FIRST AID RESEARCH PROJECT

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OCCUPATIONAL ACCIDENTS IN PRIMARY SCHOOLS
WITHIN NAIROBI COUNTY, KENYA: AWARENESS AND
PREVENTION
BY:
STEVE MBUGUA KAMAU
DIRECTOR,
MAKINIKA AFRICA INTERNATIONAL
A RESEARCH PROJECT SUBMITTED TO THE NATIONAL
DISASTER MANAGEMENT UNIT(NDMU) ,UN GLOBAL
EDUCATION FIRST INITIATIVE AND UNESCO IN RESPONSE
TO THE HEALTH AND SAFETY QUEATION.
JULY 2015

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DECLARATION
This research project is my Original Work and has not been presented for any degree or thesis in
any other Institution
. Signature:………………………………………… Date ……………………
Name: Steve Mbugua Kamau

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DEDICATION
To all first aiders, first responders, EMTs and paramedics who always spend their time to save a
life. All First aid instructors and the St John Disaster Response Unit(DRU).

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ACKNOWLEDGEMENTS
I am very grateful to St John Ambulance and Kenya Redcross for giving me an opportunity to
train people in life saving skills. Special thanks to my wife Keziah Mbugua and daughter Zannet
Mbugua for being there when I needed them. I also thank the management of the primary schools
I visited and especially the respondents who were cooperative during data collection for this study.
I sincerely appreciate my entire family for their patience, understanding and encouragement.

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TABLE OF CONTENTS
TABLE OF CONTENTS
Page
Declaration ……………………………………………………………………. i
Dedication ……………………………………………………………………... ii
Acknowledgements …………………………………………………………….. iii
Table of contents…………………………………………………………………iv
List of tables …………………………………………………………………… ix
Abbreviations and acronyms…………………………………………………… xi
Abstract ………………………………………………………………………... xii
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study ………………………………………… … 1
1.1.2 Statement of the Problem …………………………………………… 2
1.3 Purpose of the Study …………………………………………………... 2
1.4 Objectives of the Study …………………………………………..…… 3
1.5 Research Questions ………………………………………………..….. 4
1.6 Significance of the Study …………………………………….......……. 4
1.7 Scope of the Study …… ………………………………………………. 4
1.8 Limitations of the study ………………………………………………. 5
1.9 Assumption of the Study ………………………………………..…..… 5
1.10 Conceptual Framework ………………………………………..…… ..5
1.10.1 Safety Education Programmes ……………………………………. 6
1.10.2 Preventive Services ………………………………………………. .6
1.10.3 Community Based Work ………………………………………….. 7
1.10.4 Organizational Development ……………………………………… 7
1.10.5 Safety Public Policy ……………………………………………….. 8
1.10.6 Environmental OHS Measures ……………………………… ..….. 8
1.10.7 Economic and Regulatory Activities ……………………………… 8
1.11 Definition of Terms …………………………………………………. 8

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CHAPTER TWO: REVIEW OF LITERATURE
2.0 Introduction .......................................................................................... 8
2.1 Risk Assessment and Audit .................................................................. 9
2.2 Policy Awareness .................................................................................. 10
2.3 Duty of Employer/Employee ............................................................... 11
2.4 Prevention procedures and regulations ................................................ 11
2.5 Reporting............................................................................................... 11
2.6 Training ................................................................................................ 11
2.7 First Aid ................................................................................................ 11
2.8 Summary of Gaps ................................................................................. 11
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Introduction ………………………………………………………… 12
3.2 Research Design ……………………………………………………. 12
3.3 Variables ……………………………………………………………. 12
3.4 Location of the study ………..……………….............………….….. 12
3.5 Target Population … ……………………………………………………..13
3.6 Sampling Techniques and Sample Size ………………………………….13
3.6.1 Sampling Techniques …………..………………………………………13
3.6.2 Sample Size …………………………………………………………….13
3.7 Research Instruments……………………………………………………..13
3.8 Pre-Test …..……………………………………………………………….13
3.8.1 Validity ……….………………………………………………………...13
3.8.2 Reliability……….……………………………………………………..14
3.9 Data Collection Techniques …………………………………………….14
3.10 Data Analysis and Presentation ……………………………………... ..14
3.11 Logistical and Ethical Considerations………………………………… 14
CHAPTER FOUR: FINDING AND DISCUSSION
4.0 Introduction ………………………………………………………….… 14

