Community teachers in remote villages

Pheomeo teaches her class. (c)UNICEF/2013/S. Nazer

17-year-old village-teacher Pheomeo smiles when she was asked how she felt when her former pre-school students started primary school: "I was very proud and happy. When my children started there I went to watch them. I saw they knew how to sing the Lao songs, and I saw how much more confident they were than the other children who hadn't come to my class."

Most community based pre-schools claim similar outcomes. When entering primary school, children from pre-schools were emotionally and socially more developed than those who had no attended.

Toilets for all

World Toilet Day, 2013 (c) UNICEF/2013

Weaving his way through a menagerie of chickens, ducks, dogs and pigs, past his family’s wooden stilt house and a dirt playground, fifth-grader Somkhan, 14, points at two small concrete outhouses at the side of the school grounds.

“This is where we go to the toilet now,” he says.

Two taps for hand washing stand close to the basic latrines, which serve the primary school in Don Xai village, a remote community of 50 households nestled in the dramatic landscape of mountainous Phongsaly province – one of the poorest in land-locked Lao PDR.

Community preschools: Reaching out to the most vulnerable

Saphieu, 5 ©UNICEF/2013/S. Nazer

Five year-old Saphieu, in a remote Akha-speaking village in far Northern Lao PDR, beams at her teacher when she is congratulated for the tower she has built with brightly coloured building blocks. The teacher has to make sure Saphieu is looking directly at her as she is deaf, and never speaks.

"I have to pay extra attention to her," explains the community teacher, 17 year-old Pheomeo. "I have to make sure she sees everything, and often I write things down for her. But she is very smart and picks everything up very quickly. Often, when I demonstrate something on the board for the children to repeat, I turn around and she's already completed it."

Community Based School Readiness

A photo essay on a recent UNICEF trip to Luang Nam Tha Province in Northern Lao PDR, visiting 'Community Based School Readiness' programmes in remote, non-Lao speaking villages.

Photos & Text by Simon Nazer

Life in Ban Nuun Sawang

By Hannah Pool


Schools

Now, it’s really time for Muck to get ready for school. She has to find her clean school uniform and while her grandmother combs her long hair she talks about what they will do in school today. She is in first grade and is starting to learn how to read and write. She loves it and cannot wait to take her school bag and go off to school to see her friends. One more button on the uniform… Let’s go.

Muck walks to school with her friends who live nearby. The primary school is at the end of their small village which makes it very easy for her and the other children to walk there. The secondary school on the other hand is in the village on the opposite side of the big street and the students have to take their bikes to get to it, which is also one of the reasons why some students fail to complete their education.

Muck’s walk through to school takes her past the wooden, stilted houses that stand high over the village’s main road.
Hand in hand with her friend, Dao, she walks by the small village shop where Aim, the daughter of the owner, runs out and joins her friends. They take a right past a new, concrete house and take a muddy path towards the village wat – a Buddhist temple. Until a few years ago children walked around the temple but gradually a new, shorter path was beaten through the wat to the school.

The three girls walk past small trees and some housing for the orange robed monks, after which they jump a fence to arrive In front of their new school. The new school year has just begun one week ago and has a wonderful surprise for the students: they can now study in a new building.

Until last year the primary school was just built out of wood without electricity and toilets. Students didn’t have enough chairs and tables, so up to four students had to sit on one table to learn. During rainy season the floor became muddy as no floor was given. Muck and Dao also complain that during the hot season the corrugated metal roof stores all the heat, making it hard to concentrate.

At the end of 2012 the Rotary Club, a charity organization, began to rebuild the school and now students learn in a new, concrete building.

The old school is still there and to the joy of the children serves now as a little shop that sells sweets and drinks. On special days Muck’s Grandmother gives her 2000 kip (0,25$) to buy some candy.

A lot has changed and the eagerness with which the students work proves the impact the improved school has. Importantly the new school is a symbol of more emphasis on education.

Even though the school is supplied with everything it needs now to give qualified education, the teachers are afraid that they will still face many obstacles when not all students come to school. Students are often needed to help their families with farming so that they cannot spend their time in school, even if they wish to study together with their friends.

