NAIROBI, Kenya – Ranjan Patel has a simple lesson for students in schools around Kenya’s capital, Nairobi: Think twice about what you eat, because it could have long-term consequences.
Patel is among a handful of volunteers with the Diabetes Association of Kenya who makes regular visits to schools around the city to talk to students about non-communicable diseases (NCDs), which are rising dramatically in the East African country. And many of these NCDs, like diabetes and heart disease, are fueled by unhealthy eating habits that start at a young age.
So Patel and the other volunteers use whatever approach they can to try to teach young people to eat healthier and curb Kenya’s NCD emergency, building on a model of school-based, behavior-change education that was successfully introduced at the height of the country’s HIV epidemic.
“We use pictures, movies, role plays,” she said. “We carry food models, plate sizes and cups,” which they use to offer guidance on portion sizes. “We make the lesson more interactive, hands-on and fun.” And by the end of the class, the volunteer said, many of the students are more than eager to throw away the chips, cookies and cakes they had been planning to have for a snack.
Patel and the other volunteers also understand that these once-a-year lessons are probably not enough to help students navigate the complex situations they will face both at home, where options may be limited by income and availability, and in their schools, where junk food is sold alongside healthier options.
That is why officials with the Diabetes Association are celebrating Kenya’s decision to introduce a pilot program to integrate NCD education into the school curriculum this year. Patel and others think the decision could be key to slowing Kenya’s emerging NCD crisis.
Kenyans have long recognized the role that schools can play in helping to change behaviors and control health emergencies.
The government introduced HIV/AIDS education into the national curriculum in 2000 in an effort to educate young people about how to protect themselves and to reduce rates of new infections. And there is evidence that it has contributed to raising awareness about HIV prevention – a critical step in reducing transmission.
So it was natural that as NCDs became more prevalent in Kenya, Dr. Kirtida Acharya, the national chairperson of the Diabetes Association, would look to the school system to help address the problem.
“NCDs are diseases that every person needs to be familiar with, but unfortunately people know diseases such as HIV/AIDS yet 52 percent of both public and private hospital beds are occupied by NCDs patients,” she said. “Just like HIV/AIDS prevention and sex education was introduced in schools to protect students from becoming prey of sexually transmitted diseases and HIV, the same way we need to protect our children from NCDs and unhealthy eating.”
The health ministry estimates that 55 percent of all deaths in the country are associated with NCDs. Cardiovascular conditions, which can be linked to poor nutrition, are the leading form of NCDs, and diabetes is on the rise. According to a 2015 health survey, there were 750,000 people living with the condition and 20,000 annual deaths.
In part, this rise is being driven by changing consumer demands, particularly in urban environments. Fast food restaurants are ubiquitous in places like Nairobi and they are marketed as cool places for young people to hang out or easy options for busy professionals looking to pick up a quick meal. Acharya said it is also a product of little education about what young people should be eating instead.
That is why she started the classes in March 2010. Her team approaches schools individually and asks if they can give lessons to as many students as possible. Most administrators, she said, are more than welcoming.
Acharya said her goal is to help young people take control of situations they can control, including the food they eat at school. She said this has actually become a new battleground in the fight to control NCDs, with many schools serving cheap, non-nutritious foods like sodas, fried sausages and bhajia – deep-fried potatoes covered in spices.
And the volunteers from the Diabetes Association can help counter the daily messages the students are seeing across their different screens advertising fast food and give them strategies to find healthier options.
But she said they also see children as ambassadors to other people in society, particularly their families – which might translate into an outsized impact for their lessons.
“When you educate a child not just in academic education but lifestyle choices then you are empowering the nation,” she said.
The Kenyan government seems to agree.
Starting in January of this year, the Kenya Institute of Curriculum Development rolled out a pilot project to integrate NCDs into the curriculum of all government-run schools. Teachers are trained on NCDs and expected to teach or incorporate age-appropriate discussions about the diseases into the various subjects they teach.
Peris Njoroge, the chief curriculum development officer at the institute, told News Deeply that officials are monitoring the pilot to learn what appears to be working. They will then refine the curriculum with an aim to officially launch it in 2019.
“We realized that there are many contemporary issues that needed to be infused into the curriculum and we came up with matrices to address the issues people are dealing with in real life via the school curriculum and from an early age,” she said.
Meanwhile, the Diabetes Association is continuing to offer their lessons in schools, in a bid to assist teachers who are new to the curriculum and to supplement the lessons that students are now receiving.
“Kenyans cannot afford to continue to bury their heads in the sand,” Acharya said. “Ignorance is not an excuse anymore. The more empowered you are the better you will be to fight this war against NCDs.”