Back to School: New Sanitization and Hygiene Challenges for Indian Schools

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Webinar 7

Back to School: New Sanitization and Hygiene Challenges for Indian Schools

Children spend a significant portion of their day at school where WASH services can impact student learning, health, and dignity, particularly for girls. The inclusion of WASH in schools in the Sustainable Development Goals (targets 4.a, 6.1, 6.2), which emphasizes the need for WASH outside of the home. (UNICEF) Covid-19 pandemic has highlighted the fallacies of WASH practices in schools and elsewhere. Increasing sanitation and hygiene is now more important than ever. With the on-going discussion on re-opening of schools, a discussion on WASH challenges in Indian schools is pertinent.

The webinar aims to highlight back to school sanitation practices pre & post COVID-19 and the impact on adolescent health due to mismanagement of WASH practices

By our eminent panel which included:

MR. RAM CHANDRA SINGH WASH in School Expert, UNICEF

DR. ARUNDATI MURALIDHARAN Manager (Policy) - WaterAid India DR. SHUNILA JOY CHAUHAN Principal - Thakur International School & Global Goodwill Ambassador Foundation

MS. ANJALI MAKHIJA, COO S M Sehgal Foundation

KEY TAKEAWAYS

SCHOOL HEALTH • COVID19 has given a different context for the school health programs that will test our preparedness for sanitation in schools. • If we are reopening schools we must ensure that the most basic WASH facilities are made available in schools and are effectively being promoted by the teachers. • The pandemic has increased the number of hand washing stations and has imposed the application of hygiene standards in schools. • Schools must prepare sanitation kits for students, conduct sanitation sessions, and design contactless hand washing stations. • While ensuring the safety of the students, the school management also has to take care of the safety of the teachers. • UNICEF is building capacity through online platforms, they are making teachers more aware of the COVID situation and certifying them as leaders who can assess the readiness of schools for reopening. • Three immediate concerns of schools when they reopen are, first: to convince parents, teachers and students to attend school, secondly, ensure monitor the sanitary levels and lastly, reduce the panic attached to a positive case.

CARE FOR CHILDREN WITH SPECIAL NEEDS • Going back to school may not be as easy for children with special needs as compared to others. • Differently abled friendly washrooms are the need of the hour.

KEY TAKEAWAYS

WASH AND MHM FACILITIES IN SCHOOLS AND AROUND • We’ve built toilet facilities in and around cities, however we still lack a lot facilities like sufficient water supply. • Due to the coronavirus imposed lockdown, many girls have lost out on the sanitary products that were being provided by the government schools. • Separate washrooms for boys and girls must be constructed, clean drinking water should be made available and roof water harvesting facilities should be taken up to ensure adequate and cost effective WASH facilities in schools. • To overcome the problem of menstrual hygiene among girls from rural India, we need to change the cultural mindsets, inform them about the menstrual hygiene practices, educate the teachers and get rid of the social stigma. We need to develop a supportive environment for girls by changing attitudes of the community members as well.

Adequate knowledge should be provided about the sanitary products. Lastly, the installation of incinerators should be looked after.

CREATING AND ENSURING OPTIMUM RESOURCE UTILISATION • Community radio can be used as an alternate for online classes for students who do not have access to computer. • Role of community and parents should not be ignored. • A private-public partnership through CSR and other mediums would upgrade the schools’ WASH program in distinct parameters. • Funds need to be raised to take care of the wear and tear of the available facilities. • Maintaining a close dialogue with the state government and local civil policy makers is extremely important since they also help in generation of funds for operation and maintenance of school infrastructure.

SOME ADDITIONAL TAKEAWAYS • We need to get rid of the stigma attached to COVID. • We need to figure out new ideas to encourage investments for guidance and awareness sessions, it is one of the areas that receives bare minimum funds and mostly goes unnoticed. • Students could be given the responsibilities for spreading awareness and train the parents to ensure a safe and healthy environment.

SURVEY FINDINGS

95% of the audience have an opinion that sanitation and hygiene will be a major challenge in hostels and boarding schools. Approximately 95% of the audience also believe that it would be difficult to follow social distancing norms in schools. Close to 72% have a feeling that schools are not ready with adequate facilities and infrastructure to reopen amidst the coronavirus. Over 63% of the population is not in favour of reopening of schools. 71% of the population thinks schools should not charge a COVID fee after reopening. Nearly 50% of the audience believes that adequate information is not available to schools to reassert hygiene and sanitation.

Webinar 8

Investing in the age of opportunity to break cycles of poor Health and Nutrition – Adolescence of the Subaltern

Covid-19 lockdown has highlighted the most gruesome state of malnutrition and hunger in India. With the subaltern pushed to the margins, the realities of public healthcare are evermore exposed. Implementation agencies and CSR wings have a chance to invest in health and nutrition & change how rural India perceives healthcare. This convergence with the support of schools will ensure no child sleeps on an empty stomach in the country.

