Participants included the adult participants (multipliers) from Day 1, plus a group of 25+ children, mostly 10 to 12 years old. A majority were non-disabled schoolchildren. Ten were disabled. Of these, four had physical disabilities (three of whom were in wheelchairs), two were blind, three had intellectual disabilities or combined disabilities, and one was a 7-year-old with behavioral problems. Two of the children couldn’t speak. (We had planned also to include deaf children and street children, but that didn’t work out.) The parents of some of the disabled children were present, and also participated. In all we comprised a group of about 80 persons!


Note: Most of the Child-to-Child activities facilitated in the workshop are described in sections of 3 of David Werner’s books: Helping Health Workers Learn, Disabled Village Children, and Nothing About Us Without Us. For this reason we do not describe the full details of the activities here. All these books are available in English and Spanish through HealthWrights and are fully accessible online at Also, the Child-to- Child material from these 3 books (in Spanish) was assembled as a booklet and given to workshop participants. This booklet is accessible on our website at


Day 2 began with a brief discussion of the purposes of the workshop. We emphasized that one big challenge for the day was to make new friends and that everyone should look for ways to include, as fully as possible, those children who were “differently-abled.” We said that, if the children liked today’s activities, we hoped they and their teachers might help to introduce these and similar activities to classmates in their schools. They might also put some of the health-promoting activities into practice in their homes and communities. That way the children in this workshop could become teachers and junior health promoters themselves. They could become “agents of change” in building a healthier, friendlier community. We asked the children whether they would like that. Those who were listening sat up straighter and a bit nervously, said, “Yes!”

Breaking the Ice

For this we used a playful introductory activity to help everyone, large and small, relax and get to know each other. Participants made simple drawings (of birds, plants, animals, faces), tore the pictures in half, folded them up, and put them into a box.

Then everyone, children and adults, picked a folded half-picture out of the box and hunted for his or her “other half.” To actively include the blind children, in addition to drawings, objects such as pencils and plastic cups were also broken in half and included in the box—so the blind children could identify these objects by touch. When each person had found their “other half,” they spent a few minutes getting to know each other. Then each introduced his or her “new friend” to the group, stating—very briefly, because there were so many participants—the person’s name and what he or she liked most and liked least.

Simulation Games

“Let’s pretend we have a disability.” To help the non-disabled children taste what it’s like to have an impairment, volunteers were called for, to be given a “temporary disability.” (We found the children much more eager to volunteer than the adults.) Some of the volunteers were blindfolded; others plugged their ears; others tied one foot to their backsides so they had to use crutches or a wheelchair.

Then games were played and races run. The results were eye opening. One boy who was truly blind helped to guide and orient a child whose eyes were temporarily covered and was at a total loss (the blind leading the blindfolded).

The two truly blind boys ran in a race—finding their way by a voice calling from the finish line—and came in ahead of some kids with make-believe impairments. Children who were experienced wheelchair riders came in ahead of the novices. Rather than feel sorry for the disabled children, everyone marveled at their abilities. It was great fun for all—though at times a bit chaotic. The energy level was high.

Community Diagnosis

For this activity three groups were formed: two made up of children (with 3 adult facilitators); the third formed of adults only.

The first children’s group conducted a diagnosis of common health-related problems using a large flannel-graph (a blanket spread across 2 tables stood vertically). On the flannel-graph they placed a series of small pictures, drawn on bits of cloth, representing different health problems and their causes. Then they placed next to these drawings different small cloth symbols to indicated how common, how dangerous, how contagious, and how long-lasting the different problems are. Then they stretched ribbons between different problems to show which ones (like poverty) lead to others (like hunger). Finally they discussed things they could do, individually and collectively, to help prevent or resolve some of the problems.

The second children’s group made two sets of pictures on two giant sheets of poster paper. On one sheet they drew things in their communities that cause sickness or injury or made them unhappy. On the other sheet they drew things that protect health and make them feel good.

The third (adults only) group was asked to make a poster diagramming important health-related problems in Michoacán, and their root causes. They drew a tree showing the problems as leaves on the branches and the causes as the roots. What they produced was clear and carefully done though perhaps not as colorful or imaginative as what the children came up with.

Finally, each group presented their “diagnosis” to the plenary (larger group). By this time most of the children had gained more confidence, spoke out loudly and clearly, and made a point of including disabled children among the presenters.

Discovering Innovative Ways to Include Disabled Children: “Community Diagnosis”

One of the most heart-warming aspects of these activities was the way the group of children looked for and figured out ways to include their disabled peers.

