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Health & Sex Education

Lack of adequate health education causes disease, death, and social instability, which aggravate poverty and the hunger problem in a positive feedback loop.

Especially in Sub-Saharan Africa, HIV/AIDS and other lethal diseases burden families due to medical/funeral costs, lost manpower, extra caretaking, and lost labor due to mourning (Haslwimmer, 1996). Rural small farmers are affected the most due to incomplete medical coverage and their reliance on human labor for non-mechanized agriculture (weeding, mulching, pruning, clearing land).

In high-mortality regions, the labor shortages caused by disease and death constrain farming practices. Such areas in Africa have seen a recent shift away from labor-demanding cash crops such as bananas and coffee to less laborious and more drought-resistant subsistence crops such as sweet potatoes and cassava. The decrease in crop diversity may threaten food security, and the inability to produce cash crops decreases the possible profit for farmers. Pastoral herders also lose capital due to medical expenses, as they often sell their animals to pay bills and cannot tend to them during sickness. Studies show a decrease in herd size in high-disease areas.

Microfinance in the form of agricultural credit programs is also threatened by the high default rate due to sickness or death. Credit is often used to pay medical expenses rather than fund investments; when farmers die, their family assets may be seized if the credit is not paid back, leading to increased poverty (Haslwimmer, 1996).

All of the above factors compel families to keep their children home from school in order to work. Their low level of primary education decreases their earning potential and ultimately constrains their opportunities throughout life.

Adult deaths often produce orphans, who are thrown into poverty and generally cannot continue in school because they must work to survive. In some patriarchal communities, the death of the patriarch alone may result in the expulsion of many women and their children from their land. This could lead to increased prostitution, disease, poverty, and child undernutrition (Haslwimmer, 1996). Parent ignorance regarding nutrition also contributes to child malnutrition. In some areas of Africa, swollen bellies in children are seen as normal because they are so common, even though they are actually a sign of inadequate caloric intake and protein deficiency

The Solution

Teachers will be sent to both rural and urban central cluster schools to give lessons to local teachers on nutrition, sanitary practices such as hand-washing, and sex education with a special emphasis on preventing STI transmission. Trained teachers will then go back to their schools and give classes on health education. The classes will be given about once a year and would be mandatory for every student aged 14 and older, including adult students in the farmer/vocational education program. Nutrition and sex education teachers will be hired to train local teachers in health education as part of their standard training at central cluster locations. Every school within a cluster will be required to give health classes at least once a year; if possible, the government will mandate this. Condoms would also be available in schools, along with other health resources such as micronutrient supplements and cheap water purification devices. (See "Water Purification Technologies" in the Direct Aid article.)


The program will be implemented in both city and rural village schools within the cluster school system, especially in Sub-Saharan Africa. According to the CIA World Factbook, all of the countries with a prevalence of HIV/AIDS over 5% are in Sub-Saharan Africa (Central Intelligence Agency, 2007). The UN Population Fund also reports that in Swaziland, the country with the highest adult prevalence of HIV/AIDS (at over 26%), “nearly one-third of young people in secondary school have had sex by age 16 (IRIN Humanitarian News, 2004).” Sex education in such regions is crucial to decrease the rate of disease incidence and death, which exacerbate poverty and hunger.


In the short term, this solution will immediately give local teachers the knowledge and resources to begin educating their communities on nutrition and sex education. Every teacher being trained at the central cluster locations will be required to attend a health education session. In the long term, the local teachers would continue to spread their knowledge throughout their respective towns and eventually turn what they teach into common knowledge.


Ideally, the program will be funded partially by the government and partially by the NGO funding source for the cluster schools. If the government is not able to support the program, it will be funded entirely by the NGO funding source.

