Goducate encourages adoption of Moringa in Sabah

When we started our de-worming program in Sabah in March, 2012, we felt that it ought to be accompanied by the provision of nutritional supplements to the students and to the villagers at large. This is because in these poor communities, access to nutritional foods is limited. Toddlers often do not get sufficient milk or good nutritional food, so they grow up underweight and malnourished. The school-going kids are often infested by intestinal parasites, which cause poor physical development and malnourishment. Adults, especially women who go through multiple pregnancies and are breastfeeding their children, often end up anemic and weak.

What we want to provide is a sustainable solution to the nutritional needs of the community. In July 2012, we started to educate our teachers in Sabah about Moringa, a plant containing many nutrients. Teaching about theory is accompanied by cooking demonstrations using Moringa leaves as the main ingredient.

We recently received Moringa seeds and started to plant them in the compound of our main literacy center, but a recent flood wiped out our seedlings. Learning from this painful experience, our teachers now grow the seedlings on elevated racks.

We’ve also started to distribute these plants to those of our literacy centers located inland, for the teachers there to replicate the nursery and then hand out these Moringa plants to their students’ families, and we hope, eventually, to the rest of the community.

Riding on the activities of our de-worming program, our teachers decided to bring along free Moringa chicken porridge when they give out the de-worming treatment. This way, the students not only learn about the nutritional benefits of Moringa, they also get to taste it.

Students from one of our literacy centers even decided to turn a small plot of land behind their class into a Moringa nursery where they grow and look after the plants themselves.

We have noticed Moringa trees growing around the houses of some of our students, which indicates that some of the locals have adopted this plant as part of their diet. We hope to learn from these few villagers what made them adopt Moringa so readily, to help us expand acceptance of this plant across all the villages we serve.

Having meal of chicken porridge with moringa
Having meal of chicken porridge with moringa
Moringa nursery tended by students
Moringa nursery tended by students

Goducate community health program in Sabah extended to students’ families

About a year ago we started a de-worming program for students attending Goducate literacy centers in Sabah. By now we are able to conduct 6-monthly de-worming treatments for all our students, which is the recommended treatment frequency for children.

Many of our teachers have told us that their students are now better able to concentrate in class and are much more active than they used to be. To monitor the effect of the program, we are using WHO’s free software to calculate all our students’ height, weight, and body mass index (BMI) and to track their growth relative to age and sex.

Students identified as severely malnourished are followed up by our community health worker.

We are going to extend the de-worming treatment to the students’ immediate families, who will be charged a nominal fee to cover the cost of the medication. To ensure that we can keep up with the program, we have trained two more community health workers, so that there is now a team of three.

Our local community health workers are also equipped with a digital blood-pressure machine and also a glucometer (for measuring blood sugar). They are trained to recognize abnormal readings and provide health advice accordingly. Villagers now approach these workers for routine follow-up to monitor their blood pressures and/or their blood sugar levels.

Through these activities, we have raised awareness among the adults of diabetes and hypertension and also of the pervasive problem of poor sanitation and its impact on their children’s health and growth.

Queueing for de-worming medicine
Queueing for de-worming medicine
Measuring height and weight
Measuring height and weight
Reinforcing importance of handwashing
Reinforcing importance of handwashing

Using technology for Goducate health program in Sabah

Goducate’s health program in Sabah is implemented by our local health educator. Since most of the community served by Goducate there do not have access to state health services, our health educator is often consulted about health problems. We have been exploring how to support her through a telehealth system that enables her to consult our registered nurse based in Singapore.

We initially tried live teleconsultation, but because of unreliable 3G connectivity in the field, it was not possible; however asynchronous teleconsultation was.

When our health educator is approached by a villager about a health problem, she will take measurements of some basic vital signs as well as record the villager’s medical concerns on a form that she will submit online to our nurse in Singapore. The clinical advice is then given in a form of skype chat/call to the relevant patient.

This online consultation does not cater for emergency situations, but rather for cases with chronic conditions. In the first two weeks of the trial, advice was given to 12 patients through this method.

Another area in which we are trying to use free technological applications to help our health educator is in growth monitoring. Traditionally, health workers use the Age-BMI growth chart to plot measurements and detect a child who is malnourished or severely underweight.

Age-BMI for girls

Since this process is manual and can be very time consuming, and considering the vast number of students whose growth we are monitoring, a free application tool is used instead to obtain z scores (a measure of the degree of deviation from the mean) more quickly and accurately.

With this free application, known as Anthro Plus, our health educator needs only to input the student’s age, height and weight, and the software automatically calculates the z-score of the student.

Arthroplus z score

So far, these two technology tools have proven to be reliable and effective to keep the team in Singapore in touch with the team in Sabah.