For example, in the group of children making drawings of the different causes of good health and poor health, one member of the group was Yonathan, who is blind. The group members were concerned that Yonathan could not see or make the drawings. So they asked for some clay. One of the healthy activities they had drawn was sports. So on their drawing of people playing basketball, they had Yonathan make a small round ball of clay, and helped him press it onto the drawing, near the net.

Then they asked Yonathan what he thought was a serious problem affecting health in his community. Yonathan said, “Drunkenness and drugs.” They asked him if he could make something out of clay to show the dangers of drunkenness. Yonathan began to model a train. One of the sighted children helped him select the colors and Yonathon modeled a locomotive and couple of cars, which he placed on long, worm-like clay tracks. Then he and the sighted boy together modeled a small clay figure of a drunk man, and sat him down asleep on the tracks, in front of the train.

When the time came for the group of children to present their “community diagnosis,” they took turns explaining the different causes of healthy and unhealthy events. Yonathan took an active part, fingering the train and the drunk man, and explaining how the accident would be a disaster not only for the man but for children that needed him to provide for them. Yonathan, who was still rather timid, spoke softly, but expressed his concerns clearly and passionately. And the group of children glowed with pride at the way they had found to include him.

Hands-on Child-to-Child activities

For these activities the children divided into 4 groups, each with 3 adult facilitators. Two groups were involved in activities related to the health of young children. The other 2 groups were involved in activities related to including and assisting disabled children.

Group 1. Child-to-Child Activity: Diarrhea: “Discovering what to do when your baby brother or sister has diarrhea.” This activity involves the famous “gourd baby” in which the children actively discover the different signs of dehydration, the dangers involved, and how to combat dehydration by giving the sick children lots of liquid. It is a messy hands-on undertaking involving pulling plugs to have the gourd baby pee, poop and vomit. The children of course love it and learn a lot (see front page photo). They learn not only how to recognize the signs of dehydration, but by measuring how much liquid comes out and goes in, how much fluid they need to give to keep the signs of dehydration from developing. If school-aged children put what they learn to practice in their homes and communities, and help teach others, they can make a real difference in the health and even the survival of babies and young children in their communities, and their own health as well.

Group 2. Nutrition of young children. “Which young children in the community are too thin and need more food?” In this activity the children learn to measure the upper arm circumference of children between 1 and 5 years old, to see which children are OK, which are at risk, and which are “too thin.” To do this, the children first make their own simple measuring tapes, coloring them with a green zone (OK), a yellow zone (at risk), and a red zone (too thin). They practice by measuring the upper arms of life-size cardboard dolls (one plump, the other skinny). Next they pretend to conduct a community survey of children under five, by measuring a batch of tubes and bits of branches of different widths. Then they create a “graph” of their results by stacking up small matchboxes—each box with the name written on it of a different imaginary child they tested, and colored green, yellow, or red to show which children fall into which category. Finally, when they have discovered and recorded in this way which young children are at risk or too thin, they learn what they can do to help these children to get more and better food to eat.

The purpose of this activity is to prepare a group of school-aged children to actually carry out a process of “participatory epidemiology,” in which they go into their community after school and measure the arms of all the children aged 1 to 5, recording graphically their results.

Then, having identified those small children who are at risk or too thin, each schoolchild can become a “food helper” for one of those undernourished children, trying to see that he or she gets something to eat more frequently, mixing a bit of vegetable oil in the baby-food, and so on. Finally, after 2 or 3 months of such action, the class of schoolchildren can repeat their survey and see what results they’ve achieved.

The children in the workshop carried out this activity enthusiastically, and seemed to gain a clear understanding of what it involved and why it was important. They were eager to carry out a real study in their communities, and see if they could actually improve the health of younger children.

Group 3. Difficulties with Seeing and Hearing. “What can we do to understand and help children who can’t see or hear as well as most of us?” In this activity a group of children, with the help of their facilitators, devised simple ways to test the hearing and vision of younger children just beginning school. To test vision they made and used an “eye chart” by pasting different sized black letters on a poster paper. To test hearing they had part of the group pretend to be younger children. Each young child paired up with an older child with a notebook. Then one child, standing at a distance, spoke a list of words, beginning quite loud and then softer and softer. When the younger children heard a word, they whispered it into the ear of their older partner, who wrote it down. At the end of the “test” the word lists of different children were compared. Any child with a shorter list was likely to have a hearing problem.

To make this activity more real, some of the children tested were given a temporary visual or hearing impairments, by covering their eyes with a thin cloth that blurred their vision, or by plugging their ears.

Finally, the group of children tried to think of ways they could help those with problems seeing or hearing to take full part in the classroom and learn as well as the rest of the children despite their disabilities. The children thought of all kinds of simple solutions, such as making sure the child with the difficulty sat in front of the class so he or she could hear and see better. They also thought of a “buddy system” where a normal child would sit next to the child with the difficulty, and one way or another make sure that child understood what was said or written.

