(e) Tobacco, lime, beetle-nuts, and alcohol intake
(f) AIDS is found mostly with generalized skin cancer called Kaposi's sarcoma
(g) Some of the bacteria and viruses: For example:
a. Liver cancer by Hepatitis- B virus
b. Gastric cancer by Helicobacter pylori
c. Cervical cancer in females by Human Papilloma Virus (HPV)
(h) Untreated wound for a long period of time
(i) Disturbance of hormonal activities in the body
(j) Excessive exposure to sunlight
Signs and symptoms of cancer
(k) Abnormal growth and thickening of body parts
(l) Unhealed wounds with irregular bleeding for a long period of time
(m) Unsolved indigestion for a long period of time
(n) Growth of tumors, wart, or moles
(o) Pale appearance and fatigue
Prevention and control of cancer
(a) Adoption of healthful habits like proper exercise and rest, intake of healthy
and hygienic diet, yoga and meditation, etc. It is estimated that about forty
percent chance of cancer is reduced just through healthful habits only
(c) Excessive exposure to sunlight and any other strong rays should be
avoided
(c) Early diagnosis of cancer and timely attention to any abnormal growth or
tumors or unhealed sores and wounds
(d) Mothers should continue breast feeding to her baby throughout the full
lactation period.
(e) Wounds should be treated timely
(d) Diabetes
Diabetes is a non-communicable disease prevalent all over the world. It is
noticed more in developed countries. This disease is caused when there is excess
accumulation of carbohydrate and sugar in the body with no proper utilization
of them. People who do not perform regular physical labour or exercise become
the victims of diabetes easily. Diabetes is a disease in which sugar level in the
blood is more than normal. The normal range of sugar is 70-120 mg% in the
blood before meal. After having a meal, glucose level increases up to 140 mg%
in the blood. A diabetic person has increased glucose level compared to a normal
person. First onset of diabetes is characterized by increased glucose in blood
but in the later stage sugar level of urine also increases. It is a chronic disease
that occurs when the pancreas does not produce adequate amount of insulin,
or alternatively, when the body cannot effectively use the insulin. Insulin is a
Health and Physical Education - 8 51
hormone produced from the pancreas that regulates blood sugar. This chronic22
disease cannot be controlled easily and it leads to serious damage to many of
the organs including retina of eyes, the nerves, and blood vessels too. Infections
in other parts of the body cannot be healed easily in diabetics.
Signs and symptoms of diabetes
a) The first sign of diabetes is frequent urination followed by excessive thirst.
b) Sweating increases remarkably.
c) Excessive hunger but gradual weight loss.
d) Increased fatigue and lethargy.
e) Increased irritation and itching.
f) Weakness and fatigue in the patient.
If it is not diagnosed in time, other chronic diseases are developed in a diabetic
person. Some of the common chronic diseases are diabetic retinopathy, diabetic
neuropathy, diabetic cardiovascular disease, and diabetic kidney failure.
Prevention and Control of Diabetes
(i) Develop healthier food habit.
(ii) Avoid spicy, oily, fatty, and unhealthy food.
(iii) Reduce consumption of carbohydrates and fats.
(iv) Avoid tobacco and alcohol use.
(v) Perform physical exercises or yoga on a regular basis.
(vi) Maintain physical fitness. Obesity and overweight are the risk factors of
diabetes.
(vii) Control mental tensions and live with happiness.
(viii) Monitor the glucose level frequently.
(ix) If sugar level is increased, follow the doctor's advice. Take the foods for
diabetic patients only.
(e) Heart Diseases
I. Heart Attack (Myocardial Infarction, MI)
It is one of the major fatal Superior Arota
diseases in the world. The vana cava
earlier symptoms of heart Left pulmonary
attack include shortness of Right veins
breath and pain in the chest. pulmonary
The patient may die suddenly Left atrium
due to heart attack. Excessive veins
use of fatty foods and food Right atrium Inter-ventricula
containing cholesterol causes Coronary sulcus sulcus
arteriostenosis or narrowing of
the arteries. The blood vessel Inferior vena cava Left ventricle
that supplies blood to the heart
muscle (i.e. coronary artery) is Coronary
blood vessels
22 Chronic = Diseases that remain persistent for a long time Right ventricle
52 Health and Physical Education - 8
very thin and small obstacle like a blood clot may block the supply of blood
completely or partially. As a result, some portion of heart muscle is deprived of
oxygen and other nutrients. Then the heart muscle loses the strength to pump
blood out into the arteries.
Ultimately, the portion of heart-muscle starts dying too. This condition is known
as heart attack. Most of the patients of heart attack experience some symptoms.
Some may not have any symptoms and they may die suddenly of cardiac arrest
or sudden stoppage of heartbeat.
Symptoms of heart attack
(i) Persistent chest discomfort
(ii) Frequent burning pain in the chest
(iii) Shortness of breath
(iv) Abnormal sweating
(v) Palpitations (feeling of heartbeat over the ribs)
(vi) Lightheadedness, fatigue, and fainting
(vii) Sudden death due to cardiac arrest, if not treated in time.
Preventive measures for heart attack
(i) Acquire education and awareness regarding heart diseases
(ii) Adopt healthy food habits. Avoid intake of tobacco, alcohol, drugs.
Avoid oily, spicy, and fatty foods
(iii) Avoid intake of sugar and excessive carbohydrates
(iv) Increase intake of healthier food items. Always be careful about balanced
diet. Increase the intake of vegetables, fibrous foods, and fruits
(v) Obesity increases workload to the heart. Excessive fatness can be reduced
by doing regular physical exercise, yoga, and adopting good food habit
(vi) Reduce mental tension, anxiety, and depression
(vii) Maintain physical, mental, and social health as well
(viii) Routine checkup of blood pressure indicates the probability of heart
attack
(II) High Blood Pressure (Hypertension)
Blood is a fluid connective tissue that circulates throughout our body through
many blood vessels. Blood exerts pressure on the wall of these blood vessels.
The pressure exerted by blood on the wall of arteries is known as blood pressure
or BP. It is also known as hypertension. Blood pressure is not consistent in our
body. It is high when the heart contracts and pumps blood towards the vessels.
Blood pressure at this time is known as systolic blood pressure and its value in
a normal individual is 120 mmHg. Adversely, it is low when the heart dilates
to receive blood. This pressure is called as diastolic blood pressure and its
normal value is 80 mmHg. When the medical practitioners examine our blood
Health and Physical Education - 8 53
pressure, they mention it with systolic and diastolic values as in numerator
and denominator respectively. Normal blood pressure=120/80 mmHg. Blood
pressure is measured with a special instrument called sphygmomanometer.
If the pressure of blood on the wall of arteries rises and exceeds 130/90 mmHg,
this condition is called high blood pressure. High blood pressure can be felt with
the fingertip at the site of pulses as sharp and distinct beating. Hypertension
has become a growing health problem all over the world nowadays. Its victims
are increasing day by day. It attacks people at the later adulthood of life after the
age of about 40 years and more. People who do not perform regular physical
labour or exercise and eat more amount of fatty, oily, and spicy food for a long
period of time are mostly found to be affected by hypertension.
Causes of hypertension
(i) Lack of physical labour or exercise
(ii) Intake of fatty, oily, spicy, salty food for a long time
(iii) Accumulation of fat and cholesterol on the inner wall of blood vessels
(iv) Excessive mental tension
(v) Abuse of alcohol, tobacco, or drugs
(vi) Dysfunctions of different endocrine glands present in our body
(vii) Obesity and gastrointestinal diseases
Symptoms of hypertension
(i) Persistent headache
(ii) Vertigo and delusion
(iii) Increased mental tensions
(iv) Loss of self control in emotional extremes like anger and frustrations
(v) Insomnia, loss of sleep
(vi) Fainting sometimes and even death not treated in time
Prevention and control of hypertension
(i) Regular physical exercise
(ii) Intake of fibrous and hygienic food
(iii) Avoidance of fatty, oily, spicy, and hot food items
(iv) Regular health check-up
(v) Education and awareness
(vi) Harmony and good relationship with family members and friends
(vii) Avoidance of burden and activities which are not of interest
(III) Low Blood Pressure (Hypotension)
We have already discussed about blood pressure and its normal values in the
human body. If the value of systolic and diastolic blood pressures are less than
90/60 mmHg, this condition is called as low blood pressure. This is also called
as hypotension. Hypotension is not as prevalent as hypertension in the world.
Causes of hypotension
54 Health and Physical Education - 8
(i) Lack of nutrients and balanced diet
(ii) Hunger and starvation for a long period of time
(iii) Hormonal imbalances due to various reasons
(iv) Continuous hard work and restlessness
(v) Loss of blood in excessive amount due to accidents and injuries
Symptoms of Hypotension
(i) Weakness and fatigue
(ii) Low and weak heartbeat
(iii) Random vertigo and imbalance of body
(iv) Less circulation of blood
Prevention and control of hypotension
(i) Intake of balanced and nutritious food
(ii) Avoidance of alcohol, tobacco, and drugs
(iii) Avoidance of fatty, oily, spicy, junk, and street foods
(iv) Regular exercise and rest
(v) Education and awareness
(vi) Regular health check-up
(vii) Harmonious and good relationships between family membranes and
friends
(IV) Rheumatic heart disease
Rheumatic heart disease is mostly found in the children under fifteen years of
age. It is associated with joint pains and infections of the bones and joints. Germs
developed in the body during the conditions of tonsillitis23 and pharyngitis24 are
the main causes of rheumatic heart disease. In the age interval between three
to fifteen years, the onsets of tonsillitis and pharyngitis are found to be very
common in children. If these are not treated properly and the onset is very
often, the patient is vulnerable to the infection of bacteria called "Beta-Hemolitis
Streptococcus Group-A". The bacteria travel in the body along the bloodstream
and reach the joints and heart. In the joints, they cause pain and swelling. Due
to the presence of bacteria and their activities the victim gets fever too. The
situation of these collective symptoms is termed as 'rheumatic fever'. In the
heart, it damages delicate heart valves. Children suffering from rheumatic fever
have damaged heart valves and heart muscles. About 50 percent of the total
infected children have rheumatic heart diseases. Damage to the heart muscle
and heart valves from rheumatic fever, caused by Streptococcal bacteria25 is
called rheumatic heart disease. Rheumatic fever and rheumatic heart disease are
two stages of the effects of the same causative agent. Rheumatic fever is the first
23 Tonsillitis: inflammation of tonsils
24 Pharyngitis: inflammation of pharynx
25 Streptococcal bacteria: a kind of Gram-positive spherical bacteria
Health and Physical Education - 8 55
stage of rheumatic heart disease. In order to prevent rheumatic heart diseases,
sore throat, tonsillitis, and pharyngitis should be treated properly in time.
Antibiotic may be necessary to cure the sore throat, tonsillitis, and pharyngitis.
Prevention of rheumatic heart disease and rheumatic fever
• Adopt hygienic and healthy lifestyle.
• Remain safe from throat infections.
• Get treated earlier if there is an onset of tonsillitis and pharyngitis.
Exercise
A. Answer the following questions.
1. What do you mean by disease? Differentiate between communicable and
non-communicable diseases.
2. Describe any three methods of prevention from communicable diseases.
3. What is the situation of HIV/AIDS in the world? What are the modes of
communication of HIV/AIDS?