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4.1 DEMOGRAPHIC INFORMATION ………………………………… 15
4.1.1 Section/Department …………………………………………………… 15
4.1.2 Age ……………………………………………………………………. 16
4.1.3 Gender ………………………………………………………………… .16
4.1.4 Number of Years Worked in Current Employment …………………… 16
4.1.5 Level of Education …………………………………………………….. 17
4.1.6 Hours Worked Per day …………………………………………………. 17
4.2 AWARENESS ……………………………………………………….… 18
4.2.1 Safety Regulations and Laws ……………………………………….… 18
4.3 PREVENTION ………………………………………………………… 18
4.3.1 Safety Responsibility ………………………………………………… .19
4.3.2 Training ……………………………………………………………… .19
4.3.3 Information on Use of Equipment …………………………………… 19
4.3.4 Working Conditions ………………………………………………… ..19
4.3.5 Preventive Measures ………………………………………………… ..19
4.3.6 Protective Gear ……………………………………………………….. .19
4.4. POLICIES AND PROCEDURES …………………………………… 20
4.4.1 Emergency Preparedness …………………………………………….. ..20
4.4.2 First Aid ……………………………………………………………… ..20
4.4.3 Common Accidents …………………………………………………… 20
4.4.4 Work Procedures ……………………………………………………… 20
4.4.5 Reporting ……………………………………………………………… 21
4.4.6 Risk Assessment and Audit …………………………………………….21
4.4.7 Safety Committee ……………………………………………………….21
4.4.8 Safety Policy Statement ………………………………………………….21
4.4.9 Medical Examinations ……………………………………………………21

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CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1 Introduction ………………………………………………………….. 22
5.2 Summary ………………………………………………………………22
5.2.1 Demographics ……………………………………………………….22
5.2.2 Existence of Policy ………………………………………………….22
5.2.3 Awareness …………………………………………………………..22
5.2.4 Preventive Measures ………………………………………………..22
5.3 Implications of Findings ……………………………………………..23
5.4 Conclusions …………………………………………………………23
5.5 Recommendations for Policy ………………………………………23
5.6 Recommendations for Further Research …………………………… 23
5.6.1 REFERENCES ……………………………………………………23
6.0 APPENDICES

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ABBREVIATIONS AND ACRONYMS
WHO - World Health Organization
ILO - International Labor Organization
HSE - Health Safety Executive
UK - United Kingdom
OHS - Occupational Health and Safety
NCC – Nairobi City County
HIRA - Hazard Identification and Risk Assessment
MOH - Ministry of Health
OHSA - Occupational Health and Safety Act
WIBA - Work Injuries and Benefits Act

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ABSTRACT
This study is entitled, ―Occupational Accidents in Schools within Nairobi County: Awareness
and Prevention. The specific objectives of the study were to establish whether First aid knowledge
is embraced in the primary schools, if there are policy guidelines relating to prevention of
occupational accidents and to check whether legal requirements relating to safety at work are
followed; determine the level of awareness of the safety procedures by the staff and proprietors of
primary Schools within Nairobi County and to establish preventive measures that are in place to
prevent Occupational Accidents in Schools. The independent variables examined were the years
worked, type of school(private or public) and level of education while the dependent variables
included awareness of staff on safety requirements, policies and accident prevention measures as
they relate to the areas of occupational health and safety promotion activities. The study employed
the descriptive study design which is the most appropriate in achieving the stated objectives and
allows generalization of the results to the population. Data was collected from Schools and First
aid training companies like St John Ambulance and Kenya Redcross, using stratified and simple
random sampling which ensures that all staff from the population had the same chance of being
selected and stratified sampling to ensure that cases from the smaller strata of the population are
included in sufficient numbers to allow comparison. The study was done in the central business
district of Nairobi town in which, 16 primary schools from 3 major sub counties were studied. An
interview was administered to school proprietors or the headteachers to establish accident
prevention measures taken by the school management as well as the policies put in place to ensure
awareness and prevention of these accidents. Staff of various caliber filled questionnaires to shed
light on accident prevention measures and awareness. An observation checklist was also used to
establish the safety practices of the schools. The data collected was then used to establish the extent
to which accidents occurred, state of awareness and prevention measures that were undertaken by
the Schools. The data was then transcribed and content analysis (identifying, coding, and
categorizing the primary patterns in data) done. Thereafter the data was organized in tables and
analyzed using the SPSS data analysis programme. Major findings were that though most primary
school had safety policy statements, most staff were unable to outline them and worse still were
not aware of safety procedures, policies and laws governing health and safety in schools. Training
was considered as one of the methods of ensuring prevention of accidents. Although risk
assessment audits were done regularly, most schools had no system of reporting risks, hazards and

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accidents. After correlation, it was found that the awareness of safety rules/policies/regulation are
influenced by education levels of the staff and not necessarily the working year/experience
meaning that staff get OHS information mainly from formal professional education rather than at
the work place. In conclusion, most primary schools neither had guidelines for preparedness for
emergencies or a system for reporting hazards and accidents and the staff were not aware of safety
regulations, safety procedures and policies or laws governing the learning institutions. On the other
hand preventive measures put in place included training, availing necessary equipment and
disciplinary action. Recommendations included providing clear policies on safety procedures in
the learning institutions and training staff on these policies to create awareness. Also, mandatory
First Aid training for all pupils in Kenyan primary schools.

