390 School Update In Biharl
Sandrine Willert
On 16 July 2013, at least 23 students died, and dozens more fell ill at a primary school in the village of Gandaman in the Saran district of the Indian state of Bihar after eating a Midday Meal contaminated with pesticide.[1][2][3] Angered by the deaths and illnesses, villagers took to the streets in many parts of the district in violent protest.[4] Subsequently, the Bihar government took a series of steps to prevent any recurrence of such incidents.[5]
Across India, the Midday Meal Scheme provides roughly 120 million children with free lunch, making it the world's most extensive school lunch program.[6] In spite of corruption involved in implementing the scheme, it aims to fight widespread poverty and improve children's school attendance and health as a large number of India's children suffer from malnutrition.[7][8]
Bihar in northern India is among the nation's poorest states.[9] According to Mashrakh residents, students have suffered from food poisoning after eating school lunches on multiple occasions.[10] P. K. Shahi, Bihar's education minister, said complaints about food quality were not uncommon, but there had been no reported incidents of widespread food poisoning during his tenure.[7] The nonprofit Hare Krishna Food for Life describes the meal programmes in Bihar and neighbouring Uttar Pradesh as "the worst in India." Public health is poor in general, with most water sources contaminated, and hospitals underfunded.[4]
The primary school Dharmashati-Mata Mandir, in the village of Gandaman, was established in 2010. At the time of the incident, 89 children were registered with the school.[11] The food material for Midday Meals was stored at the house of the headmistress as the school did not have sufficient infrastructure.[12]
On 16 July 2013, children aged between four and twelve years at the Dharmashati Mata primary school complained that their lunch, served as a part of the Midday Meal Scheme, tasted odd.[4] The headmistress rebuked children who questioned the food.[7] Earlier, headmistress Meena Kumari had been informed by the school's cook that the new cooking oil was discoloured and smelled odd.[10] Kumari replied that the oil was purchased at a local grocery store and safe to use.[9][10] The cook, who was also hospitalized by the poisoning, later told reporters that it looked like there was "an accumulation of residual waste at the bottom [of the oil jar]".[9] The meal cooked at the school that day consisted of soya beans, rice and potato curry.[9]
Thirty minutes after eating the meal, the children complained of stomach pain and soon after were taken ill with vomiting and diarrhoea. The number of sick children overwhelmed the school and the local medical system. Some of the sick children were sent home, forcing their parents to seek help on their own.[4] According to the official count, 23 children died as a result of the contaminated food.[1] Parents and local villagers said at least 27 had died.[2] Sixteen children died on-site, and four others were declared dead upon arrival at the local hospital. Others died in hospital. Among the dead were two children of a female cook, Panna Devi; her third child survived.[12][13] A total of 48 students fell ill from the contaminated food. Three remained in a critical condition as of 17 July.[9] Thirty-one children were moved from the local hospital to Patna Medical College Hospital (PMCH) for further treatment.[7]
Late on 17 July, officials stated that they believed the cooking oil had been placed in a container formerly used to store insecticides.[4] According to state officials, the school's headmistress had bought the cooking oil used in the food from a grocery store owned by her husband.[1] On 20 July police said that a forensic report confirmed the cooking oil contained "very toxic" levels of monocrotophos, an agricultural pesticide.[3][15]
Nineteen of the children's bodies were buried on or near school grounds in protest. Across Bihar, numerous students refused to eat their meals in the days following the incident.[1] On 17 July, hundreds of Mashrakh residents took to the streets in protest.[10] Demonstrators lit fires and burned effigies of Bihar Chief Minister Nitish Kumar.[9] The flames damaged four police vehicles.[10] Others threw stones at the police station and chanted slogans denouncing the government.[9] Some villagers demanded that the Midday Meal program be scrapped.[2] Angry protesters carrying sticks and poles blocked roads and rail lines.[10] Desks and chairs from the school were taken and smashed, while the kitchen area was destroyed.[2] In nearby Chhapra, multiple arson attacks were reported, including reports that a crowd set fire to a bus, but no injuries were reported from either city.[1][2][4][10]
Bihar State Education Minister Shahi commented that many people involved in the program were looking for easy money and that "it is just not possible to taste meals in all the 73,000 schools before children eat the food."[4] He also alleged that the contaminated oil had been purchased from a member of a rival political party.[2] Opposition party members accused the ruling Janata Dal (United) party of acting too slowly[9] and called for a general strike.[7]
Background: School environments affect health and academic outcomes. With increasing secondary school retention in low-income and middle-income countries, promoting quality school social environments could offer a scalable opportunity to improve adolescent health and wellbeing.