4. Differentiate between HIV and AIDS.
5. What do you mean by the ABC method for the prevention of STDs?
6. Write any two identifying symptoms of
a) Encephalitis b) Meningitis c) Hepatitis
7. How is diabetes caused? What are the preventive measures against
diabetes?
8. Write any three symptoms of
a) Asthma b) Stone c) Cancer d) Heart attack
9. List the causes of hypertension and rheumatic heart disease.
B. Fill in the blanks.
1. The inflammation of meanings is called. ………………
2. The full form of HIV is Human …………………. Virus.
3. When the number of cells of our body increases abnormally, the condition
is called …………..
4. ………….disease is characterized by increased glucose level in blood.
5. Normal diastolic blood pressure of human body is…… mmHg.
6. The name of vaccine that prevents tuberculosis disease is ………….
56 Health and Physical Education - 8
5
Adolescence, Sex
And Reproductive
Health
Before You Proceed to the Text
ACTIVITY-A MINI RESEARCH WORK four years
Are you an adolescent? What do people think about b. Few of my friends of opposite sexes are naturally
your age and developmental characteristics of your not closer as earlier
present life? Choose any ten of your intimate friends c. Closeness is more intimate with the friends of
and conduct a research with the help of following MCQs same sex
(Multiple-Choice Questions). Do not collect the names of d. Closeness is more intimate with the friends of
your respondents/friends. Give a printed, photocopied, opposite sex
or a handwritten form to each of your friend. Request 8. Which of your body system has experienced more
them just to mention their gender (male or female) and changes during the last two years? ?
age in the form. a. Reproductive b. Digestive
MINI-RESEARCH QUESTIONNAIRE c. Urinary d. Nervous
RESPONDENT'S AGE: ……Years. SEX: Male o 9. Have you ever seen any contraceptive device like
Female o condom or pills in reality?
Please tick the best answers a. Yes, at my home
1. Which of the developmental stage do you belong to? b. Yes, with my friend
a. Baby b. Child c. Adolescent d. Adult c. Yes, at other place, (………………………….)
2. What do your parents tell about your developmental stage? d. Never seen
a. Baby b. Child c. Adolescent d. Adult 10. Have you ever watched or heard any advertisement
3. What do your friends tell about your developmental of contraceptive device?
stage? a. Yes, from radio
a. Baby b. Child c. Adolescent d. Adult b. Yes, in television
4. Whatdoyourteacherstellaboutyourdevelopmentalstage? c. Yes, in papers
a. Baby b. Child c. Adolescent d. Adult d. Never seen
5. How do you label the changes on your body within 11. Do you think it is good to talk and share the matters
last two years? of reproductive health and contraceptive devices
a. No change at all with others?
b. Changes are there but it is not known to others a. Yes, but only to close friends
c. Changes has made me noticeably different b. Yes, but only with siblings
d. Changes are unexpectedly more c. Yes, but only with sex partner
6. Have the differences made change in your lifestyle? d. No, not necessary
a. Not at all 12. What would you choose if you are powered to change
b. To some insignificant extent your gender now for only one time in your life?
c. I have to be more careful about my body and health a. I am a girl now. I would be a boy if so.
d. The differences has reduced the risks down b. I am a boy now. I would be a girl if so.
7. How have you changed your friends' circle within c. I am happy for being a girl
the last four years? d. I am happy for being a boy
a. The friends' circle now is as it was before three or
Collect all the forms and prepare a short report analyzing the answers from the respondents. Present your report in the class
and put it for comments and discussion among your friends and the teacher.
Health and Physical Education - 8 57
5.1 Responsibilities of adolescents
Adolescence is the period of rapid growth and development. According to WHO,
adolescents are the people in the age group 10-19 years. There are several physical,
mental, social, and emotional changes during adolescence. The achievement of
a person during adolescence is regarded as the base for adulthood. Therefore, the
adolescents should be sincere for their future career at this age. Besides, they have
different responsibilities towards themselves, their families, society, and the nation.
a. Personal responsibilities
i. Maintain personal health and hygiene to become a healthy person.
ii. Become active for shaping future career by studying, training, and having
work experiences.
iii. Follow the guidelines of guardians, teachers, and the senior members of the society.
iv. Abstain from tobacco, alcohol, and drugs.
v. Take proper care about the sexual and reproductive health. Accept the
changes in primary and secondary sex characteristics positively.
vi. Share your ideas and knowledge with your friends and family members to
keep themselves healthy and happy.
b. Responsibilities towards their family
i. Maintain good relationships with the senior and junior members of the family.
ii. Give proper attention to the issues of family health like food, drinking
water, indoor sanitation, etc.
iii. Become cooperative for the accomplishment of family works.
iv. Stand against the superstitious and unscientific health practices and
motivate the family towards scientific health practices.
v. Pay proper attention to the issues like immunization, nutrition, and healthful
behaviours.
vi. Share your ideas and knowledge with your family members to motivate
them for the contribution towards your family.
c. Responsibilities towards their community and nation
i. Maintain good relationships with the members of the society. Always show
caring and loving behaviours towards children and modest respect towards
the senior members.
ii. Show a genuine respect towards the existing social norms and values.
iii. Advocate against unscientific, unhealthy and superstitious practices in the society.
iv. Participate yourself in the social works and activities.
v. Makeyouramplecontributionstothepreservationofnaturalandculturalheritages.
vi. Share your ideas and knowledge about the personal responsibilities of
citizen towards their community and nation with others.
58 Health and Physical Education - 8
5.2 Safer sexual behaviours
Sexual behaviours are the activities related to reproductive and sexual phenomena
of human body. It is primarily determined by the knowledge and attitude of an
individual to human sexuality. It is very important that the adolescents pay proper
attention to safer sexual behaviours. Because of production of sex hormones and
development of reproductive organs, the adolescents develop curiosity and interest
in sex-related matters. They naturally experience sexual desires as well. In such
situation, the adolescents should be guided properly with education and counseling.
Some of the guidelines for safer sexual behaviours are:
i. Have proper knowledge about human sexuality and accept the changes on
primary and secondary sex-characteristics positively.
ii. Protect yourself from:
a. Unhealthy sexual behaviours (Having sex with the victims of STIs like HIV/
AIDS, gonorrhea, syphilis etc., animal sex, anal sex, etc.)
b. Unsafe sexual behaviours (Having sex without using condom properly)
c. Illegal sexual behaviours (Having sex within blood-relation or minors, rape, etc.)
d. Immoral sexual behaviours (Sexual relation before marriage, sexual relation
against social norms and values).
iii. Show respectful behaviour to the people of opposite gender. Always stand
against teasing, mocking, bullying, harassing, etc.
5.3 Reproductive health
In simple words, reproductive health is the state of health affected by one's reproductive
processes and phenomenon of human body. Reproduction is the process of producing
offspring by the living things. Human health encompasses physical, mental, social,
and emotional aspects. In this light, reproductive health can be defined as the state of
health primarily concerned with the physical, mental, social, and emotional aspects of
human sexuality and reproduction. According to WHO (World Health Organization),
"Reproductive health is a state of complete physical, mental, and social well-being
and not merely the absence of diseases or infirmities in all the matters related to the
reproductive system and to its functions and processes."
Reproductive health is, nowadays, taken in broader sense. It is also concerned with
appropriate age at marriage, problems of pregnancy and child birth, unsafe sex
behaviours, and prevention from sexually transmitted infections.
Health and Physical Education - 8 59
5.4 Safe Abortion
5.4.1 Concept
Abortion is the deliberate ending of a pregnancy at an early stage. It is
traditionally practiced in illegal and unscientific ways like inducing trauma1,
inserting toxic2 substances into the uterus, or by intake of abortive substance
orally. Such superstitious practices are very often harmful to the health of
pregnant woman and sometimes it becomes fatal3.
Safe abortion is a medical and scientific procedure to end an unwanted pregnancy
at an early stage. Abortion should be safe from the point of views of physical,
legal, psychological, and emotional aspects. In broader sense, safe abortion can
be defined as the process of ending or terminating a pregnancy according to the
‘Safe Abortion Service Process 2060’4 by a legally licensed health practitioner.
‘Safe Abortion Service Process 2060’ has clearly made different provisions for
safe and unsafe abortion. Registered and listed medical practitioners and health
service providing centres are providing comprehensive abortion care (CAC)
services in Nepal.
5.4.2 Legal conditions of abortion
Abortion is legal only with the consent of the pregnant mother. Only the pregnant
woman holds the right to choose to continue or terminate the pregnancy. If
the pregnant woman is less than 16 years of age or not in a position to give
her consent (unconscious or mentally impairment), the nearest guardian or
relative can give the consent of abortion services. The following conditions are
considered legal.
i. Up to 12 weeks of gestation5: According to the desire of pregnant woman.
ii. Up to 18 weeks of gestation: If the conception is due to rape6 or incest7.
iii. At any time before delivery of the baby: If a certified doctor prescribes
abortion because of
a. Threat to the mother’s life.
b. Possibility of severe harm to the mother’s physical or mental health.
c. If the foetus is suffering from a severely debilitating or fatal deformity as
certified by a registered physician.
5.4.3 Techniques of safe abortion
1 Trauma=an injury
2 Toxic=poisonous
3 Fatal=causing or ending in death
4 ‘Safe Abortion Service Process 2060’=A legal provision promulgated by Nepal Government in
2060 BS to control unsafe abortion in Nepal
5 Gestation=pregnancy
6 Rape=to have sex with somebody by force or by threatening
7 Incest=sexual activity between two people who are very closely related in a family, for example
a brother and sister, or a father and daughter
60 Health and Physical Education - 8
Safe abortion can be done in the following ways:
a. By oral medication for the termination of gestation up to 9 weeks (63 days)
b. By using the medical instruments and surgical procedure for the termination
of gestation up to 12 weeks.
5.4.4 Illegal abortion
Abortion is illegal in the following conditions:
a. Termination of any gestation for the sole purpose of sex selection after
determining the sex of the foetus.
b. By forcing, luring, threatening, or such any other unethical activities.
c. By adopting any other traditional, superstitious, or illegal method except
indicated by the law of Nepal.
5.4.5 Unsafe abortion and its harmful effects
Unsafe abortion is the process of ending or terminating a pregnancy by any
traditional, superstitious, and unscientific method that is against the existing
law of Nepal. Unsafe abortion has the following adverse consequences.
i. Threat to the life of mother
ii. Probability of cessation8 of fecundity9 power of the mother
iii. Infection in the uterus (womb) and other reproductive organs of the mother
iv. Chronic10 pain in the lower abdomen
v. Legal punishment and penalty
vi. Condition that may lead to the excision of the uterus
5.5 Concept of contraception
Contraception is a method of preventing a woman from becoming pregnant. When
a male and a female have desire to have sex but not a child, they use any one of
the various methods of contraception. Contraception includes the methods and tools
which prevent fertilization of the ovum by sperm. This situation eliminates the chance
of conception and gestation.
5.6 Methods of contraception
The methods of contraception can be classified into two groups, i.e. natural and
artificial methods of contraception. The artificial methods of contraception are further
categorized into temporary, emergency, and permanent methods.