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1.2 PROBLEM STATEMENT AND JUSTIFICATION
The learning institutions have become one of the fastest growing industries due to increase in per
capita income and population growth in urban areas. Nairobi County has experienced
tremendous growth in the number and magnitude of primary schools establishments over the past
ten years leading to massive employment of staff into the schools. Grimaldi and Simonds (2003)
said that the history of safety is full of the records of specialists who knew where injury causes
were but could not persuade line management to eliminate or control them. According to the
Vicino Joe, (2006), ―New employees are involved in one in three workers' compensation
accidents, and they too often don't have the right training or management to avoid injuries‖. This
creates a concern that staffs may not be aware of their safety rights and safety procedures or if
they are aware, these may not be practiced within the establishments such that schools end up
being health hazards. Policies on safety at schools adopted by various countries, particularly
Norway and Sweden clearly demonstrates that safety at work is vital in order to protect the
health of the pupils and staff (Lindoe, 1997). This highlights the importance of ensuring policies
are put in place and preventive measures taken into consideration to avoid occupational
accidents. In the Sixteenth International Conference of Labor Statisticians, it was regrettable that
data on occupational accidents is not available from all countries in the world. Bamford (1995)
says ―We do not know how many people suffer from minor injuries. These must be
considerable and they have the potential to go on and cause personal discomfort, pain, and
possibly further complications. Minor injuries may not be recorded and may not receive
appropriate treatment and care. It may be attributed to various factors that include what the
following writers have pointed out. There is evidence that poverty and low educational standards
expose staff to exploitation by employers and to some extent high levels of occupational hazards
(Mitullah et al, 2003). Workers themselves may also be unwilling to expose health problems in
situations of high job insecurity, informal employment, and high labor turnover, factors
exacerbated by employment patterns created by globalization (Packard, 1989). With insecure
employment, particularly in small enterprises, accidents are likely to go undetected and workers
with severe disability will be dropped out of work (Loewenson, 1998). This is compounded by
the fact that the provision of occupational health services is usually in larger organizations;
people in small organizations have little or no access to occupational health advice (HSE, 1985).

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The study will therefore assist in determining the occupational safety policies in place, how far
safety procedures are being adhered to and what is being done to create awareness on these very
important safety requirements
1.3 PURPOSE OF THE STUDY
The purpose of the study was to establish if primary schools have any measures put in place to
detect accident prone activities and areas and to find out if pupils, staff and other personnel were
aware of these measures to ensure their safety. It also aimed at establishing what preventive
measures are in place to prevent accidents and majorly to check whether the personnel are trained
on First Aid.
1.4 OBJECTIVES
BROAD OBJECTIVE
To determine the level of accident prevention awareness and the preventive measures put in
place in the primary schools within Nairobi County.
SPECIFIC OBJECTIVES
1. To establish whether there are policy guidelines relating to prevention of occupational
accidents and to check whether legal requirements relating to safety at schools are followed.
2. To determine the level of awareness of the safety procedures by the pupils, staff and
proprietors of primary schools within Nairobi County.
3. To establish preventive measures that are in place to prevent Occupational Accidents in
primary schools within Nairobi County.
1.5 RESEARCH QUESTIONS
1. Are there safety procedures and policies that govern the primary schools in Nairobi County?
2. Are staffs and proprietors aware of these safety requirements and policies?
3. Are there preventive measures that have been put in place to prevent Occupational health ans
safety hazards in the schools?

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4. Are pupils and staff trained on First Aid and able to administer it to casualties?
1.6 SIGNIFICANCE OF THE STUDY
The learning institutions are a very labor intensive industry whereby staffs play a major role in
running all aspects of its activities. While some staff are employed on a permanent basis, a
number of them are on casual/part-time basis thus compromising their position as stakeholders in
the institution they work in. Due to this, their safety in terms of preventive measures put in place
and ensuring of awareness in safety matters are often overlooked. In spite of the above, it is very
important that the health and safety of these employees and pupils are carefully considered in an
institution‘s policies. This study might help provide direction in terms of what is actually
happening on the ground and what can be done to improve this situation to ensure occupational
accidents are prevented as far as is possible while the staff are made aware of how they expect to
be protected from the occurrence of such occupational accidents by both themselves, the pupils,
the employer and according to stipulated law.
Primary School proprietors will benefit from increased productivity due to reduction in lost time
due to accidents as well as significant improvement of work place infrastructure. Staff on the
other hand will benefit from increased awareness of Occupational Health and Safety, which will
inspire positive attitude change which will in turn result in a lowering of Occupational accidents.
This study might also form a baseline to establish safety practice so as to lay foundation on the
improvement of occupational safety, accident awareness and prevention in the learning
institutions. This may also assist in knowledge generation on the subject of occupational health
and safety for primary school pupils. The study might also help in policy formulation to make it
mandatory for all pupils in Kenya primary schools go through a mandatory First Aid training.
1.7 SCOPE OF THE STUDY
The study will be limited to physical accidents that occur to pupils and staff working in primary
schools within Nairobi County.
1.8 LIMITATIONS OF THE STUDY
• Lack of local literature that particularly refer to learning institutions to back up this study as no
similar studies have been done before. This was however compensated by use of literature from
other sectors with the need for Occupational Health and Safety procedures.

