Health, Population and Environment Education 9

iii. Earthquake
The process of shaking the land is

called earthquake. It is caused due
to the movement and collision of
tectonic plates of the earth. It is
also caused due to big volcano. It
increases environmental pollution
with destruction of houses,
production of dust and spreading the pollutants in the environment.
iv. Flood and Landslide
Excessive flow of water along
with the solid materials of the
earth surface is called flood.
Downward falling or sliding
a mass of soil or rock along a
steep slope of land is called
landslide. Flood and landslide
erodes the upper part of land
and accumulate such materials
at other places. It causes
destruction of the natural structure of land and causes pollution.
v. Ozone Layer Depletion
It is a gaseous layer of ozone gas at the upper atmosphere that absorbs
ultraviolet rays, thereby preventing them from reaching the surface of
the earth.

Ultraviolet rays cause skin cancer, extinction of species, depletion of wild
lives land pollution and desertification of land. The ozone layer protects

Health, Population and Environment - 9 151

us from such harmful results by preventing UV rays enter into the lower
atmosphere and the earth’s surface. When the ozone layer becomes
thinner, UV rays arrive on the earth’s surface and cause environmental
imbalance.
b) Environmental Pollution caused by Human Activities
Human is the most responsible creature for environmental imbalance and
pollution of the nature. Deforestation, extraction of mines, wars, explosions,
industrialization and unmanaged urbanization are some man-made factors
causing environmental pollution.
i. Deforestation
Deforestation is the process of destroying forests. In other words, the
act of cutting down and removal of all or most of the trees of a forest
is called deforestation. It erodes soils, contributes to desertification and
the pollution of water resources, and decrease biodiversity through the
destruction of habitat.
ii. Mining
Mining is the extraction of valuable minerals or other geological materials
from the earth. The adverse environmental impact of mining includes
soil erosion, formation of sink-holes, loss of biodiversity, contamination
of soil and water with mining chemicals etc.

Environmental Pollution and Global Warming

iii. Industrialization
Green house gases emission, global warming, climatic disasters, water

shortages, drinking water contamination, freshwater and marine
pollution, deforestation, and other environmental problems are becoming
serious threats to the well-being of mankind due to the harmful and

152 Health, Population and Environment - 9

hazardous outcomes of industrialization. Excessive industrialization is
responsible for rapid depletion of natural resources and production of
harmful components like carbondioxide, methane, chlorofluorocarbon,
dust, smoke, and a number of harmful chemicals. There are various wide-
ranging effects, as well as serious consequences of industrial pollution on
the ecological balance of the atmosphere.

iv. Wars and Explosions

Wars and explosions cause severe environmental pollution when the
explosions produce excessive amount of smoke and loud irritating sounds.
Chemical wars are notorious for its toxic impact on the environment.
Besides, the nuclear weapons like Uranium bombs leave serious radioactive
hazards that persist for very long duration even after war.

v. Unmanaged Urbanization

Urbanization is the process of converting rural and underdeveloped
areas into the developed and town areas with additional services and
facilities. Urbanization brings better result in people when the services
and facilities are added in systematic and nature-friendly ways. When the
environmental sanitation, waste management and equitable distribution
of services and facilities are ignored in the process of urbanization, it
becomes unmanaged. Unmanaged urbanization results in congested
settlement, problem in waste management and environmental pollution.

7.3.3 Adverse Effects of Environmental Pollution on Human Health

a) Adverse Effects of Land Pollution on Human Health

Land is the prime component of environment. All other environmental
components are supported by the land. Most of the human activities are carried
out on land. People throw solid wastes such as broken glasses, dirty things and
other materials that are useless to them. There are two kinds of solid wastes.
They are biodegradable and non-biodegradable wastes. Biodegradable wastes
undergo the process of degradation and are decomposed into smaller carbonic
molecules that can be used by plants. Non-biodegradable wastes such as plastic,
broken glasses, metallic wastes, etc. remain persisting in the environment for
a long duration. Such things destroy the physical and chemical properties of
land and reduce the fertility. Land pollution affects both living and nonliving
things. Some of the adverse impacts of land pollution are given below:

i. Polluted land is the source of bad smell and harmful germs. Various

Health, Population and Environment - 9 153

types of diseases spread from such area.
ii. Polluted land due to chemical fertilizer and poisons like pesticide is not

suitable for survival of plants and animals. The poisonous compounds
present in food cycle are transferred to human beings through the food
they eat.
iii. Land pollution deteriorates the quality of land. It changes the natural
state of land. The productivity of land decreases due to degradation of
soil fertility.
iv. Land pollution affects the natural setting of land and cultural heritage
such as religious heritages, cultural sites, etc.
b) Adverse Effects of Water Pollution on Human Health
There are main three sources of water: surface water, underground water and
rain water. Mostly, surface water is utilized and affected by human activities.
Water pollution means the change in physical and chemical property of water
which makes it unusable for living beings. Water pollution has the following
adverse effects on human health:

i. Polluted water causes harmful effects on the health of living beings.
ii. Polluted water causes several kinds of water born diseases like, diarrhea,

dysentery and typhoid.
iii. If the polluted water is irrigated, it affects the young plants and crops in

adverse way.
iv. Harmful chemicals present in the polluted water alter the physiological

phenomenon of body systems.
v. Polluted water may transmit some of communicable diseases to the

plants, if irrigated.

154 Health, Population and Environment - 9

c) Adverse Effects of Air Pollution on Human Health
Atmosphere has different types of gases. They are nitrogen, oxygen,

carbondioxide, argon, sulphur dioxide, etc. If other elements are mixed in the
atmosphere and change its natural composition, the air gets polluted. Some
gases like carbondioxide and sulphur dioxide cause acid rain, some gases like

CFC deplete the ozone layer and some of them like methane and carbondioxide
cause global warming. The mixing of the smokes of traffic, industry dust, and
smell of waste materials also pollutes the air. Air pollution affects both living and
nonliving things. Some of the adverse effects of air pollution are given below.
i. We inhale air from the environment to get oxygen contained in it. If air

contains other harmful pollutants, they enter inside our lungs and cause
harmful effects in our body.
ii. Smoke and dust emitted in the atmosphere disturbs the visibility and
make the environment dirty.
iii. Some industries like cement factory, marble factory, and brick factory
emit smoke, dust and other harmful gases in air. When they are
inhaled, they affect the physical system of our body. As a result, kidney
problem, abortion, anemia, lung disease, eye disease, asthma and even
psychological problems can be seen.
iv. Presence of sulphurdioxide and carbondioxide in the air causes formation
of sulphuric acid and carbonic acid that causes acid rain. Acid rain
deteriorates temples, buildings and monuments made of metals.
v. The thick layer of methane, sulphurdioxide and carbondioxide cause
greenhouse effect on the earth. As a result temperature of the earth

Health, Population and Environment - 9 155

increases. Global warming has been a burning problem in the recent
days.

vi. Air pollution is harmful for various living organisms. If they are affected,
they may migrate, die, or become extinct. Such effect ultimately alters the
ecosystem and food chain adversely.

d) Adverse Effects of Sound Pollution on Human Health

Unwanted and excessive sound which harms human health is called sound
pollution. Intensity of sound is measured in decibel (db) units. If the intensity
is more than 45 db, an average person cannot sleep.