8 Cessation=a pause or stoppage, termination of the capacity 61
9 Fecundity=the biological capacity or potentiality to bear a baby
10 Chronic=long term, not healing in short time
Health and Physical Education - 8
Contraceptive Methods
Natural Artificial
Calendar method
Withdrawal Temporary Permanent Emergency
COC IUCD
(Coitusinterrupts)
method
Female Male
Cervical Mucus Pills Female Male
method IUD Condom
Basal Body Foam tablet Vasectomy
Temperature Norplant Minilap
method Depo-Provera
Breast feeding Femidom Laparoscopy
method
Fig. Contraceptive Methods and Devices
5.6.1. Natural methods of contraception
Natural methods of contraception do not need any artificial devices. It is the
method of preventing gestation by natural system. The following techniques
are followed in the natural methods.
i. Calendar Method: A method in which the fertile and infertile time of woman
is calculated on the basis of menstrual period and having sex restricted
within the infertile period.
ii. Withdrawal Method: A method followed by males in which the sperm and
semen are ejaculated outside the vagina.
iii. Cervical Mucus Method: A method in which the viscosity11 and stickiness
12of mucus secreted by the cervix13 of woman is tested to determine the
fertility and having sex only if the mucus is thin and watery.
iv. Basal Body Temperature (Bbt) Method: A method of natural contraception
in which the fertile time is estimated with a slight increment of woman’s
body temperature and having sex only during the infertile period.
v. Breastfeeding Method: A method of contraception by extending the
breastfeeding tenure after the birth of a baby. Following the rule, ‘longer the
breastfeeding period, lesser the chance of conception.’
5.6.2. Artificial methods of contraception
Artificial methods of contraception need artificial devices to prevent the
11 Viscosity=thickness
12 Stickiness=virtue of a substance by which it gets stuck with other things in contact
13 Cervix=the opening of uterus at the depth of vaginal canal
62 Health and Physical Education - 8
potential gestation that may occur after having sexual intercourse. They prevent
the union of sperm and ovum even if there is sexual relation during unsafe or
fertile period. Some of the artificial methods of contraception are:
i. Implant: An artificial method of contraception in which two small capsules
filled with artificial sex hormone are placed by a trained medical practitioner
under the skin of woman at inner upper arm site. The hormones disturb
the production of ovum and prevent gestation. It can be implanted for
contraception for three or five years as per the need of woman.
ii. IUCD (Intra-Uterine Contraceptive Device): In this method, artificial
devices like copper-T, or loop is placed in the uterus (womb) that disturbs
the conception and pregnancy.
iii. Depo-Provera: This is an injection to be administered in every three months.
It is in form of liquid solution. It is used as an intramuscular injection14
within 7 days of menstruation. It prevents conception for three months after
its administration. It suppresses the ovulation cycle in women's body. It is
available as name of 'Sangini' in the market of Nepal.
iv. Pills: Pills are female oral15 tablets for the prevention of conception. If
taken regularly once a day, as per the authorized instruction, it prevents
conception. It is available in the name of 'Nilocon', 'Gulab' and various other
trade names in the market of Nepal.
v. Condom/Femidom: It is single usable device. It is made up of thin and
strong rubber in cylinder shape. This device is worn on the erected penis
of male during sexual intercourse. The condom used by female is called
femidom. It is used inside the vagina. They prevent sperm from entering
into cervix and prevent fusion with ovum. They also prevent sexually
transmitted infections.
vi. Foam Tablet: It is one of the chemical methods of contraception. Foam
tablets are used by females inside their vagina by inserting them 5 to 10
minutes before sexual intercourse with the help of fingers. It gets melted
inside the vagina and converted into foamy viscous fluid due to the warmth
and moisture at the bottom of vagina. It destroys the sperms and makes the
fertilization impossible.
5.6.3. Emergency methods of contraception
The emergency method of contraception is the technique of averting the
unwanted pregnancy when sexual intercourse takes place without using
contraceptive devices. Unwanted pregnancy creates various health hazards as
a result of unsafe abortion. Emergency contraception should not be used for
general contraception. It may cause infertility or other health hazards. Emergency
contraceptives are used only in adverse conditions like rape, coercion, sexual
14 Intramuscular injection = an injection given in the muscle tissue, most commonly in the
upper arm or thigh muscle
15 Oral= to be administered from mouth
Health and Physical Education - 8 63
contact without any contraceptives, in the failure of contraceptives like tearing
of condom, unwanted expulsion of IUD itself, or missed pills intake for more
than two days. The emergency contraception can be done by oral intake of
medicines like E-Con or I-Pill within 72 hours after the unsafe sexual contact. If
it has already crossed 72 hours, a certified medical practitioner can implant an
IUD within 5 days of unsafe sex to prevent the conception.
5.6.4. Permanent methods of contraception
The methods of contraception in which the fecundity power of an individual
is ceased permanently by surgical methods are called permanent methods of
contraception. In all of the permanent methods, the tubes (fallopian tube in
female and vas deferens tube in males) which carry the gamete cells from the
gonads (ovaries in female and testes in the males) are cut or blocked. It is not
reversible unless a surgical re-
connection becomes successful. Urinary bladder
a. Vasectomy: It is a Permanent Seminal Left vas
Method of Contraception for vesicle Deferens (also will
Males. In this method, the vas be cut and sealed
deferens tubes are cut to Right shut)
prevent the sperms to reach ejaculatory duct
seminal vesicles. At the orgasm Prostate gland Penis
of sexual intercourse, sperm- Urethra
less semen is ejaculated. This Right vas deferens
cannot fertilize the ovum. (cut and sealed Scrotum
shut)
Testicle
Vasectomy
b. Laparoscopy/Minilap: Fallopian tube Fallopian tube
Permanent Method of
Contraception for Females
In this method, the fallopian
tubes are cut (in Minilap) or tied
(in Laparoscopy) to prevent
the sperms from reaching the Fgi. Mnilap process Fgi. Laparoscopy process
uterus. Even if millions of sperms enter during sexual intercourse, they
cannot meet any ovum and conception does not occur.
5.7 Reproductive health services and facilities
64 Health and Physical Education - 8
Human reproduction is an essential aspect of human society. Because of the process
of reproduction, human species has been sustaining for a long period of time.
Reproductive health services and facilities promote better reproductive and sexual
health of people. Therefore, all the countries of the world pay proper attention to the
reproductive health services of their citizens.
Reproductive health services and facilities are the provisions by which people get
proper knowledge, information, guidance, care, and cure for the solution of difficulties
in reproductive and sexual issues of human health in different situations.
Reproductive health services and facilities are being provided by the government
and non-government organizations in Nepal. Some of the international organizations
like UNFPA16 and WHO17 are also working for the promotion of reproductive and
sexual health in Nepal. Similarly, national organizations like FPAN18 , NFCC19 , and
Maternity Hospitals are active in this field.
Reproductive health services and facilities include:
a. Maternal and Child Health (MCH) Care
b. Family planning services and counseling
c. Reproductive and sexual health education
d. Safe and legal abortion services
e. Emergency contraceptives
f. Distribution of contraceptive devices
g. Prevention and control of sexually transmitted infections
5.8 Broader sex education: Concept and Importance
Concept
Broader sex education is the process of developing broader knowledge, attitude, and
positive behaviour related to reproductive and sexual aspects of an individual’s health.
It includes the process of educating people regarding the issues like reproductive
anatomy, human sexuality, safer sexual behaviour, maternal and child health,
reproductive rights, as well as socially, morally and legally accepted sex life of people.
Importance
Broader sex education has the following main importance.
a. It gives broader knowledge about human sexuality and reproductive
anatomy.
b. It provides wide range of information about reproductive and sexual rights.
c. It raises the awareness against gender violence.
d. It gives solutions to the curiosity about the physical and psychological
16 UNFPA=United Nations Fund for Population Activities
17 WHO=World Health Organization
18 FPAN=Family Planning Association of Nepal
19 NFCC=Nepal Fertility Care Centre
Health and Physical Education - 8 65
changes occurring at the age of puberty and adolescence.
e. It helps in strengthening healthy and sound interpersonal relationships.
f. It helps in developing healthy citizen, healthy society, and healthy nation.
5.9 Scopes of broader sex education
Broader sex education has the following scopes.
a. Sexual and Reproductive health
Broader sex education aims to promote sexual and reproductive health of
people. It teaches us about safe gestation, family planning, safe abortion, as well
as prevention and control from sexually transmitted infections.
b. Human Sexuality: The term sexuality literally means the feeling and activities
connected to sexual virtues and desires. In broader sense, sexuality means the
set of all attitudes and behaviours related to gender discrimination, sex roles,
and socio-cultural values on gender. Broader sex education aims to protect
people from the discrimination and violence on the ground of sex.
c. Violence: Violence is the act against somebody to produce physical and mental
torture. There are frequent incidents of violence on the basis of gender and
age. Broader sex education helps in controlling such violence through the
development of positive knowledge, attitude, and behaviour against various
forms of violence.
d. Pleasure and Entertainment: Pleasure and entertainment are the most
important aspects to promote mental health. Every individual possesses right
to entertainment and pleasure by means of preferred activities that do not harm
others.
e. Sexual and Reproductive rights: Every individual has right to express his/
her gender identity as male, female, or third gender20. Besides, the right to sex
education, right to express opinions, right to marry, right to produce child,
right to get reproductive health services and facilities etc. are some examples
of sexual and reproductive rights. Broader sex education helps to assure such
rights to people.
f. Individual differences: There are about eight billions of people in the world.
It is a mater of wonder that each person is unique and different from others in
many aspects. Regarding gender, there are males, females, and third gender
people in the world. People are different by age, gender, sexuality, education,
personality, and various other aspects.
g. Relationships
Relationships with other people determine the virtue of social characteristics of
every individual. Relationships are also affected by age, gender, and sexuality.
20 Third Gender=neither male nor female, having mixed sexual characteristics.
66 Health and Physical Education - 8
Broader sex education concerns the right of people to establish and maintain
good relationships with preferred individuals.
Exercise
A. Answer the following questions.
1. What is adolescence? Why should they become sincere for their future career?
2. What are the responsibilities of adolescents towards their family and society?
3. List any three unsafe sexual behaviours from which the adolescents
should abstain.
4. Define reproductive health. What are the major areas it is concerned with?
5. What do you mean by safe and unsafe abortion?
6. In what conditions the consent of pregnant mother is not essential for safe abortion?
7. What do you mean by natural methods of contraception? Give examples.
8. How is implant used for contraception?
9. Draw a diagram showing minilap and laparoscopy.
10. What is broader sex education? Explain any three scopes of broader sex
education.
B. Fill in the blanks with appropriate words.
1. The adolescents have responsibilities towards themselves, their family,
and ………
2. According to ………, adolescents are the people in the age group 10-19 years..
3. Adolescents should advocate against unscientific, unhealthy and ……..…
practices in the society.
4. Registered and listed medical practitioners and health service providing
centres are providing ………………. abortion care (CAC) services in Nepal.
5. A pregnant mother has right to abort the gestation up to ……… weeks on
her own desire.
6. The contraceptive device ………….. can also prevent people from STIs.
Health and Physical Education - 8 67
6
Drugs, Alcohol and
Tobacco
Before You Proceed to the Text
Tobacco, alcohol, and drugs have become great problems in our country. Among them,
tobacco is widely used even by Nepalese children. Do you have any friends using tobacco? If
not, find a person taking tobacco and ask why s/he started it?
