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Schools can turn the tide of diabetes in Malawi

For a country like Malawi cases of diabetes in children are now on the rise. This is partly linked to unhealthy diet and the widespread shrinking of physical education across primary schools. Now stakeholders are calling for the swift reforms of the curriculum. DINGAAN MITHI writes

It is all clear to Olive Kadzakumanja, a volunteer diabetes nurse at Kamuzu Central Hospital, as to the role of teachers in primary schools in fighting diabetes.

“They can play a key role in promoting physical activity among children which is important in tackling diabetes. When these teachers lack capacity, it is hard for them to deal with children who have type 1 diabetes within the walls of a class room,” she says.

One of the key challenges at present is that primary schools across the country are not taking physical activity seriously as it used to be the case previously.

Education stakeholders blame it on the new primary school curriculum currently in use which has integrated physical education within the subject of Expressive Arts. This, they say, has led to many schools to reduce physical education and view it as a low priority; in some cases other schools have abandoned it altogether.

Kadzakumanja therefore agrees with the call to ensure the urgent review of the primary school education curriculum so that physical education is made a stand-alone subject and also enhance it further with diabetes education and information on other related Non Communicable Diseases if possible.

In addition, she observes, there is need to build the capacity of primary school teachers and primary education advisors.

“Teachers are very critical in this work because now many children of primary school going age are being diagnosed with diabetes. It is important to have well-trained teachers, because they lack knowledge and are struggling to even provide first aid when the sugar levels have gone up in a child at school,” she notes.

Kadzakumanja who runs 27 diabetes clubs across Lilongwe district and works with diabetic patients under the Diabetes Association of Malawi is also planning to set up a diabetes club for children who number up to 20 at the Kamuzu Central Hospital.

According to the 2015 Diabetes Atlas of the International Diabetes Federation (IDF), whilst type 1 diabetes is less common, it is still increasing by around 3 percent every year, particularly among children.

Around 86,000 children develop type 1 diabetes each year globally and when insulin is not available, the life expectancy for a child with type 1 diabetes is very short. The IDF Life For A Child program supplies insulin to 17,000 children in 46 countries.

Arnold Nkhukuzalira is a teacher from Mbidzi Primary School. He observes that physical education has dwindled across many public schools in Malawi due to the curriculum being used at present. The curriculum does not prioritise physical activities among school children, unlike the old curriculum which set physical education as a top priority.

“I think this is an urgent issue; the Ministry of Education needs to move with urgency and review the curriculum. This is going to help a lot in diabetes prevention and we can protect our children,” he says.

The World Health Organisation (WHO) 2014 Global NCDs Report discloses that insufficient physical activity is one of the 10 leading risk factors for global mortality, causing some 3.2 million deaths each year.

Adults who are insufficiently physically active have a 20−30 percent increased risk of all-cause mortality compared to those who do at least 150 minutes of moderate to intense physical activity per week, or equivalent, as recommended by WHO.

In addition regular physical activity reduces the risk of ischaemic heart disease, stroke, and breast and colon cancer. Additionally, regular physical activity is a key determinant of energy expenditure and is therefore fundamental to energy balance, weight control and prevention of obesity.

Ward councilor for Chinsapo, Christopher Namakhwa, expresses concern on the increasing cases of diabetes both among children and adults and calls for political commitment to improve health infrastructure, for instance, the building of specialised diabetes clinics across the country to lessen this chronic disease burden.

Namakhwa also agrees with the appeal to the Ministry of Education to urgently make reforms in the primary school education curriculum to make physical education an important priority as part of enhancing physical activity among children in schools for primary diabetes prevention.

“I am really shocked to hear that cases of diabetes among children are rising, yet physical education is also going down in schools; prevention is better than cure. On my part as a councilor I want to mobilise my fellow councilors to take diabetes as an emergency. I am committing to set up a specialised diabetes clinic here in Chinsapo which will help a lot of patients with diabetes,” says Namakhwa.

He also urges district education managers, Malawi Institute of Education and other stakeholders to collaborate in kicking diabetes out of schools by reviewing the curriculum.

The World Health Organization adds that in 2010, globally, 81 percent of adolescents aged between 11 and 17 years were insufficiently physically active in 2010 – i.e. they had less than the 60 minutes of moderate- to-vigorous daily physical activity, as recommended by WHO. Adolescent girls were less active than adolescent boys.

Overall, older people were less active than younger people: 19 percent of the youngest

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