Long-term exposure to more than 85
db of sound can cause permanent loss
of hearing. Crowded public mass 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 area and heavy construction
site are highly affected areas of sound
pollution. Some of the adverse effects of
sound pollution are given below.

i. Much noisy environment affects
our hearing ability. 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 which
affect the health of people.

iv. Noise affects our mind which, in turn, harms our physical condition.

7.3.4 Methods of Controlling Environmental Pollution
a) Methods of Controlling Land Pollution

Land pollution has several adverse effects on human health. Some of the
methods of controlling land pollution are:

i. Use of plastics, glasses, and other non-degradable materials should be
reduced. Reuse of such materials should be given priority.

ii. Solid wastes should not be thrown in open places.

iii. The harmful solid wastes released from industries and hospitals should

156 Health, Population and Environment - 9

be purified before disposing them.

iv. Biodegradable materials such as residue of plants vegetables and other
wastes of plants should be used to make compost manure.

v. Broken machines, vehicles, etc. should be recycled or reused as far as
possible.

vi. Use of chemical fertilizers, insecticides, and pesticides should be reduced.
Farmers should be encouraged to use compost manure.

vii. Legal provisions should be made on the management of solid wastes. It
encourages the people to manage solid wastes properly.

b) Methods of Controlling Water Pollution

Controlling water pollution is very essential for the protection of our
environment. Some of the ways of controlling water pollution are:

i. We should try to reduce household wastes. Such wastes should not be
disposed to river, rivulet7 , pond, lake, well8 and their surroundings.

ii. Wastewater of industries, factories, hospitals and laboratories should be
processed properly before discharging.

iii. Precaution for the control of soil erosion, landslides and floods should be
taken because such natural calamities damage the water sources.

iv. Water pollution control programs should be launched at central and
local levels.

v. Enforcement of legal provisions and its implementation play a vital role
in control of water pollution.

c) 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 more 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. Factories and industries should be established far away from human
residence.

7. Rivulet : a small stream or river

8. Well : a wide vertical and downward hole that is excavated into the earth’s ground to fetch
the underground water

Health, Population and Environment - 9 157

iv. Sources of alternative energy like biogas, solar energy and hydroelectricity
should be used in place of wood, cattle dung, and petroleum which
produce pollutant smoke.

v. Tree plantation program should be run in open area and both sides of
roads.

vi. Public awareness program should be initiated in order to increase
people's participation in pollution control activities.

d) Methods of Controlling Sound Pollution

Sound pollution has several adverse consequences on human health.
Controlling sound pollution is the best way for being prevented from such
adverse effects. The methods of control of sound pollution are:

i. Airports, bus-parks, industrial areas should be away from the residential
area.

ii. Tree plantation programs should be run in open barren land. Trees
absorb sound and control sound pollution.

iii. The workers who work in noisy area should use the earplugs or cotton
swab in ears to restrict noise in the ears.

iv. Walls should be built around the noisy industrial areas which will protect
the sound of that area.

v. Noisy equipment like mills and generators, etc. can be installed
underground.

vi. Strict laws against sound pollution should be made and implemented by
the government.

vii. Awareness programs regarding sound pollution can play important
roles in the control of sound pollution.

7.4 Solid Wastes

Solid waste can be defined as the residues of vegetables, ash, waste paper, broken
glasses and plastics. When these are mixed 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. Wastes pollute our surroundings. It makes our environment unhealthy.
Therefore, the wastes should be managed properly.

158 Health, Population and Environment - 9

7.4.1 Sources of Solid Wastes

i. Domestic Wastes

The wastes produced from everyday household activities are called
domestic wastes. It includes kitchen wastes, plastic wrappers, bottles,
old and rusted metals, papers and dust.

ii. Industrial Wastes

Industries use several kinds of raw materials for manufacturing their
products. When machines and factories run, there is production of
useless bi-products as well. Some industries produce huge amount of
chemicals and pollutant substances in the environment. It increases solid
wastes in the environment.

iii. Wastes from the Market Area and Streets

Market areas mainly produce wastes like plastics, wrappers, fruit-peels,
vegetable wastes, etc.

iv. Wastes from the Offices

Waste materials produced from the official activities mainly include
paper pieces, plastics, furniture wastes, dust and broken official materials.
Wastes from the offices pollute the environment by getting mixed into
the environmental components.

v. Wastes from the Construction Sites

Construction sites produce wastes like pieces of metals, instrumental
wastes, wooden wastes, pebble, dust, iron nails etc.

vi. Wastes from the Hospitals
Hospital wastes are often contaminated with disease germs. Therefore,

such wastes should be managed separately. Hospital wastes mainly
include blood contaminated swabs, syringe, needles, date-expired and
unused medicines, x-ray films, plastering materials, etc.

7.4.2 Classification of Solid Wastes

Solid waste can be classified into organic and inorganic wastes.

a) Organic wastes (Biodegradable wastes): Degradable wastes produced from the
residues of biotic9 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,
vegetable residues, 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.

Health, Population and Environment - 9 159

b) Inorganic wastes: (Non-biodegradable 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 into our body.

7.4.3 Methods of Managing Solid Wastes

a) Methods of Management of Biodegradable Solid Waste

i. Landfill Method

This is a popular method in city area. In this method, wastes are collected
in a particular area, carried by carrier vehicles, and thrown in a dumping
site which is generally far from the residential areas. It is widely practised
in the 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.

ii. Pit Method
In this method, the biodegradable wastes are kept safely in a pit of

appropriate size. After a pit is filled, the wastes are allowed to be
decomposed inside the pit. As the wastes are biodegradable, it is
ultimately get mixed into the soil.

iii. Burial Method
If the wastes are foul-smelling and harmful, the burial method is used. In

this method, the wastes are collected and buried under the land.

iv. Incineration Method
The process of managing solid wastes by burning is called incineration.

This method is more useful in those places where there is no land fill site.
It is better to dispose more harmful wastes like the wastes of hospital,
pharmaceutical, chemical industry, etc. by incineration because it kills
the germs and worms responsible for diseases.

v. Composting Method
It is common practice from the beginning of agricultural age. Farmers

use the waste materials produced from herbs, animal dung and other
degradable organic substances for preparation of compost manure.
Decaying bacteria helps to decompose the wastes and convert them into
compost in this process. For this purpose, pits of different sizes can be
made to prepare compost. There are major three methods of preparation
of compost manure. They are:

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

160 Health, Population and Environment - 9

Aerobic method: The prefix “aero-” means air or oxygen. Thus, aerobic
method depends on presence of oxygen. It is a method of preparation
of compost manure in which the aerobic bacteria decomposes organic
matters in the presence of oxygen or air. Aerobic bacteria are those
bacteria which respire in aerobic method10 . In this method the organic
solid wastes are collected in a pit of suitable size. The wastes are turned
repeatedly after 4-7 days. This helps in supplying oxygen for the bacteria
and accelerates the process of waste decomposition. The manure becomes
ready in about one month period.

