Oasis Health, Physical Education & Ceatve Arts 7

Stages of HIV/AIDS

HIV/AIDS is a chronic disease that develops progressively in human
body over a long period. It begins from the entrance of viruses in the
body and ends at the death caused by other opportunistic diseases19
like TB, cancer, etc. The first symptoms of HIV infection appear two to four weeks
after the entrance of viruses in the body. This period is known as incubation
period. After incubation, the infection progresses to the stage-I of HIV infection,
known as window period.

Stage I-Window Period

This is the first stage of HIV infection. This is called window period because the
viruses are not seen in blood in the laboratory tests. They multiply rapidly and
start destroying immune cells in the body. The viruses destroy special types of
lymphocytes known as CD4 cells. This stage lasts for about one to three weeks.
Some minor symptoms like headache, mild fever and cough, swelling of the
lymph glands, oral ulcers, and red spots on the body are developed in this stage.
These symptoms disappear when the infection is developed into the next stage.

Stage II – Latency Period

In this stage, viruses grow remarkably in number and can be seen in the laboratory
tests of blood. This period may not have any remarkable symptoms unless the
immune cells are destroyed to a significant extent. This is the stage of losing
defense power against various disease germs. This stage may show very few or
no symptoms at all and may last from two weeks to fifteen years or even more.
If the victim follows hygienic and healthful habits to prevent oneself from other
infections, s/he can live a healthy life. Relatives, friends, and other people in
touch with the victim must maintain a cordial, helpful, and friendly relationship
with the victim to lengthen his/her life.

Stage III – AIDS

The final stage, AIDS, is the stage before death. This stage is characterized by
various opportunistic infections. The immune power of AIDS victim becomes
severely declined. The following symptoms are seen in the AIDS stage.

(i) Enlarged and painful lymph glands (Lymphadenopathy).
(ii) Oral20, pharyngeal, and esophageal sore21.
(iii) Persistent unhealed skin wounds throughout the body surface. This may

be Kaposi's sarcoma22.

19 Opportunistic disease = diseases that attack when the immune power of body remarkably declines
20 Oral = pertaining to the mouth
21 Sarcoma = a type of cancer

Health and Physical Education # 7 47

(iv) Remarkable weight loss.
(v) Unhealed malignancy in any part of the body.
(vi) Continuous fever, cough, sores, diarrhea, etc. which remain unhealed.

Minor and Major Signs of HIV/AIDS

AIDS is a syndrome creating suitable environment for various forms of other
diseases. It doesn’t have its own characteristic symptom. But, it is always associated
with the signs and symptoms of other diseases. Unhealed and persistent cough,
fever, swelling of the lymph glands, oral ulcers, and red spots on the skin are
the minor symptoms of HIV infection. These are the minor symptoms of HIV
infection and last for about one to three weeks. When the infection develops to
the stage of AIDS, some major symptoms appear. The major symptoms include
long and persistent fever, diarrhea, and remarkable weight loss of about ten
percent or more than that.

B) Syphilis

Syphilis is one of the most common sexually transmitted diseases. Though it
is transmitted through sexual intercourse, it affects the vital organs located in
safe site of the body like heart, liver, and brain. It is caused by a microorganism,
Treponema pallidum. Syphilis can also be acquired from a blood transfusion. It
is transmitted through common use of syringes. It is found spreading among
injecting drug users. Syphilis is also transmitted from a pregnant mother to the
fetus23 through the placenta. There is almost fifty percent chance of transmission
of syphilis from an infected mother to the fetus.

Symptoms of Syphilis

The symptoms of syphilis gradually develop over a long period. There are
three stages of syphilis based on the onset of symptoms of the disease. They are
primary stage, secondary stage, and tertiary stage.

i. Primary stage: The first sign of syphilis in its primary stage is a chancre24
. It generally appears two to four weeks after infection. The most common
locations for the chancre are the genitals, anus, lips, inner parts of mouth,
breast etc. The chancre does not have any pain or itch. It disappears itself
within one to five weeks.

ii. Secondary stage: Secondary syphilis begins anywhere from one week to
six months after the chancre heals. The symptoms include a pale red rash,
fever, sore throat, headaches, poor appetite, weight loss, and hair loss. If
not diagnosed and treated properly, it is developed into third stage syphilis.

23 Fetus = growing baby inside the mother’s womb
24 Chancre = a small wound that appears on the genital organs, lips, or breast in the first stage of

syphilis

48 Health and Physical Education # 7

iii. Tertiary or late syphilis: It is the third and final stage of syphilis. Late
syphilis involves serious heart problems, eye problems, and brain or
spinal cord damage. The victim becomes mentally deranged and dies.

C) Gonorrhea

In medical language, the prefix ‘gono-’ denotes the genital organs and the suffix
‘-rrhea’ means discharge. In this way, the name of the disease suggests one of
the main symptoms of this disease, i.e. unusual discharge of fluids from genital
organs. Gonorrhea is caused by microscopic organism 'gonococcus of Neisser'.
It affects male and female genital organs including anus and throat too. It is
transmitted through the contamination of infected blood. It is also acquired with
infected blood transfusion. Gonorrhea is the oldest form of STI.

Symptoms of gonorrhea
(i) In early stage of gonorrhea, there may not be remarkable symptoms.
(ii) The main characteristic feature of gonorrhea is the discharge of yellowish

fluid with foul odor from the genital organs.
(iii) Swelling, appearance of red spots, and pain in the genital organs.
(iv) Fever with abdominal pain.
(v) Frequent and inflamed urination.
(vi) There is accumulation of pus in prostate gland of males.
(vii) In females, there is lower abdominal pain, fever, nausea, and irregular

menstruation cycle.
(viii) Gonorrhea may damage the reproductive organs resulting in infertility.
(ix) In infants, it is marked with redness of eyes and its surroundings and over

secretion of tear.
Preventive Measures against Sexually Transmitted Diseases

HIV/AIDS, Syphilis and Gonorrhea

Preventive measures of these sexually transmitted diseases (STDs) can in short
be mentioned as ABC method. ABC-method of preventing STDs includes:
A – Abstinence: It is the practice of staying away from sexual indulgence.
B – Be a faithful partner to your spouse only. Have sexual intercourse with

only one partner.
C – Correct and consistent use of condom.

Health and Physical Education # 7 49

Besides the above-mentioned ABC rule of preventing STDs, the following rules
should be adopted.
i. Never indulge in unsafe sex. If the partner is doubtful, use condom.
ii. Never use common syringe and needle for any purpose.
iii. Awareness program we should be conducted for community people

about STIs, HIV and AIDS.
iv. HIV monitoring must be conducted during blood donation and

transfusion.
v. HIV infected females should not be pregnant.
vi. Spread the knowledge about condom and its method of appropriate use

to prevent STIS and HIV/AIDS.
vii. HIV infected persons should be treated normally without any sort

of isolation and discrimination. Proper counseling may support the
adjustment of the patient in the family and society.
viii. Provide proper care and help to the victims.
ix. Health education should be made accessible to all. Inclusion of
communicable diseases, precautions, safety measures, and prevention
methods should be included in health education.
x. If one's spouse (husband/wife) or sex partner is diagnosed with any form
of STI, probability of infection becomes high. In this condition, immediate
check-up and treatment should be sought.
xi. STIs should not be concealed in any circumstances. It should be treated in
early stage.
xii. Hesitation to discussions and education related to sex and sex-related
matters should be overcome. STI, sexuality, safe and healthy sex-
behaviours should be openly discussed among friends, teachers, and
family members.

