School physicals are an important (and fun) part of my nursing responsibilities. This year at Gyetighi Primary school, I started the physical exams with the younger children in “Awali,” which is the Tanzanian equivalent of kindergarten. During the physical, each child receives a head to toe exam, including dental, vision, and neurological screenings.
Since I know it can be scary when a strange person comes at you with a thermometer and stethoscope, I gathered the whole class together and showed them how the instruments were used by demonstrating on a brave volunteer. Individually, most students were still shy, but by having them imitate me roaring like a lion or stick their tongues out as far as they could go, I was able to examine everyone’s teeth and throats. By the time we were hopping on one leg, the giggles could not be suppressed. Now that the ice was broken, I wanted to go one step deeper, and learn about their home life and friends at school. Since many children are used to saying yes to any question an adult asks them, I threw in questions about animals in their household, in order to elicit an honest response. I started with chickens, but each time I got to “cats or dogs,” most kids did a double-take to make sure they understood what I was talking about. I then told them about my two cats, Chipsi and Mayai. This whole charade was done with the goal of reducing their fears and helping them start to connect this slightly silly person with someone who can care for them when they are ill.
Despite the fun we had in the exam room, I was shocked by the number of children who were experiencing stunted growth (a sign of long-term malnutrition) in the lower grades. Over 60% of the youngest students I saw were at or below the 30th percentile according to the World Health Organization’s standards for weight and height for age. Since malnutrition can also affect intellectual development, it poses a serious threat to their educational opportunities and future life choices. On a positive note, once I started examining students who have been attending Gyetighi for more than one year, I began to see marked improvements in the growth rates. At the risk of making an incorrect correlation, these improvements may stem from the lunch and vitamin programs that TCF provides at Gyetighi, which guarantees that each student receives a certain nutritional intake each day.
Meaningful, lasting solutions, do not happen overnight. By providing education, disease prevention, and care for chronic illnesses, TCF is helping to provide a foundation that will allow this generation of Tanzanian children to positively transform their district, country, and if we are lucky, the world.