Anaerobic method: The prefix “an-” means no or without and “aero”
means air or oxygen. Thus, anaerobic method11 means the method
without air or oxygen. It does not depend on the presence of oxygen. It
is a method of preparation of compost manure in which the anaerobic
bacteria decomposes organic matters in the absence of oxygen. Aerobic
bacteria are those bacteria which respire in anaerobic method . In this
method the organic solid wastes and mixture of organic sludge are placed
alternately one after other in a suitable pit of about 4 to 5 feet depth)
The thickness of waste and sludge layer is made about 9 and 2 inches
respectively. After the pit is filled, the pit is covered with a layer of soil
or sludge at its top to prevent any leakage of heat from the pit. It is, then,
left undisturbed for about 4 - 6 months for its anaerobic decomposition.
The manure can be used after the decomposition.

Differences between aerobic and anaerobic methods of compost manure preparation

Aerobic Method Anaerobic Method

i. There is need of air or oxygen in this i. There is no need of air or oxygen in this
method. method)
Anaerobic bacteria are the active
ii. Aerobic bacteria are the active decom- ii. decomposers.
posers. It does not need turning of waste.

iii. It needs turning of wastes after about 4-7 iii. Layers of wastes and sludge are made.
days.
The pit should be covered with soil and
iv. The layers of wastes are not made. iv. sludge.

v. The pit should not be covered. v. It takes longer period of about 4-6
months.
vi. It takes short period of about one month) vi.

10. Aerobic method of respiration : the method of respiration that needs oxygen. It is represented by the
chemical equation, 6O2 + C6H12O6 -- > 6CO2 + 6H2O + Energy

11. Anaerobic method of respiration : the method of respiration that does not need oxygen. It is represented by
the chemical equation, C6H12O6 - > 2C3H6O3 (lactic acid) + Energy

Health, Population and Environment - 9 161

Vermicomposting method: It is a method of converting organic wastes into
compost manure with the help of certain species of worms like wrigglers and
earthworms. In this method, the organic wastes are collected in a safe container
and the worms are kept there for composting. Worms consume the organic
wastes and produce vermicast or the manure. They reproduce and multiply
in number in the container. The time taken by the wastes to be converted into
manure depends upon the volume of the wastes and number of worms kept.

b) Methods of Managing Non-
biodegradable Solid Waste

Wastes should be managed in the
same place from where it is generated.
Otherwise, it should be collected
and carried to a fixed area where
management is possible. There
are different ways of management
possible. There are different ways of
managing the solid waste. Among
them 3R method of management of solid waste is popular 3R stands for Reduce,
Reuse, and Recycle.

i. Reduce

Reduction of waste is the process of

production of solid wastes in minimum

amount as far as possible. Wise use of

resources helps to reduce waste. People

are mainly responsible for generating and

managing waste. Reduction of waste helps

us to maintain environmental cleanliness

which prevents several kinds of diseases. 3R Principles of Solid Waste

The use of paper bags and baskets in the Management

market instead of polythene bags can be

very helpful in this task. We should minimize the use of such materials

which are to be thrown after use.

ii. Reuse

Using the same materials with slight- or no-modification time and again
is called reuse. Repeated use of plastic bags and baskets is one example
of reuse. Similarly, use of old newspapers as wrappers by shopkeepers is
widely practised example of reuse in our markets.

162 Health, Population and Environment - 9

iii. Recycle

Recycling uses old wastes to make new products. It is the process of
making new useful product by processing waste materials. It cuts down
the amount of rubbish and saves natural resources by reducing the need
for new raw materials. Items which are most suitable for recycling are the
organic matters (plant and animals) which can be composted and used as
fertilizers. Similarly, some metals (such as aluminium cans), paper, and
plastics are also recyclable.

7.5 Drainage and Excreta Disposal

7.5.1 Drainage

Drainage is a system of removal of wastewater through canals and pipes set
in a systematic way. Drainage helps in managing wastewater produced from
the household activities, market area or agricultural field. Household sewage
is commonly drained away with the help of pipelines set indoor. Drainage
for the market area is most commonly constructed as narrow and deep canal
along the roadsides. They are kept covered with cement slabs. Wide concrete
rings are also used for draining the wastewater of market areas. There are open
and wide canals made for the drainage of wastewater of agricultural fields.
The system of drainage is very useful in controlling environmental pollution.
Drainage protects the wastes being scattered in the environment. The proper
management of waste water helps to keep the surroundings clean. The waste
water discharged from residential area, industries, hospitals, and hotel area
deteriorates the environment. It pollutes the water sources and spreads foul
smell in the surroundings. Waste water also creates the problems of different
kinds of communicable and non-communicable diseases. So, it is necessary to
make a proper drainage system and protect the surroundings from pollution.
Some of the methods of the proper management of drainage are as follows:

i. The accumulation of unwanted water in agriculture is harmful to soil,
plants, and other organisms living there. It destroys the natural qualities
of soil. It loosens the grip of soil that may cause landslide and soil erosion.
In this way, polluted water destroys the natural structure of land. It is
necessary to make proper drainage system in agricultural land to manage
proper outflow of water.

ii. In city area and crowded residential areas, it is better to make concrete
drains and pits to manage the waste water. Drain of waste water and
drinking water pipe should be placed separately to prevent from

Health, Population and Environment - 9 163

contamination of drinking
water with drain water.

iii. Wastewater discharged

from factories, industries,

distilleries should not be

released without processing.

iv. Proper care and maintenance
of drainage system should be
done regularly.

v. Government should provide

technical support to the Drainage Management System
hospital, industry and other

related sensitive areas to develop the drainage system and process of

waste water if necessary.

7.5.2 Excreta Disposal

We pass the wastes of our body as different substances. They are called excreta.
Human excreta generally mean faeces and urine. Excreta itself is a strong source
of causative agent12 for many gastrointestinal13 diseases. Therefore, excreta
should be discharged only into the latrine. Proper use of latrine contributes a
lot to keeps the environment healthy. In some rural places and even in town
areas, human excreta found in open places and in busy street. It is the source of
infection and it causes environmental pollution. Some of the problems created
by open excreta are given below:

a) It pollutes the surroundings

The disposal of excreta in open places and streets provides favourable
environment for flies, germs, and worms to grow. It gives off smell in
the environment. Proper disposal of excreta in latrine helps to solve the
problem but the latrine should be kept clean.

b) Pollution of air, water and land

Disposal of excreta in open place pollutes the land. It is immediately
attacked by microorganisms and produces pollutant gases with bad
odour that causes air pollution. Leakage of gas pipe of septic tank also
pollutes the air. In the same way, contamination of faeces in water
resources pollutes water.

12. Causative agents : microorganisms and parasites that live in human body and are responsible for causing diseases
13. Gastrointestinal : relating to the stomach and intestine

164 Health, Population and Environment - 9

c) Spread of communicable diseases

Human excreta are the sources of many communicable diseases. The
agents spread through excreta to our food. We suffer from different
kinds of communicable disease like cholera, diarrhoea, dysentery, worm
infestation, typhoid, etc. due to contamination of faeces in our food.