50 Health and Physical Education # 7

Exercise

1. Match the following:

Ascariasis Bacteria
Diphtheria Protozoa
Malaria Virus
Measles Helminth

2. Fill in the blanks with the best option.

a. Diphtheria is the disease of …………………….. (throat, nose, ear)
b. ………………… is an example of communicable disease. (scurvy, night

blindness, kala-zaar)
c. The reservoir, ………………., and medium are the elements of the disease

cycle. (receiver, transferor, vector)
d. The full form of second T in TT is tetanus ……………….. (taxis, texis,

toxoid)
e. Asymmetric paralysisis one of the symptoms of ………………….. (polio,

diphtheria, ascaris)
f. ‘A’ stands for ………………………… in the ABC method of prevention of

STDs. (appropriateness, abstinence, accuracy)

3. Write any two differences between communicable and non-communicable
diseases with examples.

4. Define causative agent. List any four causative agents from protozoan, helminthes,
virus, and bacterium with related diseases.

5. Draw a diagram of disease cycle. What role does the reservoir play in this cycle?

6. How does tetanus communicate from one person to others? List any three
preventive measures.

7. What are the symptoms of diphtheria? Which vaccination is used to prevent it?

8. Why is the alternate name ‘lockjaw’ given for tetanus? Give reason.

9 How does polio communicate? List any three measures to prevent polio.

10. What are the major causes of pneumonia?

11. List any three modes of transmission of gonorrhea.

12. Write the symptoms of tapeworm infestation.

13. What is HIV/AIDS? Why has it become a very dangerous disease all over the world?

Health and Physical Education # 7 51

5Unit

Adolescence, Sex, and
Reproductive Sex Education

Before You Start the Text

Visit and interact with any two children younger than you. Ask them about their
interests, everyday activities, responsibilities modes of dependency and aim of life.
Ask similar questions to any two senior members of your community. Note their
answers and share them among your friends and teacher.

52 Health and Physical Education # 7

5.1 Introduction to Adolescence

The growth and development of
human beings starts from the womb
of the mother. When a child is born,
it grows and develops throughout
its life. The growth may be physical,
mental, social and emotional. The
entire life of human beings is divided
into three periods; childhood (birth to 9
years), adolescence (10 to 19 years) and
adulthood (above 19 years).

Adolescence is a very important phase
of human life. We enter adolescence group once we pass childhood. Therefore,
it is also called a transitional period. Different changes are seen in our body,
thinking, behaviour and emotions. Thus, adolescence is the period in which
various physical, mental social and emotional changes occur. These changes
should be taken normally because it is natural. Some of the changes that occur
during adolescence are discussed below.

Characteristics of adolescence

Adolescence is characterized by distinctly observed changes. They can be
categorized into physical, mental, emotional, and social changes. Because of
these changes, they possess the following characteristics:

i. They understand the changes and develop positive attitude towards them.
ii. There is an increase in decision making power.
iii. They try to be more responsible in their works.
iv. They search for more freedom.
v. They are curious to learn new things.
vi. They develop interest in every new thing and event.
vii. They become interested in social and cultural aspects of life.
viii. They can plan for future and start doing so.

5.2 Sex Orientation

Sex orientation is the position of an individual on the basis of sex characteristics,
interests, and behaviours. Sex behaviour of people is affected by social, cultural,
religious and other contextual features and identity. There are mainly three
categories of people according to their sex orientation.

Health and Physical Education # 7 53

a) Heterosexuals: People with the sex attraction with opposite sexes are
called heterosexuals. Most of the people fall in this category.

b) Homosexuals: People with the sex attraction with the same sex are
called homosexuals. Male homosexuals are known as ‘gay’ and female
homosexuals are known as ‘lesbian’.

c) Bisexuals: People with equal attraction towards both sexes are called
bisexuals.

5.3 Need and Importance of Reproductive Health
Education

Many adolescents fall in the problems of sex abuse due to lack of proper sex
education or its application in life. This stream of education is an integrated
programme which deals with healthy sex behaviors. There are different
misconceptions about sex-related matters in adolescents and non-adolescents in
our society. Adolescents show shyness to discuss freely the matters of sex. As a
result, they are concealing their sex and reproductive issues in their life. Due to
this, they face troubles in their future life. But the sex education aims to eradicate
such types of problems and give good guidelines. Some of the important points
of sex education are:
i) Sex education helps to fight against the traditional and unscientific beliefs

related to sexual behaviour of people. Some examples of traditional,
superstitious, and unscientific beliefs are: the number of children is
predetermined by fate, the reproductive health is deteriorated by the
practice of masturbation, and sons are more important than daughters,
etc. Sex education is found to be a strong tool to eliminate such wrong
beliefs existing in the society.
ii) Sex education helps adolescents to understand the natural reproductive
phenomenon of human beings.
iii) It helps to bring positive changes in knowledge, attitude, and behaviour
in children related to sex behaviour.
iv) Sex education makes people aware about transmission of HIV/AIDS and
other STIs.
v) Sex education fights against the system of gender discrimination in
families and societies. The gender of the child is not determined by the
status of the mothers. But, there are many systems of discrimination and
domination of mothers due to the birth of daughters by them. In fact, it
depends upon the chance of type of sperm which fertilizes the ovum.
vi) It helps to eradicate the orthodox and superstitious matters regarding sex.

54 Health and Physical Education # 7

vii) It helps to promote adolescents to discuss freely about the sex-related
matters.

viii) It provides information about family planning and proper use of
contraceptive devices.

5.4 Gametogenesis Process

Sperms and ova are the gamete cells. Gamete cells are the special types of cells
which take part in fusion for sexual reproduction. Process of production of the
gamete cells (sperms and ova) is called gametogenesis.

5.4.1 Spermatogenesis and nocturnal emission

Process of formation of sperms inside the testes of males is known as
spermatogenesis. There are several small coiled tubules in the testes of males.
They are called semeniferous tubules. After the maturity of late childhood,
adolescence starts in boys. With the development of adolescence, cells situated
in the testes develop into spermatogoniums and primary spermatocytes. They
undergo meosis cell division and produce sperms. A sperm consists of a head,
a body, and a tail. They are highly motile in the semen. A normal human cell
has 46 chromosomes set as 23 pairs. But a sperm has only 23 chromosomes
altogether. Therefore, they are called haploid (or half) cells.

Spermatogonium

Primary spermatocyte
(Diploid number) 46

Secondary spermatocytes 23 23

Spermatids 23 23 23
Head

Middle piece
Tail

Sperm
Spermatogenesis

Health and Physical Education # 7 55

Cell Neck
Membrane

Tail Mid-piece Head

Axial filament of Distal
tail Centrilole

Mitochondria Nucleus

Acrosome

Proximal Centriole

A Sperm

5.4.2 Oogenesis and menstruation

The cells present in the ovary of females develop into primary oocyte with the
maturity of late childhood and onset of early adolescence. It undergo meosis cell
division and produces four haploid cells. Among them, one haploid cell develops
into ovum and remaining three become polar bodies which cannot be fertilized.
The haploid ovum has 23 chromosomes and can be fertilized with a sperm.

