Dhaka Community Hospital is a trust owned private non- profit making and self sustainable health care providing organization since its inception in 1988, DCH has been experimenting, an integrated and sustainable health care delivery system at an affordable cost both in urban and rural area. Dhaka Community Hospital is a 75-bedded hospital, including out patient department (OPD), emergency services and pathological laboratory. Besides its clinical activities it has individual research, training and community based project implementation division.

Dhaka Community Hospital started the School Health Program to identify the handicap and disabilities. DCH is conducting the school health program to the schools of under privileged children in different area of Dhaka city. The schools are run by different NGOs, like Bangladesh Mohila Samity, Ain-O-Shalish Kendro. Now DCH is running the program at 11 (Eleven) schools.

A Medical officer and a health assistant visits these schools every fortnight.

An effective School Health Program has three components, which are inter related and inter dependent.
 

These are:

Early detection of disabilities of vision, hearing, dental carries or any hidden diseases were detected and treated accordingly. Patients were referred to DCH or nearby health facilities according to their choice. Growth of the children was monitored by taking regular height and weight. Regular health education was given which covers topics like Primary Health Care, Acute Respiratory Infection, skin infection, Chronic diarrhoeal diseases, worm infestations, communicable diseases, reproductive health etc. Students and their families were entitled to receive 24 hours emergency and OPD services at hospital. All kinds of investigations and hospitalization supports were offered at affordable cost. These integrated activities were all implemented from one center.
 

To provide preventive and curative health care and screen for early detection of developmental disability so as to help them to maintain a healthy life style and thereby the community.
 

Objectives

Method

Health education session

Doctor visits every fortnight along with a health assistant; prescribe medicine, and advice necessary investigation. In case of need patients are referred to DCH or nearest health facilities according to their choice.

Dhaka Community Hospital has performed a School Health Program with the under privileged school children which were run by some NGOs which have education components supported by Radda Burnen, located in different area of Dhaka city like Mirpur, Demra, Goran, Mohammadpur etc from 95-98. After completion of the project DCH still continuation its health support to those schools.
 

A Paediatrician and a health assistant visits the schools every fortnight. A consultant Pediatrician's service is available whenever necessary.
 

Dhaka Community Hospital started “Urban School Health Program” in the middle of May 1999. The journey began with 3 Bangladesh Mahila Samity School (BMSS), situated in different places of Dhaka city. After a short while, 6 more new schools or Drop in Centers were included into the program of “Ain-O-Salish Kendro” In order to provide health care to these students of these School (DIC), one physician accompanied with a health assistant from DCH use to visit each center for health check- up as per schedule i.e. twice per months.

Majority (74.22%) of the students attended to these school were between the age group of 08 to 12 years & is between 03 to 07 years were 133 (16.74%) students. Less number of students were found above the age group of 12 years, because School of BMS were upto class five and in DIC, students after completing grade One get enrolled to some other schools or get involved in to their work. Though majority (58.80%) of the students were male but a considerable segment (41.20%) of female students were also taking education from these schools. The male over to female ration as detected was 1:1.4

After medical check-upon each school, a health card was distributed to all students by the Physician at their respective school/ drop in center.

It is seen that 80% of the students suffers from different grades of malnutrition of which 2% of them were severely, 28% moderately & 50% mild.

Majority of the parents of the children could not show any vaccination card so prediction of EPI vaccination coverage was not possible. Whereas BCG vaccination coverage was estimated on the basis of the presence of BCG scar on left upper arm at the deltoid region.

54.37% of the children born in Dhaka & 45.63% born out side Dhaka.

7.7% children are home less. 29.6% children live in Kacha house.

In spite of residing in Dhaka city 48.3% of the children use to drink tube-well water.

.44% of the children still practice open-air daefection habit. Only 70% uses sanitary latrine.

Regarding the disease profile Helminthiasis, Dental carries & Dermatitis were the common presenting illness (64.47%).

Six point two percent (6.2%) children had CSOM or other ENT problem (among them three children found deaf). Some children were referred to SHAHIC or other hospital to get the treatment of glue ear and audiometric assessment. Due to lack of attention of the parents, poverty long distance they did not receive referral.

25cases (3.7%) children had eye related problem. Among them there were some squint and abnormal visual acuity. Only three children receive referral at DCH. Two got spectacles.

Bilkis a 13 years old female child from Goran, can not see by her right eye& has partial deaf ness& has reduced vision on left eye. She needs operative correction which she cannot effort.

Badsha a 14 year old boy from Basabo, had gradual weakness and wasting of muscles of limbs, more on lower limbs. His higher psychic function was normal. For diagnosis he was supposed to be hospitalize which his mother could not manage.

Ibrahim a12 year old boy from Bashabo (ASK) had right sided facial palsy, since birth. He had no other neurological deficit, no history of birth trauma. He was absent on subsequent visit & did not come to DCH.

Three cases of rheumatic fever were diagnosed & now they are under treatment.

Rahmatullah 14 years boy from Goran had Pulmonary Tuberculosis, now got cured after six months treatment with four drugs.

Three cases of congenital acyanotic heart disease were detected. Two of them were male from Goran & one female from Shaheedbagh.
 

From this program it is clear that the health of the school children need to be addressed properly. Unhygienic housing condition, lack of health knowledge and more over poverty affects their health. Teachers and parents should be encouraged to pay proper attention to their young children. A low cost community involved integrated quality School Health Program is essential with some support of medicine. School Health care system, which is included in the curriculum, should be practically implemented, so students can understand the massage properly.

Govt. and None govt. organization should implement School Health Program. It should be community based sustainable and affordable according to the need of the community.

Early detection and intervention can prevent number of disability & thereby reduce the national health expenditure and bring up healthy Children and healthy nation.