7.5.3 Latrine

Latrines are the safe places for disposal of human excreta. We defecate14 and
urinate in latrine for safe disposal of faeces and urine. The process of releasing
excreta out from our body keeps us healthy by removing harmful substances.
It creates new space in our body for intake of food and water. Latrines are
necessary to keep the environment clean and healthy. If there is no proper
management of latrine, people defecate at any place or wherever they like.
Latrines are made in accordance places where people live. As there is lack
of space in town areas, people make latrine inside or attach to the house.
Attached concrete latrines are easy to use and convenient for children, elderly,
and handicapped family members too. In village area, latrines are made at a
safe distance from the house. Raw materials used in construction of houses and
latrines in village areas are not long-lasting. People use hay15 , straw, wood and
similar materials for construction purpose. There are different types of latrines
used at different places in our country. Some of them are described below:

Types of Latrine

a) Trench Latrine

Trench latrine is an immediate

improvement against the problem of

open defecation. It is a type of temporary

latrine made particularly for the events

like fair and camps. It has a longitudinal

pit divided into few cubicles (segments) Auger used for borehole latrine Borehole

separated by the sheets of straw, plastic,

tin, wood or any other locally available material.

The trench is about 2 feet deep and, once filled, will be covered with soil and
another trench is dug parallel to it. The recommended maximum length of
trench is 6m, providing six cubicles.

14. Defecate : process of passing feces out from the body
15. Hay : dried shoot of herbs, particularly of crops like paddy, wheat, barley, etc.

Health, Population and Environment - 9 165

b) Borehole Latrine

A borehole drilled by machine or hand-powered auger can be used as a latrine.

This has a typical diameter of 20 to 40 cm and a depth of 6 meter (20 feet). At

the top, a sitting seal is set for convenience of

defecation. This structure is protected by the

walls made up of locally available materials

on three sides and a door on one side. A

roof made up of tin, straw, hay or plastic

protect the interior from rain. It should be

constructed about 15-50 meters away from

the water resources depending on the nature Trench Latrine

of soil. Borehole latrines are most appropriate in situations where boring/

drilling equipment is readily available, where a large number of latrines

must be constructed rapidly, and where pits are difficult to excavate, either

due to ground conditions or lack of a suitable labour force. The relatively

small diameter permits a simpler, smaller, lighter and cheaper floor slab and

foundation, but limits the storage capacity. A bored-hole latrine is suitable

for stable, permeable soils, free of stones, and where the groundwater is deep

beneath the surface. It was first started in India in 1930 by Rockefeller in order

to control the transmission of hookworms.

c) Pit Latrine

This kind of latrine is popular in rural areas.
A simple pit is made in a certain place from
the house. Its size depends upon the size
of the family and their need. It is simply
made with locally available raw materials
like straw, hay, bamboo, wood, etc. Local
villagers with no special training can also
construct the simple pit latrine. In this latrine,
there is a simple pit and a safe defecating
chamber with boundaries and roof. The feces are collected in the pit which is
covered safely. Pit latrine was brought in use from West Bengal since 1949 A.D.
It is useful in rural areas where there is no sufficient water and construction
materials like cement, sand, rods, bricks, etc.

Some of the important information regarding the site selection of simple
pit latrine are given below:

i. It should be selected at least 30 feet away from the house and water

166 Health, Population and Environment - 9

sources such as well, tube-well, etc.

ii. It should be constructed below the water source. It prevents water from
being polluted.

iii. It should be constructed in hard soil area that increases the life of latrine.

iv. Latrine should not be constructed too far from the house because it will
be difficult for old and young members as well as for sick people.

v. The door and ventilation of latrine should not face towards the house.
Otherwise bad odor of latrine spreads towards the house.

Advantages of Pit Latrine
i. Pit latrine can be constructed even in low cost and using the locally
available materials.
ii. It needs less amount of water compared to other advanced types of
latrines.
iii. It doesn't need trained manpower to construct.
iv. Use of pit can help to make the surroundings clean. It protects the growth
and spread of fly, insects and germs.

v. Ventilator and wooden slab can be used to keep it clean and safe.
Disadvantages of Pit Latrine

i. It is not durable in comparison to other concrete latrine especially it
creates problems in rainy season.

ii. It cannot be made near the residence. So, it creates problem at night,
rainy season and for children and aged family members to use.

iii. It pollutes the surroundings and provides habitat for fly, insect and
germs.

iv. It is not very safe from the point of view of transmission of diseases as
houseflies and other insects go inside it easily.

d) Water Seal Latrine

This type of latrine is permanent and more hygienic than the pit latrine. It
prevents the spread of foul smell because of the use of water-seal pan.

The lower part of pan consists of a looped
portion that contains water. It allows
excreta to pass easily down towards the
pit but prevents gases and foul smell of
the pit to spread in the environment.

Health, Population and Environment - 9 167

Advantages of Water-Seal Latrine
i. It is more hygienic and even semi-skilled manpower can make it.
ii. This type of latrine can be constructed near the house.
iii. It helps to keep the surroundings clean and healthy. Water-seal pan16
helps to prevent foul smell.
iv. This latrine prevents spread of the diseases from human excreta.

e. Sanitary Latrine
It is modern concrete latrine. This type of latrine is

more hygienic and made of advanced technology
like flush system, safety tank, etc.
Modern concrete latrine is widely used in urban
areas. It can be constructed inside or outside the
house.
Advantages of Sanitary Latrine
i. It is the most hygienic among all. As it is made by killed manpower, it is

more comfortable from various aspects.
ii. This type of latrine can be constructed inside the house. It is very useful

for elderly people, handicapped people and children.
iii. It also uses water-seal pan that helps to prevent foul smell and

transmission of diseases' germs through vectors like flies and insects.

Activity

How many latrines are there at your home? Write a short report on the
excreta management system at your home and show it to your teacher.

16. Water-seal pan : the pan used in improved and modern latrines that have collection of small amount of water as
barrier or seal to prevent the movement of insects, flies, and foul odor

168 Health, Population and Environment - 9

Notes

l According to WHO, "Environmental health is the aspect of human health
and disease that are determined by factors in the environment. It also
refers to the theory and practice of assessing and controlling factors in the
environment that can potentially affect health"

l Environmentalpollutionmeansdirectorindirectchangesinthecomponents
of the environment that deteriorate the environment. These changes are
unfavourable to the living things due to new harmful substances or energy
in the environment.

l Environmental pollution may be caused due to the natural events and
human activities both.

l Biodegradable wastes undergo the process of degradation and are
decomposed into smaller carbonic molecules that can be used by plants.
Non-biodegradable wastes remain persisting in the environment for a
long duration.

l Presence of sulphurdioxide and carbondioxide in the air causes formation
of sulphuric acid and carbonic acid that causes acid rain.

l Solid wasates are classified into two groups. They are biodegradable
wastes and non-biodegradable wastes.

l Aerobic method of composting is a method of preparation of compost
manure in which the aerobic bacteria decomposes organic matters in the
presence of oxygen or air.

l Anaerobic method of composting is a method of preparation of compost
manure in which the anaerobic bacteria decomposes organic matters in the
absence of oxygen.

l Vermicomposting is a method of converting organic wastes into compost
manure with the help of certain species of worms like wrigglers and
earthworms.

l 3R method of management of solid waste stands for Reduce, Reuse, and
Recycle.

l Drainage helps in managing wastewater produced from the household
activities, market area or agricultural field.

l Latrine helps in proper disposal of human excreta, Water-sealing system in
latrine prevents transmission of diseases germs and spread of foul smell.

