How schools can provide quality health care to students and staff

Maria Teresita D. Ramos, RN has been clinic coordinator for O.B. Montessori Center, Greenhills and its four branches (Sta. Ana, Las Piñas, Angeles and Fairview) for over 4 years. She is an Ateneo de Manila University Management graduate with a second degree in BS Nursing. She holds both a Philippine and USA RN License.

Her more important duties and responsibilities is to see to it that all eight registered nurses for all the five O.B. Montessori schools remain competent and provide quality health care to students and staff, and intervene with actual and potential health problems. She oversees school health policies and programs, coordinates health screenings (BMI, hearing – vision screening, annual physical and dental exams, drug testing, postural screening, etc.) and referrals to specialists an ER. She serves as a liaison between school personnel, family, community to advocate for health care and a healthy school environment; invites physicians, dentists to lecture on important health concerns, and conducts monthly meetings and branch visits.

She says that all the above are possible with daily prayers to God on bended knees and 100 percent support and cooperation of her seven hardworking co-nurses, four of them have worked faithfully in the school for more than five years, Florence Padojinog (19 years), Joy Umali (13 years), Pia Natividad (6 years), Roxanne Aleta (7 years). O.B. Montessori also has retained doctor consultants for each branch.

Body Mass Index

In SY 2010-2011, the clinic of O.B. Montessori Center, Inc. encouraged the students and employees to be conscious of their health by starting the year off with a “Nutrition and Obesity” lecture. It was also then that O.B. Montessori Greenhills began taking the Body Mass Index (BMI) for students, 6 years old and above, twice a year – June and February. In SY 2011-2012, the OBMCI branches (Sta. Ana, Las Piñas, Angeles and Fairview) also began their BMI recording.

What is BMI? It is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. In the 3 years of monitoring, a lot of the intermediate and high school began being conscious of their weights and what they eat.

By April 2013, among all the levels the Casa students ranked the highest with 52 percent of them being obese. More male casa (37%) than female casa (15%) were obese. The most number of overweight boys were recorded in Grade 4. Obese Grade 4 boys in June 2012 totalled 23 percent of their population. By February 2013, this dropped to only 12 percent. They started to be conscious of the food they eat and were more participative in sports and extra curricular activities. Grade 5 students had a very impressive normal BMI recording – 72 percent of them had normal BMI. The students’ obesity was only 4 percent and overweight was 23 percent. A year older, they were now more conscious of their developing body. Normal BMI went up to 84 percent for the Grade 6 level. This group had the most students with normal BMI for the Grade school level.

The most overweight students in high school were found in the first year level, wherein 35 percent were male and 12 percent were female, usually because they are height of the awkward age. The most number of obese students were also in this group at 8 percent of the population. Ninety-three percent of the second year high school students have normal BMI, while third year high school students have the most number of obese girls, at 2 percent of the population. Eighty-five percent of the fourth year high school boys had normal BMI, but more impressive were the girls with 93 percent of them having normal BMI!

Long term health effects that may induce cardiovascular disease,cancer, osteoarthritis, diabetes, etc.

Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Obesity is defined as having excess body fat. Overweight and obesity are the result of “caloric imbalance” – too few calories expended for the amount of calories consumed, and are affected by various genetic behavioral and environmental factors.

Childhood obesity has both immediate and long term side effects. Immediate health effects: Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure; obese adolescents are more likely to have pre-diabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes; children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.

Preventing later-age diseases

Long-term effects on health and well being: Children and adolescents who are obese are likely to be obese as adults and are therefore more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis; overweight and obesity are associated with increased risk for many types of cancer, including cancer of the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, and prostate, as well as multiple myeloma and Hodgekin’s lymphoma.

Here are some ways to prevent being overweight and obese: Healthy lifestyle habits, including healthy eating and physical activity, can lower the risk of becoming obese and developing related diseases. Children inherit the food habits and body constitution of their parents. Overweight parents have likely overweight children. There should be consistency in the dietary and physical activity behaviors of children whether at home, in school, or during vacation; limit soda, bottled juices and fast foods to once a month; encourage children to drink more water; serve reasonable food portions.

Cervical cancer and flu vaccines

Nurse Marites Ramos’ memo to all OBMCI employees read:

How important is cervical cancer, flu vaccines? Cervical Cancer (HPV) vaccine – Human papilloma virus bivalent (types 16 and 18 with cross protection for type 31 and 45) vaccine recombinant facts: Cervical cancer is a cancer that affects women; it is the second most common cancer affecting women second only to breast cancer; it is the second highest killer cancer in women. HPV vaccine protects women from cervical cancer. Eight out of ten women will get HPV within their lifetime. Twelve Filipino women die of cervical cancer everyday and 3 out of 4 women diagnosed today may die within 5 years.

How many shots are needed to complete and what are the contraindications and side effects of HPV vaccine? A three-dose vaccination schedule that should be completed within six months of the initial dose (month 0, 1, 6) is the number of shots needed. It is not recommended for use in pregnant women and women who had total hysterectomy. There are no serious side effects from the HPV vaccine. Most common is pain at the injection site, in others it might be redness and swelling. These adverse effects are temporary and may last only for two to three days.

What is the minimum age of women who may avail of the HPV vaccine, and what is its potency period? Females 10 years old and above may avail the vaccine. It is potent for 10 years. No need for a booster shot after this.

How much is the cost per vaccine? The complete dose is at P6,000 (P2,000 x 3 shots).

Who can avail of the HPV vaccine and what will be the mode of payment? O.B. Montessori employees, their dependents and relatives, novice teachers, probationary employees, Alta Serve, security guards may avail the vaccine at their respective OBMC branch clinics. For permanent employees, it is payable in 6 salary deductions (P1,000 per payday) or pay in cash. For novice teachers, probationary employees, Alta Serve and security guards it is payable in cash basis only.

Problems on the correct dosage

What if I miss the first dose? Which physician can I go to and how much will it cost? You have to go to any OB-Gyn of your choice who has the vaccine closest to the missed date. The earlier you go to the doctor for the missed dose, the better because the second dose is 1 to 1 ½ months after the first dose done in O.B. Price will depend on the physician.

How about the second and third dose? May I still be able to avail of it at OBMC even if I missed the first one but received it somewhere? You may still have your second and third shots in OBMC. Just be present on the scheduled dates.

What happens if I missed the second dose or the third dose? You will have to go to the OB-Gyn of your choice for the second or third shot you missed.

Can a pregnant woman avail the HPV vaccine? What if the first dose was administered then a woman gets pregnant, what happens to her second and third dose? The second and third dose may be given after giving birth. It will still be potent.

When will the flu vaccination be given and where? How often is the flu shot given? Flu shots may be given hopefully before the classes begin at your respective OBMC branch clinics. Ideally a person may take the flu shot yearly.

How much is the flu shot and who can avail of it? Flu shot costs about P350. O.B. employees, their dependents and relatives, novice teachers, probationary employees, Alta Serve, security guards may avail of it. Permanent employees may pay through 6 salary deductions.

School budget for health care

Tuition fees of private schools cover the health care of students. The care of faculty and administrative personnel must also be looked after to have quality management of personnel, who work hard to help the children mature from preschool to adolescence and develop their full potential.