Potential Issues

Some cultures around the world may view sex education as offensive, inappropriate, or unnecessary. For regions dominated by these cultures, we will need to tailor the program in order to prevent undue conflict. (University of Michigan)

Similar Programs

UNICEF currently has a program in Burkina Faso that educates new mothers on how to properly nourish their children. The program also trains a few outstanding mothers to train other women in the community, thus creating a long-term, sustainable impact (Martinek, 2006). Our efforts would complement the UNICEF program by targeting not only mothers, but teens and other adults in communities as well.
The Global Service Corps has a program in Tanzania similar to the one we are proposing, in which trained teachers are sent to towns and rural villages to give classes on nutrition and HIV/AIDS prevention (Global Service Corps, 2008). Our program will be on a larger scale and focus more on training local teachers to educate their own communities than on entering and educating villages one by one.


Sample Nutrition Curriculum

This curriculum is designed as a practical guide to food and essential nutrients for adults with little or no prior knowledge of basic human nutritional requirements.

Major Topics Covered

1) Essential nutrients and foods that contain them

2) Common nutritional disorders: causes, prevention, identification, and treatment

3) Use of water purification technology


1) Essential nutrients and foods that contain them

Nutrient-Rich Foods:

Milk, eggs, spinach and green leafy vegetables, red meat (esp. beef), fish, chicken, nuts (esp. peanuts), sweet potato, peas, beans, whole wheat bread, fortified cereals, soybeans, liver, carrots, broccoli, citrus fruits



Good Food Sources


Vitamin A and Beta Carotene

Liver, milk, eggs, carrots, spinach, green and yellow vegetables, broccoli, potatoes, pumpkin, yellow fruits, cantaloupe, sweet potatoes with peel, fortified cereals, mangoes, papayas, tomatoes, squash, and yellow maize

Vision, immune function, reproduction

Vitamin B1

Whole grain, fortified cereals, wheat germ, organ meats, eggs, rice, pasta, berries, nuts, legumes, pork

Processing of carbohydrates and protein, nervous system regulation

Vitamin B2

Meats, poultry, fish, dairy products, fortified cereals, eggs

Conversion of food into energy; helps produce red blood cells

Vitamin B3

Meat, fish, poultry, enriched and whole grain breads, fortified cereals, milk, eggs, peanuts

Assists in digestion and the conversion of food into energy; important in the production of cholesterol

Vitamin B5

Chicken, beef, potatoes, oats, cereals, tomatoes

Important in fatty acid metabolism

Vitamin B6

Fortified cereals, organ meats, chicken, fish, liver, pork, eggs, soybeans, carrots, cabbage, cantaloupe, peas, spinach, wheat germ, sunflower seeds, bananas, beans, broccoli, brown rice, oats, bran, peanuts, walnuts

Important for the nervous system; helps the body metabolize proteins and sugar

Vitamin B7

Liver, fruits, meats

Helps with the synthesis of fats, glycogen and amino acids

Vitamin B12

Fish, poultry, meat, fortified cereals

Important in the production of red blood cells

Vitamin C

Citrus fruits, bell peppers, green beans, strawberries, papaya, potatoes, broccoli, tomatoes

Protects against cell damage, boosts the immune system, forms collagen in the body

Vitamin D

Fish liver oils, fatty fish, fortified milk products, fortified cereals; forms in response to sunshine

Metabolizing calcium for healthy bones

Vitamin E

Fortified cereals, nuts, peanut butter, vegetable oils, spinach

Protects cells against damage

Vitamin K

Green vegetables like spinach, collards, and broccoli; brussels sprouts; cabbage

Blood clotting and bone health


Red meats, some seafood, fortified cereals

Immunity, nerve function, reproduction

Folic Acid

Oranges/orange juice, strawberries, green leafy vegetables, spinach, beets, broccoli, cauliflower, fortified cereals, peas, pasta, beans, nuts

Development of cells, protein metabolism; in pregnant women, helps prevent birth defects


Milk, yogurt, hard cheeses, fortified cereals, spinach

Essential for bone growth and strength, blood clotting, muscle contraction, and the transmission of nerve signals


Processed foods and iodized salt

Important in the production of thyroid hormones


Fortified cereals, beans, lentils, eggs, foods of animal origin such as liver, red meat and blood products, dark green leafy vegetables and millet