Health, Population and Environment - 9 169

Exercises

Group "A"

Give very short answers to the following questions.
1. What do you mean by environmental health?
2. Define environmental sanitation.
3. When do we celebrate World Environment Day?
4. Write any one harmful effect of environmental pollution on our health)
5. Write the full form of CFC.
6. What is flood?
7. How does mining affect environment?
8. Give any one example of non-biodegradable waste.
9. Which gas depletes ozone layer? Write name of the gas.
10. Write any one source of sound pollution.
11. Define domestic wastes.
12. Write any one disadvantage of pit latrine.
13. What is the main advantage of water seal latrine?

Group "B"

Give short answers to the following questions.
1. How has World Health Organization (WHO) defined Environmental
Health? Explain its meaning in different perspective.
2. How do you maintain better environmental health status at home and
school? Explain.
3. What is environmental pollution? Introduce briefly.
4. How do global warming and volcano cause environmental pollution?
5. Mention any five adverse effects of water pollution on human health.
6. What is sound pollution? What are its effects?

170 Health, Population and Environment - 9

7. List any five methods of controlling:

a) Land pollution b) Water pollution.

8. What do you mean by sources of solid wastes? Why are the wastes
from hospitals possess higher risk to human health?

9. Write short notes on:

a) Landfill site b) Incineration c) Vermicomposting

10. Differentiate between aerobic and anaerobic methods of preparing
compost manure.

11. Draw a diagram of:
a) Borehole latrine. b) Water-seal pan

Group "C"

Give long answers to the following questions
1. List any five importance of environment health. Describe any two of
them briefly.

2. How do human activities cause environment pollution? Explain with
examples in detail.

3. Explain the methods of managing biodegradable waste.

4. Explain '3R principles' of management of solid wastes with examples.

5. Show the difference between simple pit latrine and sanitary latrine.
Explain their advantages and disadvantages in detail.

Health, Population and Environment - 9 171

8 ADOLESCENCE, SEXUAL
AND REPRODUCTIVE
HEALTH EDUCATION

Contents

8.1 Adolescence
8.1.1 Characteristics of Adolescence
8.1.2 Changes in Adolescence
8.1.3 Demands and Needs of Adolescents
8.1.4 Problems of Adolescents
8.1.5 Management of the Problems of Adolescents

8.2 Sex Education: Introduction
8.2.1 Objectives of Sex Education

8.3 Reproductive Health
8.3.1 Aspects of Reproductive Health

8.4 Reproductive System
8.4.1 Male reproductive system
8.4.2 Female Reproductive System

8.5 Reproductive Rights

8.1 Adolescence

According to WHO, adolescence is the stage
of life which ranges from 10 to 19 years of age.
It is the period of rapid physical, mental and
emotional changes in life. Our life is dynamic in
nature. It is changing from birth to death. We pass
various stages from birth to death such as infancy,
childhood, puberty, adolescence, adulthood and
elderly stages. Adolescence is the important
period of our life, in which various important
changes occur in the body and mind. According
to WHO1 , adolescence is the range of 10 to 19

1. WHO : World Health Organization

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years marked with physical, social, and emotional changes. This is also known as
fast-growing period, changing period, the period of storm2 and stress and maturity
period of life. Such features of adolescence make it very important. Adolescence
covers many social and emotional changes. This transition between childhood and
adulthood leads to rapidly changing behaviors, identity disturbances and strong
emotions. Although these characteristics can frustrate or confuse parents, they are
developmentally normal and a natural part of an adolescent’s growth.

8.1.1 Characteristics of Adolescence

a) It is a stage of rapid change

During adolescence, the reproductive system becomes fully matured. Body
becomes physically stronger due to changes in muscles, height, weight and the
improved functions of organs.

Besides, there are remarkable changes in their thinking level, behavior and
emotional aspects.

b) It is an important stage

Adolescence is an important stage because an individual gains the strengths
like physical maturity, reproductive capacity and the basic skills of life that
persists till death. It is the time of carving the shape of life.

c) It is a stage of unstable emotions

Adolescents can shift moods rapidly, wavering between happiness and distress
and self-confidence and worry. Some of these mood changes are caused due
to biological sources like changes in hormonal level. Increased hormones
and changes to the brain structure arise from normal physical growth. Also,
complex social interactions such as conflicts with friends, school pressures
and experimentation with romantic relationships can aggravate the fragile
emotional state of adolescents.

2. Storm : very bad weather with heavy rain and excessive thunder

Health, Population and Environment - 9 173

d) Adolescence is the stage of designing personal identity

Adolescence is a time when teenagers begin to explore and assert their personal
identities. During this developmental period, teenagers engage in a process of
searching for where they fit in with peers and society at large. It is common
for adolescents to have an unstable sense of self and try out new personal
labels and associate with various peer groups. Additionally, adolescents might
struggle to define their sexual and gender identity during the teenage years.
While these unstable identity issues are a common part of early adolescence,
they tend to stabilize during the later adolescence.

e. It is a stage of peer relationship

During adolescence, relationship with
peers begin to take precedence over
relationships with the family. Although
family interactions are still important
and essential for a adolescents’
development, adolescents often place a
stronger emphasis on their friends’
perceptions and values. Likewise,
during the adolescent years, teens might
be strongly influenced by their peers’
beliefs and behaviors. Paired with adolescents' limited life experience and
under-developed decision-making skills, teenagers are often vulnerable to
negative peer pressure.

f) Adolescence is the stage of day-dreaming

Daydreaming is a short-term detachment
from one's immediate surroundings with
blurred reality and imaginary fantasy.
Adolescents are comparatively more
ambitious and make several plans for their
life. They remain dissolved in such unreal
and imaginary world for prolonged time
even when they are busy in everyday work
schedules.

g) Adolescence is a problematic stage

During adolescence, the instabilities in mental, social, and emotional behaviors
create several problems. They cannot take right decisions and there is higher
tendency to get deviated away from the family norms and social norms. It is

174 Health, Population and Environment - 9

difficult for them to adapt with the physical changes that they have recently
experienced during puberty and early adolescence.

h) Adolescence is the threshold of adulthood

Adolescents prepare for establishing a new family and take more responsibilities
at adulthood. Therefore, it is also called the threshold stage for adulthood.

8.1.2 Changes in Adolescence

As mentioned earlier, it is the period of several rapid changes in both of the
genders. There are many remarkable changes which have significant influences
in the entire life. Some changes are described below:

a) Physical Changes
Physical changes in adolescence refer to the changes in body structures, organs,

and tissues of human beings. The physical changes are of two types: Internal
changes and external changes.

The external changes during adolescence include:

• Change in height
• Change in weight
• Change in secondary sex characteristics3
• Increase in size of reproductive organs
• Increase in shoulder dimensions
• Production of hair in the armpits and pubic hair4
• Increase in shoulders and muscles
• Increase in size of penis, testes in boys
• Increase in the appearance of beard and moustache in boys
• Enlargement of breasts and vagina in girls
• There is nocturnal emission5 in boys and menarche6 in girls in the

beginning of puberty during adolescence.

