Located on the grounds of the King George Hospital Complex (now known as the King Dinuzulu Hospital Complex- KDHC) in Durban, ‘King George V Primary School’ is indeed a school with a difference, catering to the special educational and social needs of a unique class of children.
It was the last morning of November 2015, when, as a member of an engagement tour organized by Lilly MDR TB Partnership, in conjunction with the 46th Union World Conference on Lung Health, I got the opportunity to be in the company of these bright eyed children, neatly dressed in their school uniforms. Outwardly they seemed to be like other children of their age and it was difficult to believe the harsh truth that all of them were in-patient children, undergoing intensive phase of treatment for multidrug resistant TB (MDR-TB) at the hospital.
MDR-TB refers to developing resistance to two of the most powerful anti-TB medicines (Rifampicin and Isoniazid).
King Dinuzulu Hospital Complex is a public sector specialist referral hospital in Durban for the management of MDR-TB for the whole of KwaZulu Natal (Durban). Doctors here treat all cases of MDR/ XDR-TB, paediatric XDR/ MDR-TB, and the hospital also acts as a local site for the surrounding eThekwini district which has an enormous burden of MDR-TB. The TB component of the hospital manages around 2500 MDR-TB patients per month, with around 150 new MDR-TB patients initiated on treatment every month. Many of those infected are children and keeping them in mind this one of its kind school was started in the hospital premises nearly 50 years ago all for all the inpatient children undergoing treatment for MDR-TB.
Children from 2-3 months till older age are admitted for 6-8 months, when they are on injectibles. On the day when I was in the hospital, there were 32 paediatric MDR-TB cases admitted in the hospital. It was heart wrenching to see even toddlers and babies under treatment. The admission chart in the paediatric ward read as: Inpatient MDR-TB juveniles =15 (those also on ART = 11), MDR-TB babies = 16 (those also on ART = 3), XDR-TB juvenile = 1.
Parents/ guardians are allowed to visit their wards only on weekends and/ or take children home for the weekend. But very often nobody comes, as for most families it means an unaffordable travel of as long as 500 km to reach the hospital.
The current school Principal, Vani Singh, has been with the school for the last 17 years - from 1999 - and has been instrumental in bringing up the school to its present quality status. For her, these children are very special children. Each one of them comes from a unique background and has unique needs. She proudly told CNS (Citizen News Service) that, “We are the only school of this kind in the whole of Kwazalulu town. This is the only hospital that has an in-house school. We follow the national curriculum of education as per the department of education. The medium of instruction is English as well as the local language IsiZulu”.
The number of students has increased over the years, as more and more of paediatric MDR-TB patients are being taken in by the hospital for treatment. Currently, at any point of time there could be 40-65 pupils in the age group of 5-17 years. Classes are segregated accordingly on the basis of age and level of education of a child - 4 to 5 years, 6 - 10 years, and then 11 to 17 years.
“Many of these children have disabilities due to side effects of TB medication and also because of the underprivileged backgrounds they come from. Some are academically impaired, some others have hearing impairments due to treatment side effects. We have a very good team of 6 educators who teach according to the special needs of the children,” said Vani.
The school has also started a ‘flying teacher project’ wherein twice a week the teachers go to teach the children who are admitted in other wards of the hospital with spinal and other type of orthopaedic problems (as they cannot be taught with those who have MDR-TB). Vani is trying to get funds to extend this to everyday as it helps stimulate the children very well.
All children with MDR-TB admitted in the hospital attend this school. This helps not only in providing them a continuum of education, while they are on treatment, but also makes the children feel loved and wanted. During their 6 to 9 months of stay in the hospital, they have access to committed care, a warm bed, proper clothing, and at least three nutritious meals a day. They have the added advantage of receiving quality classroom education and education material - like books, crayons, colorful toys - interactive teaching methods, uniforms. For most of the children this is the only glimmer of hope in their otherwise dismal lives.
It is a cruel irony that while their discharge from the hospital is indicative of their recovery, for many of them it also means going back to a squalid life in an overcrowded makeshift, metal sheet home on borrowed land, a distant communal water tap, and deficient nutrition. Let each one of us do our small bit to ensure that no child suffers from TB.
(Shobha Shukla was on a special engagement tour organized by Lilly MDR TB Partnership and partners, before the 46th Union World Conference on Lung Health opens in Cape Town, South Africa. She is supported by the TB Alliance to provide thematic coverage from this conference. Follow her on Twitter: @shobha1shukla)