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• Hesitation to volunteer information by employers/employees for fear of victimization which
was overcome by assurance in the consent form that the information given would be used for the
study‘s purpose only and not divulged to other parties.
• Some staff were not willing to respond to the questionnaire. They were replaced by colleagues
who were willing to respond.
1.9 ASSUMPTIONS OF THE STUDY
Assumptions are:
prietors are in control of the school’s policies.
schedules.
This is especially because the study was to look at awareness of pupils and staff and prevention
measures which do not substantially vary with regard to the location sine the staff are trained all
over the country.
pancy are the same in the schools being studied.
similar in the schools.

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2.0-4 LITERATURE REVIEW
Health and Safety at the workplace and learning institutions has become an area of great concern
and the government is taking great steps through the Directorate of Occupational Health and Safety
Services (DOSH) to address the issue and establish mechanism related to the field. At enterprise
level, a bipartite approach is facilitated by the Safety and Health Committees Rules made under
OSHA, 2007. Established safety and health committees include equal representation from
management and workers. Kenya has a population of 36.8 million people; of these, 2 million are
employed in the formal sector and 8.8 million are employed or self-employed in the informal sector
across the country.
The DOSHS, with 71 professional OSH officers, is not capable of inspecting the estimated
140,000 workplaces effectively, and this leaves most workers exposed to OSH hazards without
Intervention. DOSHS representation in 29 counties leaves the remaining 18 counties with no
officers. Illiteracy levels are high in the rural areas, which are insufficiently covered by DOSHS
officers, and thus illiterate workers in these areas are exposed to OSH hazards.
In Kenya, 75 institutions offer OSH training for safety and health committee members, and
also for awareness creation. This, together with the master’s degree and postgraduate diploma
courses offered by one local university, is likely to increase awareness levels, and thus impact
positively on the national OSH profile. The country has 49 active registered safety advisers,
30 fire safety auditors, 38 designated health practitioners, and many other professionals such as
plant examiners involved in the OSH field.
There is only one poison control centre in the country, the National Poison Information and
Management Centre at Kenyatta National Hospital (KNH), which has been operating for the
last five years. It provides an information and resource centre for all the hospitals in the country,
and for anyone who requires information about poisons and their antidotes.
The Ministry of State for Special Programmes has the mandate for coordinating disaster risk
reduction programmes and emergency response. Nationally, this Ministry coordinates the
response to any emergencies that may occur. It developed a draft national policy for disaster
management in 2009, and a national disaster response plan that is hazard specific.

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The history of OSH in Kenya dates back to 1950, when it was found necessary to have a legal
instrument to manage the safety, health and welfare of people employed in factories. The then
colonial government adopted the British Factories Act of 1937. In 1990 the Factories Act was
amended to the Factories and Other Places of Work Act, in order to enlarge its scope of coverage.
In 2007 this Act was repealed, and was replaced by the Occupational Safety and Health
Act. In the same year, the Work Injury Benefits Act was enacted. Both these laws are administered
by the Directorate of Occupational Safety and Health Services (DOSHS).
Other legislation that touches on OSH includes the Public Health Act CAP 242, the Environmental
Management and Coordination Act (1999), the Radiation Protection Act CAP 243, and
the Pest Control Products Act Cap 346. These laws are enforced by different ministries and
departments of the Government. What is conspicuously missing is an act on health and safety at
school which would cascade into a school curriculum on health and safety and just basic First Aid
and Fire Safety training.
Several training institutions like St John Ambulance are offering pediatric First Aid/Life saver for
babies and children course but very few people are aware and able to study the course.

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SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
5.7 INTRODUCTION
Various conclusions touching on the existence of policy guidelines relating to prevention of
occupational accidents, the level of awareness of the safety procedures by the pupils, staff and
managers and preventive measures in place to prevent occupational accidents in primary schools
within Nairobi County have been made. Recommendations on the way forward for the sector and
directions for further research are also given.
5.8 SUMMARY
5.8.1 Demographics
The study was carried out in Nairobi County primary schools. The respondents were mainly
from the 18-35yrs age bracket (89%), with slightly more females (58%), than males. Most
respondents had worked in their current employment for less than 3 years (56%), with most staff
having attained a tertiary education (67%).
5.8.2 Existence of policy guidelines and legal requirements relating to occupational
accidents and safety at work.
In terms of safety procedures, policies or laws governing the hotel, most managers stated there
were none and even those who said they had, did not have them written out. This is despite the
fact that most of the respondents (staff 68%, managers 52%), stated that they had a safety policy
statement in their workplace. On the other hand, there was almost no difference between the
number of managers who said they had a guideline for preparedness for emergencies (47%), and
those who did not though the ones who said they had did not (53%), have a document to show.
The main safety procedures, policies or laws that were mentioned to be in place are fire
evacuation, insurance, availing necessary equipment, disciplinary action, providing first aid and
fire extinguishers while the defined work procedures stated were duty lists, job descriptions and
supervision. Most managers (53%) stated they did not offer protective clothing or equipment to
ensure safety, while those who said they did provided gloves, uniforms and gumboots which
were provided by the employer. However, most staff (57%) rated their working conditions in

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terms of safety as above average. Most of the respondents (staff 63%, managers 58%), stated that
there was a programme for safety training for staff in their workplace with no much difference
between the number of those who had first aid training (55%) and those who did not have (45%).
All schools had first aid boxes that were mainly placed in the kitchens, rooms and reception
areas. Also most managers (58%), said they did not have a system of reporting risks, hazards and
accidents. Majority of the headteachers/managers (95%) stated that they did not have a safety
committee and for those who had, it comprised of staff. Most managers (63%), also said risk
assessment audits and other safety routine inspections which are done mainly yearly or after 6
months.

