St James Manyama primary school is just outside the small town of Kalisizo in rural Uganda. St James has been one of the schools involved in Brighter Smiles Africa since 2006. The principal and teachers have worked hard to develop and take ownership of the program. The children are enthusiastic and making good progress. Every year the combined team from MUK and UBC visit to encourage the teachers and students, provide teaching sessions to reinforce the key concepts and practices central to the program, and do a formal evaluation of the impact of health promotion on the participating children. Evaluation involves questionnaires about the children’s oral health practices and knowledge, an examination of each child, and interviews with teachers and parents. A group of children at St James is also taking part in the first study in Sub-Saharan Africa looking at the protective effect of fluoride varnish painted onto the teeth to strengthen tooth enamel.

St James teachers and the school’s head boy came to Kampala in February 2010 to contribute their experiences from 4 years of participation in Brighter Smiles Africa to a stakeholder’s workshop reviewing the impact of the program. They shared many valuable insights and suggestions.

This workshop and the annual evaluation indicate that what the children learn not only benefits them, but other also. Children report “that their mouths no longer smell bad’ (a measure of improved oral health as it reflects less tooth decay and gum inflammation); more brush their teeth than before, and very few still use things like sand and ash that damage tooth enamel. Teachers and parents report that the health culture of the school has changed – everyone is more aware about their health and things they can do personally to maintain and improve it. Fewer children have pain from problem teeth or are absent from school because of dental emergencies. The community as a whole has benefited. Many brothers and sisters of participating children have adopted healthy practices, parents too have learned from their children, and others in the broader community know of the program and what it teaches. Many people interact with and get to know the MUK students and combined University teams when they are staying in Kalisizo. The local hospital in particular has established a special link with the teams (see Kalisizo Hospital).

The parents of the children at St James have made important contributions. One way they have done this relates to promotion by the program of the importance of good nutrition for both growth and long term health, and also as a key factor for achieving good academic performance. During evaluation our teams had noticed many children were weak and sleepy by the end of the afternoon. Enquiry revealed that these children, in addition to walking a long way to and from school like many others, often have no breakfast, bring no lunch, and only eat when they get home in the evening. Having come to understand the importance of nutrition through the program a plan was made to provide these children with lunch each day at school. To do this 70 parents volunteered and cleared land at the school for a vegetable garden, and donated the money necessary to plant maize and beans. This initiative by the community has helped many children and continues to be supported by the program; teachers now report beginning to see an improvement in the academic performance of these children.

However, to optimize the benefits of the garden, and improve the health of all the children at the school, a water source for irrigation and hand washing is needed, with the capacity to also provide clean drinking water. Brighter Smiles and the school are collaborating with the Kalisizo Rotary club in order to achieve this goal.