Key component of red blood cells and many enzymes


Milk and other dairy products, peas, meat, eggs, some cereals and breads

Allows cells to function normally; helps the body produce energy; key in bone growth


Sweet potato, bananas, yogurt, yellowfin tuna, soybeans

Important in maintaining normal fluid balance; helps control blood pressure; reduces risk of kidney stones


Foods to which salt has been added: salted meats, nuts, butter, processed foods

Important for fluid balance

Chart compiled from:

Gelfand, Jonathan, M.D. (2010, March 5). Food Sources for Vitamins and Minerals. Retrieved November 22, 2010, from WebMD:

American Pregnancy Association. Essential Nutrients & Vitamins For Pregnancy. Retrieved November 22, 2010:

WebMD. (2010, March 5). 12 Foods for Moms. Retrieved November 22, 2010, from WebMD:


·      Especially important for pregnant women to have adequate amounts of Vitamin A, B-Carotene, D, E, C, B1, B2, B3, B6, Folic Acid, Calcium, Iron, Zinc, and the essential amino acids. (WebMD, 2010)

Essential Amino Acids

·      Methionine, Tryptophan, Histidine, Phenylalanine, Leucine, Isoleucine, Valine, Threonine, Lysine

·      Most plant proteins are poor in Lysine and Tryptophan. (Human Nutrition, 2010)

·      Pinto beans (and other legumes) contain all of the essential amino acids except for Methionine; eaten with corn, which contains Methionine, it provides the complete set.

*Using knowledge of the foods that grow best in the region, teachers could also suggest possible recipes for wholesome meals.

2) Nutritional disorders: causes, prevention, identification, and treatment

Disorders and Their Causes

1. Protein-Energy Malnutrition (PEM) spectrum disorders:

·      Caused by inadequate caloric intake

·      Children with PEM are underweight, shorter than normal, and tend to have infections frequently.

·      The most severe forms of PEM manifest themselves as Kwashiorkor and Marasmus.

2. Kwashiorkor:

·      Symptoms include edema, muscle wasting, loss of fat layer beneath the skin, apathy/listlessness, changes in hair (for thick black hair, lightening of color and thinning in texture), anemia, diarrhea, facial swelling

·      Inadequate protein intake causes retention of excess sodium and water (edema); the breakdown of muscle tissue and subcutaneous fat to make up for the lack of other energy sources results in muscle wasting.


Above: Kwashiorkor

Agriculture and Consumer Protection. (1997). Human Nutrition in the Developing World. FAO Corporate Document Repository. Retrieved November 22, 2010 from


3. Marasmus:

·      Symptoms include severe emaciation and muscle wasting, changes in hair texture (thinning), loss of fat beneath skin, anemia, diarrhea, and dehydration due to diarrhea and vomiting. Ravenous appetite may also be noted.

·      Causes may include common childhood infectious diseases such as malaria, measles, and whooping cough. Marasmus is also often caused by early termination of breastfeeding.

4. Iron Deficiency Anemia

·      Symptoms: tiredness, fatigue, breathlessness, dizziness, headaches, heart palpitations, pallor of the lower eyelid and nailbed, edema

·      Causes: Insufficient iron intake and subsequent lack of adequate hemoglobin levels, especially in situations where blood is lost (e.g. during or after childbirth, during menstruation)

5. Vitamin A Deficiency

·      Symptoms begin with night blindness and progress toward total blindness. The mucous membrane over the sclera begins to dry, and then raised whitish plaques that look like foam begin to form. The corneal surface then begins to dry, followed by corneal softening, ulceration, and necrosis.

·      Vitamin A Deficiency can be detected by shining a flashlight into a person’s eyes and examining them.

(Agriculture and Consumer Protection, 1997)


Consuming more food will prevent disorders due to undernutrition. Consuming foods containing adequate amounts of the essential nutrients enumerated above can prevent malnutrition.

The World Health Organization’s “5 Keys” to a healthy diet:

“ 1. Give your baby only breast milk for the first six months of life.