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5.8.3 Awareness of the safety procedures by the pupils, staff and proprietors of primary
schools within Nairobi County.
When staff were on one hand asked if they were aware of safety regulations in their work areas,
most of them (80%), said they did yet when they were asked if they knew any other laws
governing occupational safety in the workplace, a majority (45%), said they didn‘t while of those
who said they did, most of them could not outline any. This makes it evident that staff are not
aware of the safety procedures, policies or laws governing the learning industry. This was
evidently confirmed by the majority of head teachers and managers (78%), who said their
schools had no safety procedures, policies or laws clearly laid out and mentioned that finances,
ignorance and lack of cooperation from proprietors as problems encountered in enforcing these
laws. While correlating variables, it was noted that there was no significant association between
the years worked and either the awareness of policies of occupational safety at workplace (r= -
.12, p>0.05), the awareness of safety requirement/regulations at workplace (r= -.09, p>0.05), and
the awareness of prevention measures at workplace (r= -.07, p>0.05). On the other hand, it was
also noted that there was a significant association between the education level of the respondents
and the awareness of policies of occupational safety at workplace (r= -.24, p<0.01), the
awareness of safety requirement/regulations at workplace (r= -.21, p<0.01) and the awareness of
prevention measures at workplace (r= -.18, p<0.05). It can therefore be concluded that the
awareness of safety rules/policies/regulation are influenced by the staffs‘ education level and not
necessarily their working year/experience. This means that at the work place, staff are not
educated on these issues and that the information and awareness they have is based on the formal
professional education one gets in learning institutions.
5.8.4 Preventive measures for Occupational Accidents in Schools within Nairobi County.
Most head teachers and managers (58%), stated that they ensure safety of staff through training.
The managers who said they offered training to their staff mainly offered it after several years
all staff. Those who did not offer training gave reasons as the organization not being keen on
safety and their having no equipment. Training may be expensive but presents the best
effectiveness outcome (Daltoy, 1997). As a preventive measure, the managers stated they ensure
safety of staff through training, availing necessary equipment, disciplinary action and providing
first aid and fire extinguishers. They added that they avoided accidents by avoiding carelessness,

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creating awareness, conducting routine checks, quick accident response, duty delegation,
provision of first aid kit and fire extinguishers, putting up appropriate notices, training and use of
proper equipments. Half the staff (51%), got written information on use of equipment while the
rest got the information verbally. A good number indicated the availability of warning signs,
protective gear, accessible fire exits, equipped first aid kits and provision of medical services as
safety measures and this concurred with the results of the observation checklist.

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5.8.5 Outline of the First Aid Course conditions and Injuries
Course Objectives:
At the end of the course, having passed the mandatory assessment,
the candidate will be competent in the skill needed to:
1. Manage an Incident in which people are ill or have been injured
2. Administer proper First Aid in a manner that is Prompt, Safe
and Effective
3. Take good care of the casualty (i.e.) until medical help is
available.
Course Contents
Introduction to First Aid
First aid is the help given to someone who is injured or ill, to keep them safe until they can get
more advanced medical treatment by seeing a doctor, health professional or go to hospital.
The role of a first aider is to give someone this help, while making sure that they and anyone else
involved are safe and that they don’t make the situation worse.
Incident Management
Always protect yourself first - never put yourself at risk
Only move the injured/sick to safety if leaving them would cause them more harm
If you can’t make an area safe, call 999/112 for emergency help
Communication and Delegation in emergency
Stay calm and take charge of the situation
Introduce yourself to the casualties to help gain their trust
Explain what’s happening and why
Say what you’re going to do before you do it

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Personal Protective Equipment (PPE)
Always use surgical gloves when attending to a casualty.
Initial Assessment
If there’s more than one casualty, help those with life-threatening conditions first
Start with the Primary Survey and deal with any life-threatening conditions
Then, if you’ve dealt with these successfully, move on to the Secondary Survey
Unconscious and NOT Breathing (Resuscitation/CPR)
AED (Defibrillation)
If they’re unconscious and not breathing, you’ll need to do CPR (cardiopulmonary resuscitation).
This involves giving someone a combination of chest compressions and rescue breaths to keep
their heart and circulation going. If you have an AED and is trained to use it defibrillate the
casualty.
If they start breathing normally again, stop CPR and put them in the recovery position.
Unconscious BUT Breathing (Recovery Position)
Conduct primary and secondary survey and then put the casualty into a recovery position.
Contact the 999/911.
Disorders of Airway and Breathing: (Hypoxia, Choking,
Asthma, Drowning, Hyperventilation… etc)
CHOKING
Encourage them to cough. If this doesn't clear the obstruction, support their upper body with one hand
and help them lean forward. If coughing doesn’t work, help the casualty bend forward. Use the
heel of your hand to give up to five sharp back blows between their shoulder blades. Check their
mouth to see if there’s anything in there and, if there is, get them to pick it out. If back blows
don’t work, give up to five abdominal thrusts.Stand behind them.Link your hands between their
tummy button and the bottom of their chest, with your lower hand clenched in a fist. Pull sharply
inwards and upwards.