The tobacco user may or may not tell the truth in the beginning. Guess it. If you think it is
untrue, then try again. Explore the truth.
6.1 Drugs
In general, a drug is a chemical substance that can alter physiological1 process of the
body systems. Drugs are used as medicines or used in a medicine. The meaning of drugs
is not confined only to its general meaning in the context of using drugs for addiction
purpose when drugs are abused. Besides this, other non-medicinal substances are
also consumed for addiction nowadays. Some of the drugs and substances used
commonly by the addicts are: diazepam, ibuprofen, opium, morphine, heroin,
cocaine, cannabis, etc. There is a practice of illegal and excessive drug intake to satisfy
drug addiction. World Health Organization defines drug as “any chemical entity or
mixture of entities, other than those required for the maintenance of normal health,
the administration of which alters the biological function and possibly structure.”
Microsoft Encarta Dictionary gives the meaning of drug abuse as “deliberate use
of an illegal drug or of too much of a prescribed drug.” It has been a worldwide
psychosocial problem nowadays.
Causes of Addiction
i. Most of the addicts learn drug intake from friends.
ii. Drug abuse is taken wrongly as a solution to frustrations of life.
ii. Drug addiction is promoted by religious support. Some Hindus take drugs
to please Lord Shiva.
iv. Abusers try to induce this habit.
1 Physiological = Related to bodily functions.
68 Health and Physical Education - 8
v. High degree of curiosity of drug intake among adolescents.
Effects of drug intake
i. Low efficiency in body functions.
ii. Reduction in motor coordination.
iii. Change in body homeostasis: elevated blood pressure and heart beat.
iv. Loss of appetite.
v. Headache, sweating, nausea, dizziness.
vi. Increases vulnerability to needle based communicable diseases like HIV/
AIDS, hepatitis B, hepatitis C, etc.
vii. Loss of memory and comprehension.
viii. Loss of social prestige imbalance in social relationships, inclination to social
crimes, etc.
Prevention and Control of Drug Abuse
i. Management of proper health education including knowledge and
information about drugs in school and higher education.
ii. Public awareness programmes against drug abuse by the government and
non-government organizations.
iii. Enforcement of strict laws and provision to monitor and control illicit drug abuse.
iv. Management of recreational and rehabilitation centres.
v. Family workshops and family counseling on drug abuse.
vi. Participation of vulnerable groups (children and adolescents) in anti drug
abuse campaign.
vii. Maintain good harmony and peace in families.
viii. Provision of strict punishment and fine against illicit drug dealers and
producers.
6.2 Alcohol
Introduction to alcohol
Alcohol is a chemical compound which is formed by the
decomposition of organic matters. Its main constituent
is ‘ethanol’, which generates abnormal brain waves and
gives a feeling of different sensation. If alcohol intake
is excessive, the person may die due to poisoning or
intoxication. If alcohol intake becomes frequent for a
certain time, a habit develops to take it again and again.
Such condition is known as alcoholism. Alcoholism has
been a common problem in Nepal, persisting equally in
rural, urban, underdeveloped and developed areas. There
are various types of alcohols in markets.
Health and Physical Education - 8 69
Alcohol is sold openly and widely in the markets of Nepal. It is easily available
and there is no strict restriction in alcohol use. The extent of alcoholic production,
transaction, and tax collection is so high that policy makers deny taking effective
actions against alcoholism in Nepal. It has been a burning social problem in Nepalese
society. However, some laws for controlling alcoholism have been initiated by the
government, which aim to regulate its transaction within legal parameters.
Causes of alcohol intake
Alcohol is a familiar drink in most parts of the world from ancient period of histry.
In some ethnic groups, alcohol is considered indispensable in their cultural and
religious practices. Even in the holy book of Hindus–Rigbeda, alcohol (somaras)
has been described as an energetic drink extracted from specific climber plant called
‘somalata’. There are various causes of alcohol intake. Some of them are:
i. Alcohol is used for entertainment and recreational purpose in feasts and festivals.
ii. Alcohol has some religious and cultural support.
iii. It is commonly used to get relief from tiredness and muscle ache by individuals
who involve in hard physical labour.
iv. Some people think that it eases digestion.
v. People take alcohol under pressure and request from friends and relatives.
vi. Some are attracted by advertisements.
vii. There is a worldwide tradition of entertaining guests with alcohol.
viii. People have a wrong belief that alcohol reduces tensions and mental stresses.
Effects of alcoholism
Immediate or short-term effects
i. Alcohol acts as a stimulant. It increases uncontrolled physical and verbal
activities.
ii. Alcohol acts as depressant to some people. In such effect, the physical and
verbal activities become limited.
iii. The person vomits if the intake is excessive.
iv. Body becomes imbalanced and passive. In case of excessive intake,
unconsciousness may occur.
v. It causes impaired, blurred, or double vision due to imbalanced movement
of eye muscle.
vi. It leads to loss of short-term memory.
Long-term effects
Physical Effects
i. Alcoholism hampers the performance of body systems.
ii. Liver is affected severely, leading to liver damage or cirrhosis.
iii. It causes infertility.
70 Health and Physical Education - 8
iv. Digestive system is affected adversely.
v. Symptoms of ageing start earlier.
Mental Effects
i. Thinking capacity and creativity decreases.
ii. There is loss of memory.
Social Effects
i. The drunkard loses social prestige.
ii. Social relationships are ruined.
Prevention and Control of Alcoholism
Alcoholism has been a problem all over the country. In urban areas, there is a trend
of alcohol intake among all groups of people from children to aged. It is widely
available in our markets and everybody can purchase various brands of alcohol easily.
Following measures can be adopted for prevention and control of alcoholism.
i. Awareness programmes should be conducted.
ii. Proper knowledge and information about alcohol and alcoholism should be
included in formal and non-formal educational programmes.
iii. The cultural and religious norms promoting alcoholism should be discarded.
iv. Alcohol should be banned in public places.
v. Strict laws and rules should be made to manage the production and
distribution of alcoholic substances.
vi. Organized effort should be initiated for the rehabilitation of drunkards.
Stay away from the company of drunkards.
vii. Free time should be utilized in recreational and creative activities.
6.2 Tobacco
Introduction to tobacco
Tobacco is a herb plant with flat and broad leaves. It
contains nicotine, tar and other chemical substances, which
give a remarkable euphoric sensation if taken. It is taken
in many ways. Chewing tobacco, cigarette, beetle, bidi,
hookah, tamakhu, surti, jarda, etc. are common forms of
tobacco intake. Tobacco gums are also manufactured in the
form of chewing gum, which is helpful for those who want
to give up tobacco. Tobacco is a major cause of diseases all over the world. About
five million people are dying in the world every year due to tobacco-borne diseases.
It is estimated that the number will be ten million by the year 2020 AD. It has been
proved that the chance of heart diseases, brain strokes, asthma, and lungs cancer is 3,
1.5, 1.5, and 12 times more respectively in tobacco users than the others. It lowers the
body temperature and reduces temperature difference between the environment and
Health and Physical Education - 8 71
the body. Due to the fall in difference in temperature, the user feels virtual warmth,
which leads people to tobacco abuse. Tobacco contains more than 4,000 poisonous
substances in it. Among them,43 substances including nicotine and tobacco tar are
carcinogenic substances (i.e. causing cancer) found in tobacco.
Causes of tobacco intake
There are many causes behind adopting the habit of tobacco intake. People start
tobacco intake primarily in late childhood and adolescent period. Some of the main
causes are listed below:
i. Imitation of tobacco intake among peer group
ii. Request and pressure among friends’ circle
iii. Imitation of the senior members in the family and community
iv. To satisfy the curiosity to taste and become habituated
v. To believe in the wrong concept that it reduces tension and gives pleasure
vi. To have a desire to look matured and adult
vii. To adopt the habit as fashion
viii. To feel warm in cold seasons
Effects of tobacco intake
Immediate or short-term effects:
i. Vertigo and nausea in the beginners
ii. Feeling of intoxication with change in brain waves, which the abusers term
as “pleasure”
iii. Sudden fall in body temperature
iv. Increase in pulse rate
v. Irritation in respiratory track
Long-term effects
i. Teeth, skin, nails, fingers, and palm turn yellowish in colour
ii. Asthma, cough, cancers, and heart diseases
iii. High chance of heart attack and brain stroke
iv. Limited function of nervous system. Gradual damage of optic nerve causing
blurred vision and progressive blindness
v. Stillbirths or miscarriage in women
vi. Increased level of nicotine, intensifying the desire for regular and continued
nicotine intake
Prevention and control of tobacco
i. Management of proper health education including the knowledge about
tobacco
ii. Awareness programme in villages and urban areas especially focused
72 Health and Physical Education - 8
among adolescents
iii. Declaration of smoking-free zones in public places
iv. Restriction in advertisements in public media and public places
v. Encouraging people to have healthy personal habits
vi. If the abusers want to give up this habit, following methods can be adopted:
a. Have a strong commitment to give up tobacco and renounce the habit
abruptly and immediately
b. If not possible, start reduced doses with minimum frequency
c. Consume soft forms of tobacco like tobacco gums and other soft alternatives
like clove, pepper, etc
d. Increase involvement in creative, recreational, and entertaining activities
Exercise
A. Answer the following questions.
1. Give short introductions to:
(a) Drugs (b) Alcohol (c) Tobacco
2. List the immediate effects and long-term effects of tobacco intake.
3. What are the factors boosting alcoholism in Nepalese society? Explain
with examples.
4. What do you mean by drug abuse? Do you agree that drugs are important
for our life?
5. How can we control the use of tobacco, alcohol, and drugs in our society?
6. What are the major causes of tobacco intake?
7. How can we confirm that one has drunk alcohol?
B. Match the followings:
Smoking • • Tobacco
Nicotine • • Drug
Brandy • • Lung cancer
Hashish • • Alcohol
Health and Physical Education - 8 73
7
Environmental
Health
Before You Proceed to the Text
A Short Story Pemba and Polluted Environment
A healthy boy from Solukhumbu district started
living in Kathmandu city. He was a student of class
eight and his parents had taken him to the capital
city for better education. He cannot remember
having any sort of health problem. It is because,
he has good health habits. He is conscious about
balanced diet. He never takes junk food, street
food, stale and unhygienic food. He takes bath
regularly and maintains all personal cleanliness.
He has maintained his good and healthful habits
in the city also.
After one month……………….
He started coughing black sputum regularly. He started feeling pain in his chest. He became
lean and thin gradually. His father, Dawa, asked him, ‘Pemba, my dear son, what happened to
you?’ Dawa added, ‘You cannot go to school, let’s go to hospital today’ He was, then, admitted
to hospital.
______________________________________________________
Name: Pemba Sherpa Age: 13 years.
Address: Garma-3, Solukhumbu Sex: M
______________________________________________________
Chief Complaints: Black sputum, chest pain, headache, and fever.
…………………………………
…………………………………
______________________________________________________
What may be the reasons of Pemba’s sickness? Discuss among your friends and tell it to your
teacher.
74 Health and Physical Education - 8
7.1 Introduction
Our health is determined by various factors.
Some of them are our foods, habits, inherited
characters, and the environment. The state
of our health which is determined by our
environment is called environmental health.