In January the land has to be prepared for the rice and then in April and May the rice is planted. Later in November and December it can be harvest and most times kids are needed to help. But even in the months of late September and October it seems harder than expected to give the adequate education to the students.

Now it’s the rainy season and often kids don’t go to school because they know that their teachers also won’t go because of the mud. It is a vicious circle, as teachers say that they would not go because students are not going - it is hard to decide, but in the end the kids are lacking these precious days and sometimes weeks to learn more.

Often, students don’t show up at school after lunch break because they start doing work for their family or prefer to play at home. Muck’s grandmother sends Muck to school every day; she wants her to get a better education than she received. Only two of her daughters completed secondary school and Muck will study to get even further than that if she wants.

The dropout rate is going down but still many students do not finish school, complains Ba the teacher at the elementary school. The teachers know about the struggles that their students have to get to school every day, but they themselves face problems. Until last year the salary for teachers was so low that they all had to have a second job. Sometimes they were the ones who didn’t come to school. Now this will change, as the government just tripled the salary for all educational jobs.

The true problem is the children that stay unreached by the new improvements. Many parents did not receive secondary or even elementary education and don’t see the importance of school. Puck is 7 and she does not like to go to school. In the class room there are too many students for her and she cannot follow the class. She wants to be outside, play with her friends or watch TV at home.

Even though every child in Lao PDR has to go to school, the institutions in the village are too weak to force children to anticipate in school. A result of this is that children like Puck start falling behind and have almost no chance to get back in the educational process.

Before school starts Muck and Dao run to their friends and play down by the little lake. They collect little stones that they use for a game they thought off.

Noy, a 4th grader, is hitting a stick against the metal shield next to the old school door. Bang, Bang, Bang! Three times and all children start to collect their bags and run to their classrooms. Standing outside they have to form a queue and enter the classroom in pairs, greeting their class teacher.

There is a spirit of hope and optimism in the school of Nuun Sawang.: this will be a good new school year!

Promoting exclusive breastfeeding and safe maternal health practices

By Ruth Ansah Ayisi

Huayngua Village, Saravane province – When her labour pains began, Ouddala walked into the forest and gave birth alone inside a hut which she had built. Her son was born paralysed. She waited until he cried to breastfeed.

“My son died last year at the age of five,” says 22-year-old Ouddala, softly. “I had to feed him even when he was big because he could not move his body.”

  

Ouddala sits heavily pregnant on the wooden floor far from her visitors. She explains that she is not allowed to sit in front of the bedroom door of her mother-in-law, the most influential member of the family of 11. Instead, Ouddala is confined to the kitchen side of the three-bedroomed house built on stilts. Ouddala is responsible for all the domestic chores, including fetching water and firewood for cooking.

“I will be able to rest for three days after giving birth,” says Ouddala, smiling with no hint of resentment.

However, Ouddala, who left school to get married, is looking after herself better during this pregnancy thanks to the visit of the health volunteer, 55-year-old Duangta, from the same village.

Duangta moves to sit closer to Ouddala, spreading out laminated flip charts showing antenatal and postnatal care. She grins and nods as Ouddala shyly recounts what she has learned, “As soon as the baby is born I must breastfeed my baby and continue to give my baby only breast milk for six months. Then I must give food at six months while I continue to breastfeed.”

Ouddala’s shyness dissipates as they laugh and chat together; they share similar experiences. Duangta went to the forest to deliver her 11 children. She lost one child at birth and three others from diarrhoea.

World Breastfeeding Week

This week, Laos is celebrating “World Breastfeeding Week”, an annual event, every first week of August, which this year is built around the theme of “Breastfeeding Support for Mothers.”

The theme stresses that more mothers, like Ouddala, breastfeed when they receive support, counselling and education in health centres and their communities.

As well as counselling from the volunteer about exclusive breastfeeding, Ouddala is also finding other incentives to take care of her health.  The ‘Community Nutrition Project’ under the Ministry of Health has set up a fund to pay expectant women to attend antenatal clinics and also to deliver their babies in health facilities. Like other pregnant women in her village, Ouddala received 50,000 Kip (about US$7) to cover food and transport costs for antenatal visits to the health centre each month, and will receive 250,000 Kip (almost US$36) for giving birth there. She did not attend any antenatal clinics during her first pregnancy.