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If they’re still choking, repeat steps 2 and 3 – back blows and abdominal thrusts – up to three
times or until you’ve dislodged what’s in there and they can breathe again.
ASTHMA
First, reassure them and ask them to breathe slowly and deeply which will help them control
their breathing.
Then help them use their reliever inhaler straight away. This should relieve the attack.
Next, sit them down in a comfortable position.
If it doesn’t get better within a few minutes, it may be a severe attack. Get them to take one or
two puffs of their inhaler every two minutes, until they’ve had 10 puffs.
If the attack is severe and they are getting worse or becoming exhausted, or if this is their first
attack, then call 999/112 for an ambulance.
Help them to keep using their inhaler if they need to. Keep checking their breathing, pulse and
level of response.
If they lose consciousness at any point, open their airway, check their breathing and prepare to
treat someone who’s become unconscious.
Disorders of Circulation (Internal and External Bleeding, Shock,
Heart Disorders,…Fainting)
FAINTING
Kneel down next to them and raise their legs, supporting their ankles on your shoulders to help
blood flow back to the brain. Watch their face for signs that they’re recovering.
Make sure that they have plenty of fresh air – ask bystanders to move away and if you’re inside
then ask someone to open a window.
Reassure the casualty and help them to sit up slowly.
If they don’t regain consciousness again quickly, open their airway, check their breathing and
prepare to treat someone who is unconscious.

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SHOCK
If they are showing signs of shock:
Lay them down with their head low and legs raised and supported, to increase the flow of blood
to their head.
Call 999 or 112 for medical help and say you think they are in shock, and explain what you think
caused it (such as bleeding or a heart attack).
Loosen any tight clothing around the neck, chest and waist to make sure it doesn’t constrict their
blood flow
Fear and pain can make shock worse, by increasing the body’s demand for oxygen, so while you
wait for help to arrive, it’s important to keep them comfortable, warm and calm. Do this by
covering them with a coat or blanket and comforting and reassuring them
Keep checking their breathing, pulse and level of response.
If they lose consciousness at any point, open their airway, check their breathing, and prepare to
treat someone who has become unconscious.
HEART ATTACK
Call 999 or 112 for medical help and say you think someone is having a heart attack.
Then, help move them into the most comfortable position. The best position is on the floor
leaning against a wall with knees bent and head and shoulders supported. This should ease the
pressure on their heart and stop them hurting themselves if they collapse.
Give them a 300mg aspirin, if available and they're not allergic, and tell them to chew it slowly.
Be aware that they may develop shock. Shock does not mean emotional shock, but is a life-
threatening condition, which can be brought on by a heart attack.
If they lose consciousness at any point, open their airway, check their breathing, and prepare to
treat someone who has become unconscious. You may need to do CPR.

26
Clean the wound by rinsing it under running water or using alcohol-free wipes.
Pat it dry using a gauze swab and cover it with sterile gauze. If you don’t have these, then use a
clean, non-fluffy cloth.
Raise and support the part of the body that’s injured. If it’s a hand or arm, raise it above the head.
If it’s a lower limb, lay them down and raise the cut area above the level of the heart. This will
help stop the bleeding.
Remove the gauze covering the wound and apply a sterile dressing. If you think there’s any risk
of infection then suggest they see a health care professional.
Poisons and Poisoning in the Workplace…
If the person is conscious, ask them what they have swallowed, how much and when. Look for
clues, like plants, berries or empty packaging and containers. Call 999 or 112 for medical help
and tell them as much information as possible.
If they become unconscious, open their airway and check breathing. Follow the instructions for
treating someone who is unconscious.
Never try to make the person vomit, but if they vomit naturally then put some of their vomit into
a bag or container and give it to the ambulance. This may help them identify the poison.
Burns and Scalds
Stop the burning getting any worse, by moving the casualty away from the source of heat.
Start cooling the burn as quickly as possible. Run it under cool water for at least ten minutes or
until the pain feels better. (Don’t use ice, creams or gels – they can damage tissues and increase
risk of infection). Assess how bad the burn is. It is serious if it is: larger than the size of the
casualty's hand, on the face, hands or feet, or a deep burn
If it is serious, call 999 or 112 for emergency medical help.
Remove any jewellery or clothing near the burn (unless it is stuck to it).
Cover the burned area with kitchen cling film or another clean, non-fluffy material, like a clean
plastic bag. This will protect from infection.