   2. Eat a variety of foods.

   3. Eat plenty of vegetables and fruits.

   4. Eat moderate amounts of fat and oils.

   5. Eat less salt and sugars.”

(World Health Organization)


Body Mass Index: a measure of height to weight ratio

BMI can be a tool for identifying individuals whose weight may be dangerously low. A BMI of below 18.5 may indicate the need for weight gain. A BMI of over 25 may indicate the need to lose or maintain one’s weight. A BMI of over 30 indicates the need for weight reduction. (University of Illinois, 2009)

Above: Sample BMI chart

University of Illinois. (2009). McKinley Health Center Body Mass Index. Retrieved from


3) Use of water purification technology

The SODIS method:

1.     Obtain and wash with soap a transparent plastic polyethylene (PET) bottle.

2.     Partially fill the bottle with water, cap it, and shake it to oxygenate the water.

3.     Completely fill the bottle and lay it out in direct sunlight on a reflective surface such as a metal sheet.

4.     Leave it in continuous direct sunlight for six hours.

5.     Consume the water from the bottle or a clean drinking container.

Above: the Solar Water Dinsinfection method

Swiss Federal Institute of Aquatic Science and Technology. (2010). SODIS: How does it work? Retrieved November 27, 2010, from


Very Important Tips:

1.     Be sure that the water is not so turbid that solid particles will block the sunlight from killing the bacteria. When looking through the neck of the bottle into the bottom, you should be able to read a newspaper headline placed under the bottle. If you cannot, the water is too turbid.

2.     SODIS should not be used during long periods of rain.

3.     If over half of the sky is cloudy, bottles should be left out for at least two consecutive days, not six hours. (Swiss Federal Institute of Aquatic Science and Technology, 2010)

4.     The bacteria in treated water may grow back if the bottle is left in the dark for several days. Water should be re-treated every few days, or hydrogen peroxide may be added to lengthen the time between purifications. (Sciacca et al., 2010)




Works cited: 

Central Intelligence Agency. (2007). Country comparison: HIV/AIDS- adult prevalence rate. Retrieved November 19, 2010, from

Global Service Corps. (2008). HIV/AIDS Prevention and Nutrition Education in Tanzania.  Retrieved November 19, 2010, from

Haslwimmer, M. (1996). AIDS and agriculture in sub-Saharan Africa. FAO Farm Management and Production Economics Service (AGSP). Retrieved November 15, 2010, from

IRIN Humanitarian News and Analysis. (2004). Southern Africa: focus on sex education - an antidote to HIV/AIDS. Retrieved November 15, 2010, from

Martinek N. (2006). Nutrition education for mothers promotes child health in Burkina Faso.  UNICEF. Retrieved November 19, 2010, from

University of Michigan. Cross-cultural perspective: sex ed in Africa. Retrieved November 15, 2010, from

Agriculture and Consumer Protection. (1997). Human Nutrition in the Developing World. FAO Corporate Document Repository. Retrieved November 22, 2010, from

American Pregnancy Association. (n.d.) Essential Nutrients & Vitamins For Pregnancy. Retrieved November 22, 2010, from

Gelfand, Jonathan, M.D. (2010, March 5). Food Sources for Vitamins and Minerals. Retrieved November 22, 2010, from WebMD:

Human Nutrition. (2010, May 26). Retrieved November 29, 2010, from

University of Illinois. (2009). McKinley Health Center Body Mass Index. Retrieved November 29, 2010, from

Swiss Federal Institute of Aquatic Science and Technology. (2010). SODIS: How does it work? Retrieved November 27, 2010, from

Sciacca,Frédéric, Rengifo-Herrera,Juliàn A., Wéthé, Joseph, &  Pulgarin, César.(February 2010). Dramatic enhancement of solar disinfection (SODIS) of wild Salmonella sp. in PET bottles by H2O2 addition on natural water of Burkina Faso containing dissolved iron. Chemosphere, 78(9), 1186-1191. C doi:10.1016/j.chemosphere.2009.12.001