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Campaigns for continence

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VOL: 102, ISSUE: 12, PAGE NO: 46

Nickie Brander is campaigns' organiser

Penny Dobson, MSc, RGN, CQSW, is director, Education and Resources for Improving Childhood Continence (ERIC).

School food has occupied the attention of the government and the media in the past 12 months, but what pupils drink...

School food has occupied the attention of the government and the media in the past 12 months, but what pupils drink at school and the standard of school toilets have not received the same publicity. Despite this, two national campaigns, 'Water is Cool in School' and 'Bog Standard', demonstrate that hard work and commitment can bring about change.

Both campaigns were set up by the national charity ERIC - Education and Resources for Improving Childhood Continence. 'Water is Cool in School' was launched in 2000, and 'Bog Standard' in 2004 (in England) and in 2005 in Northern Ireland. Both campaigns were prompted by concerns from school nurses that inadequate fluid intake and sub-standard toilets were having a negative effect on childhood continence problems, including urinary infections and constipation. There was also concern about the risk of children becoming dehydrated, particularly during active playtimes and PE, as well as during the afternoons, resulting in poor concentration and therefore poor school performance.

ERIC appointed one part-time campaigns' organiser, Nickie Brander, and she has been the power behind them. She is supported by the ERIC team and a similarly dedicated network of health professionals. Other organisations, such as the Community Practitioners' and Health Visitors' Association, the School Councils UK, the British Toilet Association and members of the National Healthy Schools Programme, have been closely involved. Financial backing for the Bog Standard campaign from Unilever and Armitage Shanks has been essential.

As part of both campaigns we undertook baseline research, met with key influencers from health and children's organisations and worked to gain the support of teachers and school governors. We achieved national and local press publicity and intensively lobbied MPs and ministers. Two campaign websites - www.wateriscoolinschool.org.uk and www.bog-standard.org - were designed to provide information and resources to all concerned. A competition held last year, called 'More than a Loo', successfully engaged over 1,000 pupils in designing their ideal toilet area.

A survey of 928 schools in 70 local education authorities during 2003 showed a huge improvement to drinking water provision and access. For example, in 2000, it was rare for pupils to use personal water bottles in lessons, whereas by 2003 it was commonplace for the majority of primary schools, and was allowed in 78% of the primary schools surveyed.

For secondary schools, the figure for personal water bottle use was 48%; we believe that this lower figure was due to resistance from teachers, who were concerned that free access to water might lead to disruption and a loss of revenue from purchased drinks. The survey also found that more schools were replacing their traditional water fountains - often situated in the toilet areas - with modern and hygienic plumbed-in water in coolers and chilled modern fountains, both sited more appropriately. For an outline of the full results of the survey see www.wateriscoolinschool.org.uk.

The 'Water is Cool in School' campaign has been a catalyst for water initiatives across the UK.

There are now government guidelines stating that pupils should have access to free, palatable, fresh, chilled water, ideally from water coolers situated away from toilet areas; that they should be permitted to carry water with them, and that consumption should be encouraged, both in class and during break and lunch time (DH, 2005; DfES, 2003, 2004).

Government initiatives include the Food in Schools programme, which supports the National Healthy Schools Programme. ERIC has been actively involved in the Water Provision project of the Food in Schools Programme. A toolkit is available that provides practical guidance for schools on improving water provision: www.foodinschools.org.

The increase in awareness about the need to drink more water in schools has yet to be matched by a corresponding awareness that children need open access to toilets that are clean, safe, private, and well stocked with essentials, such as toilet paper, soap and drying facilities.

A national survey undertaken in 2005 as part of the Bog Standard campaign revealed that seven out of 10 school toilets are more than 20 years old, so it is not surprising that over half of these schools rated their toilets as being in a poor condition.

A significant number of pupils choose not to go to the toilet all day because they are repellent and lack basic supplies and privacy.Also, they are prevented from going to the toilet at school when they need to, or access is restricted. This not only affects pupils' health but, we believe, also affects their learning, their behaviour and their morale. Furthermore, the worst toilets often become a magnet for anti-social behaviour, turning them into no-go areas for other pupils. For further information on the Bog Standard survey see www.bog-standard.org/adults_survey_results.aspx.

With the government's plans to encourage schools to be venues for 'wraparound care', raising standards of access to, and provision of, toilets is even more critical than before.

The efforts of nurses and other health professionals in raising awareness about drinking water has brought tangible benefits for school pupils. Similar commitment is now needed to achieve open access to high quality toilet facilities. Educating schools on pupils' toilet needs and offering practical help and assistance can make a real difference (see case study).

For more information about the campaigns and how you can help, visit www.wateriscoolinschool.org.uk and www.bog-standard.org.

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