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If necessary, treat for shock (shock is a life-threatening condition, not to be confused with
emotional shock).If you are unsure if the burn is serious then tell the person to see a doctor.
Head Injuries and spinal injuries (Concussion, Compression, Skull Fracture
etc)…Disorders of the Brain (Stroke, Epilepsy, Diabetes…)
If you think the casualty could have a spinal injury, you must keep their neck as still as possible. Instead
of tilting their neck, use the jaw thrust technique: place your hands on either side of their face and with
your fingertips gently lift the jaw to open the airway, avoiding any movement of their neck.
DIABETES
What you need to do ‒ for high blood sugar (hyperglycemia)
Call 999 or 112 straight away for medical help and say that you suspect hyperglycemia.
While you wait for help to arrive, keep checking their breathing, pulse and level of response.
What you need to do ‒ for low blood sugar (hypoglycemia)
Help them sit down. If they have their own glucose gel, help them take it. If not, you need to give
them something sugary like fruit juice, a fizzy drink, two teaspoons of sugar, or sugary sweets.
If they improve quickly, give them more sugary food or drink and let them rest. If they have their
glucose testing kit with them, help them use it to check their glucose level. Stay with them until
they feel completely better.
If they do not improve quickly, look for any other causes and then call 999 or 112 for medical
help.
While waiting, keep checking their responsiveness, breathing and pulse.
What you need to do ‒ if you’re unsure whether their blood
sugar is high or low
If you’re not sure whether someone has high or low blood sugar, give them something sugary
anyway, as this will quickly relieve low blood sugar and is unlikely to do harm in cases of high
blood sugar

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If they don’t improve quickly, call 999 or 112 for medical help.
Fractures and Soft tissue injuries….
If it is an open fracture, cover the wound with a sterile dressing and secure it with a bandage.
Apply pressure around the wound to control any bleeding.
Support the injured body part to stop it from moving. This should ease any pain and prevent any
further damage.
Once you’ve done this, call 999 or 112 for medical help. While waiting for help to arrive, don’t
move them unless they’re in immediate danger.
Protect the injured area by using bandages to secure it to an uninjured part of the body to stop it
from moving. For example, fractures on the arm can be secured with a sling, and a leg with a
fracture can be tied to the uninjured leg. Keep checking the casualty for signs of shock. This does
not mean emotional shock, but is a life-threatening condition, often caused by losing blood.
Soft tissue injuries
Help them to sit or lie down and support in a comfortable raised position the part they’ve hurt.
To cool the area, apply a cold compress, like an ice pack or cold pad. This will help to reduce the
swelling, bruising and pain. Do not leave on for more than ten minutes.
Leave the cold compress in place or wrap a soft layer of padding, e.g. cotton wool, around the area. Tie a
support bandage around it, to hold it in place, which goes up as far as the next joint on each side. For
example, for an ankle injury, the bandages should go from the base of the toes to the knees.
Elevate the injury and support it with something soft, like cushions.
If the pain is severe, or they can’t use their limb at all, take or send them to hospital. Otherwise,
just tell them to rest it and to see a health care professional, if necessary.

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Common Infections and their prevention
If someone has any of the signs of meningitis, like shielding their eyes from the light, call 999 or
112 for emergency medical help straight away and treat the fever.
Check to see if they have a rash, with most rashes if you press the spots with the side of a glass,
the spots will fade – if they don’t fade, call 999 or 112 for medical help at once.
While you’re waiting for help to arrive, reassure them and keep them cool.
Keep checking their breathing, pulse and level of response
Other conditions like allergic reactions, epilepsy, stroke, medical conditions, and infectious
diseases are covered in the course.
Specifics hazards in the work place
Electrical and chemical safety and preventive culture.
Lifting and Carrying
Different methods of evacuating and transporting casualties.
Contents of a First Aid Box
Examination at the end of the course.

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5.9 DISCUSSIONS/IMPLICATIONS OF FINDINGS
The findings show that without clear safety procedures and policies within the learning
institutions, the staffs working in these primary schools are more prone to accidents since most
of them are not aware of them thus having a considerable percentage of them rating their
working conditions as average, poor and very poor leading to occurrence of common accidents.
The findings also provide insight on the fact that though head teachers and managers have
training programmes for the prevention and provide protective clothing and equipment,
guidelines for preparedness for emergencies are not clearly stipulated due to lack of
documentation and worse still, a considerable number of staff are not trained on first aid. This
however can be attributed to the high turnover levels shown by the way most staff are in their
current employment for the past three years and below. Without a system of reporting risks,
hazards and accidents in most primary schools implies that accident cases are not properly
recorded and for any improvement in terms of occupational health and safety of workers to be
implemented, this will need to be corrected. Despite staff and managers indicating they had had
risk assessment audits and safety policy statements, these were not documented or made
available to staff since they were not in a position to outline safety regulations or state laws
governing occupational safety in their work areas. This could be easily handled by safety
committees or worker‘s unions which are not existent in a number of the primary schools. This
would also be complimented by the fact that most of these staff are relatively young and literate.
5.10 CONCLUSIONS
The results of the study and interpretation of its findings has provided information that can be
used to develop a policy on emergency preparedness guideline for learning institutions since
majority (53%) of the headteachers/school managers who were interviewed were not aware on
its existence. Concerning policy guidelines, most schools had no safety procedures, policies or
laws. Most of them also neither had guidelines for preparedness for emergencies or a system for
reporting risks hazards and accidents. Contrary to the OHS Act(2007) requirement, most of the
schools had no safety committees and few had first aid boxes and fire extinguishers. Very few of
them also had safety training programmes and did assessment audits regularly.

