Ana Bertha Quiróz has created a revolutionary educational model in which the promotion of health principles and a horizontal management structure are the basis of a school's operation.
The New Idea
Ana Bertha Quiróz has designed an educational model which promotes critical health practices and an innovative administrative structure. Health issues are treated within the school's curriculum and through structural changes in the school, such as an on-site infirmary, pharmacy, purified drinking water in each classroom and a lunch room which provides nutritious meals. Currently, Peruvian schools provide none of these basic services. Her model school is unprecedented in Peru, bridging the health and education sectors by directly addressing health problems through both its curriculum and its practices. Teachers receive specialized training to actively incorporate health issues into their curriculum. The students in her school consistently outperform students from other schools in Peru in both health indicators and educational achievements. Ana Bertha's idea is also unique in that a democratically-elected committee of students, staff and parents represent all stakeholders in the process of planning and decision-making for the school's health policies. Her idea incorporates parents into her campaign for health by providing them with training, to reinforce the lessons the students learn in the school. Her model school is one of very few to enlist the opinions of staff, students and parents in making administrative decisions. At a time when Peru's educational system is suffering from a huge loss of interest on the part of the teachers, administrators and students, by providing them with respect and giving them decision-making powers, Ana Bertha's program has been able to inspire tremendous pride and dedication in its staff and students. Policies are more effective because they include the direct and active input of those who will be most affected by them. Ana Bertha is working towards spreading this model throughout Peru, to create permanent and systemic changes in the systems which deliver both healthcare and education to children.
According to Ana Bertha, children's basic health needs are not currently being met in Peru. One of the most effective ways of preventing disease is through health instruction, which is rarely incorporated in the Peruvian education system. Poor health conditions prevent children from becoming productive members of society. Without specific prevention measures, appropriate sanitary conditions and proper education, children suffer unnecessarily from preventable diseases. Obviously, health problems that are not prevented become more costly to treat later. As tuberculosis is spreading through Latin America, only 25% of Peru's Health Ministry programs conduct examinations and provide anti-tuberculosis treatment. In 1997, only one in four suspected cases of tuberculosis received a bacterial examination. (National Program of Communicable Disease Control, December 1998) According to Maria del Carmen Villazón, working on tuberculosis prevention in Bolivia, every case of tuberculosis that goes undetected runs the risk of infecting between 15 and 20 people. Many parents from poor sectors of society lack updated and accurate information on appropriate health and hygiene practices. Ana Bertha has witnessed how poor health and nutrition cause students to fall asleep in class and miss out on important lessons. The illnesses that many children are suffering from also lead to low self-esteem and contribute to school absences. The majority of schools are kept in unsanitary conditions and have no provision for potable water, nutrition or health services, leaving poor children without the opportunity to receive a nutritional meal during the day.
Ana Bertha describes an educational system in which teachers' morale is extremely low. They have few opportunities to determine the content of their curriculum and school policies. Teachers who are left outside of the decision-making structure feel neglected, ineffective and end up abandoning many of their responsibilities, becoming disciplinarians instead of educators. The rate of absenteeism among teachers as well as students is steadily increasing, provoking more serious long-term problems such as dropping out altogether. Numerous administrators feel the same sense of hopelessness and frustration and have given up on trying to effectively manage their schools. Many misappropriate or pocket funds that could be used to improve school services. Though there are programs within the Ministry of Health to provide health services for school children, for example, very few administrators take the time to learn about or take advantage of these programs.
The key instrument in Ana Bertha's pilot school is the Health Committee. The student body, parents and staff select the members of this committee as their representatives. This committee works together to analyze the problems within the school and to then plan, organize, execute and evaluate the strategic health plan for the school. These plans have included placing health topics into the curriculum, including AIDS prevention and birth control, and training teachers in the implementation of such curriculum into various subjects; creating an infirmary where students can be examined and treated for certain illnesses and a self-financed pharmacy; establishing a dining room and lunch program to serve the students' nutritional needs; incorporating janitorial staff into decision-making processes to make sure all facilities are kept sanitary; and providing basic health promotion services, such as chlorinated water. Additionally, Ana Bertha has developed a relationship with the Ministry of Health and made it her responsibility to learn about the health programs they offer. She then takes advantage of these little-known or under-utilized State-run health programs to attend to school children's illnesses.As an example of the important role education and appropriate services within the school system can play, in Ana Bertha's school, before she implemented her health program, 63% of the students suffered from parasites and 61% from lice. After the implementation of her program, these percentages dropped to 29% and 36% respectively. Her program was also able to reduce the number of tuberculosis cases by 25%.
