Recent statistics show that out of the 12 million Filipino schoolchildren, 97% suffer from tooth decay, 67% are infected with intestinal worms, and 30% are malnourished. It is alarming that a number of Filipino children suffer from basic proper hygiene and simple healthy habits which can have a direct impact in their attendance to school. When basic needs are not met, the future of these children is in jeopardy.
This is when somebody who cares enough to identify these educational and health deficits can start a huge change. Someone who thinks outside the box and uses minimal resources but maximizes participation of stakeholders and policy makers come into play. Someone who “engineers change” and understands that health and education are key to alleviate poverty.
Cromwell Bacareza originally from Iligan City but currently resides in Cagayan de Oro City, Philippines is that “someone”. He is the Director for Operations, of FIT, an NGO that works closely with the education and health sectors to develop and implement effective health programs. Cromwell is the contributor partner with the different agencies in institutionalizing sustainable health practices in the educational sector such as twice yearly deworming, daily handwashing with soap, and daily toothbrushing with fluoride. These strategies may not be new however; these tried and tested programs, address essential factors in the improvement of the lives and the future of Filipino schoolchildren. With his strategic planning and collaborative approach with various public sectors, such as with the Department of Education and Department of Health, Cromwell sees the future of the Filipino children happening now. He says, “To have the change we want, we must be the change ourselves. Change should start from within!”
This is his story:
AMS: Tell us about yourself. Your education, training and where you are currently involved in.
Cromwell: After a Bachelor of Science in Industrial Engineering from DE LA SALLE University in 1996, I pursued an MBA degree at ATENEO DE CAGAYAN-Xavier University. I also attended a District Health Management Course, sponsored by INWENT and aWASH in Schools Course conducted by EmoryUniversity sponsored by UNICEF. As FIT Director of Operations, I lead the FIT project staff in supporting the Department of Education and the Local Government Units to implement and institutionalize the Essential Health Care Program in more than 40 provinces. FIT provides technical assistance such as capacity building activities to partners, staff and other stakeholders in the institutionalization and management of the Essential Health care program. FIT is involved in the formation of training modules to be used in schools and day care centers all over the county and utilizes its extensive network with LGUs to convince various government executives to support and own the program.
I represented the Philippinesin the United Nations High Level meeting on Non Communicable Diseases in 2011 and in the 1st Asian Public Health Dentistry Meeting in 2009. As FIT Director of Operations I served as a resource speaker on the Global Forum on Sanitation and Hygiene held in Mumbai,India and the Handwashing University in Nairobi,Kenya.
AMS: Growing up, did you always dream of putting together a mission and being involved in charitable organizations?
Cromwell: Growing up in a family of businessmen, entrepreneurs and politicians, I never imagined to be working in an NGO. I have always wanted to be an entrepreneur. Surprisingly, fate led me here to become a social entrepreneur.
AMS: Tell us what is FIT for school and its many missions?
Cromwell: Fit for School Inc. or FIT is a Philippine NGO that was established in Cagayan de Oro in March 2009. Though we may be a young organization, we fully commit ourselves to supporting the government’s health and education sectors in their efforts to improve health and learning of Filipino children in schools and day care centers. FIT supports the DepEd and LGUs in the management of the Essential Health Care Program (EHCP). This national flagship DepEd program is funded by about 30 LGUs throughout the country and implemented by more than 50 DepEd divisions, targeting about 2 million children in public elementary schools. EHCP uses effective interventions – daily handwashing with soap, daily toothbrushing with fluoride toothpaste, integrated into daily school activities, and twice yearly deworming to combat high-impact diseases that often plague Filipino schoolchildren.
Cromwell: The Essential Health Care Program is unique in that it’s the largest handwashing program in the developing world that is funded with government resources. The intersectoral collaboration between FIT, DepEd, and LGUs plus financial and technical assistance from international development partners such as GIZ, AusAID (through BEAM-ARMM), and Unicef are key to the implementation and sustainability of the program. Each partner has a crucial role to play to ensure that health and hygiene issues are addressed.
Daily program management is in the responsibility of school heads and teachers, thus ensuring that the program can be implemented in almost all schools, even in under-resourced locations. Main funding for the Essential Health Care Packages (toothpaste, toothbrushes, and soap) is provided by local governments. FIT facilitates cooperation between DepEd and LGUs; advocates for funding; offers training to DepEd and LGUs; develops new tools, strategies, and practices to improve program implementation; helps monitor EHCP implementation; and researches the impact on the health and education of children beneficiaries.
FIT also works closely with the University of the Philippines National Institutes of Health (UP-NIH), the Province of Camiguin,Xavier University, and the St. Radboud University Nijmegen on a scientific research project that evaluates the effectiveness of EHCP on child health, educational performance, and behavioral change.
AMS: In your experiences with FIT and deworming – what is your regular day-to-day routine? Do you also go out in the community on a regular basis to conduct deworming?
