THE absence of on-site school nurses to provide care to students in primary schools across the island is creating what some educators are calling a health crisis.

Currently, it’s guidance counsellors or teachers who provide basic first-aid assistance to students in many schools, even as there have been calls over the years for Jamaica to get on par with developed countries and ensure that most, if not all schools, have a nurse on staff.

The current education policy ensures that a nurse is placed in every secondary school, but there have been calls for serious consideration to be given to having nurses at every level of the educational spectrum.

Because now, educators are left to handle medical emergencies without professional support, leaving students and teachers in primary schools in panic mode when there’s a health emergency with students.

The issue is particularly severe at schools like Clarksonville Primary in St Ann where Principal Otis Simpson has raised concerns about the number of students falling ill without medical personnel on-site to assist.

“We do our best to support our students but without an on-site nurse it’s difficult to address their immediate health needs,” Simpson said.

“We’ve had cases where children experience severe belly pain and headaches… we cannot administer medication, so we cannot give them even a Panadol or a painkiller. That’s where the need for a school nurse comes in. When a child is badly injured on the school compound, for example, or has a terrible bruise, a teacher has to leave his/her class to rush that child to the hospital.”

While Government officials have acknowledged the important role of the school nurse, and have supported providing a limited level of primary health care intervention through school nurses to ensure students have access to initial treatment for minor and other injuries, cost has always been cited as the drawback to full implementation across the entirety of the sector.

The ideal situation would be to have nurses in all schools, but the economic reality within which the education system operates is unable to facilitate such a provision, they’ve said.

In 2023, then Minister of Education and Youth Fayval Williams, in a statement, lauded public school nurses for the crucial role they play in promoting the well-being and academic success of students across the nation, stating that from administering basic health care services to providing health education and support, public school nurses are an essential pillar of the education system.

“School nurses continue to play a critical on-site role in identifying and treating students and the staff who present with illnesses or psychosocial issues, and having to accompany them to a medical doctor or health facility as may be required in emergencies and critical incidents at school,” read Williams’ statement at the School Nurses Special Interest Group’s 19th Annual General Meeting and Health Education Conference.

She further commended the contribution of school nurses “in providing health, education and assistance with decision-making about health and immunisation against preventable diseases…” in schools, and emphasised their continued prioritisation of interventions for acute illnesses, communicable diseases, obesity, substance abuse, adolescent pregnancy, mental health, nutrition, and sexually transmitted infections.

Williams also assured school nurses that the concerns facing the profession are being addressed; key among the issues being the shortage of professionals, especially at the primary level, which she said would be treated as “a matter of policy”.

In the meantime, Simpson said reliance on teachers continues to be the order of the day.

“Luckily, we have a few assistant teachers to facilitate a teacher’s class in cases when the teacher has to rush out with an ill child,” he explained.

“We have visits from clinic health nurses but they don’t come by as often as we wish. When they do come by, they come to check on the immunisation books to ensure that the students are fully immunised. When emergencies arise we are left scrambling to get help, and that is unacceptable.”

The issue extends beyond Clarksonville Primary, as schools across Jamaica lack adequate health care infrastructure, putting students ­— particularly those from low-income backgrounds — at risk. Many children rely on their schools as their primary place of care, yet the institutions remain ill-equipped to handle even the most basic medical needs.

The urgency of the situation has been consistently highlighted by the Jamaica Teachers’ Association (JTA) over the years, and in 2020 during the COVID-19 pandemic, then President Owen Speid said since 2016 there has been a call for more nurses to be placed in primary and secondary schools, but it has fallen on “deaf ears”.

“There is a deficit in that some high schools are without a school nurse, and no primary school, at all, has a school nurse — unless they are willing to take it on, raise funds, and pay the nurse,” Speid told the media then.

“We’ve been saying that to the Government for years, that we need the primary schools to have school nurses. We are calling on the Government every time. Almost all the time I get the chance to speak at a public function, I call on the Government to give us school nurses. This call is going for four years now; it was in the last negotiation. We carried it in the last negotiation and the Government flatly rejected it, and we think it is a big mistake that they have made,” Speid said.

He added: “It is something that should be there. It is an imperative now. We have seen in many instances where guidance counsellors have taken over the roles, sometimes the principals and vice-principals. Class teachers have taken over the roles and many times these class teachers are not even trained in first aid, needless to say in health care, and so on. That is what goes on in the schools on a daily basis and it is untenable.”

Speid said ironically, the secondary school children really may not even need a school nurse as much as the little ones.

“I think the little ones need the nurses more because they are not able to tell sometimes what exactly is going on in their bodies but the bigger ones may be in a better position to explain, even though we know that some of the older ones sometimes can’t even explain themselves either.“

But despite these warnings, schools are still left without dedicated health care professionals.

Nurse Kadett Grant, a public health nurse who has worked in school outreach programmes, confirmed the troubling reality of student health trends.

“We are seeing an increase in childhood illnesses such as respiratory infections, untreated fevers, and cases of malnutrition among students,” she said. “Immunisation rates remain stable, but many children still go to school unwell and in need of care.”

Grant said the Government has made some strides in expanding school health programmes, like the National School Nutrition Policy and Standards, but full-time nurses in schools to monitor students’ health and prevent medical emergencies properly should also be high on the agenda.

Until then, as more children continue to face these challenges educators and medical professionals are demanding action — even while the schools navigate these challenges with limited resources — hoping that necessary changes come sooner rather than later.

Shakeria Drummond is a third-year journalism student at Northern Caribbean University. The above piece gives credits for her final project requirements for the News Writing 2 course.