Ana Bertha has created a network of older children working with younger children to teach health basics within the classroom. These older children play an early detection role as they watch out for cases of children who may be suffering from certain illnesses and work with them to ensure that they receive proper attention. Ana Bertha recognizes that the valuable lessons taught in her school must be reinforced at home, as well. She has created an educational program for parents in which they attend classes regarding basic health and nutrition practices. Many of the parents are very pleased with the changes they have seen in their children and are eager to participate in the school's programs. The attendance rate for these programs is close to 89% of the parents. Ana Bertha notes that many parents have invited her into their homes to show her the changes they have made since taking her health education classes.
Ana Bertha's model of horizontal management strives to incorporate the opinions and cooperation of all of its stakeholders. All members of the committee and staff are treated with respect, within an informal environment where everyone, including the director, is on a first-name basis, breaking down traditional barriers to communication. In addition to specific training in health education, Ana Bertha's program provides self-esteem building workshops and methods for promoting active education. Ana Bertha has also established agreements with universities for on-going training for her school's educators. By respecting the ideas of her staff members, providing opportunities for them and encouraging their participation in decision-making, Ana Bertha has been able to achieve what few schools in Peru have been able to accomplish, an enthusiastic staff, including the janitorial team, that takes pride in its work, its school and its students. The students share this sense of respect and pride in their school. Since Ana Bertha has implemented her model the levels of health, attendance and performance have improved significantly. The positive results that Ana Bertha has been able to achieve within her pilot school have led it to win the first prize in the nation's Model School competition.
The respectful and collegial treatment which her staff members receive has also made them eager to contribute to the school by utilizing program funds economically and using their personal connections to bring benefits to the school. For example, when they first decided to create a lunch program at Ana Bertha's pilot school, they were able to cut back on funds that are often misappropriated or pocketed by staff members in other schools, and put them towards the nutrition program. With a small family contribution, approximately five dollars per year, and a minimal State participation, staff members have secured donations of food from various companies and institutions to ensure the feasibility of the lunch program. Ana Bertha has noted that the more the staff members are able to contribute to the school, the more important they feel and the more dedicated they are to making the school a success. With the dedication her staff now displays toward the school, it is easier to manage funds efficiently. She has also made it her duty to research what resources the Ministries of Health and Education offer and takes full advantage of them. Ana Bertha collaborates with the Ministry of Education, evaluating teachers that they send to teach at her school and making sure that they pass minimum standards before they become part of her staff.
Due to the success of Ana Bertha's pilot health school, she has received many requests to introduce her model in schools across the country in Lima, Ayacucho, Iquitos, Cusco and Piura. She is currently working with 13 other schools to spread her methodology. Her strategy for replication involves having key administrators and staff members come to her pilot school to witness the various programs in action. Later she visits these schools and works directly with the staff on-site to train them in her methodology. She is establishing a program to return to these schools after their first training session to evaluate their progress and work with them to make additional improvements. As part of her training sessions she teaches other administrators how to work with the Ministries of Health and Education to take full advantage of the programs they offer and to refuse poor service.
Ana Bertha has secured the assistance of KALLPA, a well-respected national health NGO in Peru. They have agreed to help her spread her idea by providing her with contacts in other schools and in the Ministry of Education. Furthermore, they assist her in the production of didactic materials which she uses when training other directors and teachers. As the rest of the Andean regions faces similar problems in both health and education she envisions spreading her program to these countries as well, and is eager to make use of the Ashoka international network to teach and train others in her specific techniques.
Born and raised in a very poor section of Lima, Ana Bertha spent a good portion of her childhood sitting in her classrooms, thinking of ways in which her school could be improved. At age 8, while she respected her teachers, Ana Bertha felt that they were not always effective in their teaching methods. She witnessed sanitary conditions within her school that she found appalling, and saw widespread illness among her classmates. She began to ask herself why a school had to be so filthy, and why so many of her classmates had to suffer from illness. She dreamed of a school where teachers enjoyed their work and respected their students and where students were happy to attend, and felt clean and healthy. Her attention to detail and can-do attitude pushed her to think of ways to address these issues. As a teenager she developed the idea of a school based on health principles and has used her dedication and persuasive skills to successfully implement these ideas ever since.With quality education and health as her primary goals, Ana Bertha studied education and became a teacher, always promoting good hygiene and incorporating health education into her lesson plans. When she first began teaching, director positions were hand-selected by members of the Ministry of Education. Her poor background made it very difficult for her to achieve director status through this system. Five years ago, however, the Peruvian system of selecting school directors was opened up to competition. Ana Bertha won a high ranking in the competition which allowed her to select the school for which she would be director. She chose one of Lima's poorest schools, where teacher and student absenteeism was rampant and health indicators very low, and decided to make the school the testing ground for the ideas she had been developing over a life time. Though she has turned this school around and made it a nationally-acclaimed success, she is not satisfied to stop there. She will not rest until she sees the Peruvian educational system adopt her model and work effectively towards improving the education and health standards of young people throughout the country.