The environment is composed of many
components. Some of them are air, water, soil,
etc. These components have a direct relation
with human health. If they are polluted, the
pollutants present in these components come
in contact with human body and make us diseased. Therefore, our environment must
be kept clean and healthy to keep ourselves healthy. The components of environment
determining our health are the components of environmental health too.
7.2 Water Pollution
Water is an essential component for our life. We cannot survive without water. If the
environment is polluted, many disease germs and harmful chemicals may contaminate
water. If polluted water is used for washing, cleaning, bathing, drinking, and other
purposes by us, our health is affected adversely. We suffer from diseases. Water is a
part of the environment and it must be kept in natural condition. Water pollution is the
alteration of water in its natural characteristics by mixing wastes, sewages, harmful
chemicals, and decayed organic matters leading to make it inappropriate for our use.
Polluted water is not good for other organisms including plants, fishes, and animals.
7.3 Waterborne Diseases
Polluted water is the reservoir of various kinds of disease germs. These germs are
microscopic in size and cannot be seen by our naked eyes. The diseases transmitted
through polluted water are called waterborne diseases. Some of the waterborne
diseases are cholera, diarrhea, dysentery, and typhoid. In order to keep ourselves safe
from waterborne diseases, we should always drink clean and pure water. Safe and germ-
free water can be obtained from the environment if it is clean and pollution-free.
7.4 Modes of transmission of diseases through polluted water
Water becomes polluted by various means. Human activities have become the major
cause of water pollution in our country. Some people take bath, wash clothes, and
take their domestic animals to the water resources like rivers, ponds, and other
resources. Many people have the habit of defecating on the bank of rivers and water
canals. The intestinal parasites, worms, and other disease germs quickly spread
Health and Physical Education - 8 75
due to such activities. If other healthy people are exposed to polluted water for any
purpose like washing, drinking, or swimming, they are also infected by the germs
and worms. In this way, diseases are transmitted to them. We should not wash our
clothes, utensils, foods, vegetables, hands and other body organs with polluted water.
Contamination of water by diseased person’s body fluids like blood, mucus, spit, etc.
is more dangerous. The waste products from the hospitals and health centres contain
a number of germs and worms as they include urine, stool, blood, and sputum of
diseased people.
7.5 Methods for prevention of waterborne diseases
In order to prevent the waterborne diseases, the following methods should be followed:
i. Drinking water should be pure, clean, and germ-free.
ii. The sources of water should be kept clean. We should avoid the activities
like taking animals for grazing, taking bath, washing clothes etc. at the
sources of drinking water.
iii. The food items should be washed properly with clean water before eating.
iv. All people, especially ill, should use latrine in a proper way. Feces and urine
should not be discharged in open environment.
v. Water should be purified before drinking.
7.6 Methods of purification of water
(a) Boiling
Boiling is one of the best and easiest methods of
purifying water. This process raises the temperature
of water to such an extent that disease germs cannot
tolerate and die. Some of the microorganisms may
tolerate the boiling temperature of water for a few
minutes. Therefore, we should keep water boiling at
least for five minutes. Mixing cold impure water with
the boiled water does not make the water germ-free.
Lukewarm water is not safe for drinking purpose.
(b) Sedimentation and decantation
Sedimentation is the process of making the
impurities settle down at the bottom by keeping
water in a clean container. After allowing the
water to remain in the container for a few hours,
the heavier and harmful particles present in the
water settle down. We can pour the safe and
clean water into the glass or any other vessel for
drinking purpose by using a glass rod. While
76 Health and Physical Education - 8
doing so, we must be careful that the impurities are not poured along with clean
water. Sedimentation and decantation process is used especially for purifying
water in a large scale. Big water reservoirs made for supplying water in the
urban areas adopt this method by making the impurities decanted in a maze of
narrow canals present in the reservoir.
(c) Filtration
Filtration is the most widely Support Raw water
used method of purifying structure
water at home. People use
Raw water
different types of commercial Filter Container
filters made up of metals and medium 1
soil. There are two chambers Filter
in a water filter. The upper Filter motion
medium 2
chamber has filtering candles Filtered Support Filtered
that do not allow impurities water water
and germs but the pure water
to pass down to the lower chamber. Thus, the lower chamber contains safe
drinking water that is free from germs and impurities.
Small volume of water can be filtered quickly by using a filter paper. The filter
paper is set on the inner surface of a clean funnel, which is set on an iron stand
for support. The impure water is poured in the funnel to get safe and filtered
water in a clean container placed below the funnel.
There is another type of filter that can be made with four soil-pitchers placed
one over another. The uppermost pitcher has a small dropping hole at its
bottom. That allows water to drop slowly through it. The two pitchers in the
middle are filled with charcoal, sand, and pebbles. They also have few minute
holes at bottom. Water dripping from the first pitcher is passed through the
second and third pitchers. Impurities are filtered in these two pitchers and pure
drinking water is collected in the bottom pitcher. A commercial tap can be set at
the bottom pitcher to collect safe and pure drinking water.
(d) Chemical Method of Water Purification
This method is also called chemical disinfection of water. Some chlorine
compounds are used to kill harmful bacteria and germs present in water.
Therefore, this method is also termed ‘chlorination’. There are many marketed
chlorine products nowadays. Some of them are ‘water guard’ and ‘Piyush’. In
this method, few drops of chlorine solution are mixed in impure water kept
in a clean container. It is then kept covered well for half an hour or as per the
direction given by the producer. The directions for use are printed on its cover.
Chlorination method cannot make water free from other physical particles and
harmful chemicals.
Health and Physical Education - 8 77
7.7 Proper use of water
Water is the major constituent of our body. We must drink pure drinking water for our
survival. Water is very important to keep ourselves alive. There are various sources
of water but not all the sources have safe drinking water. Increased urbanization and
industrialization due to skyrocketing population growth has left various natural
resources polluted. There is limited amount of drinking water for us. Many urban and
village areas are gradually facing severe shortage of safe drinking water. Therefore,
people should use drinking water wisely. We should not use drinking water for any
other purposes like irrigation in the garden or washing clothes. We should close the
tap as soon as we finish its use. Repairing pipelines and water tanks can prevent loss
of water. Unnecessary over-collection of water may cause its scarcity to other people.
Therefore, we should develop a habit of using water wisely. We can collect rainwater
in rainy season and utilize it for different purposes. Wastewater from the kitchen and
bathroom can be used in the garden.
7.8 Solid Wastes: Introduction and Management
Introduction
Solid wastes occupy major share in environmental pollution. Different useless solid
materials like plastics, papers, kitchen wastes, market wastes, etc. are the main
components of solid wastes around us. If the solid wastes are scattered haphazardly
in the environment, the environment becomes polluted. Therefore, solid wastes
should be managed properly.
Solid waste management: 3R principle
Solid waste management is the process of reducing solid wastes in the environment
and making it clean. 3R-principle is regarded as the best policy to manage solid wastes
in the environment.
R-Reduce: We have an old and popular saying that ‘prevention is better than cure’.
The first R of the principle stands for the reduction of solid wastes in the environment.
If there is no or less production of solid wastes, there is no problem of waste. Solid
wastes are the result of human activities. We must carry out our activities in such a
way that we produce minimum amount solid wastes.
R-Reuse: Some solid wastes can be used for different purposes. For example, plastic
bags can be used time and again. Glass bottles of cold drinks and beverages are also
collected and reused time and again. This process contributes remarkably in reducing
the adverse effects of wastes. Thus, the principle of reuse is the process of managing
solid wastes by using reusable solid wastes time and again.
R-Recycle: Recycle is the method of using solid wastes as raw materials for the
preparation of new useful materials. Some of the common waste materials that can
be recycled are plastic utensils, papers, etc. Waste paper is recycled by grinding the
wet paper first and making it float on a water container. A wire-net is used to separate
78 Health and Physical Education - 8
the layer of paper-paste from water. This layer is then dried and pressed in between
two dry sheets of papers. Similarly, the plastic apparatus and utensils are first metal
and moulded into new shapes. Recycling of waste materials reduces the cost of raw
materials while producing new goods.
Management of Human Excreta
Human excreta, perhaps, is the dirtiest solid waste among all. Though it is produced
from our own body, we dislike it extremely. Human excreta are the main source
of various germs and worms responsible for many diseases in the human body.
Excreta itself is a fertile source of causative agents for many gastrointestinal diseases.
Therefore, excreta should be discharged only into the latrine. Proper use of latrine
contributes a lot in keeping the environment healthy. In some rural areas and even
in urban areas, human excreta are found in open places like barren fields, sides of
streets, and banks of rivers. It causes environmental pollution and it is the source
of infection. Open excreta create various problems like environmental pollution,
epidemics, communication of infectious diseases and imbalance in the environment.
Therefore, human excreta should be managed properly in a planned manner.
7.9 Air Pollution
Air makes our atmosphere. It has a certain composition of different gases. The major
component of air is nitrogen gas. Oxygen gas occupies the second biggest share in
air. All the living organisms use oxygen. Not any living thing can survive without
oxygen. We inhale air into the lungs. Red blood cells in the blood capillaries present in
the lungs absorb oxygen. The remaining gases are exhaled outward through the nose.
If there are any other impurities or poisonous gases in air, they are also inhaled with
air. Some of the harmful components and toxins are also absorbed into the blood from
the lungs and distributed to all the parts of the body. Therefore, the air around us
must be kept clean. Polluted air is mixed with such harmful components and toxins.
Air has its own natural composition. If the natural state of air is altered, it is called air
pollution.
Air pollution can be defined as the alteration or change in the components of air by
getting the harmful components and toxic substances mixed in it.
Causes of air pollution
i. The pollutants like smoke, dust, solid waste pollute the air when they are
mixed in atmosphere.
ii. In rural areas, the sources of fuel and energy are wood, cow-dung, buffalo-
dung. When they are burnt, these things emit smokes that pollute the air.
iii. Growing industrialization and urbanization give rise to gases and cause
pollution.
Effects of air pollution
Air pollution affects both living and non-living things. Among them, some are given below:
Health and Physical Education - 8 79
i. We inhale air from the environment to get oxygen contained in it. If the air contains
other harmful pollutants, they enter inside our lungs and harm our body.
ii. Smoke and dust emitted from kitchen, vehicles and industries pollute air.
As a result, people are affected by lungs disease, eye disease, asthma, etc.
iii. Some industries like cement factory, marble factory, and brick factory emit
smoke, dust and other harmful chemical substances. When they are inhaled,
they affect the physical system of our body. As a result, kidney problem,
abortion, anemia, and even psychological problems can be seen.
iv. Presence of sulphur dioxide and carbon dioxide in the air causes the
formation of sulphuric acid and carbonic acid that causes acid rain. Acid
rain deteriorates temples made of metals, buildings and monuments.
v. The thick layer of methane, sulphurdioxide and carbondioxide causes
greenhouse effect in the earth. As a result, temperature of the earth increases.
Global warming has been a burning problem in the recent years.
Methods of controlling air pollution
There are different ways of controlling air pollution. Some of the main methods are
given below:
i. Old vehicles which emit a lot of smoke should be replaced by new ones. The
vehicles should be inspected from time to time.
ii. Solid wastes should be disposed properly. They should not be scattered in
the open places.
iii. New factories and industries should be established far away from human settlement.
iv. Sources of alternative energy like biogas, solar energy and hydroelectricity
should be used in place of wood, cattle dung, etc.
v. Tree plantation programme should be run in barren land and both sides of
roads.
vi. Public awareness programme should be initiated in order to increase
people's participation in pollution control activities.
