Vision Health of Rural Primary School Students Worrisome

About 30% of students in rural schools have poor vision.

The REAP/OneSight “Seeing is Learning” project officially launched on September 11, 2012 in 11 districts in Yulin prefecture with the goal of understanding the status of vision health among rural primary school students. Our research shows that while national investment in rural education—including improved school facilities and a free lunch program—has gradually increased year to year, poor student vision health and school vision care remain neglected issues.

We discovered that in many schools, chairs and desks were in poor shape, with the height of chairs and desks inappropriately matched with students’ height. For example, many students at the front of the class are relatively short, so they often need to stand to reach their desks (Chinese classrooms seats are arranged by height, with the shortest students sitting closer to the front of the classroom). All classrooms we inspected had simple wooden stools without back support; students use cotton padding for added height so they can reach their desks. This makes it difficult to maintain proper posture for a prolonged period of time. Many students end up sprawled over their desks with their eyes centimeters away from their books, increasing eyestrain.

“Yes, I can see the blackboard, but there aren’t any words on it,” says one near-sighted student.

In addition, the lighting in most classrooms is insufficient. In one school, a classroom had 9 lights, but only 4 worked. In a classroom converted from a dugout shelter in Zizhou county, there is only 1 lamp, installed on the left side classroom wall. In Hengshan county’s “Hope School,” there is no lighting in the student dorms. The principle told us that after dark, the students go to sleep, and therefore do not need lighting!

Besides these obvious structural inadequacies, what we learned from the schools, teachers, and students about vision health is also cause for concern. A primary issue is schools and also students themselves neglecting vision health. Many students have never had a vision test before, with many unable to understand how the vision tests work. One principle told us that there shouldn’t be any near-sighted students, or if there were, it would only be 1% or 2%; a homeroom teacher told us that at most, there were 2 or 3 near-sighted students and since they were sitting in the front of the class, they had no problems seeing the board. However, based on our vision tests, more than 30% of the students in this school had worse than 20/40 vision. In the homeroom teacher’s class there were 10 students who were near-sighted, with one student requiring a special prescription. This student is somewhat mischievous and sits in the back. When we asked if the student can see the blackboard, the student responded, “Yes, I can see the blackboard, but there aren’t any words on it.”

Desks and chairs are often mismatched, leading some rural students to stand while others slump over their books.

Glasses were a source of fear for many schools, parents, and students. At a check up in Jing Minsi Primary School in Jia county, one parent was very relieved to know her children did not need glasses, telling us, “Kids this young cannot wear glasses.” The Director of Education at an primary school in Zizhou county told us that all the near-sighted teachers try not to wear glasses because they believe the more they wear their glasses, the worst their vision will become. Students often say that their parents do not want them to wear glasses out of fear that glasses will make their vision worse. Furthermore, they say glasses are not attractive. Very few students who tried on glasses told us they thought glasses looked attractive.

When it comes to vision health, both environment and attitude toward glasses matter; both aspects desperately need to be addressed in rural China through increased financial and educational investments.

农村小学生视力健康环境令人担忧

“保护视力，提高成绩”项目从2012年9月11日正式开始在榆林地区的11个区县开展调研。项目围绕农村地区小学生的视力健康问题开展了调研。调研中发现，国家对贫困地区的教育投资逐年增加，比如逐步开展的校舍改造工程和义务教育阶段免费营养午餐计划等，但是小学生视力健康以及学校提供的视力健康环境仍然是受到忽视的问题。视力健康环境不仅仅包括看的到的硬件设施，比如教室的照明，提供给学生的桌椅配置，也包括教师、家长和学生对于视力健康的问题的正确认识。

让我们感触非常深刻的是在很多的学校，小学生的桌椅板凳破烂不堪，桌椅的高度严重不符合小学生的身高，坐在班里靠前的孩子们由于身材较为矮小，写作业的时候总是不自觉的站起来才能够得着；所有调查的学校孩子们坐的椅子都是最简单的木质板凳，没有靠背；孩子们只能通过加厚的棉垫子增加舒服度，同时增加高度来够得着写字的桌子。长期在这样的环境下学习，孩子们的坐姿不可能保持正确。很多孩子都是趴在桌子上，眼睛离书本距离很近，这势必增加他们的用眼负担。

此外，教室里的照明严重不足，在预调研的一所学校，班里有9盏灯，可是只有4盏灯能亮；在子洲县的一所窑洞小学里，一个窑洞内只有一盏灯，安置在教室左边的一面墙上；在横山的一所希望小学里，学生宿舍里面没有任何一盏灯，校长告诉我们，住校生一下晚自习就是回去睡觉，不需要照明。

除了这些显而易见的落后的视力健康硬件环境外，学校、教师和学生所告诉我们的关于视力健康的认识更是让我们担忧。首先是学校包括学生自己对视力问题的忽视。在众多的学校中，学生们居然都是第一次接受视力检查，很多孩子不明白视力检查表上“E”的开口方向是什么意思。一所学校的校长告诉我们学校应该没有近视的娃娃，最多也就1%或者2%的学生近视；一位班主任告诉我们班上最多两三个孩子近视，而且这些孩子都坐在第一排，看清黑板没问题。但是我们的视力筛查结果显示，这所学校高达30%的学生视力水平低于0.5，班主任所在班级多达10个孩子近视，有个孩子的验光结果显示配镜度数尽然高达500度。这个孩子由于平时比较调皮，坐在最后一排，我们问这个孩子“你平时能看见黑板吗？”孩子给了我们这样实际的回答“能看的见黑板，看不见黑板上的字”。

对于近视的最佳矫正方法——配戴眼镜，不管是学校、学生还是家长都是持一种恐惧的态度。在佳县金明寺小学的验光检查中，一个学生家长前来询问孩子视力情况，当得知孩子不需要配戴眼镜后如释重负，告诉我们“这么小的孩子，可不敢给戴上眼镜！”子洲一所学校的教导主任告诉我们，学校近视的教师中能不戴眼镜的都没有戴眼镜，还是要少戴，最好不要戴，因为眼镜越戴，视力越差。孩子们给出的答案是：爸爸妈妈不让戴眼镜，害怕戴上眼镜把眼睛给戴坏了！而且，戴眼镜不好看！很少有学生告诉我们戴眼镜好看的，因为他们戴过家里人或者班上同学的眼镜，照了镜子发现自己戴上眼镜不好看。

一方面是视力健康硬件环境的极度落后，另一方面又是对配戴眼镜的极度抵触，中国农村地区的视力健康问题亟需硬件和软件两方面的大量投资建设。