The following issues were addressed during the webinar: • Novelty of CSR/Govt. Initiatives for investing in adolescent nutrition • Tips for schools to ensure equality of health education • Focus on food safety & hygiene in schools and hostels • How implementing agencies can play a part in changing perspectives of rural India towards healthcare (preventive v/s reactive health)

The audience was given an opportunity to interact with the eminent panel which included:

MR. BASANTA KUMAR KAR Recipient of Global Nutrition Leadership Award 2019 [Fondly known as “Nutrition Man”]

MR. DANIEL SINNATHAMBY Country Director Pathfinder International DR. SURESH KUMAR RATHI Associate Professor, Indian Institute of Public Health, Hyderabad

DR. DAMODAR BACHANI Deputy Project Director John Snow India Private Ltd. MS. NIRUPAMA SHARMA Joint Director & Head, Agriculture, Food Processing & FMCG, ASSOCHAM India

KEY TAKEAWAYS

THE ISSUE OF MALNUTRITION • Malnutrition increases chances of infectious diseases resulting in the vicious cycle of morbidity and mortality. • India has a double burden when it comes to the nutritional status; it suffers from under-nutrition and stunted growth as well as from obesity. Approximately two-third of the death among adolescents happens due to malnutrition. • Every child has two windows of opportunities for a nutritious growth and development, the first window is the first 1000 days of life, the second is for adolescent girls. • Approximately 16% adolescents have micro and macro nutrient deficiencies, 24% have vitamin D deficiency, 32% have zinc deficiency, 37% of school children have folic deficiency and approximately 10.4% adolescents are pre-diabetic. • Children are treated for the illness caused by malnutrition; however no solution is looked for the nutritional conditions of the child. • 100 million deaths every year that happen due to under-nutrition and 15 million due to over nutrition. 3000 adolescents die every day due to preventable or treatable causes, this also the age that triggers mental health disorder in adulthood. • Fruits and vegetables are not consumed in adequate quantities, especially in rural

India. The farmers would rather sell their produce than consume it themselves to lead a healthier life. • The PDS mainly provides wheat and rice at cheap prices and of poor quality leading to chronic illnesses .

KEY TAKEAWAYS

There are 2 big challenges to nutrition in rural India, first is the infant and young child feeding. 91% of children don’t get appropriate feeding in the early stages of their lives. The second would be the consumption of food with high trans fats, sugar and salt.

IMPACT OF COVID ON MALNUTRITION • The pathogenic microorganisms of the coronavirus can severally affect the malnutrition status of India. • COVID has impacted three major areas; first, the human resource, the capability of humans to cater to such issues and programs, adapting skills and making adjustments to fulfill the needs of the program. The second is the delivery platforms, the CSR and medical campaigns are not happening anymore, and lastly, how do these programs reachtheir target audience.

CHANGES IN DIETARY HABITS • We need to get rid of the common mindset that a full stomach is equivalent to a healthy diet.

ROLE OF SCHOOLS AND PRIMARY CARETAKERS • Sexual Health Program needs to be segregated from the main program. In schools we could have male and female nodal members to separately address the genders age wise.

ADOLESCENT ACTION AGAINST MALNUTRITION • Fulfilling the nutritional requirements of a adolescent also addresses diet related chronic diseases. • A self-care and self-controlled model should be followed to prevent NCDs. First is PHD, where P - physical exercise, H – hygiene and D – diet would help us in maintaining a healthy body. Every individual must inculcate the habit of saying “NO” to unhealthy food items. • TATT (Tired All Time Time) Syndrome, occurs due to dehydration. Adolescents must take care of their water intake and the color of urine, they affect the body by causing muscle cramps and constipation.

NOVELTY OF GOVERNMENT AND CSR INITIATIVES • The major challenges that exist are: lack of awareness among teenagers about the

KEY TAKEAWAYS

dietary changes, they need to be introduced according to their bodily changes, purchasing power, non-availability or lack of awareness of alternatives and inefficient implementation of food security programs. The midday meal scheme of the government provides high carbohydrate diets to students instead of nutritional diets. Provisions must be made to deliver dry rations at home when midday meals are not provided and other provisions like nutri gardens, putting girls in the PDS must be checked to build a more inclusive program to improve the nutrition of girls. A paradigm shift needs to be brought about from the concept of beneficiaries to entitled individuals. The approach towards the nutrition for the subaltern is different because of availability and accessibility. There must be an inventory for the nutrition of the marginalized sections under the government programs.

SURVEY FINDINGS

Approximately 84% of the population thinks that the approach to nutrition is different for subaltern India. 68% of the population feels that not enough attention is paid to food hygiene in schools and canteens. As many as 93% of the population counts on the implementing agencies to change the situation of food security in India. Close to 80% of the population opines that a change in the justice system could be one way to secure better health for the adolescent of the subaltern. Close to 80% of the population opines that a change in the justice system could be one way to secure better health for the adolescent of the subaltern. 63% of the audience thinks that the midday meal crisis in the lockdown received enough reforms

Webinar 9

Investing on Adolescent Girls- Second Window of opportunity

Adolescence is a window into the future and girls are the forebears of the window. The impacts of intervening during this period can be seen to endure, as adolescents age into their adult lives and for future cohorts of their children. Investing early in positive health behaviour of the mothers of the future generation in has lifetime benefits.