The aim in all these activities was to get the children thinking and discovering solutions for themselves.

The aim of the activities was to get the children thinking and discovering solutions for themselves.

Group 4. Including Children with Disabilities. “What can we do to make people realize the strengths of persons with disabilities, and look for ways to include them?” This group had a number of children with disabilities, including some children who were physically and/or intellectually disabled. Together they looked for games they could play and things they could do in which the disabled children could take part. The feeling that they were a part of the action seem to help some of these disabled children open up and seem happier. This was especially evident in an older boy with Down Syndrome, who at the beginning of the workshop was very withdrawn and negative, and who refused to take part in anything. During this “including” activity the boy suddenly began to relax, smile, and participate. In this process one of the special education teachers, who had enormous patience and understanding, was a great help, as well as a good role model for all the children and teachers.

One of the most inspiring examples that emerged in this group was a partnership formed by two of the disabled children, one of whom was blind and one of whom had spastic cerebral palsy and could not move her wheelchair by herself. Together the two of them discovered that by helping each other they could get around and do things neither could do alone. The blind boy pushed the girl’s wheelchair, and despite her trouble speaking, she was able to tell the boy which way to go. When in the plenary they demonstrated this to the whole group, everyone was impressed.

The 4 groups spent an hour or so developing these different activities independently. Then each group of children, with little or no guidance from any adults, presented their activity to the larger audience, pretending that they were demonstrating it to an assembly of youngsters in their school.

What was most enlightening throughout these diverse events was the imagination and enthusiasm with which the schoolchildren explored ways to include the disabled children in the activities, combined with the creativity and eagerness to participate demonstrated by many of the disabled children themselves. Both the disabled and non-disabled children seemed thrilled by their discovery of how well they could communicate and work together. Even Jason, the large boy with Down syndrome who had started off scowling and resistant, began to join in with the others with a smile.

Slide Shows of Street Theater and of Disabled Children Helping One Another

To add variety to the workshop and give the children a chance to consider new possibilities, after the busy Child-to- Child activities everyone sat down to watch a couple of short digital slide shows, from Sinaloa and Nicaragua, respectively:

The Story of Manolo, Jorge and Luis.

I decided, at the last minute, to present this slide show because the “hero” in the show, Manolo, so much resembles Jason, the big youth with Down syndrome in our workshop, who at first was so insecure and uncooperative. The slide show—a true story—depicts how Manolo, when he first came to PROJIMO (the Community Based Rehabilitation Program in Sinaloa), was so angry that he said no to everything. But some of the other disabled children succeeded in befriending him.

Eventually Manolo found happiness providing assistance to children with severe physical disabilities. In a program run by physically disabled villagers, Manolo’s strength was very much appreciated. He found meaning and pride in being able to help others.

This slide show led to a discussion on the importance of looking at people’s strengths, not their weaknesses. The children picked up on this quickly.

“The Measles Monster”

This colorful slide show presents a street theater skit in Nicaragua, performed by children and health workers in Ciudad Sandino, Nicaragua, to educate people about the importance of immunization. (See Disabled Village Children, p 455.) In the skit a giant, fearsome Measles Monster with horns and huge claws chases after children who have not been vaccinated. In the end, after all the children are vaccinated, they overcome the Monster. This skit was presented to the teachers and children to give them ideas on how they could use community theater to communicate the importance of healthy practices and greater inclusion.

During this activity, one small, very wild boy with some cognitive impairment, fascinated by the ferocious Measles Monster on my computer screen, ran up and began poking the keys on my computer—which at once went blank. I tried to ward off the boy with one hand while resetting the computer with the other, but with little success. People in the hall asked the teacher who had brought this wild little boy, why he didn’t intervene to help me. With a good-natured smile, the teacher replied, “Because I want him to realize what I have to go through every day!” Everyone laughed. At that point the boy, who was frantically trying to get past my arm to reach the computer, bit my bare forearm. But at once his mouth filled with hairs (my arms are very hairy) and the boy backed off, spitting and clawing at his mouth. After that he left me in peace.

Note: Click here to see The Measles Monster presentation.

End of the Workshop: Conclusions

“What did we learn and how did it change us?” This was a brief closing session where first the children and then the adults commented on how they felt about the workshop, what they had learned, and how they might put into action or share with others some of the activities and approaches to learning and inclusion that they had engaged in during the workshop.

Because this closing session was a preliminary to the more extensive Evaluation and Planning process the following day, the participants’ various responses will be covered there. Over all they were very encouraging.