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Kampala, Uganda | THE INDEPENDENT | Diseases of the upper respiratory system are on the rise in boarding schools possibly due to congestion in dormitories, according to medics. Most common among them is Tuberculosis and Rheumatic fever, an inflammatory disease that develops as a complication of inadequately treated strep throat.
According to doctors, both the diseases are airborne in nature and can easily be spread from one person to another. Dr Moses Kiwanuka, a cardiologist says the poor flow of air in congested dormitories leads to the quick spread of colds that can turn into Rheumatic fever in the long run.
“Rheumatic fever quickly spreads in congested environments. The disease-causing virus can easily move from one unsuspecting person to another because when someone sneezes, the person next to them is likely to also fall sick. The lack of enough windows makes the situation worse.”
He says that he receives around 30 people with Rheumatic fever on a daily basis, 20 of who, are school going children who developed the condition as a simple cold in school that is most times ignored until it is too late.
According to medical research, Rheumatic fever can lead to Rheumatic Heart Disease, a notable cause of morbidity and mortality in resource-poor settings.
If untreated, Rheumatic Heart Disease can result in heart failure and stroke, and other diseases that are likely to cause progressive disability, reduce the quality of life and can cause premature death in young adults.
Dr Kiwanuka says that in the long run, the poor flow of air in dormitories can also lead to common airborne diseases and that if dormitories had fewer beds and more windows, the rate at which diseases like these spread would be low. He adds that due to the low frequency of medical checkups, students are likely to live with Rheumatic fever for a long time.
According to the building occupancy standards, two double-decker beds that accommodate four people are supposed to occupy a total floor space of 7.25 meters squared, with a floor to ceiling height of at least 2.9 meters squared. One window should be provided for every 5 meters squared of floor space.
A dormitory of 40 students occupying double-decker beds should at least have a floor space of 72 meters squared plus an additional 20 meters squared for navigational space between the beds. A building of this nature should have a minimum of 14 windows that open back to allow the flow of air. A set of washrooms-a bathroom and toilet are supposed to be provided for every 10 students.
In 2017, the National Tuberculosis and Leprosy Programme carried out studies on the prevalence of Tuberculosis in secondary boarding schools located in Kampala, Wakiso and Mukono. According to the findings, most of the schools did not follow building occupancy standards.
In dormitories, the average living space per student was 3.1 meters squared and the window living space area ratio was 4.5 per cent. According to the Ministry of Health and public health standards, each student should have an average living space of 5 meters squared.
Dr Robert Majwala, an epidemiologist at the National Tuberculosis and Leprosy Programme says that due to congestion in schools, they are registering many school-going children on the TB registry.
“We are registering many students on the TB registry. Ongoing work shows that 35 students out of every 1,400 suffer from TB most times which is spread quickly in schools because of congestion.”
Dr Majwala highlights schools in the areas of Kampala, Wakiso and Mukono as being the most prone to congested dormitories hence spreading the disease.
Due to human resource problems, Dr Kedrace Turyagenda, the director of the Directorate of Education standards traces the problem to the failure to ensure that all schools are inspected.
“We carry out school inspections annually but we know for a fact that not all inspectors get the chance to visit the dormitories of these schools. Some stop in the classrooms because they have a lot of work to do.”
With unreliable school inspections, Dr Turyagenda says that parents need to hold schools responsible and demand that they provide better living and sleeping conditions for their children.
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