Methods: We did a cluster-randomised trial to assess the effectiveness of a multi-component whole-school health promotion intervention (SEHER) with integrated economic and process evaluations in grade 9 students (aged 13-14 years) at government-run secondary schools in the Nalanda district of Bihar state, India. Schools were randomly assigned (1:1:1) to three groups: the SEHER intervention delivered by a lay counsellor (the SEHER Mitra [SM] group), the SEHER intervention delivered by a teacher (teacher as SEHER Mitra [TSM] group), and a control group in which only the standard government-run classroom-based life-skills Adolescence Education Program was implemented. The primary outcome was school climate measured with the Beyond Blue School Climate Questionnaire (BBSCQ). Students were assessed at the start of the academic year (June, 2015) and again 8 months later at the end of the academic year (March, 2016) via self-completed questionnaires. This study is registered with ClinicalTrials.gov, number NCT02484014.
Findings: Of the 112 eligible schools in the Nalanda district, 75 were randomly selected to participate in the trial. We randomly assigned 25 schools to each of the three groups. One school subsequently dropped out of the TSM group, leaving 24 schools in this group. The baseline survey included a total of 13 035 participants, and the endpoint survey included 14 414 participants. Participants in the SM-delivered intervention schools had substantially higher school climate scores at endpoint survey than those in the control group (BBSCQ baseline-adjusted mean difference [aMD] 757 [95% CI 611-903]; effect size 188 [95% CI 144-232], p
Interpretation: The multi-component whole-school SEHER health promotion intervention had substantial beneficial effects on school climate and health-related outcomes when delivered by lay counsellors, but no effects when delivered by teachers. Future research should focus on the evaluation of the scaling up of the SEHER intervention in diverse contexts and delivery agents.
Handwashing with soap is an important preventive health behavior, and yet promoting this behavior has proven challenging. We report the results of a program that trained teachers to deliver a handwashing with soap behavior change program to children in primary schools in Bihar, India. Ten intervention schools selected along with ten nearby control schools, and intervention schools received the "School of Five" program promoting handwashing with soap using interactive stories, games, and songs, behavioral diaries to encourage habit formation, and public commitment. Households with children aged 8-13 attending the nearby school were enrolled in the study. Handwashing with soap was measured using sticker diaries before eating and after defecation 4 weeks after the intervention was completed. Children in the treatment reported 15.1% more handwashing with soap on key occasions (35.2%) than those in the control group (20.1%) (RR: 1.77, CI: (1.22, 2.58), p = .003). There was no evidence that handwashing with soap after defecation was higher in the treatment group than the control group (RR: 1.18, CI: (0.88, 1.57), p = .265), but there was strong evidence that handwashing with soap was greater in the treatment than in the control before eating (RR: 2.68, 95% CI: (1.43, 5.03), p = .002). Rates of handwashing increased both at home (RR: 1.63, CI: 1.14, 2.32), p = .007) and at school (RR: 4.76, 95% CI: (1.65, 17.9), p = .004), though the impact on handwashing with soap at key occasions in schools was much higher than at home. Promoting handwashing with soap through teachers in schools may be an effective way to achieve behavior change at scale.
No specific trend was observed in the prevalence of depression according to the division of study. On the contrary, Basin et al. have reported a higher prevalence of depression in 10th and 12th division students due to the pressure of academic performance in the board examinations.[16] We tried to identify factors responsible for the prevalence of depression. Guilty feeling, pessimism, sadness, and past failure were the prominent factors found to be responsible for depression. Inability to cope with academics at the school was another leading reason observed for the higher BDI scores followed by problematic relationships and economic difficulty. Other factors such as parental fighting, punishment at home or school, teasing at school, loss of parents, and substance abuse had a minor effect. The above findings suggest that students should receive mental counseling at school to cope up with studies and to mitigate other factors responsible for depression. Extra coaching by school teachers for students who are especially weak can help in overcoming hurdle.
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