Primary oocyte

Primary oocyte
(Commencing maturation)

Secondary oocyte First polar body

Mature ovum Polar bodies
56 Health and Physical Education # 7

Menstruation is a monthly-periodic process of discharging useless blood, mucus,
and dead ovum out from vagina. It starts after the maturation of reproductive
organs in adolescent girls. The first menstruation is called menarche and it takes
place at the age of eleven to thirteen years. Menopause is the end of menstruation
with the cessation of reproductive power. It takes place at the age of 45 to 50
years. Thus, the fertile age of a woman begins from menarche and ends with
menopause. It occurs normally at the interval of 28 days; but sometimes, it can
be a little bit earlier or later.
When the ovary starts developing an ovum in it, the uterus starts the preparation
of implantation of the fertilized egg. During this preparation of implantation,
there is formation of an internal layer on the internal wall of uterus consisting of
many new blood vessels and mucus membrane. An ovum is developed every
month but there is no chance of presence of sperm every time when there is
ovum. If there is no fertilization, the preparation works of uterus, i.e. new layer
of blood vessels and mucus start to degenerate. Due to this, there is discharge of
blood from vaginal opening. Process of discharge of useless blood and mucus
with the unfertilized dead ovum from the vaginal opening once in a month is
called menstruation.

Uterus

Ovary developing egg
(ovum)

Cervix (neck Vagina
of uterus)

Fallopian tube

Lining Blood & tissue Egg released
breaking being lost through
the cervix & vagina
down

Egg has not been
fertilised lining of uterus
5.5 Pregnancy not needed

Period from conception to childbirth is called pregnancy. It ranges about 280
days or 9 month and 7 days. The estimated date when the baby’s natural birth
takes place is known as expected date of delivery (EDD). It is calculated by
adding 9 months and 7 days to the date of last menstruation.

Health and Physical Education # 7 57

5.6 Infections in the Reproductive Organs

Reproductive organs in males and females have high probability of being infected
with germs. It is because of various wrong health practices, ignorance, lack of
proper sanitation of the reproductive organs, and lack of adequate knowledge
about it. Many people try to conceal the problems of reproductive organs. If
there is infection, they hesitate to go to hospitals. Annually, 3.4 million of people
get infections in reproductive tract in the world. Some of the measures to reduce
the problems of reproductive tract infection are given below:
i. Management of proper and accessible health education to a wide range of people
ii. Improvement of the health service providing centers
iii. Proper sanitation of reproductive organs
iv. Encouragement on using the barrier contraceptives (condom and

femidom) in insecure sexual relationship
v. Conduction of various formal and non-formal education programme
vi. Increasing awareness among the vulnerable group

Exercise

1. Fill in the blanks with the best option.
a. Adolescence is the age between …………….. to 19 years. (10,11,12)
b. Most of the people in the world are …………………………. (heterosexuals,
homosexuals, bisexuals)
c. Sperms are …………………….. cells. (somatic, gonad, gamete)
d. Seminiferous tubules are found in …………………………. (ovaries,
fallopian tubes, testes)
e. The average period of pregnancy is about . ……………….. days. (270, 280, 290)

2. Define adolescence. List the physical changes in adolescent girls and boys.

3. Describe the mental and emotional changes in adolescence briefly.
4. Discuss the major problems of adolescence with respective measures of their solutions.
5. What do you mean by reproductive health education? Describe the present

situation of reproductive health education at national and international level.
6. Define gametogenesis. How are sperms produced?
7. What is menstruation? Why does menstruation occur in girls?
8. What do you mean by sex orientation? Differentiate between gay and lesbian.
9. Write a short note on the infection of reproductive organs. How can such

problems be controlled in our society?

58 Health and Physical Education # 7

6Unit

Alcohol, Smoking
and Drugs

Before You Enter the Text

Try to make an interesting story about drunkard Harke with the help of the following clues
and tell it in your class.
Drunkard Harke…………… quarrel at home……… wife and children irritated……………once
stayed late at hotel for drinking alcohol…………… quarreled on the street…………… caught
by policemen……………tried to fight with policemen…………got punished badly…………
wife came and requested …………… Harke released ……………took him home………
Drunkard Harke gave up alcohol……………happy family…………lived happily.
Our body receives nutrition from the foods that we take every
day. People have learnt taking various harmful and euphoric1
substances for different purposes. Such things are harmful to our health. Tobacco,
alcohol, and drugs are such substances creating numerous problems in human health
all over the world.

1 Euphoric = producing different sensation in the brain
Health and Physical Education # 7 59

6.1 Alcohol and Alcoholism

It is a liquid substance produced by decomposition of organic food materials like
fruits and grains. It smells foul and produces abnormal sensation in the person who
drinks it. If alcohol intake is excessive, the person may die due to its intoxication1
. If alcohol intake becomes frequent for a certain time period, a habit develops.
This condition develops strong desires to take it time and again. Such condition
is known as alcoholism. Alcoholism has been a common problem of Nepal,
persisting equally in rural, urban, underdeveloped, and developed areas. There
are various types of alcohols sold openly in the markets of Nepal. It is easily
available and there is no strict restriction implemented against alcohol use.
Therefore, it has become a big social problem in our country.

Causes of alcohol intake

(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 be relieved from tiredness and muscle ache by

individuals who involve in hard physical labour.
(iv) Some think that it makes the digestion easy.
(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 respect of guests with alcohol.
(viii) There is a wrong belief that alcohol reduces tensions and mental stresses.

Effects of alcoholism

Immediate or short-term effects of alcohol
(i) Alcohol increases uncontrolled physical and verbal activities.
(ii) Alcohol sometimes reduces physical and verbal activities.
(iii) Vomiting is likely, if the intake is excessive.
(iv) Body becomes imbalanced and passive. In case of excessive intake,

unconsciousness may occur.
(v) Causes impaired and blurred vision due to imbalanced movement of eye

muscle.
vi. Short term memory loss can occur.

Long-term effects of alcohol

Physical effects of alcohol

1 Intoxication = poisoning effects

60 Health and Physical Education # 7

(i) Alcoholism decreases the performance of body systems.
(ii) Liver is affected leading to liver damage.
(iii) It causes infertility.
(iv) Digestive system is affected adversely and there is problem of in

indigestion.
(v) Symptoms of ageing start earlier.
Mental Effects of Alcohol
(i) Thinking capacity and creativity decreases.
(ii) Loss of memory can occur.
Social Effects of Alcohol
(i) The drunkard loses social prestige.
(ii) Social relationships are disturbed.

6.2 Smoking and Smoking Habit

Smoking is the process of inhaling smoke of different substances through
smoking items like cigarette, hookah, chilim, bidi, paper, etc. People use
different substances for smoking. Some of the substances are tobacco,
marijuana, and dhaturo. Tobacco is the major and most widely used substance
for smoking. It is a herb plant with flat and broad leaves. It contains a toxic2
substance called nicotine which gives a remarkable sensation. 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.

Causes of tobacco intake

There are many causes behind 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 groups

(ii) Request and pressure in friends’ circle

(iii) Imitation of the senior members in family and community

(iv) To satisfy the curiosity of taste and become habituated

(v) To believe wrongly that it reduces tension and gives pressure

(vi) To have a desire to look matured and adult

(vii) To adopt the habit as fashion

(viii) To feel warmth in cold seasons

2 Toxic = poisonous

Health and Physical Education # 7 61

Effects of tobacco intake

a) Immediate or short-term effects of tobacco intake
(i) Vertigo3 and nausea4 in the beginners
(ii) Feeling of intoxicated sensation with change in brain waves, which the

abusers term as “pleasure”
(iii) Sudden fall in body temperature resulting in feeling of warm sensation
(iv) Increase in pulse rate
(v) Irritation in respiratory track
b) Long-term effects of tobacco intake
(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) Poor function of nervous system; gradual damage of optic nerve causing

blurred vision and progressive blindness
(v) Stillbirths5 in pregnant women
(vi) Increased level of nicotine, causing desire of regular and continued

nicotine intake

6.3 Drugs and Addiction

Drug is any chemical substance that can change the working mechanism
of body organs. Drugs are used as medicine to change the wrong
working mechanism of different organs and systems. Medications
prepared for treatment of different diseases are taken by drug abusers6
to produce different sensations. Drug abuse is the deliberate use of an illegal
drug or of too much of a prescribed drug. After repeated abuse of any drug, the
abuser may develop strong desires to take it again and again. This situation is
known as drug addiction.