7.10 Sound Pollution (Noise)
Unwanted and excessive sound that harms human
health is called sound pollution. Intensity of sound
is measured in decibel units. If the intensity is more
than 45db, an average person cannot sleep. Long-
term exposure to more than 85db of sound can cause
permanent loss of hearing. Crowded public places with
noise, markets, factories and industries, and sources of
music like loudspeakers, mike, radio, etc. are the main
sources of sound pollution. In the same way, industrial
areas and heavy construction site are highly affected area in regard to sound pollution.
80 Health and Physical Education - 8
Causes of sound pollution
i. City areas that produce much sound cause sound pollution.
ii. Market areas, bus stations, and other densely populated areas have more
sound pollution.
iii. Construction sites like road construction and metal workshops produce
unwanted noise which causes sound pollution.
iv. Some industries like cement factory, furniture factory, stone-crusher, etc.
produce much sound which causes sound pollution.
v. Musical instruments and electronic media, if they are played in high volume,
cause sound pollution.
Effects of sound pollution
i. Very noisy environment affects our hearing power. It may cause impairment
in hearing power or permanent hearing loss.
ii. In noisy places, we feel mental tension and headache.
iii. Sound pollution disturbs our digestive system and sleeping habit affecting
the health of people.
iv. Noise affects our mind which, in turn, harms our physical condition.
Methods to control sound pollution
There are different methods to control sound pollution.
i. Airport, bus-park, industrial areas should be away from the residential
area.
ii. Tree plantation programme should be run in open barren land. Trees absorb
sound and control sound pollution.
iii. The workers who work in noisy areas should use earplugs or cotton swab to
restrict noise in the ears.
iv. Walls should be built around noisy industrial areas that will absorb the
sound of that area.
v. Noisy equipment like mills and generators can be installed underground.
vi. Strict laws against sound pollution should be enforced and implemented by
the government.
vii. Awareness programmes regarding sound pollution can play an important
role in the control of sound pollution.
Health and Physical Education - 8 81
Exercise
A. Answer the following questions.
1. Define environmental health. What are the major components of
environment?
2. List any five causes of water pollution in the context of your society.
3. Name any five diseases caused due to air pollution. List equal number of
diseases caused due to air pollution.
4. Write short notes on a) Boiling b) Filtration c) Chemical disinfection
5. What are solid wastes? Explain the 3-R principles of solid waste
management.
6. How can we control the adverse effects of sound pollution?
B. Write ‘T’ for true and ‘F’ for false sentences.
1. Waterborne diseases can be controlled by using safe
drinking water.
2. Harmful chemical components of water can be cleaned by
boiling it.
3. Iodine and chlorine are useful things for chemical
disinfection of water.
4. SODIS method uses sunlight to disinfect water.
5. Air pollution can cause hookworm and roundworm in the
lungs.
6. Sound pollution can also cause hypertension.
82 Health and Physical Education - 8
8
Safety and First Aid
Before You Proceed to the Text
There are various types of accidents that we encounter in our everyday life. Some of them are
minor and some are major. Some examples of minor accidents are piercing, cutting, slipping,
falling down, bleeding, getting struck, etc. Some of the major accidents are vehicle accidents,
instrumental severe accidents, gas cylinder explosion, etc. The nature of accidents differs
according to place and time. List the last five accidents you have seen or heard about. What
type of accidents are they? How can we protect ourselves from such accidents? Conduct a
short symposium in the class.
8.1 Introduction to Safety Education
There are two terms in safety education: ‘safety’ and ‘education’. Safety means
protection from or non-exposure to risk of harm or injury. Education is the process of
learning. In this way, safety education can be understood as the educational process
of teaching and learning the methods of protection from the risks of harm or injury in
different activities. Safety education is the process of changing our behaviours to be
safe from potential dangers and probable accidents or injuries. Safety education helps
us to be careful about the risks in different situations. All the accidents may not be
preventable, but we can reduce the chance of accidents if we are careful and conscious
about safety measures.
8.2 Introduction to First Aid
‘Aid’ is the assistance or help given to somebody in difficult situations. The difficult
situations may come up due to an accident, injury or any sort of sudden harm.
Therefore, ‘first aid’ should be understood as the first assistance or help given to an
individual until a medical personnel and service become available.
The provision of medical personnel and service can be made available in two ways:
(i) By taking the casualty victim to a medical centre.
(ii) By calling an ambulance or doctor to visit the victim.
Health and Physical Education - 8 83
First aid is given by any person around the site of casualty. There may not be an expert
at the time of accidents or injuries. Therefore, everybody must have knowledge of first
aid. The education of first aid brings knowledge, attitude and behaviour in students
to help the wounded, injured, fainted, drowned, cut, animal-bitten and other people
having similar sudden health problems in different situations.
8.3 Objectives of First Aid
(i) To save the life of the casualty victim before an appropriate medical care
becomes available.
(ii) To make medical care available for the casualty as soon as possible.
(iii) To provide proper rest and consolation to the victim.
(iv) To provide artificial respiration and heart movement if necessary.
(v) To prevent from excessive blood loss in case of bleeding due to accidental cuts
and injuries.
(vi) To avoid further worsening of the victim's condition.
(vii) To provide right and truthful information about the victim and nature of
accident or injury to the medical personnel.
8.4 First Aid for Different Accidents and Injuries
(a) Sprain
It is a painful injury to the tendons and ligaments of a joint caused by wrenching
or overstretching. Tendons and ligaments are stronger than other types of
muscles. But if they are broken or injured, it takes longer time to get them
repaired. The most common sites of sprain are the joints of elbow, knee, ankle,
wrist, waist, fingers, shoulder, and neck. There may be dislocations of bones
and injury to the muscles too. Sprain may be caused due to uncontrolled fall,
strike or hit.
Safety Measures Against Sprain
Sprain occurs mostly while running, playing, jogging, and walking in rough
and careless ways. The following safety measures must be followed to prevent
ourselves from probable sprains.
First Aid for Sprain Ankle Swelling, inflammation,
sprain and bruising of ankle
Sprain is an internal injury. Therefore,
there may be troublesome accumulation of Damage to
body fluids – lymph and blood around the ligaments of
injured tendon or ligaments. Therefore, the
first aid for sprain is focused on preventing the ankle
accumulation of body fluids around the
injured portion of ligaments and tendons.
The first aid for sprain is represented by a
short term ‘RICE’, which stands for:
84 Health and Physical Education - 8
• R=Rest: The victim should be placed in a comfortable position.
• I=Ice: Apply ice or any cold pack around the part of sprain. It helps in
narrowing blood vessels and preventing fluid leakage and accumulation.
• C=Compression: Compress the sprained part with soft and thin bandage to
reduce swelling and excessive fluid accumulation in the tissues.
• E=Elevation: Let the injured part be elevated to upper level. It reduces
excessive blood supply and relieves pain. If there is sprain of legs, elevate
it by placing it in upper level. An arm-sling can be used to elevate a sprained
arm.
Besides the first aid mentioned above, the following first aids should be
considered:
• Open or loosen the tight clothes worn by the victim.
• Close the wound if there is continuous bleeding. Excessive loss of blood
may result in death of the victim. A bandage or clean piece of cloth can be
used to cover the wound to prevent bleeding.
• Perform artificial respiration, if the victim is not respiring.
• Provide sufficient fluids to the victim.
• Console and boost the victim’s self-confidence.
• Seek immediate medical care for the victim. If the sprained part has swelling
and burning sensation of pain, x-ray is necessary. X-ray helps to verify bone
fracture and dislocation.
(b) Electrical Shock
Electricity is a form of energy. Shock is an unexpected,
intense, and distressing experience that has a sudden
and powerful effect on somebody’s emotions or physical
reactions. If such shock is caused by the electricity, it is
called electric shock. Many people die every year due to
electric shock. It may be mild or severe on the basis of
intensity of voltage, electric current, and its effects on the
victim.
Causes of electric shock
• Negligence and ignorance
• Lack of knowledge
• Improper handling of electrical appliances
• Lack of monitoring the wiring system at home
• Accidents that lead to contact with electric wires and appliances
• Leakage of electricity
Safety measures against electric shock
• Be careful while working with electrical devices.
• Educate family members about safety measures and first aid of electric
shock.
• Handle the electrical appliances correctely. Do not forget to switch them off
Health and Physical Education - 8 85
after their use.
• Check electrical wirings regularly.
• Keep children away from electrical appliances.
First aid of electric shock:
• Switch off the main supply of electricity.
• Unplug the cord.
• Pull the victim safely with insulator support (dry wood, plastic, or threads).
• Provide necessary aid on the wounds and burns.
• If there is bleeding, block it with a bandage or clean piece of cloth.
• Place the victim in cool and calm place. Apply cold water or ice if there is
burn. Do not scratch the skin on the burnt parts.
• Check vital signs: breath, heartbeat, pulse, sensations, consciousness, etc.
• Provide CPR (Cardiopulmonary Resuscitation) if necessary.
• Take the victim for medical care immediately.
(c) Drowning
Drowning is to be under the surface of water
in such a way that there is accumulation
of unwanted water through various ways
and suffocation due to lack of air in water.
Drowning is a common problem in ponds,
wells, rivers, lakes and similar other water
resources. People, especially children, must be
well aware about it for its prevention. Infants
sometimes get drowned in water containers
at home. Big buckets, bowls, and other water
containers should not be kept open filled with
water. Water tank should be kept covered well
and out of reach of the children and infants.
Safety measures against drowning
(a) We should not go near the deep water resources and reservoirs unnecessarily.
(b) If there is some important reason to go there, always have a company and
be careful.
(c) Learn swimming and help others to learn it. A good swimmer does not get
drowned.
(d) Manage fence around ponds, lakes, and such big water reservoirs.
(e) Control small children from playing around the places with risk of
drowning.
(f) Indoor water containers like buckets, bowls, water tanks, etc. must be kept
covered well and out of the reach of children.
Symptoms of drowning
• Difficulty in breathing
• Cyanosis i.e. presence of blue colour in body tissues. It is due to lack of
86 Health and Physical Education - 8
oxygen in blood.
• Unconsciousness
• Vomiting of water
First aid for drowning
• Rescue the victim safely out of water.
• Remove obstruction in respiratory system (if any).
• Keep the head downward and give gentle compression to the stomach to
remove excess water there.
• Apply CPR (cardiopulmonary resuscitation) if there is no respiration and
heartbeat.
• Make medical care available for the victim as soon as possible.
(d) Snakebite
Snakes are very common reptiles found in our
country. They are abundantly found in the
terai region. Hilly region is also a habitat of
some species of snakes. Some non-poisonous
snakes are sometimes seen in the mountain
region. Many people are dying due to
snakebite in the terai region every year. Most
of the snakes are not poisonous but few of
them have very strong poison in their poison
glands. The poison glands lie on the lateral
sides of oral cavity and open at the incisor teeth of snakes. Therefore, poison is
easily ejected into human body when there is a bite with incisors. Snakebite is
more common during the hot season because snakes are active in the summer.
They hibernate and remain inactive during the cold season. Common poisonous
snakes found in Nepal are cobra and karat.
