During holidays, it’s easy for students to get exposed to various diseases because naturally they will engage in many predisposing activities. For this reason, it is healthy for parents and schools to ensure that students carry out compressive check-ups before returning to school as one of the measures to ensure everyone’s health.

For instance, at Riviera High School, according to the principal, Boniface Onyango, they always screen students whenever they are back from holidays to void cases of students spreading diseases to others.

He explains that they do this with the help of a resident doctor.

"The school also works out how to handle those students with chronic diseases such as asthma and heart diseases, among others, after looking at the medical records provided by parents during admission,” Onyango adds.

Common conditions to check for

According to Evarest Ntaganda, the in-charge of cardiovascular diseases at Rwanda Biomedical Centre (RBC), in most cases, they always do screening for different rheumatic heart diseases in school-going children.

He points out that this is done through announcements and massages to parents to bring their children to health facilities to be screened for any heart problems.

"This is important because it prevents the sick students from developing complications and also helps in proper treatment. Early detection of diseases in young ones enables the concerned people to provide early treatment and limit disease progression, which limits the cost of care,” he says.

Ntaganda adds that a prevalence study is required to understand the real burden of rheumatic heart diseases in Rwanda, and this will pave a way for screening mostly in school-going children. "Parents are advised to ensure children are properly treated in case they have sore throats instead of self-medicating.”

Dr Joseph Mucumbitsi, a pediatrician at King Faisal Hospital, Kigali, and president of Rwanda Heart Foundation, says it’s vital for every school to have such check-ups for the school administration to know how to help each and every child in case of emergencies.

This, he says, prevents the spread of contagious diseases such as pulmonary tuberculosis. Mucumbitsi says this also helps to prevent avoidable accidents that occur in schools when students are involved in different activities such as doing sports.

"It’s even worse if students have contagious diseases as it’s easy to spread because some of them like TB don’t have a lot of symptoms. One may only experience some coughing but infect many others,” he says.

Mucumbitsi says there are some diseases such as asthma that limit one’s involvement in some activities.

"When such students are identified and on record for having certain health conditions, it’s easier to help them as well as assign them to activities that won’t be a threat to their health while at school,” he says.

Additionally, Mucumbitsi notes that having first aid kits and personnel that provide help in case of emergencies at school is vital as well.

He warns that before any student is involved in physical activities; there should be preliminary assessments of their medical record before they start engaging in sports and more especially those in a boarding school.

Janvier Rusizina, a general practitioner at Nouvelle Clinic in Remera, Kigali, says immunisation is also important for school-going children because it helps in preventing deadly infections. This, he says, should be systematically and yearly.

On the other hand, he points out that through check-ups, it’s easier to provide support to prevent further complications in students who are found to be overweight or underweight.

According to Dr Philbert Muhire, the director-general of Rwamagana Provincial Hospital, screening both adults and school-going children has different objectives, the major one being education on disease prevention and early detection of infectious or non-communicable diseases.

"The results depend on how the activity is organised; it may be organised in such a way that not only students will be educated and screened for diseases, but rather a broader screening site at a health care centre. This will have a positive impact on health accessibility in general,” he says.

For school-going children, Muhire says the check-ups should target nutritional disorders, malnutrition, intestinal worms and provision of immunisation services (vaccines), depending on the age of the child.

The reason behind this, he says, is because children in this age group are more exposed to infectious diseases, mainly intestinal worms, which may actually lead to recurrent episodes of diarrhoea and malnutrition.

How to handle children with chronic conditions

Mucumbitsi points out that HIV/AIDS, asthma and heart problems are some of the most common chronic diseases some students may have; and therefore knowing how to handle all this is important for the school authorities.

For those who are diabetic, he says the school should follow the nutrition recommendations from the doctor.

"This is important because failure to do that can worsen the condition, leading to complications that may require a lot of attention and resources to cure,” he adds.

Mucumbitsi, however, notes that all these recommendations, depending on what a child is suffering from, should come from specialised physicians such as pediatricians, nutritionists, pediatric endocrinologist, and general practitioners, among others.

For conditions such as ulcers, Rusizana says it’s good to have specific diet for the affected students both at school and home. He explains that foods have a role in fighting against an infection caused by H.plori bacteria which brings about stomach ulcers.

Apart from just medications, Rusizana notes that such students need to be provided with a diet such as leafy greens like kales and spinach, yorgut if possible as well as decaffeinated tea. These are among the foods that help fight ulcers, according to him.

He explains that this is because such foods are rich in antioxidants, which are vital as they help protect and activate the immune system and help fight the infection as well.

Rusizana adds that avoiding caffeine, chocolates, acidic foods such as tomatoes and citrus fruits, is important as well.

For those with problems like asthma, Dr Mucumbitsi says the school should be aware on how to handle the attack in case it occurs.

He says the first sign to recognise this is change in breathing which is always accompanied with coughing, wheezing and tightening of the chest.

Good nutrition key for school-going children

Faustin Machara, a nutrionist at RBC, says almost all school-going students are teenagers or adolescents, which is a period of significant and increased nutritional needs. Therefore it is not only those with special medical conditions that need a special diet, but all students.

He notes that during adolescence, having a balanced diet that covers one’s nutritional needs is of particular importance, not only to allow good growth and normal development, but also to ensure good health.

"Eating right for adolescents doesn’t mean eating special foods. It’s about getting a balanced diet. Eating regularly (three meals and a snack) and eating a mix of foods from all the food groups will help adolescents get the nutrients the body needs,” he says.

Machara further notes that calcium intake is so important in teen years for bone growth.

"Intake of calcium-rich foods should be increased during this time. The recommended daily intake (RDI) for calcium for both boys and girls between the ages of 12 to 18 years is 1300mg a day,” he says.

Machara adds that having at least three serves of dairy foods every day will provide almost three quarters of their RDI for calcium.

He also says iron intake should be increased because of tissue growth and red blood cell multiplication.

"The recommended range is between 12 and 18 mg per day for boys and between 13 and 18 mg for girls. It is particularly for girls due to loss of iron during menstruation.

"To meet iron requirements, adolescents can consume foods of animal origin such as liver,” he adds.

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experts share tips

Crispin Gishoma, director of Rwanda Diabetes Association

Parents should make sure their children stick to the right diet throughout the holiday. This is because bad eating habits and less physical activity have a negative effect on children’s health.

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Aline Gihoza, final year medical student

For schools, having comprehensive health programmes is important as it helps provide students information on how the human body functions and factors that prevents illness or danger to health. This aids them to take precautions where necessary.

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Bandora Iraguha, general nurse

Encouraging students to be involved in extra-curriculum activities such as sports is important. However, there should be restrictions for those with sensitive medical conditions.

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Erick Musengimana, nutritionist

Children with eating disorders such as over-eating should be followed up by teachers, especially those in boarding school. This helps prevent health conditions such as under nutrition and obesity.