3. Secondary sex characteristics : the characteristics that develop simultaneously with the production of sex
hormones but do not have direct involvement in the reproductive
4. Pubic hair : phenomenon.

5. Nocturnal emission : hair around the genital organs of males and females
6. Menarche :
involuntary emission of semen from the penis while dreaming at night
the first menstruation cycle

Health, Population and Environment - 9 175

The internal changes during adolescence include:

• The process of strengthening digestive, circulatory, endocrine, skeletal,
muscular systems

• There is beginning of menstruation cycle in girls

• Production of sex hormones: estrogen and progesterone in girls

• Production of sex hormone testosterone in boys

• Change in voice

• Gain in strength of walls and suppository muscles of the uterus and
increase in size of uterus in girls

The girls reach maximum height at age of 17 to 18 years whereas boys grow
up to 20 years. The physical changes, growth and development is affected and
determined by the dietary intake and immunization as well. The children who
have got regular nutritious food and immunization can develop rapidly without
any developmental hazards. Lack of nutrition, unfavourable environment and
unhealthy surroundings bring retardation in physical growth and development
of a baby.

All these changes are normal for all human beings during adolescence; therefore
one should not worry about those natural phenomena.

b) Mental Changes

Mental changes mean the changes in the
thinking power and general performance of
mind) In adolescence stage, there are mental
developments along with the physical
developments. In this stage, the capacity of
concentration upon the matter of interests
as well as logical capacity is gained; and
they try to solve problems by logics7 . Some
adolescents are on the wrong path due to
pressure of bad peer groups. Sometimes,
adolescents develop negative and pessimistic
thoughts.

The major mental changes and development can be summarized in the following
points:

7. Logics : the practice and use of causes, effects, science, or factual evidence ways for reasoning

8. Peer group : the group of individuals having almost similar social status, age, enrollment, interest, etc.

176 Health, Population and Environment - 9

• Development of generalized ability
• Increase in the understanding level
• Increase in the imagination and memory power
• Development of debating and arguing power
• Capable to find the right path of life
In some of the cases, adolescents may develop negative thoughts. In such
situation, they try to find the worse aspects of each and every thing, express
irrational dissatisfactions, and may lead their life to depression. So, adolescents
should seek suggestions from the elders. They should try to control such
negative attitudes by themselves. They should think properly before doing
something. It leads them in the right path and makes them good citizens.
c) Emotional Changes
Different emotions such as love, hate, anger, jealousy, curiosity are developed
in adolescence. Curiosity emerges during the period of adolescence. There are
several changes in nervous system and the neuron cells resulting in various

secretions from them. The secretions from nervous cells cause new sorts of
feelings and thoughts in adolescence. There is a strong feeling of patriotism
i.e. love to the motherland and nation. A feeling and self-motivated effort
to be different from others develops during this period. Normal events and
discussions in certain circumstances may bring vital change in behaviour and
tendency to think in a new pattern. During this period, adolescents need proper
counselling, guidance and suggestions from the parents, teachers, and other
senior members of the family and community. The emotional characteristics
developed during this period build the foundation of whole life of an individual.

Health, Population and Environment - 9 177

The above-mentioned emotional changes and developments can be summarized
in the following points:

• Prominent feeling of love and tragedy

• Development of extreme curiosities

• Toleration of loneliness

• To have high ambitions

• Undue tensions

• Feeling of responsibilities towards family, society, and the nation

• Want to laugh, weep, and excite
d) Social Changes

Adolescence is the period of rapid
changes in social characteristics of an
individual. Social characteristics like
social relationships pattern and social
behaviours, etc. are primarily developed
during the period of adolescence. The
leadership, respect, honor and general
moral behavioural patterns are formulated
in every individual during this period.
Students learn various skills of games
and sports, extracurricular activities and
other social adjustment-skills during this
period. This is the crucial time for building one's social characteristics of life.

Major social changes and developments during adolescence are:

• Attraction towards peer groups

• Development of friendship

• Increase in different sorts of interests like games, art, sports, social works,
etc.

• Commitment of various problematic and immoral acts

• Desire of adequate income

• Formulation and performance of own styles

• Feeling of leadership

• Participation in extracurricular activities

178 Health, Population and Environment - 9

8.1.3 Demands and Needs of Adolescence

It is the period between childhood and adulthood. Therefore there may be
some childhood characteristics as well as the nature of adulthood and maturity
during this phase. Adolescents want to be regarded and respected by juniors.
They also want to show appropriate behaviour and relationship towards their
seniors. They never want to hear criticisms against their activities from others.
Adolescents want to pass most of their time with their friends and peer groups8
. They share most of their life matters among them.

Adolescence is not only the time period for positive changes but also the period
of developing negative habits and tracks of life. They learn most of the adverse
antisocial behaviours during this period. They learn drugs, disobey their
parents and take the track of wrong way of life in this period. Therefore, they
need proper guidance from their parents, teachers, and senior members of the
society.

The need and demands of adolescents can be stated as below:

a) They want their desire and interest to be understood by the senior
members of their family and society.

b) Their desires, wants, and emotions should not be criticized by others.
Instead, these factors should be heard and listened to well by the others.

c) They want appropriate time and sharing with other members of family
and society.

d) They want to participate in the decision making process in their family.

e. They think themselves as matured persons of the family and community.
Therefore, they do not want to be dominated as junior members.

f) They are attracted towards companions or friends and peer groups.
Sometimes, they also want to be alone at home. Therefore, the desired
situations should be managed and assisted by the family members.

g) Adolescents want to participate actively in family and community
problems. Therefore, their participation in solving such problems should
be encouraged by the others.

h) They do not want any discrimination among daughters and sons in their
family. The parents should respect the non-discriminative desires of
adolescents.

8.1.4 Problems of Adolescents
As we have discussed earlier, adolescence is the period of rapid changes in

Health, Population and Environment - 9 179

physical, social, and mental aspects of life; there are many hazardous and
problematic situations during adolescence. The first menstrual flow (menarche.
in girls may bring new unsolved curiosities and problems. During menarche,
there must be proper knowledge and precautions. In boys, there may be the
nocturnal emissions as the beginning point of puberty stage in adolescence.
There are some of very common problems which are mentioned below:

a) Unsafe sexual intercourse

During the period of adolescence, boys and girls are attracted towards opposite
sexes. Due to this reason, they often fall in love and may indulge in sexual
intercourse as they get secrecy of their activities and secret circumstances. The
unsafe sexual intercourse may result in unwanted pregnancy and transmission
of different venereal diseases like gonorrhoea, syphilis, and HIV/AIDS.
Unwanted pregnancy may be terminated in unsafe way due to the lack of legal
knowledge and awareness in adolescents if it is before marriage. The termination
of foetus without help and assistance of a trained medical practitioner may
result even in death of the girls.

b) Peer pressure

Adolescentsareengagedoftenamongthe
group of their friends and peer groups.
They think themselves as matured and
capable person. Their evaluation of
themselves should be regarded well
by involving them in decision making
process and other social activities.
They develop new wants, desires and
wills. They are highly influenced by the
pressure of peer groups. In this way,
their total characteristics are determined by the impacts of peer pressures. If
the members of peer group are addicted and are in wrong tracks, they are also
likely to be similar to their peer groups.