Causes of drug intake

i. Most of the addicts learn drug intake from their friends.
ii. Drug abuse is taken wrongly as a solution to the frustration of life.
ii. Drug addiction is promoted by religious support. Some Hindus take

drugs like marijuana to please Lord Shiva.
iv. Abusers try to impose this habit.

3 Vertigo = sensation that the surroundings is going round
4 Nausea = sensation or tendency to vomit
5 Stillbirth = birth of dead fetus from the womb
6 Abuser = a person who uses something in wrong and illegal ways

62 Health and Physical Education # 7

v. There is high degree of curiosity for the effects of drug intake among
adolescents.

Effects of drug intake
i. Reduction in smooth body functions
ii. Reduction in motor coordination7
iii. Elevated blood pressure and heart beat
iv. Loss of appetite8
v. Headache, sweating, nausea, dizziness
vi. Increases the probability of communications of diseases like HIV/AIDS,

hepatitis B, hepatitis C, etc
vii. Loss of memory and comprehension
viii. Imbalance in social relationships, inclination to social crimes, etc

6.4 Preventive Measures Against Alcohol, Smoking,
and Drugs

The following measures can be adopted for the prevention and control of alcohol,
tobacco, and drugs.
i. Awareness programme in village and town areas especially focused on

adolescents
ii. Formulation and implementation of strict laws against use of such

substances
iii. Declaration of alcohol-free, smoking-free, and drug-free zones in public

places
iv. Ban in the advertisements of any form of alcohol and tobacco in public

media and public places
v. Encouraging people to have healthy personal habits
vi. Arrangement of proper health education including the knowledge about

the adverse effects of tobacco, alcohol, and drugs

7 Motor coordination = coordination of brain and body parts with proper conduction of nervous
impulses

8 Appetite = hunger
Health and Physical Education # 7 63

Exercise

1. Write “T” for true and “F” for false statement.
a. Alcohol is produced from organic matters.
b. Intoxication may cause death of drunkards.

c. Alcoholism increases the fertility power.

d. Tobacco increases the irritation in respiratory track.

e. Drug abuse prevents us from diseases.

f. Formulation and implementation of strict laws against use of the addictive
substances creates problems in society.

2. Give a short introduction to alcohol and alcoholism.

3. What are the common causes of alcohol intake?

4. List the mental and social effects of alcohol.

5. Define smoking. Name any three substances used for smoking.

6. List any three short-term and three long-term effects of tobacco intake.

7. Are all the drugs avoidable? Why? Give reasons.

8. How can we prevent the addictions of alcohol, smoking, and drugs?

64 Health and Physical Education # 7

7Unit

Environmental
Health

Before You Start the Text

Do you think the environment in your community is healthy?
Do you think the air and water you are using is clean and safe?
What types of activities are making these components dirty?
Arrange a symposium in your class and share your opinions with your friends.

Health and Physical Education # 7 65

7.1 Introduction to Environmental Health

Environment is one of the most important factors determining and influencing
our health. Innumerable living and non-living environmental components
around us affect our health positively or adversely based upon their nature and
characteristics. For example, oxygen gas present in the air keeps us alive but the
poisonous gases and dust particles present in the air cause diseases. Similarly,
we cannot survive without water but there are many waterborne diseases caused
just due to polluted water.

Our environment has become imbalanced and polluted due to rapid increase
in human population, industrialization1, and urbanization2.. Global warming3,
increase in sea level, pollution of water resources, and rapid destruction of forests
are the major challenges to the present environment. These are all caused by the
foolish activities of human beings.

Environmentalhealtheducationteachesusaboutpresentsituationofenvironment,
its natural characteristics, correction methods of the anti-environment activities,
and conservation measures of our common environment. This education is very
important for the preservation of environment through increasing knowledge,
awareness, and positive attitudes towards the environment.

7.2 Water Pollution and Its Effects on Our Health

Water is an essential
component for our life. We
cannot survive without
water. If the environment
is polluted, many 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 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

1 Industrialization = process of developing certain areas extensively with industries
2 Urbanization = process of converting rural areas into the town areas
3 Global warming = rise of the temperature of the whole world

66 Health and Physical Education # 7

make it inappropriate for our use. Polluted water is not good for other organisms
including plants, fishes, and animals.

Polluted Water Transmits 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
make 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.

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 a bath, wash
clothes, and take their domestic animals in 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 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.

7.3 Dehydration and Its Effects on Our Health

When there is lack of water in Drinking clean water
our body, the condition is called Health and Physical Education # 7 67
dehydration. Water is the basis
of survival of all living things in
the world. Circulation of nutrient
substances, gases, hormones, and
several chemical substances are
dissolved in blood and other body
fluid. Water is the major constituent
of our body as it occupies about
seventy percent of the total body
weight.

In absence of water, our body functions are disturbed. The sensation of thirst
gives us information about shortage of water in our body. Therefore, as soon as
we feel thirsty, we must drink plenty of clean and safe drinking water.

7.4 Solid Waste

Solid waste can be defined as the residues of vegetables, ash, waste paper,
broken glasses and plastics. When these refuse mix with some other particles,
they become solid waste. Solid waste is produced through our daily activities.
The sources of solid waste are market area, business centers, industry, offices,
educational institutions and houses. Solid waste can be classified into organic
and inorganic waste.

(a) Organic Wastes (Biodegradable/ Decomposable Wastes)
Degradable wastes produced from the residues of biotic4

substances are known as organic wastes. This category of waste is
decomposed by certain bacteria and protozoa and complex compounds
are spat into simpler ones. The examples of organic wastes are kitchen
waste, vegetables residue, and the residue of plant and animal bodies.
These wastes are decomposed by microscopic organisms, mix in the soil
and get consumed by plants again.
(b) Inorganic Wastes (Non-biodegradable/ Indecomposable Wastes)
The waste which is not degradable is known as inorganic waste. The
examples of inorganic waste are plastics, metals, polythene, glasses etc.
This kind of waste does not mix in the soil so easily and can have negative
impacts if it enters our body through different means.

7.5 Solid Waste Management

Solid wastes can be managed in various ways. One of the best ways of its
management is preparation of compost manure from the solid wastes. It is a
beneficial process because the wastes can be used for production of valuable
compost manure that can be used in the gardens or fields for higher yield of
agricultural production. Some of the common measures of management of solid
wastes are:

Dumping

Dumping is the process of managing waste by taking it at a distant place.
The place where wastes are thrown is called dumping site. The dumping
site should be far away from human residential areas and water resources.

