vital for many important life decisions. In terms of learning outcomes the following emerge:
Awareness of personal safety and prevention of child sexual abuse - facts, strategies, assertiveness training.
- Facts and information regarding of the sexual organs, sexual act, menstrual cycle, changes at puberty, contraception, sexually transmitted diseases. Also primarily, placing sex in the context of a loving and respectful mutual relationship.
- Discussion of associated issues like attraction, boundaries, marriage, homosexuality, self-image, beauty, media and gender stereotypes. It is good to start with concerns and questions that students have.
In The School - KFI, Chennai, we have drawn extensively from two resources. We called upon an expert from a child sexual abuse prevention center who conducted workshops for teachers and students. We also accessed a site on the net called 'Advocates for Youth'.
Practices for Healthy Living
Health classes have a really major role here because health is not a single 'event'. It is a result of regular healthy habits and practices. Habits of unhealthy eating, incorrect posture and breathing once formed are difficult to break. Simple techniques that enhance health and wellbeing can be practiced on a regular basis. There are five areas that can be addressed. These are described below.
Areas that need addressing include:
- Understanding what is 'wholesome' food, about additives, preservatives, organic, chemical foods.
- Role of advertising and how it influences choices in buying (companies are increasingly using young people to sell their products and many products are targeted to capture young buyers)
- Planning menus
- Cooking practices
Invar iably, composition of food is understood in terms of carbohydrates, proteins and fats etc. It is also useful to speak of a wholesome diet in terms of an Ayurvedic understanding. This leads us to the next point.
Dinacharya and Rtucharya
The Ayurvedic concepts of Dinacharya (daily routines) and Rtucharya (seasonal routines) add tremendous richness to an understanding of health. They are prevention and maintenance practices which relate humans to the weather and the seasons (for example, the oil bath concept). The food and other routines change with the seasons. Nature and humans are made of the same five elements whose configurations change with heat and cold and therefore with the seasons. Concepts of food and healthy eating are clearly spelled out-what to eat, when to eat and how much.
There are some differences in the way nutrition is viewed by practioners of the Western model of medicine and in Ayurveda. These differences can lead to interesting discussions, as they provide a good learning ground. Nowadays we are equally at home functioning in more than one 'paradigm' simultaneously. We drink a cup of jeera milagu rasam when we feel queasy, take a paracetamol tablet when we have a headache and probably have biochemics in our travel kit!
It's amazing how many young children breathe wrongly. The stomach moves in during inhaling when it should be moving out! This restricts the air entry. It is vital for children to learn to breathe right and set apart some time when they lengthen and deepen their breathing. Teaching basic Pranayama addresses this.
Posture and Exercise
Two areas need to be addressed.
- Understanding posture - both the physiology of it and the relationship to feelings and attitudes. This is vitally important because 80% of the body's energy is used by muscles, the postural muscles particularly.
- Learning to evaluate different kinds of exercises - aerobics, games, yoga etc. Criteria for suppleness, stamina, cardiorespiratory endurance and well-being can be evolved with students.
In understanding posture the Alexander technique is very useful. Practical and theoretical lessons can be worked out based on the technique.
Sustainable Techniques for Good Health
Other than the breathing, two techniques can be taught. They are safe, simple to learn, do not take time to practice and the gains from them are many. One is an Acupressure routine for good health and the other is the Surya Namaskara. They tone and energize the whole system and can be practised life long. It is a good practical learning for children.
The basic philosophy is ' I can help myself and others around me'.
70% of ailments are self-limiting and simple remedies bring relief and comfort. First aid in emergencies can go a long way in improving healing outcomes. Learning to make simple herbal home remedies for hair lice, coughs and colds and other uncomplicated ailments, how to take care of a sick person at home, about basic sanitation and hygiene, and a first-aid course could be a part of this practical learning.
Adults and students can gain an understanding of their development related to their phase of life. What are the major concerns of the age? What are the physical changes? What are the emotional changes? The perspectives are drawn from psychology and related disciplines (Erickson, Chilton Pearce and Hurlock) Students from classes IX and above would find it relevant. The greater relevance however is to parents and educators who find these ideas valuable.
The Child to Child Health Course
This is both a teaching method and a programme. In this format, one class in a school is chosen and this class is trained to monitor and maintain the health of . the rest of the school. This class takes height and weight measurements, looks after water purification and sanitation, maintains the school medical kit, imparts first aid when necessary and plans school menus. They can facilitate the learning of other children as well.
These are some ways in which health can be looked at in the context of a school curriculum. The course content can be modified based on the age group: elements of community health, reading literature on health, understanding research in medicine, visits to medical centres, a richer understanding of the different paradigms and issues of contemporary relevance can be added if a course is being considered for XI and XII students or for adults. One hopes that schools will see the significance of this area of education, and be willing to find the necessary time and resources to include health education in their curriculum.
Suchitra Ramakumar, a medical doctor and trained counselor, has worked in community health, is deeply interested in children and their welfare and has worked with various groups of children of all ages. She has been a teacher for the last ten years, eight of them in The School KFI, Chennai, where she has designed health education programmes for children and adults besides teaching academic subjects.