c) Imitation

Though adolescents think themselves as matured persons of the society, they
do not have proper capacity to distinguish between right and wrong. The
curiosity level of adolescence is quite high. Due to this, they become curious
and are immediately attracted towards other’s activities. If the others have
wrong beliefs and bad habits, they imitate readily and create problems towards
themselves. They basically imitate habits of clothing, feeding, hair style, speech,

180 Health, Population and Environment - 9

acting, and other general day-to-day activities of life. They may learn the habit
of alcoholism, drug addiction, tobacco intake, smoking, etc. by imitation of
others.

d) Sexual abuse

As the adolescents become matured and gain the internal strength of
reproductive systems with the increased secretion of sex hormones, both boys
and girls develop desires to have sexual intercourse. If these desires are not
addressed properly with appropriate counselling, knowledge and awareness,
this situation may result in different types of sexual abuses. Some examples
of sexual abuses are teasing girls on the streets, speaking vulgar words, force
for sex, rape, making sexual talks in phone calls, develop tendency to show
abnormal closeness intended with sexual desires, etc. Such habits create
personal as well as social problems too. Therefore, there must be proper
guidelines and alternative solutions for the fulfilment of sexual desires.

e) Early marriage

Early marriage, as per the meaning of these two
terms, is marriage before marriageable age. From
the point of view of reproductive health of boys
and girls, the ages at marriage are 25 years and 20
years respectively.

The legal provisions of laws of Nepal indicate
that the appropriate legal age at marriage for both
boys and girls are 20 and 18 years regardless and
with the consent of marriage from their parents respectively. The early marriage
brings several problems in the health of the mother and the child because in
early stage, the internal reproductive organs of mother are not developed well
to gain the reproductive strengths which are essential to be pregnant and to
create appropriate environment for the growth and development of the foetus.

8.1.5 Management of the Problems of Adolescents

We have already discussed several problems seen in the period of adolescence.
These problems are natural and common for all the adolescents all over the
world. Regarding these common and natural problems to the adolescents,
following measures can be followed:

a) Counselling and service

Counselling during adolescents refers to the appropriate suggestions and

Health, Population and Environment - 9 181

guidelines given to the adolescents. Adolescents, as we discussed, suffer from
various problems related to their physical, mental, and social status of life.
The hazardous effects created by rapid physical and chemical changes within
the body and also due to socio-sexual circumstances should be addressed in a
conscious way with proper counselling and services to the adolescents.

b) Participation in creative activities
It is said that an empty mind is a devil's workshop. It is the reality that when

a person remains empty-minded with much leisure time, he/she is vulnerable
to be involved in anti-social and immoral activities. If such situations arise
during the most active phase of life in the adolescence, it is likely to bring
them in criminal activities too. Therefore, adolescents should be provided with
appropriate opportunities and environments to participate in entertainment,
art, and other recreational activities.

c) Mutual understandings

Mutual understanding refers to the understanding between adolescents
and other members of the family and community. Both of the groups, the
adolescents and non-adolescents, must understand the desires and wants of
each other. There should be mutual respects, honours, and regards between
these two groups. Such circumstance is helpful in eliminating the problems
created by the changes of adolescence. The adolescents have natural habit of
being influenced quickly by anger, jealousy, and other emotional components.
It should be regarded as common and natural; and this should be addressed
accordingly.

d) Safe sexual behaviour

Adolescents are more vulnerable to get indulged in unsafe sex behaviours due
to the curiosity of sex matters, the influence of sex hormones, and development
of reproductive organs in their body. The curiosity of knowledge about opposite
sexes develops more because such information is kept hidden in traditional
type of society. The attraction towards opposite sexes develops and there is
high chance of being indulged in unsafe sexual activities. Such conditions can
be avoided by giving proper knowledge and information about reproductive
health and reproductive processes. Such advices are meant to keep them
preventing them to be safe from STIs (Sexually Transmitted Infections) and
HIV/AIDS. The following suggestions should be given to the adolescents for
this purpose.

182 Health, Population and Environment - 9

i. Abstinence

Abstinence is regarded as one of the best solutions to be far from unsafe
sexual behaviours and the problems caused due to such behaviour. It
refers to stay away from sexual intercourse. Late marriage and alternative
ways of fulfilment of sexual desires like hugging, kissing, masturbation
may be the best suggestions for adolescents to from unsafe sexual
behaviour.

ii. To be faithful to have safe sexual relation with a single sex partner
(one’s spouse.

Limiting sexual behaviours within own sex partner is also regarded as a
safer method to solve the problem of unsafe sexual behaviour. Multiple
sex partners and multiple sex behaviours are found to be the strongest
cause of transmission of HIV/AIDS and other venereal diseases.

iii. Use of condoms

Abstinence and single-sex-partner concepts are the best solutions for
safe sexual behaviour. However, if one is habituated or in compulsion to
have multiple sex partners, there must be use of condoms without any
hesitation to be safe from the consequences of unsafe sexual behaviours.

8.2 Sex Education: Introduction

Sex Education is traditionally understood as the education regarding sexual
intercourse and similar sex behaviour. In fact, sex education has a broad scope.
Besides this, sex education encompasses the matters related to harmonious
relationship between the opposite sexes and various other aspects of gender
issues. It is concerned with development of interpersonal relationships, to bring
satisfaction among couple, age at marriage, and the feeling of responsibilities
within family and community. In this way sex education can be defined as the
process of bringing rational changes in knowledge, attitude, and behaviour regarding
human sexuality, reproductive phenomena, safer sexual behaviour, and behavioural
guidelines to interact with the people of opposite sex.

8.2.1 Objectives of Sex Education
Sex education aims to achieve the following objectives:

a) To reduce the fertility rate through the knowledge of reproductive processes
and contraceptive methods.

b) To develop basic knowledge about human sexuality and develop positive

Health, Population and Environment - 9 183

attitude and acceptable behavior among them regarding the sex and gender
related issues.
c) To make children become aware of their gender and thus behave accordingly
by adopting values and attributes of members of the sex that they identify as
their own and opposite.

d) To disseminate knowledge of natural and unnatural sex and make them aware
of the healthier sexual behavior.

e. To eliminate the unhealthy practices and superstitious faiths regarding sex for
developing healthier sex life.

f) To develop quality life with birth control and limited family size.

8.3 Reproductive Health

Reproductive health is the state of health affected by one's reproductive
processes and phenomenon. Reproductive health declines due to unsafe sex
behaviours and lack of sex education. Reproductive health education is a
branch of sex education. It gives knowledge and develops positive attitude and
behaviours towards sexual relation, reproductive phenomenon and processes.
The concept of sex education was first introduced from the Cairo conference on
“Population and Development” (ICPD) in 1994 A.D. The reproductive health is
also related to mental, social, and physical aspects of human life. World Health
Organization has defined reproductive health as follows.

"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."