4 Biotic: living things like plants (fruits, vegetables, woods, leaves, etc.) and animals

68 Health and Physical Education # 7

If the site is near, there is a chance of occurrence of diseases and spreading into
the environment. This method is appropriate when the production of solid
wastes is in very large amount. In town areas of Nepal, the municipalities are
taking responsibility of managing waste collecting vehicles and managing the
wastes at the dumping site. This method is also known as land filling method.
It is widely practised in town areas like Kathmandu, Pokhara, and Dharan in
Nepal. This method requires a dumping site, which is very difficult to get as it
should be far from residential area and water resources

Burying

If the waste materials are highly infectious, there is a chance of disease
transmission from person to person. In such condition, it is better to bury the
waste under the soil. This method of waste management is known as burying.

Preparation of compost manure

In order to prepare compost manure from the wastes, we must separate
the biodegradable solid wastes from the non-biodegradable wastes. The
biodegradable wastes are kept in a compost manure pit. The pit is kept moist
by adding water, sludge, or domestic animals’ dung and urine for their quick
decomposition into manure. If air is allowed by turning the upside wastes down
frequently, preparation of manure takes a shorter time. If we do not need the
manure quickly, the pit can be covered with a layer of soil. This prevents the
spread of foul smell into the environment. After the manure becomes ready, we
can use it in our garden to increase the agricultural yield and fertility of the soil.

Reuse of waste materials

Some of the solid wastes can be used again for different purposes. For example,
the old newspapers can be used by shopkeepers for wrapping the goods. In this
way, instead of throwing wastes, we can utilize them again. The process of using
wastes for different purposes again after the previous use of the matters is called
reuse of wastes.

7.6 Latrine

Introduction to latrine

Latrine is the place which is constructed for the purpose of safe defecation and
collection of human excreta. It prevents the problems created by open defecation
in the environment. Our stool is the most disliked thing for us. It has dirty look,
foul smell, and disgusting nature. Besides, it contains the disease germs and
worms. Though it is prepared inside our body, we have to pass it out every day.

Health and Physical Education # 7 69

Flies and insects like our stool very much. They Latrine
move from one place to another in search of
their food. They find their food in such decaying
materials like kitchen wastes and excreta.
Sometimes, they visit our food items kept in front
of us while eating or any other stored foods kept
open. In this way, they can easily transfer the
harmful germs and eggs of harmful worms from
the open excreta to our food items. Therefore,
we should discourage open defecation and
encourage people to develop the habit of using
latrine properly.

Advantages of using latrine

Some of the advantages of latrines can be listed below:

i. It protects people from communication of diseases which are caused by
the parasites found in human feces.

ii. Latrines prevent community and nation from epidemic diseases like
cholera.

Iii. Latrine provides us a secret and safe place for defecation and urination.
iv. It is very useful for elderly people, infants, and diseased people as they

cannot go very far for defecation.
v. Latrine helps in keeping the environment clean.
vi. Latrine gives identity of well civilized people. People living in those places

where open defecation system is still existing are not regarded as well-
civilized people.

7.7 Effects of Open Defecation and Urination on Our
Health

There are many communicable diseases caused by microorganisms and parasites.
Most of them live in our digestive system and body fluids. When we defecate
or urinate they escape out in the environment. If there is open defecation in the
environment, the disease germs and causative agents spread in the environment.
In such condition, there is high chance of contamination of our food and water
with them. They can enter in healthy person and grow rapidly in the body.
Open defecation is one of the major causes of wide prevalence of communicable
diseases in remote areas of Nepal.

70 Health and Physical Education # 7

Exercise

1. Write “T” for true and “F” for false statement.
a. Environment is the sum of things created and managed by people.
b. Environmental health education teaches us about the present situation of
environment.
c. Water is the major constituent of our body as it occupies about seventy
percent of the total body weight.
d. Plastic is an example of biodegradable waste.
e. Dumping is the process of burning waste materials.

2. Define environmental health. Why is environmental health education important
for us?

3. What are the major challenges to the environment these days?
4. Explain the advantages of water.
5. List any three human activities responsible for water pollution.
6. Differentiate between biodegradable and non-biodegradable solid wastes.
7. Describe any two methods of solid waste management.
8. How do the latrines protect us from various diseases?

Health and Physical Education # 7 71

8Unit

Safety and
First Aid

Before You Start the Text

We experience various minor injuries and accidents. What was your last injury?
Probably a cut on finger while using a sharp instrument, fall on some slippery surface,
collision on some hard surface. What did you do immediately after that event? Write
a short paragraph describing the incident.
My Bitter Experience

............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................

72 Health and Physical Education # 7

8.1 Safety

Introduction

Safety is the conscious measure of preventing accidents and injuries. It is the
process of taking precautions to avoid accidents. Some of the accidents and
injuries may be unavoidable but most of them can be prevented by taking proper
precautions. Safety education is the process of changing our knowledge, attitude,
and behaviour to be safe from potential accidents or injuries. Safety education
helps us to be careful about the risks in different situations. Safety measures may
be different in different situations because the risk factors associated in different
places have different nature.

Objectives and Advantages

We have a popular saying, ‘Prevention is better than cure’. If we adopt
preventive precautions, a number of accidents can be avoided. The advantages
and importance of safety education are:

i. Safety education helps people to minimize accidents and injuries.
ii. Safety education guides to adopt the safety measures in different situations.
iii. Accidents may cause death or injuries. If we are careful with the knowledge

of safety education, we can be safe from such circumstances.
iv. School children have very active and fidgeting behaviour. Safety education

given to them can save them from probable injuries while playing,
walking, and doing different works.

8.2 First Aid

Introduction

First aid is the first assistance given to the victim of accidents or injuries. It is the
most essential help given to protect the victim from worsening condition or death.
The technique of first aid given in different circumstances may differ according
to the nature and intensity of injury of the victim. Some of the accidents which
need immediate first aid to the victim are burn, vomiting, stroke, frost bite, and
foreign bodies in the eyes, nose, or throat.

Objectives of First Aid

The first aid is very important in case of accidents and injuries. It has the following
major objectives.

(i) To save the life of the casualty victim before an appropriate medical care
becomes available.

Health and Physical Education # 7 73

(ii) To make medical care available for the casualty victim 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.

8.3 Safety Measures and First Aid in Different
Situations

a. Burn and scald

Burn is an injury caused by fire, extreme heat, and any other hot materials.
Burns may be caused due to chemical action, electricity, or friction. The primary
symptoms of burn are the redness and blistering of the skin and damage to
underlying tissues. Scald is also a type of burn caused by very hot fluid like hot
water, milk, oil, or steam.

Safety measures

• Handle the stoves and gases safely.

• Keep inflammable materials away from children.

• Switch off the electrical appliances properly after use.

• Make your family members aware about safety measures and first aid of
burns and scalds.

• Avoid nylon cloths as far as possible. If you are wearing nylon clothes, do
not go near fire.

• Handle hot water, irons, and chemicals carefully. Keep them away from
children.

First aid

• If a fire breaks out on any body part, cover it immediately with wet pieces
of cloths or sacs. It helps to extinguish fire quickly from the victim’s body.

• Immerse the burnt part immediately in cold water for about ten minutes. It
reduces the extent of damage to the tissues.

• Do not burst the blisters1. It causes further damage to tissues and assists in
infection.

1 Blisters = water-filled eruptions on the skin

74 Health and Physical Education # 7

• Cover the burnt part with sterile2 dressing to make it safe from bacterial
infections.

• Do not use random applications and ointments. Consult for medical aid
immediately.

b. Foreign body in the eye

Knowingly or unknowingly some
unwanted substance may enter our
eyes. Some of the common things
entering the eyes are insects, dusts,
and eyelash hairs. Eyes are highly
sensitive organs in the human body.
They have self cleaning mechanism
with the secretion of tear from the
lachrymal glands. Most of the minor
substances can easily be washed
away with tear. But some cases may
be severe.