This webinar aimed to address the following: • Rapid growth and development - changing nutritional requirements with Covid19 scenario • NCDs caused due of lack of nutrition • Investing in SRH component & access to MH in adolescent age group • Collaboration between schools, CSRs & NGOs to invest on Adolescent Girls

The audience was also given an opportunity to interact with the eminent panel which included:

DR. SIDDHARTH WAGHULKAR Dy. Head, Nutrition and School Feeding unit, UN World Food Programme India DR. SEEMA NEGI -

DR. SHWETA KHANDELWAL Head of Nutrition Research & Additional Professor at the Public Health Foundation of India (PHFI)

MS. PRIYANKHA BAJAJ Nutrition Expert at IPE Global Principal (Sanjeevani World School, Mumbai) & Global Goodwill Ambassador

KEY TAKEAWAYS

IMPORTANCE OF ADOLESCENT NUTRITIONHEIR • “Adolescent” is referred to as the second window of opportunity because this phase of life allows a good amount of physical and psychological growth and development. • If you feed one mother right, you feed the next three generations – this implies that women are forbearers of the future generations, their nourishment is highly important for the nourishment of the next three generations. • 4 stars of health and well-being are - right nutrition, quality sleep, regular exercise and stress reduction. • A healthy lifestyle is like a tripod stand one leg refers to the policy of the government, second leg is the knowledge about nutrition, and the third leg is the active lifestyle.

SOME STATISTICS • 10% of children and adolescents are pre-diabetic, 10% have high triglycerides, 4% adolescents have high cholesterol and 28% have low HDL (the good cholesterol), 5% are diagnosed with hypertension, 7% of children and adolescents are susceptible to chronic kidney disease and 40% adolescent girls are anemic. 3 out of 4 adolescents in

India are inactive, which is causing serious health risks at a young age. • 90% of adolescents consume aerated and sweet beverages daily.

DIETS OF ADOLESCENTS • Fast foods and junk foods are not the same. Fast foods refer to those food items that

KEY TAKEAWAYS

are manufactured and packaged as snacks for ready availability with little or no consideration of the nutrient content. Whereas junk foods refer to food items with high salt, sugar, fats and energy (calories) and contain a small amount of other nutrients. The EDSO (endorphin, dopamine, serotonin and oxytocin), have a direct impact on the mood and food of an adolescent.

BEHAVIOURAL CHANGES TOWARDS DIETARY PATTERNS • Healthy weight loss regimes, under the guidance of an expert must be followed by all. • The adolescent of urban India is consuming a lot of junk food and lack knowledge about their ingredients. It is important we teach them how to read the labels on the packaged foods so that they can make an informed choice consume. • Food labels now a day come with an “F+” logo, that signifies that the food has been fortified; which means that essential vitamins and minerals have been added to the food item. • Consuming the healthier alternatives that are available around us instead of transporting food items, will not only ensure the consumption of healthy food items that are locally produced but will also reduce the cost.

ROLE OF SCHOOLS, TEACHERS AND PARENTS • We must get rid of data overload and utilize resourceful data. Teachers must cover the gap between knowledge and information. • Schools lack behind in parting knowledge on SRH, MHM and other health-related issues because knowledge is not readily available to them. • It is important we promote the concept of health and wellness coordinators in schools that look after the nutrition and mental health of students.

MHM AND SRH COMPONENT • PCOD is on the rise; reasons include: the unhealthy diet patterns and the lack of physical exercise. Additionally, the stress the adolescents face today is also a determining factor. • Mental health, nutrition, SRH and MHM are topics that can be covered in schools and must be covered under one heading only. To create a policy around it, schools can implement these practices and create a report; where they note down all the steps they took and the results, these reports can be shared with policymakers to actually implement such practices at a national level.

KEY TAKEAWAYS

GOVERNMENT AND CSR INITIATIVES • A majority of the government schemes that focus on the health and nutrition of adolescents focus majorly on girls, however these schemes have a low uptake either because of unawareness of the existing scheme or its usefulness.

OTHER BEHAVIOURAL CHANGES • The lack of social interactions among adolescents is negatively affecting them, they are connected through social media but this has a direct impact on their sleep cycle, their dietary habits and their physical exercises. The situation is even worse in rural

India where social interactions have been entirely due to lack of access to social media platforms.

SURVEY FINDINGS

83% of the audience thinks that the Covid-19 scenario is hindering the nutritional development of adolescent girls. 64% of the audience was unaware of the second window of opportunity for growth and development. Over 93% of the survey participants strongly opines that the nutritional status of adolescent girls is a determining factor for gender equality. 94% of the audience feels that schools must aim at anemia reduction. Close to 37% schools do not receive SRH (sexual and reproductive health) education in schools.