Safety measures against snakebite
The following measures should be adopted to be safe from snakebite.
(a) Snakes live in the bushy places and narrow spaces where they can hide well
and find their pray. Therefore, such places should be cleaned.
(b) Rat-holes and birds’ nests at homes attract snakes. Therefore, rats and birds
living at home should be controlled.
(c) We should wear boots and full size shoes
while going to bushy places and the places
where there is a probability of snakebites.
(d) Carry torchlight while going out from
home at night.
(e) Never tease a snake if you encounter one.
Symptoms of snakebite Figure: Cobra, A Poisonous Snake
(a) The poisonous snakes have two fangs
Health and Physical Education - 8 87
(sharp incisor teeth). If the snake is poisonous, there is a distinct mark of
fangs with incisions. The nonpoisonous snakes have no fangs but many
small teeth. They leave semicircular teeth marks at the bitten part.
(b) The affected part becomes red with pain and swelling
(c) Nausea, vomiting, and diarrhea
(d) Discolouration of skin
(e) Rapid pulse and fatigue
(f) Dizziness, increased thirst, headache and fainting
(g) Numbness, tingling and sweating
(h) Burning sensation in tissues
(i) Blurred vision
(j) Loss of sensations
(k) Loss of coordination of muscles
(l) Unconsciousness and death
First aid against snakebite
(a) Identify the mark of fangs to know whether the snake is poisonous or not.
(b) If it is poisonous, don’t let the victim walk, run, or move the bitten part to
prevent quick circulation of blood towards the vital organs1.
(c) Apply a tourniquet to check the venous return of blood from the bitten
point to other parts of the body.
(d) Provide water or juice if the victim is conscious.
(e) Do not make the tourniquet very tight. It should not obstruct arterial supply
of blood to the bitten part. Loosen the tourniquet for few seconds after every
fifteen minutes for prevention of blood clotting and narcosis2 of tissues
around the bitten part.
(f) Manage ambulance or any other appropriate means to take the victim to
hospital or snakebite treatment centre as fast as possible.
(g) Do not waste even a single second in the name of any traditional and
superstitious unscientific treatment. Administration of anti-venom serum
at hospital is the most reliable treatment of snakebite.
Altitude sickness
Altitude sickness is a condition caused by low level of oxygen in the air at high altitudes,
resulting in breathlessness, nausea, vomiting, fatigue, and unconsciousness. It is also
called mountain sickness. Our body is adopted in normal environment where we
live. People living in high altitude have higher lungs capacity compared to the people
living in lower altitude. Due to lack of oxygen in high altitude, particularly about
8000 meters above from the sea level, there is low density and pressure of air. Air is
thinner at high altitudes. As there is inadequate amount of oxygen, there is increase
in heart activities to supply required oxygen for the body. Due to this reason, pulse
rate, cardiac output, and blood pressure increase. If these increments cross the limit or
level of oxygen becomes too low, the travelers suffer from altitude sickness.
1 Vital organs=the organs like brain, heart etc. that are most essential for survival
2 Narcosis = death of tissues
88 Health and Physical Education - 8
Symptoms of altitude sickness manage CPR
• Difficulty in breathing
• Increased pulse rate and blood pressure
• Headache, nausea3 , and vomiting
• Dizziness and vertigo
• Pulmonary and cerebral edema (i.e. swelling)
• Unconsciousness and death
First aid of altitude sickness
• Supply oxygen as soon as possible.
• Bring the victim to lower altitude.
• Serve hot drinks.
• Tell the victim to take light exercises.
• In case of severe conditions and unconsciousness,
(cardiopulmonary resuscitations) and proper medical care.
Exercise
A. Answer the following questions
1. Define the terms ‘safety’ and ‘first aid’.
2. Write any five objectives of first aid.
3. What does ‘RICE’ stand for? Elabourate its steps in short.
4. How can we save the life of a victim suffering from electrical shock? What
precautions should be taken while saving others?
5. List the first aid techniques given to a drowned victim.
6. What are the safety measures against snakebite?
7. What do you mean by altitude sickness? What are its symptoms?
B. Write ‘T’ for true and ‘F’ for the false statements.
1. First aid does not mean the medical treatment given by a specialist doctor.
2. Safety education teaches us the techniques of protecting from injuries.
3. Sprain generally occurs inside the brain and abdomen.
4. We should wash our hands with clean water and make it wet before we
touch the electrical appliances.
5. The main cause of altitude sickness is the tiredness when we climb up
very high altitude.
6. In case of a poisonous snakebite, a tourniquet should be tied very tightly
above the bitten part.
3 Nausea = sensation to vomit
Health and Physical Education - 8 89
9
Family and
Community Health
Before You Proceed to the Text
A Short Story
There lived a happy family at Aiselukharka VDC of Khotang district in Nepal. There were
parents, a son, and a daughter in the family. All the family members were educated and
well civilized. They had good habits of maintaining sanitation, personal hygiene, and having
nutritious and balanced diet at their home. They had a small and beautiful kitchen garden. All
the family members used to work there every morning and evening. They had planted few
fruit plants. They had a cow named ‘Mali’. Mali had a lovely and cute calf named ‘Sinduri’.
They used to have green vegetables, pulses, cereals, and milk products in every meal. There
was no history of any sort of illnesses in their family.
Over time, both the children got married. The daughter married and went very far and the son
married a dirty girl from Mayalpur.
The new member in the family, the daughter-in-law, was not conscious about personal and
environmental sanitation. Nor did she take proper care about balanced diet. The kitchen
garden turned barren gradually. After few years, all the family members started getting
different types of illnesses and diseases.
What may be the probable causes of poor health in this family? Discuss in class.
**********
Count the following, if available, in your community. Write about their present status and
mention how they are helping people.
• Health service centres (health post, sub-health post, primary health centre, hospital,
private nursing homes, or clinics)
• Drainage systems
• Medicine shops
• Aaurvedic and homeopathic centres
• Ambulance
• Drinking water supply system
• Natural sources of drinking water
Show your report to the teacher.
90 Health and Physical Education - 8
9.1 Concept of Family
Family is a basic constituting unit of the society. It is a group of individuals related by
blood, marriage, or adoption, living in the same house, sharing a common kitchen,
and practicing common health behaviours influenced by their economic, cultural,
and religious traits. There are two types of families. One of them is nuclear family
which has less number of family members because it is constituted of parents and
unmarried children only. The second type of family is the joint family. There are more
members in this family. There may be grandparents, grandchildren, two or more
married couples, and other members.
A nuclear family has a few members and a joint family has many members in general.
But it is not true for all the nuclear and joint families. Some nuclear families may have
a couple of parents and many unmarried children. In contrast, some joint families
may be smaller if they have only parents and children. People should know that they
must make their family smaller and happier. It is so because, there are less demands
and needs, which are easy to be fulfilled. Fulfilment of needs makes a family satisfied
and happy.
9.2 Introduction to Family Heath
Families practice their distinctive food behaviours and other hygienic behaviours
inherited from their parents. Besides, education, environment and social factors
influence the behaviours of families. All the members living in a family take foods of
similar quality and nutritional values. They have similar clothing and personal hygiene
practices. Therefore, the status of health of each individual is mainly determined by
the family characteristics.
Family health can be defined as the state of one’s health which is determined by family
norms, values, religious and cultural traits adopted by the family, and other health
influencing practices and behaviours of the family.
There are different designations of different members in each family. Each individual
plays roles according to their position in their family. Parents take main responsibilities
to arrange for food. Grandparents play very important roles in transmitting religious,
cultural, and social values to grandchildren. Nepalese families are male dominated
from the ancient time. In such a situation, male members take most of the important
decisions. They are active in the outdoor activities. The female members are engaged
more in kitchen and other indoor works. The situation of elderly peoples’ family
health depends directly upon the status of the active members of the family. There
should be an environment of peace and harmony in each family to keep everybody’s
mental health sound. It is all the members’ duty to play their roles according to their
designations and positions in the family. It is the prime duty of the parents to educate
their children about personal cleanliness and personal hygiene. Children should also
acquire good and important information from their parents in their practical life.
Health and Physical Education - 8 91
9.3 Factors Influencing Family Health
There are many factors that affect family health directly or indirectly. Some of the
factors influencing family health are as follows.
a. Knowledge and Education
The status of family health becomes better if the family members are educated
well about health and hygiene. Education can be acquired in both formal and
informal ways. Formal education can be acquired through different levels of
educational institutions including schools and colleges. If the family members
know about diseases, hygiene, and various other factors related to health, they
can use their knowledge in practical life of all the members. Informal education
can be acquired from senior members, their experiences, and other informal
programmes held in the family. There are various superstitious beliefs existing
in our society. These wrong beliefs are inherited through generations. Such
superstitious beliefs make people deviate from modern health services and
scientific and truthful knowledge.
b. Religious and Cultural Practices
Religion and culture of people influence their health behaviours remarkably. For
example, there are common types of food behaviours in similar religious groups
of people. The religious practices and myths give the guidelines for daily baths,
fasting, and specific food items. Many cultural practices are related to feasts,
fasting, dress ups, meditations, and even religious travel as pilgrimage. All
these factors determine and influence peoples’ health in various ways. Besides,
some of the cultures boost the wrong beliefs and superstitions affecting health
adversely. For example, some holy books explain the cause of leprosy as the
curse of gods in previous life. They also emphasize that the disease is treated
by worshiping gods and goddess. Such wrong information may lead people to
treat diseases and detract people from scientific medication systems. Therefore,
such religious and cultural superstitions should be amended1 in proper ways.
c. Family Size
Family health is basically determined by the size of the family. If there are many
members in a family, there are many demands and needs. The basic needs
including food, cloth and health services are also comparatively more in a large
family. If the family size is larger, it is difficult to fulfill the basic needs. Family
health cannot be maintained well if these basic needs are not fulfilled. A small
family consists of few family members and their needs can be fulfilled even
with low income. Therefore, a small family assures better family health.
d. Family Income
Income is the main factor determining the fulfillment of needs in a family.
Adequate food, nutrition, clothing, personal hygiene, sanitation, health check-
1 Amend = modify, make changes
92 Health and Physical Education - 8
up, etc. are possible with adequate income. Afamily is composed of economically
active and dependent members. The active members generate income for the
family whereas dependent members do not earn. All the families may not have
sufficient income. There are various needs in each family but it is the parents'
responsibility to allocate the income wisely for the betterment of family health.
9.4 Introduction to Community Health
The health status of people is determined by various factors. Human being is a social
creature and it lives in society or community. People living in a community are linked
in various ways. They share a common environment, climate, social norms and
values, and common health services and facilities available in the community. There
are various types of diseases, which affect a group of individuals in different ways.
Some diseases can be controlled by personal effort but some of them, especially those
which are communicable and become epidemic, need group or community effort
to control. There is a need of public participation or the involvement of the whole
society. Therefore, community health is synonymously known as public health,
community medicine, or social medicine. In the past, community health programme
was understood as the programme of sanitation of public places and cure of diseases
in the community. However, these days it is considered in a broad sense and it includes
curative, promotive, preventive, as well as rehabilitative health services. Community
health focuses in the participation of community people for preventing diseases in
the community.