Safety measures to prevent foreign body in the eyes

• Never play or go to the dusty area.

• Do not rub eyes excessively. This may remove the eyelash hair and drive
into the eyes.

• Never stay very close to any source of bright light especially in the evening.

• Always use sunglasses while riding bike or bicycle.

• Keep the rooms and living area clean and free from dusts.

• Cover the eyes with handkerchief if the dusts appear suddenly in the windy
season.

• Never play with dust, sand, and similar other things which are likely to
enter the eyes.

• Close eyes while applying soap or washing face.

First aids for the foreign body in the eyes

• Never rub the affected eye. Rubbing may increase the friction of the foreign
body and surface of the eyeball.

• Allow the flow of tear from the eye. It helps to wash the foreign body out in
a natural and easy way.

• If the foreign body is still stuck inside the eye, immerse the affected eye in

2 Sterile = germ-free

Health and Physical Education # 7 75

cold and clean water filled in a clean and wide container. Blink the eye in
the water until the foreign body is washed.

• It can be removed with a clean, soft and wet corner of cotton cloth or
handkerchief.

• If the problem still persists, take the victim to the nearest health service
centre as soon as possible.

c. Foreign body in the nose and throat

Nose and throat are the organs of airway for the respiration process. Therefore,
any obstacle in these parts can create a problem in respiration. Major causes of
foreign body in the nose and throat are:

• Carelessness while eating,
attempt to swallow bony or
bigger substances forcefully

• Habit of keeping marble,
coin, or any hard and solid
substance in mouth

• Fish-bones may be stuck in
the neck while eating fish
carelessly

• Accidents like sinking may An X-ray showing a coin in the throat
cause the entry of sludge or
any solid things collected at
the bottom of water resource

Safety measures

• Never eat hurriedly.

• Never try to swallow big or hard substances like bones.

• Don’t let infants and children play with coins and marbles. Watch them
closely if they have the habit of putting these things in the mouth.

• Laughing and talking excessively while eating may result in the entry of
foods into the windpipe.

• Never try to swim in dirty and deep water resource without having good
skills of swimming.

First aid given to the victim with foreign body in the throat and nose:

• Tell the victim to remove the object with soft effort. Don’t ask him or her to
do it forcefully.

• Never try to remove the things forcefully with any external effort.

76 Health and Physical Education # 7

• Loosen the clothes or any other things around the neck if they are tight.

• Apply gentle and soft patting on the back of the neck. This may facilitate
the removal of the foreign body.

• Keep the position of the victim as comfortable as possible.

d. Foreign body in the ear

Ear is an organ which helps for perception of sound. It helps us to hear different
types of sounds. There is a hole in each ear. It is known as external auditory3
canal. At the inner endofthis canal,there isverythin sound-sensitive membrane.
This membrane is calledeardrum. The canal is protected by a type of waxy germicide4
substance known as earwax. Sometimes, small insects may enter into the ear-
hole. When they reach inside, there is severe pain because of the movement of
insect. While swimming and bathing, water may enter into the ear. It is harmful
because the foreign bodies may cause injury to the eardrum or inner wall of the
auditory canal.

Safety measures

In order to prevent foreign bodies from entering the ear, we should not go or
stay at dirty places where there are insects or dirt. While swimming or taking a
bath, we should cover our ear with cotton swab. Sharp instruments should not
be used in the ear hole for the purpose of cleaning earwax or any dirt.

First aid

• If there is water in the ear, the head should be tilted sidewise to release
water outside.

• If there is any insect in the ear, few drops of pure mustard oil can be put
into the canal.

• Immediate medical assistance should be sought if the problem persists
continuously.

e. Heat stroke

It is also known as sunstroke or loo. It is the condition occurring due to extremely
hot environment around us. If our body cannot tolerate the exposure to the high
temperature, we become victimized by sunstroke.

Prevention of sunstroke
• Remain indoors when the environment is too hot.
• Do not schedule outdoor works during the sunny days of summer.
• Keep the room temperature low during hot days.

3 Auditory = pertaining to sound
4 Germicide = substance that can kill germs

Health and Physical Education # 7 77

First aid for sunstroke

• Take the victim to cool place or shadows of tree.

• Place the casualty in airy place.

• Loosen the tight and thick clothes worn by the victim.

• Wipe the victim’s body parts with wet pieces of clothes.

• Provide some cold drinks or cold water.

• Take the victim to the nearest health service centre in case of unconsciousness
or any difficult situation.

f. Frost bite

It is the situation when the marginal
body parts like fingers and earlobes
freeze due to extremely cold
environment. Due to freezing for long,
the affected part turns bluish and may
be damaged permanently sometimes.
With first aid and proper care in time,
the organs can restore the circulation
and remain safe from the probable
damage. Frostbite is also known as cold
bite.

Safety against frostbite

• Never get exposed to extremely cold temperature.

• Always wear windproof gloves and clothes while going in high altitudes in
very cold climate.

• Keep your work place and home warm.

• Use heaters and other warming methods in winter season.

• Wear thick and warm clothes in very cold climate.

First aid for frostbite

• Apply warming process slowly on the affected part.
• Do not apply extreme heat for quick recovery.
• Provide hot drinks as soon as possible.
• Massage the affected part gently for restoration of blood circulation in the

affected part.
• Keep the affected part below the heart level if possible.
• Tell the victim to move the affected part and perform light exercise.

78 Health and Physical Education # 7

g. Road accident
Road accident is very common in unmanaged and crowded town areas. It may
occur due to lack of information of traffic rules, negligence of people, drunk
drivers, malfunctioning vehicles, use of mobile phones during the drive, and
high speed. Many people die every year in Nepal due to road accident.

Safety measures
• Traffic education should be made widely available to people.
• Traffic rules should be followed and monitored properly.
• Strict rules should be made and implemented for management and

maintenance of traffic efficiency.
• Old vehicles should be replaced.
• Malfunctioning vehicles should be repaired properly in time.
• Alcohol should be totally banned for drivers of vehicles.
• Mobile phones should not be used while driving.
First aid

The first aid given to the casualty of a road accident are:
• The wounds or cuts, if any, should be covered properly with a bandage or

a piece of clean cloth.
• If there is heavy bleeding, it should be stopped by covering the place of

bleeding properly.
• If there is fracture, the broken part should be supported by a splint to protect

further movement of the broken part.
• If there is problem in respiration and pulse, the victim should be provided

with artificial respiration.
• The casualty should be provided with the medical assistance if the condition

is serious.
h. Tooth injury
Teeth are the accessory organs of the digestive system. Teeth help in grinding
food items before they are swallowed. Tooth injury may occur while playing,
hitting, or falling down.

Health and Physical Education # 7 79

Safety measures

• We should be careful while playing games.

• Hard substances like bricks and stones should be removed from the
playground.

• We should not play or jump in risky places.

• Rules of the games should be followed properly while playing.

First aid

• Clean swab or clean piece of cloth should be kept at the wounded part of
mouth.

• In case of tooth-break, the broken piece of tooth should be kept under the
tongue until reaching the hospital.

