I met Arif in early spring when I visited Morocco as a part of an exchange program sponsored by Legacy International and the US State Department that pairs public health professionals in North Africa and the United States. The goal is to collaborate on solutions to vexing health challenges.
One of several places we visited in a very short period of time was Ait Haddou Youssef, a remote village in the Atlas Mountains. At the local school we were greeted warmly by Arif, a 25-year-old Moroccan Ministry of Health nurse who serves the entire community. Arif spends three weeks at a time in the village and then goes home for one week; the distance and difficulty of travel makes more frequent returns impossible. For now, nursing his people is his life and passion.
When he first arrived, Arif’s time was consumed with treating basic, preventable diseases. One of those, the severe diarrhea that was contributing to the death of children between the ages of one and five, was one Arif knew could be prevented.
His medicine? Education. Arif created a “health club” at school to teach handwashing, basic water purification and food sanitation. I met the club’s three students, one girl and two boys between the ages of nine and 13. They looked much younger than their real age, and U.S. clinical experts in our delegation said they appeared to be malnourished. Cognitively, though, they shined.
They gave a performance for us and for their peers, drawing the “germ cycle” on newsprint and carefully demonstrated hand washing with confidence and talent. Everything they said and wrote was in two languages: Arabic and Berber. Moroccan students learn at least two languages and they learn them well. In fact, most people speak French, Arabic, Berber and English. I reflected on the trend in the United States to make English the only language taught in school. Whose children are more prepared for the global economy?
One child’s father was present during our visit and shared how his daughter had taught his wife how to wash her hands between changing her baby’s diapers and nursing him. Their family has not been sick anymore.
None of this could have happened before Arif arrived at the school. Handwashing was impossible back then because there was no running water in the school. Arif used his own money to bring water to the school and to buy sinks and materials to build a latrine—a simple hole in the floor with a ceramic frame. With leadership and conviction, Arif created the most basic infrastructure that led to a simple yet highly effective way to keep this village safe and healthy.
Seeing Arif’s impact was one of the most touching experiences I have ever had. His students gained the opportunity to share vital information with others, to have a social role, and to become change agents in their community. They were empowered to make a difference, regardless of the limitations and challenges that surrounded them.
As I returned home, I felt both humbled and furious thinking about the vast inequalities in health between Americans and Moroccans. I felt proud to be an American and grateful for all our country has. At the same time, I marveled at how far we are from accomplishing full equity for our own children in America. I thought about how money can be a double-edged sword: money affords us the ability to progress but also distorts what is really important.
For instance, why are we still debating about who has the right to healthcare or quality public education? These basic rights, too often de-prioritized and de-funded here are tended to with great care in other parts of the world. Should we allow our capitalistic way of thinking to continue to deepen the differences between the “haves” and “have-nots”? Our public health and public education systems are really a euphemism for classism. Those at the bottom go to the public system and those at the top go to somewhere else.
This uneven playing field is a result of our reliance on property taxes for education funding. Those with means move to areas with better schools. The properties they leave behind decrease in value, taxes go down, housing becomes cheaper, poor people move in. They pay lower taxes so there is less money for the schools in that district. The vicious cycle of poverty perpetuating poverty is activated. Those disparities and inequities would not happen in this country if education were really a priority for all.
My experience in Morocco reinforced my commitment to create change in the U.S. that will help young people succeed and graduate. This land is one of plenty and of opportunity, but to take advantage of what our country can offer, one must graduate from high school. Educational success starts with healthy kids who are ready to learn. Children facing barriers like hunger, violence or illness are more likely to struggle in school and drop out.
This is why the Center for School, Health and Education at the American Public Health Association addresses graduation from high school as a public health priority. We advocate for school-based health care as a proven strategy for breaking down barriers to education and health. We must engage schools and communities to create infrastructure and support, much as Arif is doing, if we are to keep students in school and on track to graduate.
We can all take a valuable cue from Arif and the power he gives the children in his village. As adults, we have a deep responsibility to ensure that our young people are safe and healthy, and that they have the opportunity to succeed. Too often I see young people being villainized, blamed for violence and self-destruction. This is an easy out because it excuses us from responsibility. Instead, let’s see young people as Arif does; full of potential to become change agents in their community. Let’s understand what drives their behavior, what is happening in their environment, what they need to escape violence and self-destruction. And let’s create those opportunities.
If Arif, with only a latrine and some running water, can empower three children living in poverty in Morocco to lift their village to better health, think of all we can do to empower young people to help their communities here in the United States.