Cromwell: Here in the Philippines, the program is being implemented in more than 40 provinces. So naturally, it is impossible for me to visit every school. But I do travel a lot to visit and support implementing areas and make it a point to visit as many schools as I can. This will give me the opportunity to touch base with the teachers, PTAs, the barangays, and most especially the children.
Deworming, just as the daily group activities, is managed and implemented by DepEd’s teaching as well as health and nutrition staff.
AMS: How important is sanitation and hygiene for Pinoy children?
Cromwell: Water is an essential element in sanitation and hygiene. You need it in toilets, you need it to wash your hands, you drink it, etc. Sad to say, most schools in the country do not have access to water and in connection with that, toilets as well. Without those two elements, tackling child-related diseases such as tooth decay, diarrhoea, and intestinal worms is futile. Without those two elements, cultivating lasting sanitation and hygiene habits (handwashing and toothbrushing) in children will be extremely difficult.
Now, due to bad hygiene practices and poor personal sanitation, 67% of Filipino schoolchildren suffer from intestinal worms and almost all first-graders have dental caries (about 97%). These worms rob children of nutrients and energy, contributing to the fact that 33% of children are malnourished. In addition, tooth aches caused by dental caries cause pain and suffering, making it the number one reason for absenteeism among children.
A scientific research project on EHCP by DepEd, GIZ, and FIT in Northern Mindanao has showed that the interventions espoused by the program lowered malnutrition by 20%, reduced increments in oral infections by 40%, children had 50% lower rates of intestinal worm infections, and 30% fewer days of absenteeism.
Simply put, when twice yearly deworming along with toothbrushing with fluoride and handwashing with soap are done regularly, children have greater chances of becoming healthier (thus reduced absenteeism) and more active in school (creating positive impacts on a child’s educational achievement).
AMS: What are some of the greatest achievement that you’ve had with FIT for School?
Awards / Achievements
- 2009 South-South Cooperation Award for its innovative approach to improve child health using the existing structure of the school system
- Dr. Edward B. Shils Entrepreneurial Education Award in recognition of outstanding transformational leadership and for efforts to help improve oral health through effective health promotion initiatives
- FIT’s WASH facility prototype included in the Enabling Technologies for Handwashing Database (World Bank Database)
- Creation of International Fit for School Course with the help of GIZ, SEAMEO INNOTECH, and the World Medical Association (WMA)
- Invitation to speak in various international conferences and forums
- Given the responsibility by PPPHW of the national coordination for the Global Handwashing Day in thePhilippines
- GIZ/AusAid – expansion of the program in the Autonomous Region of Muslim Mindanao
- UNICEF – coverage in 10 divisions in thePhilippines
- Danida – particularly inCebuProvince
AMS: With FIT who are your support system? Who are/were your motivators?
Cromwell: The backbone of FIT’s operations lies in the strength of the people behind it. We have a pool of dedicated project officers who are assigned in various areas all over the country in providing support to the partners. We have also administrative and research departments based in Cagayan de Oro andMakati to help with FIT day-to-day activities.
A good sounding board and strong support is also provided by GIZ headed by program adviser Dr. Bella Monse.
The direction and guidance of the various agencies and FIT’s Trustees helped establish FIT as an organization.
FIT is known for collaborative work – involving not just the big agencies but those who do the day-to-day work, such as the school heads, district supervisions, PTA officers, Barangay captains, local chief executives, and teachers who are empowered to own the program. Their commitment and support to the program and to what it can do for the children is what keeps the program running, alive, and effective.
We are contributing to a change that would shape the lives of countless children. By maximizing their human potential and making children fit for school, we thereby give them a better chance in life.
In addition, we are also positively changing how other people approach public health. We advocate the wisdom of prevention rather than curative solutions and one way to do so is to instil lifelong habits. We also believe health and education are inseparable and thus stakeholders involved in public health and education have key roles to play.
AMS: If, you were to tell us what are the most important skills that you need in order to be successful in life- what are they?
Cromwell: I believe in not just settling for what’s there – that there is always a better way – which then leads to another skill that I believe in – being flexible in approach but firm with objectives. Another is identifying what motivates us as person, what inspires us to do what we do because these things will essentially mold and sustain our passion for whatever it is that we find ourselves doing. Last is being persistent and patient. Nothing comes easy and everything will take time – which is why it is key that you love what you’re doing if you intend to stick to it in the long run.
AMS: What are your next goals for FIT as the Director of operations? For yourself?
Cromwell: For FIT, it is to strengthen the partnership between our key partners – DepED and the LGUs. Next is to institutionalize the EHCP on a national level, thereby increasing the number of children having access to the program. In connection with that goal is to involve the children and recognize that they are not just recipients of the program but are in fact enablers of change as well. Lastly and really quite a long-term goal is to make personal hygiene and wellbeing a commitment or habit for all children and grown-ups. This includes good grooming, maintaining a clean surrounding at home and in the school, and proper diet.
AMS: Finally, what is your definition of success?
Cromwell: Success is being able to change the lives of people especially children positively.