Exercise

1. Match the following:

Burn and scald Do not put hard substances into mouth

Foreign body in the eye Inflammable things

Foreign body in the throat Wear spectacles

Heat stroke Hot drinks

Frostbite Stay indoor

2. Define safety education. Why is it important for us?

3. What do you mean by scald? How can we prevent it?

4. List any five causes of foreign body in the ear. What first aid is given to a victim
in such problem?

5. What are the first aid measures of frostbite?

6. What is the natural way of washing wastes away from the eyes?

7. List some of the common causes of entrance and sticking of foreign bodies in the
throat.

8. What are the major causes of road accident?

9. Differentiate between sunstroke and frostbite

80 Health and Physical Education # 7

9Unit

Family and
Community Health

Before You Start the Text

There are many families in our community. Find an unhealthy family in the community
and ask the reasons behind the unhealthy situation of the family. Some of the questions
to be asked may be:
(a) What is the cause of disease or illness?
(b) Is there safe drinking water available for you?
(c) How do you manage solid wastes?
(d) Do you have a safe latrine? And do all the family members use the latrine properly?
(e) Do you manage adequate nutritious food for the family members? How often do

you take green vegetables, milk products, and meat items?
Collect the answers and find the cause of the disease in the family. If there is any confusion
ask your seniors or the teacher. Discuss the conclusion in classroom.

Health and Physical Education # 7 81

9.1 Family Health

9.1.1 Introduction

Almost all the people in the world live in their family. They eat, drink, dress
up, entertain, exercise, and rest at home with their family members. All the
factors affecting and determining the status of health are maintained within the
families. There are very important roles of the family members and family health
strategies. Family health is a major influencing factor of everybody’s health.
Effort of a single individual is not sufficient to improve family health. All the
family members should contribute for the improvement of better family health.
Family health is the basis of both the personal and community health. A country
becomes healthy when family health is assured. It is very important because it
includes the most essential aspects of human health like safe motherhood, family
planning, healthy food practices, prevention from addiction and alcoholism,
safety measures, adolescence and sex education.

9.1.2 Importance of family health

There is need and importance of family health for us to:
• improve the health status of family members.
• provide proper care to the diseased members in the family.
• immunize children according to the recommended immunization schedule.
• care for pregnant and breastfeeding mothers in right ways.
• deliver babies safely from pregnant mothers.
• care for infants, children, elderly, and disabled members in the family.
• develop techniques to prepare balanced diet for all the family members.
• save the family members from communicable and infectious diseases.
• limit the size of the family by adopting appropriate family planning devices

and methods.
• manage safe drinking water in the family.
• maintain harmonious relationships among the family members.
• take right moves in different health hazards and accidents in the family.
• maintain indoor and outdoor cleanliness at home.
• eliminate the superstitious beliefs and wrong health practices.

82 Health and Physical Education # 7

9.2 Community Health

9.2.1 Introduction

Human beings live in their community. Every individual or human being is a
member of community. Communityhealth is the status of human health possessed
by a community which is determined by community health characteristics like
health services, sanitation system, and public awareness on health. It is the
process of implementing integrated effort of preventive, promotional1, curative2,
and rehabilitative3 health facilities and services in the community to make the
community members healthy. People living in a community are interrelated
and inter-influenced by 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 common communicable and non-
communicable diseases in a community. 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 be controlled. There is a
need of public participation or involvement of the whole society. Community
health is also known as public health, community medicine, or social medicine
because such issues are handled by a group of people living in a community.

9.2.2 Importance of community health

Community health is an integrated effort of ensuring sound health among many
people living in a community. Some of the importance of community health are:

1. It helps in raising common health issues of a community.
2. It helps in identifying and solving the community problems with common

efforts of community people.
3. Community health helps in uniting people in community with common

sense of motivation and enthusiasm to address community health problems.
4. It helps in management of health service centre and drainage in a community.
5. It helps in keeping the community clean.
6. It helps in solving the problems of several community health issues like

drinking water supply system and dumping of wastes.
7. It helps in formulation and implementation of health related rules and

regulations with respect to the existing health situation of the community.

1 Promotional = something that contributes for promotion
2 Curative = something that cures the diseases
3 Rehabilitative = something that helps in regaining the lost strengths and states

Health and Physical Education # 7 83

9.2.3 Problems of community health
(i) Malnutrition: Malnutrition is categorized into under-nutrition and over-

nutrition on the basis of deficit or excess of necessary nutrients in our
body. In the context of Nepal, where majority of people are poor suffering
from illiteracy and lack of health precautions, under-nutrition seems to be
most prevalent. Oily, spicy, unhealthy, insufficient, and imbalanced diet of
Nepalese people is responsible for remarkable under-nutrition in Nepal.
Seventy percent of Nepali children below five years of age are suffering
from under-nutrition. Malnutrition is not only a problem of children. It
affects adults and elderly people as well. But, in children its effects are
more harmful.
(ii) Prevalence of infectious diseases: Infectious diseases cause infection in
organs and tissues. They are caused by the presence of microorganisms like
amoeba, virus, and bacteria. Infectious diseases like diarrhea, dysentery,
tuberculosis, leprosy, HIV/AIDS, typhoid, hepatitis are major diseases in
Nepal. About 45,000 children die in one year due to diarrhea and infectious
diseases in Nepal. In the past, epidemic of malaria, smallpox, and cholera
had taken many lives in different places. Some diseases like leprosy and
tuberculosis are thought superstitiously as the result of god’s curse. Such
false beliefs are responsible for people to conceal the disease or follow
wrong methods of treatment leading to death or further communication
of disease to the healthy people. Therefore, the infectious diseases have
become a challenging problem in Nepal.
(iii) Unhealthy food habits and lifestyle: Most Nepalese people take two
heavy meals in the morning and evening. Use of oily, spicy, and hot
food has become almost a tradition in Nepal. There is lack of nutritional
components like proteins, minerals, and Vitamins in the everyday food
taken by many Nepalese people. In many families, there is overdose of
carbohydrates and fats. Food items must be well-balanced, fresh, nutritious,
and frequent for our better health. Unhealthy habits and lifestyles can be
modified by means of right health education and awareness in people.
(iv) Poverty: Income level and poverty has direct relationship with health.
One’s economic strength determines his/her capacity to obtain food, health
education, health services and facilities, etc. Diseases are most prevalent
in those areas where poverty exists. Nepal is also a poor country. People
of Nepal are compelled to live with problems of hunger and starvation
due to poverty. Therefore, poverty has become a major health problem in
Nepalese community.
(v) Lack of health education: Health education gives us knowledge and
awareness regarding various health problems in our everyday life. It is
very essential to eliminate superstitious beliefs and practices in the society.
Due to such beliefs, cholera, leprosy, and TB are thought to be caused by
the curse of God and it is concealed. Such practices and wrong beliefs still

84 Health and Physical Education # 7

exist due to lack of health education. People do not know about the causes,
preventions and controlling measures of highly prevailing diseases due to
lack of education.
(vi) Lack of health services: In most of the Nepalese communities, available
health services do not meet the need for the increased population. The
number of medical personnel is inadequate for the big population. Though
there is increasing number of sub-health posts and primary health centers
in rural areas, these are not well-managed to provide health services in
Nepal. Private health services are very expensive in the urban areas of
Nepal.
(vii) Rapid population growth: On the one hand, there is lack of health services
and facilities and scarcity of health personnel and on the other hand,
population growth has been very rapid in Nepal. It will be more difficult
to meet the health need of people in the near future if the population grows
rapidly and the new health services are not developed proportionately.

