The burden of the school bag

Community Physician Dr. Kapila Jayaratne who conducted Asia’s first research on bags that schoolchildren carry, talks to Kumudini Hettiarachchi

Bent double with a heavy burden on their backs, thousands of smartly-clad children will make their way to schools across the country, as the new academic year begins on Tuesday.

For most, their uniforms, shoes, socks, water bottles and bags will be brand new, with even the humblest of parents borrowing money to buy their children the necessities for the school year.
But are the bags that these children will carry to school, more of a health hazard than a boon?
Dr. Kapila Jayaratne

This is what Consultant Community Physician Dr. Kapila Jayaratne who was one-time the School Medical Officer of Narahenpita set out to find out having heard of the "ergonomics concept" that was becoming popular in the western world.

Focusing his attention on "ergonomics in the school education environment" which has many prongs, Dr. Jayaratne picked out school bags as the first point of entry in his research as many were the complaints he had heard about them. This was in 2006-07.

"This research was a first not only in Sri Lanka but also in Asia," says Dr. Jayaratne who got the support of the International Ergonomic Association and underwent a three-week training in the Netherlands before embarking on the research.

His research was also fuelled by the fact that when considering the disease burden in the out-patient departments of the government hospitals in the country, a majority of those who sought treatment were adults with musculoskeletal pain. A quantum of the health budget is being spent on managing such patients.

"There was a need to focus on the schooling generation because there is scientific evidence that musculoskeletal pain in childhood continues into adulthood," he says. Explaining the basic concept of ergonomics as modifying the environment according to what the human body requires, he says it includes adjustment of tools, equipment and environment to suit human characteristics. Therefore, he took the "school as a place of work and children as the workers".

The ergonomic considerations in schools included the bag, seating/classroom furniture, IT equipment, lighting, sound and vibration and Dr. Jayaratne first picked the bag.

Under the research, problems connected with the school bag were identified as the model, size, bag features and behaviour among children with regard to loading/weight, packing and wearing, while the models fell into five categories - backpack, suitcase, shoulder bag, trolley case and hand carriage.

The research focused on school-going adolescents (11-13 years old) in Grades 6, 7 and 8 in the Gampaha district. "Gampaha was ideal because it has a mixed population -- rural and urban and also semi-rural and semi-urban.

It is a representative sample of the country's school population. The sample comprised 1,607 children in 55 schools," says Dr. Jayaratne, whose research was overseen by Prof. Dulitha N. Fernando of the Medical Faculty, University of Colombo.

If defects are identified, solutions could be found in the next five years because these children would still be in school, making this research which has been funded by the Family Health Bureau and the World Bank an invaluable one.

The positive findings were that nearly 80% of the children used the backpack model and 97% carried it on both shoulders. However, the vital waist-belt was present only in 30% of the bags and among them only used by 31%.

With regard to the bag weight/body weight, with the international stipulated cut-off being 10%, more than half the children surveyed (58%) had mismatched ergonomics because the rate was over 10%. The research showed that a majority of children take ergonomically-unhealthy bags, Dr. Jayaratne pointed out.
Bag evaluation in progress during the research

A check of the bag contents had found that textbooks comprised 37% of the weight, other books (writing books) 30% and non-book items 17.7%. The bag-weight made up the balance.

The findings indicated that there were unhealthy consequences due to school bags with 72% perceiving discomfort due to carrying school material and 35% complaining of recurrent musculoskeletal pain. This may be a pointer that school bags contributed to such pain.

Plans to ease the bag burden of schoolchildren are underway with the Ministry of Education hoping to introduce a healthy bag in 2011.

Bag problem: Putting research into action

Three important considerations have come about for the solving of the "bag problem" faced by schoolchildren in Sri Lanka. They are:

  • Introduction of a model healthy bag
  • Strategies for bag-weight reduction
  • A behavioural change among schoolchildren.

Putting research into action, several measures have already been taken to bring about changes in this vital area.

A schoolgirl carrying an ergonomically-designed schoolbag

A sample bag has been manufactured locally, based on an ergonomically-designed healthy bag which has been shown not only to experts such as paediatricians and community physicians for evaluation but also principals, teachers and most importantly children themselves, the Sunday Times understands.
A child has even suggested a small pocket to carry toffees, smiles Dr. Jayaratne.

Meanwhile, behavioural changes among children are to be brought about by including a chapter in the Grade 8 science textbook from next year on school bags and ergonomic behaviour while a secondary study has been conducted on the strategies for bag-weight reduction by the Ministry of Education under the guidance of Commissioner-General of Education Publications W.M.N.J. Pushpakumara.

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