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In terms of awareness, it was noted that though staff claimed to be aware of safety regulations,
safety procedures and policies or laws governing the learning institutions, most of them could
not outline any. On preventive measures in place, the study found out that safety is ensured
through training, availing necessary equipment and disciplinary action for breach of safety rules.
Accidents were controlled by avoiding carelessness, creating awareness, conducting routine
checks and allocation of duties.

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5.11 RECOMMENDATIONS FOR POLICY
learning
institutions and provide allocations of the necessary resources for its implementations.
in learning institutions should be
restructured to conform to international standards. Short courses, seminars and conferences
should be encouraged. The ministry of education should include in their curriculum safety and
health aspects as this would contribute to behavioral change and enhancement of a positive
safety culture.
learning institutions should be encouraged to have in place functional
Job Safety Analysis (JSA) procedures.
NEMA) should be vigilant in safety
management audit processes which should be put in place in all work places and the results
disseminated to staff and all stakeholders for effective implementation.
ace for data
collection and access to information related to and all stakeholders should have means of access.
learning institutions should also keep clear records of their health and safety activities and
occurrences.
ivergent views on occupational accidents, awareness and
prevention within primary schools in Nairobi County, there is need for further research to
compare the possible outcomes.
5.12 RECOMMENDATIONS FOR FURTHER RESEARCH
- Research should be done to evaluate if poverty, job insecurity, informal employment, high labour
turnover and low education standards play a role in the state of occupational health and safety

33
within the learning insitutions. - Research can also explore the effects of staff workload Vis a Vis
staff shortage on safety.
The research can also focus on the applicability of Occupational Health and safety sensitization in
the school’s curriculums and more so First Aid course in the primary schools.
6.0 REFERENCES
Packard, R., (1989). Industrial Production, Health and Disease in Sub-Saharan Africa. 28:475
Republic of Kenya, (1990). Factories And Other Places Of Work, Cap 514, Laws of Kenya.
Government Printing Press, Kenya.
Republic of Kenya, (2004). Factories and Other Places Of Work, Cap 514, (Safety and Health
Committee) Rules, Legal Notice No. 31, Laws of Kenya, Government Printing Press, Kenya.

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QUESTIONAIRRE
Section A: DEMOGRAPHIC INFORMATION
1. Respondent No. _________
2. Name of School _________________________________
3. Section/ Department ____________________________
4. Designation/Job description ______________________
5. Age
Under 18 18 - 25 26-35 36-45 45 and above
6. Sex
Male Female
7. Number of years worked in current employment
6 months &
below
6 months – 1
year
1 years - 3
years
3 years - 5
years
5 years and
above
8. Level of education
Primary Secondary Diploma University Other
Section B: AWARENESS
1. Are there any outlined safety regulations in your work areas that you are aware of? Yes No
If yes, outline them __________________________________________________
2. Is there a safety policy statement in your workplace?
Yes No
3. Do you know any other laws governing occupational safety at your workplace?
Yes No

35
If yes, state them ___________________________________________
_________________________________________________________
4. Who is responsible for the implementation of safe working conditions at the School?
Employer Supervisor Self
Section C: PREVENTION
1. Tick the safety measures taken in the workplace.
ion of an equipped first aid kit
2. How do you get information on use of equipment,
Written Verbally Self discovery
3. Outline what the School has done to prepare you for an emergency?
__________________________________________________________________
4. How would you rate your working conditions in terms of safety?
V. Good Good Average Poor V. poor
Section D: PROCEDURES AND POLICIES
1. Have you had any first aid training?
Yes No If yes i) who was the facilitator? __________________________
ii) When? Less than 2 yrs ago More than 2 yrs ago

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2. Is there a programme for safety training for staff? Yes No
If yes,
i. When is it done? On employment during employment
ii. How often is it done? Weekly Monthly Yearly
Other _________________________
3. Have you or any of your colleagues been involved in an accident while working?
Yes No If yes,
i. What type of accident was it? Tick the type of accident.
ii. What do you think contributed to the above named accident?
4.Do you have a workers‘ union?
Yes No If yes, do the union leaders
i. Hold seminars to educate staff on their health and safety rights?
Yes No
ii. In your opinion, do they support staff who are injured to your satisfaction? Yes No
5. Is there a procedure for reporting accidents?
6. Are the pupils trained on First aid and any safety sensitization?

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