Dr. Khamseng Philavong, Deputy Director of the Nutrition Centre, stresses the life-cycle approach to nutrition and highlights the importance of breastfeeding. “Breastfeeding helps a child to survive and thrive,” says Dr Khamseng. “It protects babies against infectious diseases, provides essential nutrients during the first critical two years of a child’s life, and helps prevent stunting, which is a major challenge for our country.”

In Lao PDR, about 44 per cent of children under five years of age are stunted, meaning they are too short for their age; and the rate is as high as 60 per cent in some areas.

“Undernutrition has a detrimental impact on a child’s developmental potential,” warns Uma Palaniappan, Nutrition Specialist for UNICEF Lao PDR. “After the child’s second birthday, the damage is irreversible.”

Palaniappan explains that undernutrition impacts a child’s growth from when it is just a foetus as a result of the mother not receiving enough food and nutrients.

While government education initiatives have boosted exclusive breastfeeding rates significantly in recent years, still only 40 per cent of Lao children are exclusively breastfed to the correct age.  Moreover, only 5 per cent of children are considered to be receiving a “minimum acceptable diet”.

In some cases an underlying illness can dampen a child’s appetite and impacts on the absorption of nutrients critical for growth. Poor hygiene practices are also an important factor. Some 38 per cent of the Lao population still practices open defecation.

A sustained effort

The Lao Women’s Union provided Duangta with a series of trainings on the benefits of exclusive breastfeeding to six months of age followed by continued breastfeeding and correct complementary feeding practices for young children. Duangta spreads this advice among pregnant and new mothers in her community. The trainings are part of a government -led initiative, supported by UNICEF with funding from the European Union, USAID, and the Minerals and Metals Group (MMG).

The work of the Lao Women’s Union – many of whom also act as the village health volunteers – to promote good breastfeeding and child nutrition practices as well as good maternal health and hygiene is targeted this year in Saravane, Attapeu and Sekong  provinces, which have some of the highest malnutrition rates of the country. Their work is making a difference, according to Bounthavy Duanglasy, the president of the Lao Women’s Union in Saravane.

“The volunteers have particularly helped the community understand the importance of exclusive breastfeeding,” she explains.

Work at community level through peer-to-peer counselling sessions has ensured sustained support for mothers, strengthened by health workers, families and community leaders. However, she adds that challenges remain.

“For example, we don’t have enough materials in the different languages of the many ethnic groups, and the volunteers have to walk long distances.”

Khamphai Kaikoo, the village chief, who has lived in Huayngua for 20 years, appreciates the volunteers’ efforts. “There have been so many improvements. Before, women used to deliver their children in the forest because it was considered bad luck if they delivered in their homes. Some of the women and children would die. This practice stopped about four years ago.”

Nearby, 22 year-old Phone has put into practice what Duangta has taught her. “I learnt that I could eat vegetables and fish while I was pregnant,” says Phone, while her four-month-old baby bounces up and down on her lap. “Before my family said I could not eat vegetables while being pregnant and no fish except for carp. I also learnt how to express my milk on the days when it rains heavily and I can’t take my baby to the rice fields.”

Yet most of the households in Huayngua have no toilets or latrines. “I advise them to dig a hole and get rid of the babies’ faeces and wash their hands,” says Duangta. Ouddala has no latrine and although she knows the critical times to wash her hands, she concedes she has no soap. “I cannot afford it,” she says.

Besides the obstacles, Duangta is determined to keep working to promote the health of pregnant women and their babies. “I wanted to give something back to my village,” she says simply as she strides off to the next home.

Through support from the European Union, USAID and MMG, the Lao Ministry of Health, with technical support from UNICEF, has placed maternal and child nutrition issues high on its development agenda.

Government launches social survey report: The first of its kind in Lao PDR

© UNICEF Lao PDR/2013/Verweij

Vientiane, Lao PDR, July 4^th – Lao Statistics Bureau, the Ministry of Planning and Investment and the Ministry of Health with support from the Ministry of Education and Sports and international development partners launched on July 4^th a comprehensive report with the findings of the Lao Social Indicator Survey (LSIS).