Community health can be defined as a science and art of postulating a balanced
integration of curative, promotive, preventive, and rehabilitative health services
to make a community healthy by promoting environmental and personal health
of the community people through an organized community effort. The concept
of community health concept has been adopted by many countries in their health
policies in the world. World Health Organization (WHO) has given the concept of
primary health care, which has been adopted by Nepal in its health policies. Primary
health care focuses to provide basic and necessary health services to all the people
living in all corners of the world. That’s why, primary health care is also considered
under community health.
9.5 Status of Health Services in Nepalese Community
Nepal is a party to various international health conventions. It has signed many
international documents addressing health of people. Some of them are the
International Conference on Population and Development, Cairo Conference (Egypt,
1994), Beijing Conference 1995, Tehran Conference, etc. Nepal is a poor developing
country with many problems for people. There are many superstitious beliefs which
are strongly rooted and practiced in Nepalese communities. There are many rural and
Health and Physical Education - 8 93
underdeveloped areas in Nepal. These areas have high disparities due to geographical
characteristics, population density, development features, and access of government.
In spite of such vividness, there are following health service centres in Nepal.
(a) Sub Health Posts
It is the lowest level of health service centre run by the government of Nepal.
There is one sub health post in each of about four thousand village development
committees (VDCs) in Nepal. As per the policies of Nepal government, there
is a provision of free health check-up for all the people living in the village.
Each sub-health post is headed by a CMA (Community Medical Assistant).
There are a MCHW (Maternal Child Health Worker) and one VHW (Village
Health Worker) in each sub-health post. People can get health services like
immunizations, family planning services, and treatment of minor diseases
from sub-health posts. Nepal government has adopted a policy of upgrading
the sub-health posts into health posts.
(b) Health Posts
Health posts are higher health service centres than sub-health posts. Health
posts have been established in some highly dense villages and more than 50
town areas in Nepal.
There is one Health Assistant
(HA) in each health post.
Besides, there are CMA, MCHW,
Auxiliary Health Worker (AHW),
and Auxiliary Nurse Midwife
(ANM) in the health post. There
are more health services and
facilities in the health posts than
in the sub-health posts. People
should know about the services provided by health posts in order to benefit
from them. Nepal government has adopted policies to upgrade the health posts
into primary health centres.
(c) Primary Health Centres
Primary health centres are the higher level of health service providers. Primary
health centres are planned to be established by increasing health manpower
along with one MBBS physician, beds, and other services in existing health
posts in Nepal. This has been included in the national health policy and plan.
Primary health centres are in operation in each of 205 election constituencies
in Nepal. Each primary health centre is administered by a medical officer (An
MBBS doctor), Health Assistants, ANM, MCHW, and other staffs. Primary
health centres provide different health services like treatment of disease,
immunizations, first aid, health education, etc.
94 Health and Physical Education - 8
(d) Hospitals
Hospitals are the highest level of health service centres with provisions of
outdoor patient department (OPD), indoor patient department (IPD), beds,
specialist doctors, and modern medical equipments like X-ray, CT scan,
advanced labouratories, and operation theaters (OT).
People can get various health
services including the facilities
obtained from the above-
mentioned provisions in the
hospitals. Besides, there are a
number of doctors and specialists,
ANM, staff nurses, senior nurses,
surgeons, and other staffs.
There is a zonal hospital in each
zone and a district hospital in
each district of Nepal. District
hospitals have 25 to 50 beds whereas the zonal hospitals have more than 50
beds for the indoor patients. The indoor patients are admitted to beds and get
proper care and treatment from specialist doctors inside the hospitals. Except
the zonal and district hospitals, there are some hospitals at the national level.
They provide quality health services and facilities at the highest level. Some of
them are specialized for the curative service for particular diseases. Followings
are some of the examples of hospitals at the national level.
(a) Bir Hospital, Kathmandu
(b) B.P. Koirala Institute of Health and Sciences (BPKIHS), Dharan, Sunsari
(c) Maternity Hospital, Kathmandu
(d) Mental Hospital, Patan
(e) Shukra Raj Tropical and Infectious Disease Hospital, Kathmandu
(f) B.P. Koirala Cancer Hospital, Bharatpur, Chitwan
(e) Private Hospitals, Clinics, and Nursing Homes
The hospitals in this category are established as medical businesses in the form
of health service centres with financial investment from the private sector,
organizations, and businessmen. Some of the private hospitals and nursing
homes are providing quality health services to people but some have been
found to be exploiting the patients. Most of them are expensive and inaccessible
to poor people. They are town-centreed and profit-oriented. In the context of
skyrocketing population growth, the number of government hospitals has
become inadequate to meet the demand of health services of the people. Private
hospitals and nursing homes are playing important roles to fulfill the growing
demand of health services.
Health and Physical Education - 8 95
(f) Ayurvedic Hospitals
‘Ayurveda’ is one of the holy books among four major ‘Vedas’ of Hindu religion.
It has a collection of ample information about different herbs and their utility in
human health. The hospitals that follow the system of treatment or health care
of people on the basis of Ayurveda are called Ayurvedic hospitals.
There is an Ayurvedic Department under the Ministry of Health and Population.
It carries out the functions like formulation of plans and policies, monitoring, and
coordinating the Ayurvedic hospitals and dispensaries. It governs Ayurvedic
hospitals and dispensaries at zonal, district and area level.
(g) Homeopathic Hospitals
Homeopathy is a system of alternative medicine developed by Mr. Samuel
Hahnemann on the basis of his doctrine, “like cures like”. He believed that a
substance that causes the symptoms of a disease in healthy people will cure
similar symptoms in sick people. Though the system has not been proved very
effective against many diseases, it has been quite popular because of less or no
side effects.
In Nepal, the first homeopathic hospital was established in Kathmandu in 2010
BS by Nepal government. Its name is Pashupati Homeopathic Hospital. People
can get treatment free of cost at this hospital. Patients can get facilities like bed
and food at this hospital for their treatment.
(h) Other Alternative Therapies
The alternative therapies include the systems of treatment in different ways.
Some of the systems found in Nepal are natural therapy, acupuncture,
acupressure, yoga, etc. They are also practiced in different places of Nepal for
the treatment of diseases.
9.6 Youth-friendly sexual and reproductive health services
The pubescents and adolescents are known as youths who undergo several physical
and psychological changes at this age. They experience distinct changes in their
primary and secondary sex organs. If they lack proper knowledge on sexual and
reproductive health, they must tolerate reproductive health problems. Youth-friendly
sexual and reproductive health services include:
a. Proper counseling on the issues like safer sexual behaviour, HIV infection,
drugs, and addiction
b. Adequate information on sexual and reproductive health phenomenon
c. Knowledge on the physical and psychological changes during puberty and
adolescence
d. Youth-friendly and participative teaching and learning on the issues of sexual
96 Health and Physical Education - 8
and reproductive health
e. Provision of secrecy and respect while addressing treating venereal diseases or
any other forms of STIs
f. Assurance of reproductive and sexual rights
9.7 Counseling and positive behaviour for HIV-infected people
When HIV (Human Immunodeficiency Virus) enters into the human body and
destroys the defense power against diseases, the condition is called AIDS. The full
form of AIDS is Acquired Immunodeficiency Syndrome. The disease-resistance
power or immune power is deficient (less) in AIDS. Therefore, the AIDS victims suffer
severely from diseases like tuberculosis and cancer. Such diseases become the direct
cause of death of the victim ultimately.
HIV/AIDS is a sexually transmitted disease. It is also transferred by sharing needle,
razor, blood transfusion, and breastfeeding by an infected mother to her child. There
is no any effective treatment discovered against this disease till now. Some retroviral
medicines are developed but they are just used to inhibit the rapid replication of
viruses and prolong the victim’s life.
The victims may look equally healthy in comparison to other people. They can work,
earn, and pass happy life if they get support from the people around them. Therefore,
we must deal with them properly so that they can live without worries of infection.
It is not transmitted by living together, sharing food, shaking hand, embracing, or
talking to them from close. Some of the guidelines which suggest us how to deal with
HIV/AIDS infected people are:
a. Never discriminate them in any manner while talking, living, or sharing the
room.
b. Motivate them to continue their study or job, what they were engaged in
before knowing about their disease.
c. Do not humiliate them in the a manner that they are HIV infected and
different from you and other people.
d. Make them well-aware about the transmission of HIV from them to other
healthy people.
e. Do not let them involve in alcohol, tobacco, or drugs.
f. Manage regular provision of ARV(Anti Retroviral) medicine in order to
prolong the victim’s life.
g. Always try to keep the victim happy, optimistic, and positive.
Health and Physical Education - 8 97
Exercise
A. Answer the following questions.
1. Define family. What are the differences between joint and nuclear family?
2. Why does a small family have less needs and desires?
3. Define family health. Write the importance of family health education.
4. List the factors influencing family health status.
5. How do the religious and cultural practices affect family health?
6. “Family size and family income are the major determinants of family
health.” Justify.
7. Define community health. What are the common factors influencing
health in a community?
8. What is the status of health services in Nepalese community?
9. Write short notes on:
(a) Sub-health post (b) Health post
( c) Primary Health Centres (d) Hospital
10. “Sub health posts are serving the majority of Nepalese population.” Justify.
11. Why are hospitals regarded as the highest level of health service providing centres?
12. How do private hospitals and clinics contribute in the promotion of
community health?
13. What do you mean by youth-friendly sexual and reproductive health service?
14. How should we behave with the HIV/AIDS victims? Suggest any five ways.
B. Write ‘T’ for true and ‘F’ for the false statements.
1. All the members of a family should be conscious to keep their family healthy.
2. It is the duty of the mother and sister to make our home clean.
3. There is a CMA at sub-health post.
4. PHC has better health services than the services in a health post.
5. Reproductive health education is not essential in school-level education.
6. HIV/AIDS infected people should be isolated from the family in order to
prevent the communication of the disease.
7. ARV can prolong the life of HIV/AIDS infected person.
98 Health and Physical Education - 8
#8 Health and Physical
Education2Part
Physical
Education
Health and Physical Education - 8 99
10
Physical Exercises
10.1 Introduction to Physical Exercises
The exercises performed with scientific movement of the body parts in certain
predefined ways are called physical exercises. They are one of the important aspects of
physical education. Physical exercises include several activities like running, jumping,
climbing, balancing, and vaulting. Physical exercises are the basic skills for various
games and gymnastics. They make our body systems active and fit for accomplishing
their proper functions. In this way, physical exercises make people healthier. There
are various types of physical exercises. Some items of physical exercises are squat
thrust, dodge run, walking on hand, front headed bent, vault over, trunk twisting and
bending clap, third bridge exercise, bending back, and pyramid of three.
10.2 Warming-up Exercises
Physical exercises need preparation of our body to perform them in proper ways.
Basic requirements of physical exercises like blood circulation, muscle tone, and
psychological state become ready with the warming-up exercises. Our body can
easily and properly perform exercises in such a condition.
Items of warming-up
exercises may differ
according to the game or
sport which is going to be
performed subsequently.
For example, if we are
planning to participate
in football game, there is
a need of warming-up exercises basically for waist, thigh, knee, and feet. Similarly,
there is a need of warming-up exercises for hands, fingers, and arms if the upcoming
involvement is in volleyball game.
Jumping, running, and twisting body parts are commonly applicable for the
preparation of almost all games . Look at the pictures below and practice them under
the instruction of your teacher.
100 Health and Physical Education - 8
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