9.3 Methods of Solving Community Health Problems

Community health problems can be solved with the integrated effort of
individuals, families, community, and the nation. There may be involvement of
various organizations in solving community health problems and promoting the
status of community health. The following are some of the important methods of
solving community health problems.
(a) All the people must be provided with proper health education related to

diseases, modes of communication, and their prevention and control methods.
(b) There must be better provision of health service centres in the community.
(c) Community members’ cooperation in the community health concerns

contribute in solving health problems in the community.
(d) There must be public participation in community sanitation, plantation,

and promotion of environment of the community.
(e) Drainage, sewage, and all sorts of waste management system should be

monitored and maintained properly.
(f) National immunization programs should be made effective with the

participation of all the children in the scheduled immunization routine.
(g) There must be provision of nutritious foods for the children from poor families.
(h) Integrated programme to tackle hunger and starvation should be launched

in the community.
(i) There must be proper management of safe drinking water for all the people

in the community. Water resource should be conserved and protected.

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(j) Financially poor people should be assisted with some financial support
for the promotion of their economic status.

(k) Superstitious beliefs and myths should be eliminated from the community
through scientific education and awareness.

(l) There must be effective programs to control pollution and excessive
population growth.

Exercise

1. Write “T” for true and “F” for false statement.
a. Almost all the people in the world live in the family.
b. Family health is improved by proper care of babies at home.
c. Malnutrition is one of the major problems of family health in Nepal.
d. Infectious diseases are comparatively less in Nepalese communities.
e. Drainage, sewage, and such waste management systems are not necessary
to strengthen community health.

2. What is family health? List any five functions of family health.
3. Why is ‘family planning’ regarded as a factor of family health?
4. List any ten points of importance of family health.
5. How does community health promote people’s health in a community?
6. List the major community health problems in Nepal.
7. What factors are responsible for the existing under-nutrition in Nepal?
8. What do you mean by infectious disease? Give any five examples.
9. Introduce the existing health service centres in Nepalese community.
10. Suggest any five measures for solving the community health problems.

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Health and Physical Educati
on # 7
IIPart

Physical
Education

Unit 10

Physical Exercises

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10.1 Introduction to Physical Exercises

Physical exercises can be defined as the movements of body parts in scientific
and predetermined ways to attain smooth functioning and sound health of the
organs. It is integral and indispensable part of human health. Physical exercises
improve the agility, strength, immunity, and tolerance of our body. Physical
exercises include several activities performed by our body parts. It contributes
to enhance the skills needed for games, athletics, and gymnastics. It makes our
body systems active and healthy. There are various types of physical exercises.
Some of them are performed in pair while some are performed individually. For
example, cartwheel and invert stand are done individually but alternate carrying
on back, front bend in pair with hands on the partner’s shoulder, and paired
exercises are performed in pair.
Facts to be considered while doing exercises
Exercise is a scientific movement of different body parts in a systematic way.
It does not mean haphazard motion of body organs. Some of the facts to be
considered while doing exercises are:
i. Physical exercises should be done in a systematic manner.
ii. We should not perform exercises immediately after having food.
iii. The level of exercises should be controlled in problematic health conditions

and difficult weather.
iv. Excessively heavy exercises should not be performed without gradual practice.
v. All forms of exercises should be begun with warming up exercises.

10.2 Warming up Exercises

The light exercises performed in order to prepare the body for further exercises
or games are called warming-up exercises. It includes simple movements of
limbs and body parts. Some of the warming up exercises are:
a. Jogging at standing place
In this exercise, there is movement of hands and legs like running but it is

performed at a point without covering any distance.

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b. Skipping
This is an exercise that strengthens almost all body parts. Limbs (hands

and Legs), abdomen, neck, and spine are exercised well with skipping.

10.3 Exercise of the Sole

a. Jumping on sole: In this type of exercise, the player jumps and supports
the whole body only with soles while landing. Repetition of this exercise
helps in strengthening the muscles of soles.

b. Stretching soles: Stretching can
be done in standing or sitting
position. In this exercise, the
soles are stretched slowly and
brought in normal position. It
can be repeated up to 20 times for
good result.

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10.4 Exercise of the Limbs and Spine

a. Bending front and back
This exercise is performed individually. In this type of exercise, one

stands at ease with the legs a bit apart. The body is bent down alternately
frontward and backward for ten to twelve times.

Bending front and back
b. Carrying on back in pair
This exercise is also performed in pair. The partners stand back to back in

the beginning. They lock their hands across the elbows backward. On the
commands from the commander, the partners carry each other on back
alternately as shown in the picture.

Carrying on back

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c. Push up and modified push
Push up: In this exercise, the body is kept prone1 on the ground. It is made

straight horizontal. Then after, the body is raised up slowly supporting on
fingers and toes.

Modified Push: It is performed similarly as push-up is performed. It
is the learning stage of push-up. In this exercise, knees can be used for
supporting instead of toes.

10.5 Exercise of Abdomen and Thigh

Sit up
Sit up for the junior children is performed in pair. In this exercise, one lies down
on back on a soft and safe floor keeping both the palms at the back of the head.
The legs are not allowed to move with the help of a partner who catches them
strongly.

1 Prone – Lying the face and abdomen downward on the ground
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Sit-up
Then after, the trunk and head is raised up and brought down repeatedly at least
for ten to twelve times, keeping the buttock fixed at a point.

Exercise

1. Define physical exercise. List any three advantages of physical exercise.
2. What are the factors to be considered while doing physical exercises?
3. What are the advantages of warming up exercises?
4. Describe any one physical exercise performed in pair.
5. Draw a diagram showing ‘push up and modified push’.
6. Write short notes on:
a. Skipping
b. Jogging
c. Carrying on back in pair.

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Unit 11

Drill

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11.1 Introduction to Drill

It is a set of repeated actions under the instructions of a commander. It is also
known as disciplined training. It is a team exercise performed for many purposes
like making systematic group movement, troop exercise, or mass exhibition.
While performing drill in the school level, the students are asked to be in one
or more files. The teacher or a commander gives commands for the drill and the
students perform accordingly. Some of the basic drills are ‘march forward’, ‘right
turn’, and ‘left turn’.

11.2 Cover-up

This command is used to make equal distance between each of the front and
adjacent back person. With this command students extend both of their hands
straight forward to touch the shoulder of front student.

11.3 Stand at Ease and Attention

Stand at ease
Stand at ease command brings the troop to remain in calm position. The troop
stands with the feet about fifty centimeters apart. Both hands remain at the back
of the buttock. Body position is normal and relaxed but not with bent waist or
neck.
Attention
This command brings the troop in erect and standing position with hands
touching the lateral parts of thighs. Body is rigid and they look straight forward.

11.4 Right turn, Left turn, and About turn

When the command ‘right turn’ is given by the commander, all the students turn
their body rightward to 90 degrees. While turning right, the right leg touches the
ground with its sole and the left leg with its toes.

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12 34

Right turn

When the command ‘left turn’ is given by the commander, all the students turn
their body leftward to 90 degrees. While turning left, the left leg touches the
ground with its sole and the right leg with its toes.

12 34

Left turn

11.5 Mark Time

It is a drill performed along with the command of the commander with count of
“left…right…left… left…right…left……” or “one, two, three, four……………..”

11.6 Quick march, Eyes right, and Eyes straight

Quick march

All the students advance ahead raising and stepping feet together. They raise their
legs about 15 cm above. Hands swing in a common pattern. Their movements
of legs are according to the command ‘left…right…left… left…right…left…’
All of them look highly disciplined with very similar movement of their hands
and legs.

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