9 March 2016
Tariq* is a Grade R student who suffers from a severe and potentially life threatening peanut allergy. To protect her son, Tariq’s mother asked his school to keep and administer life-saving medication and take steps to minimise the risk to Tariq. The school refused.
The case of Tariq highlights a problem faced by many children.
The majority of public schools do not stock or administer the life-saving medication called an epiPen (a dose of adrenaline which is injected in the thigh), to a child in a case of a severe allergic attack.
Special health care needs leads in many instances to students missing school or repeating a grade. Learners with health barriers such as allergies or HIV/AIDS often drop out of school; or parents keep them at home, fearing for their lives and wellbeing.
Yet the Constitution guarantees every child the right to education in a safe learning environment and the right of access to medical treatment. The attitude of Tariq’s school, Sunrise Primary* in the Western Cape, was not only unconstitutional, but contrary to provincial policy.
The Western Cape Education Department’s “Policy Supporting Grade R to Grade 3 Learners with Chronic Illness, Guidelines for Foundation Phase” says that teachers must ensure that each student with a chronic illness has a Personalised Health Action Plan. This Plan must be completed in consultation with the parents or caregivers and must describe the symptoms to look out for, provide information about the management of the illness and the medication, give consent to manage a serious situation during school and provide the contact details and names of the health personnel.
While the Western Cape Policy is a step in the right direction, there are obstacles to its implementation. Schools and teachers seem largely unaware of it, and the policy itself only includes foundation phase students, excluding students in grades 4 to 12 that are also affected by chronic illnesses. For Tariq, the policy was unhelpful; failed negotiations between his parents and Sunshine Primary left Tariq’s mother with the choice between home schooling or finding another school - one willing to accommodate him. She chose the latter.
Another case brought to the attention of the Equal Education Law Centre is that of Jesmine*.
Jesmine is attending grade 3 at Sunset Primary School* and, like Tariq, suffers from a severe peanut allergy. In Jesmine’s case, the school is attempting to take steps to accommodate the student. However, it is crucial to raise awareness and develop sensitivity within the broader school community to make this effective.
A learner in Jesmine’s class has found out about Jesmine’s peanut allergy and is taunting her, including through life-threatening actions such as throwing peanuts at her. Jesmine’s parents, terrified for her life, contacted the other child’s parents to explain how her allergies affect her and to request that their child stop. To their dismay, the student’s parents remained unsympathetic and effectively blamed them for keeping the child in school.
Like Tariq and Jesmine, many students in South Africa suffer from severe allergic disorders, the most widespread of which is anaphylaxis. There is currently no national policy on the duty of teachers and schools to accommodate the needs of affected students and parents. If parents cannot home-school their children or find an accommodating school, they are compelled to send their child away each day knowing that there is a huge risk of exposure to allergens, which could ultimately result in death.
The Integrated School Health Policy provides for on-site services including the provision of a first-aid kit, adequate water and sanitation, physical safety and issues related to food safety and suitability.
However, it is not clear from the policy what is meant by “on-site services”. What are appropriate on-site services? Does this include taking measure to ensure that students are not exposed to allergens? Does it include provision for medical assistance to students suffering from a severe allergic attack in or outside the classroom environment?
Like all students, those with an allergic disorder have the right to a safe learning environment. Adequate steps must be taken to ensure they are not exposed to allergens at school and, if they are exposed, they must be provided with emergency medical services, including the epiPen when needed.
However, the Medicines and Related Substances Control Act says an epiPen can only be prescribed and supplied by a practitioner, nurse, dentist, or a person registered under the Health Professions Act, so schools are reluctant to instruct educators to administer an epiPen to a student suffering a severe allergic attack. The epiPen can be prescribed to the student’s parent, who may then consent to the epiPen being administered by a trained staff member at the school, but there may be hesitation and confusion which can have serious consequences.
The health, education and lives of thousands of South African children are at stake. Our Constitution guarantees that the best interests of children will be given primary consideration in all matters concerning them. In the case of students with health barriers to education, we are falling short of that promise.
The Equal Education Law Centre is working with partner organisations to advocate for a national policy to address the legal, policy and implementation gaps. This national policy should provide guidelines to school on what constitutes a safe learning environment for students with a severe allergic disorder, and make provision for training and education of school safety officers, educators, students and parents. In addition, a coherent legislative framework needs to be tabled to allow schools to stock and administer epiPens.
* Names have been changed to protect the children’s identity.
Views expressed are not necessarily those of GroundUp.
A few small corrections were made to this article after publication.