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Here is a great case study by colleagues in Plan International about members of a children’s group in Galkadewala, Anuradhapura and how they took action. It is a graphic illustration of the power of children to contribute to the improvement of their own and others’ health.

One day our village PHM visited our children’s club.  She discussed with us about the consequences of becoming over-weight.  She also explained that if our mothers and fathers are over-weight, it can reduce their life expectancy and also that they will have a lot of other difficulties in carrying out day to day activities.  Even though the way she explained all this did not frighten us, we deeply felt the gravity of it.

MeasuringWe were determined that we should prevent our parents from becoming over weight.  So we learnt from her how to calculate the body mass index and waist to hip ratio.  We practised it over and over again. We felt kind of proud of ourselves when we learnt this.  We were impatient to use this knowledge we had acquired. 

So, on the following day itself, we started to work.  We didn’t have weighing scales, so we borrowed measuring tapes from our mothers and visited every household in the village measuring the waist to hip ratio of the adults.  We kept records of the values.  Afterwards, we went through these records and calculated the percentages.  PHM told us that it’s called analysing data.  We were surprised to find that most of our parents had a higher than normal waist to hip ratio.  When we found out this fact, the enthusiasm that we had to do something about it increased even more.  Also we were very proud of ourselves in knowing that we had the knowledge and skills to change it. We knew usual health messages will not motivate the adults to change.  We thought of another way. 

As an experiment, we selected 15 families where a parent had the highest waist to hip ratio.  We invited the children from those families to participate in an art exhibition.  Mr. Nandana from Plan and the PHM helped us.  We didn’t want to just draw pictures like we do every day.  We wanted to start a discussion with the other children about reasons that led to over weight of their parents through their drawings.  11 children participated in this exhibition.  The theme for the drawings was “My home at 7.30pm”.  Most of the children had drawn how their family members sat watching television.  Some had drawn how they take dinner watching television.  After they completed drawing, we discussed how we spend time in our families and how it leads to over-weight among our parents.  We told them how sugar, salt and oil leads to increasing weight.  Then they came up with examples as to how these food items are used in their homes.

Then we agreed on things we needed to do in order for our parents to live long.  One young friend suggested that we should always remind our mothers of reducing salt every time they prepared meals.  Another friend suggested that we should measure the waist to hip ratio every week and display it somewhere so that everyone in the family can see it.  We finished the discussion by agreeing to meet every week and discuss the progress.  Since we so badly wanted our parents to live along, we all carried out the things we agreed without fail.  Since we met every week and discussed, we were able to improve some of the actions.  Since we had become really good at measuring and recording waist to hip ratios and knew how to advise, even our parents were surprised and proud of us.  The PHM also told our parents about how competent we were so our parents did not object to what we did. They changed their practices gradually.

After three months we visited the houses again and measured the waist-to-hip ratios. Out of the eleven, seven had reduced it down to the normal value. That was a progress of 64%. We were extremely happy. This happiness motivated us to take on to change a lot of other things related to our health. We asked our PHM to teach us some more about things that affect our health and we assured her that we can change them as well”.