The above definition mainly focuses on the following aspects:
i. Reproductive health refers to the condition of mental alertness and being

free from any kinds of mental tension.

ii. It focuses on the complete physical condition in the body. The outlook,
height and weight should be well balanced. The body must be free from
diseases and deformities to have sound reproductive health)

iii. It focuses on social well-being. There must be appropriate sex and
reproductive characteristics of proper social adjustment.

iv. Reproductive education is closely related to sex education. Reproductive
education makes people aware of the appropriate age at marriage,

184 Health, Population and Environment - 9

problems of pregnancy and child birth, unsafe sex behaviours, and
prevention from sexually transmitted infections.

8.3.1 Aspects of Reproductive Health

a) Planning of the family and family planning

Planning of the family includes all the family affairs related to the factors
required to run the family smoothly. The family matters like proper education
to the children, and management of income and expenditure in the family,
saving, and to make family ready to tackle against different problematic
situations in the family. The family planning is primarily related to limit family
size by giving limited number of births with the help of contraceptive devices
and proper birth spacing.

b) Safe motherhood

It is the process of protecting prenatal, neonatal,
and postnatal mother from problematic pregnancy,
complicated pregnancy, and problems of breastfeeding
periods. Reproductive education includes this as an
important aspect. In 2002, the maternal mortality rate
was 400 per one lakh in developing countries whereas
the data was only 21 per lakh in developed countries.
This data reflects the poor situation of mothers in
developing countries like Nepal. For Nepal, this rate
was 850 per lakh in 1990 AD But in 2010 AD, this
number was significantly decreased to 229 per lakh. Nepal was honoured
at the Millennium Development Goals (MDG) review summit for making
significant progress in decreasing maternal mortality rate. Data shows that
there are deaths of about five lakh of women due to complicated pregnancy
and delivery in the world every year. Main causes of maternal death are early
marriage, less birth spacing, and delivery of many children. Due to the lack
of knowledge and awareness about the facts of the causes of maternal death,
many mothers are still dying due to minor problems which can be solved easily
with minor awareness and medical assistance.

c) Infant and child health care

Infants are the children below one year of age; and the children are regarded
as the people below five years of age. Children and infants are vulnerable to
health problems because of their innocence and lack of capacity to tackle against
various adverse circumstances in life. There were deaths of 92 infants per 1000

Health, Population and Environment - 9 185

live births during the period of 1970 to
1975 A.D. This figure was 48 per thousand
in 2006 AD and it has been reduced to 46
per 1000 live births in 2011 AD according
to the Demographic Health Survey (DHS)
conducted by Central Bureau of Statistics
(CBS). This decline certainly proves the
positive changes in child healthcare in
Nepal. There must be increased effort to reduce this figure in the days to come.

d) Control of unsafe abortion and its consequences

Abortion is the process of terminating the life of foetus before its maturity. In
about 90% countries of the world, there are legal provisions for abortion if the
pregnancy is problematic from the point of view of the mother’s and foetus'
health) It is found by different surveys conducted in different countries that
there are still many evidences of unsafe abortion in spite of legal provision of
safe abortion. If continuation of the pregnancy is harmful, it is better to abort
the foetus for safe life of the mother. Recent amendment of laws of Nepal has
kept some legal provisions to legalize abortion in limited and emergency cases.

e. HIV/AIDS and other infectious diseases of the reproductive tract

There is high chance of reproductive tract infection in the pregnancy period
of females. Sexually transmitted diseases can be prevented by safe sexual
relationships among the sex partners. Sex education gives knowledge and
practical skills to be safe from such venereal diseases. Therefore, there must be
proper sex education for all.

f) Prevention and treatment of infertility

The reproductive health does not deal only with birth controls and limiting
family size, but also about the treatment and prevention of infertility. The
couples who do not have children can get proper solutions and help available
at different health centres, health posts, clinics, hospitals, etc.

g) Reproductive health of adolescents

The reproductive health education raises knowledge, attitude, and behaviour
regarding the reproductive health of adolescents. There are many physical
and mental changes causing curiosity in the adolescence. Such curiosity and
queries are answered by the reproductive health education. It gives knowledge
about age at marriage and safe sexual relationship in adolescences.

h) Reproductive health problems of elderly people

186 Health, Population and Environment - 9

After about 49 years of age, females lose the fecundity power. Cessation of
fecundity power is indicated by menopause in females. At this stage, there
may be irregular menstruation, physical tiredness and fatigue, breast cancer,
cervical cancer, etc. in females. They must know about the general symptoms
and problems at this stage. Reproductive health education gives information
and knowledge regarding the changes in sex characteristics at old age.

8.4 Reproductive System

The system in human body that is responsible for production of offspring
or new individuals is called reproductive system. All other body systems in
human body are almost similar in males and females but the reproductive
system is significantly different in the individuals of opposite gender.

8.4.1 Male reproductive system

There are two genders of human beings. One is male and another is female.
Both genders produce gamete cells which combine together to initiate a new
life. This union is called fertilization. The male reproductive system produces
male gametes known as sperms. Sperms are produced inside small tubules
called seminiferous tubules inside the testes. The main reproductive organs of
male are described below:

a) Testes

There are two testes in males. Both the testes are enclosed within a skinny bag
hanging just below the base of the penis, which is called scrotum. There are
250 to 400 small tubules inside the testes. These tubules are called seminiferous
tubules. Inside these tubules, there are many specialized cells called interstitial
cells which undergo meosis9 cell division to produce sperms. Testes are about
4.5 cm long, 2.5 cm wide and 3 cm thick. Follicle Stimulating Hormone (FSH)
and Luteinizing Hormone (LH) produced from pituitary gland stimulate the
interstitial cells to produce male sex hormone testosterone and sperms. LH in
males is also known as Interstitial Cell Stimulating Hormone (ICSH).

9. Meosis : a type of cell division that produces the daughter cells with half number of chromosomes, which are
called the haploid cells, gamete cell, or sex cell, that takes part in sexual reproduction by fusing with
opposite sex cell

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A Sperm

b) Vas deferens
These are small tubes connecting the epididymis and ejaculatory duct. These

tubes help to transfer the sperm from epididymis to seminal vesicles. These
tubes are about 4.5 cm long which are disconnected during the male sterilization
process.
c) Seminal vesicle
The seminal vesicles are two small fibro-muscular bags which are situated
on either side of ejaculatory duct. It produces sticky, milky-white, nutritious
viscous fluid called semen, which provides nutrition to the spermatozoa) The
spermatozoa move towards the ejaculatory duct.
d) Penis
This is the main reproductive organ to define male character. This is main
copulation organ of male during sexual intercourse with female, situated under
the stomach. It is made up of erectile muscle tissue covered by a thin layer of
skin. The spongy muscular head of the penis is called glans that becomes most
sensitive during sexual intercourse and excitement. It ejaculates the sperms
(male sex cell) with semen inside vagina the during period of sexual intercourse.
Penis is cylindrical in shape and of about 8 to 12 cm long in the erected state.

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Bladder

Seminal vesicle

Urethra Prostate gland
Penis Urethra
Vas deferens

Epididymis

Testicle
Male reproductive system

e) Scrotum

It is a skinny bag like pouch that holds the testes10 . This is divided into two
compartments and each compartment contains a testis. It mainly safeguards
the delicate and soft testes made up of connective tissues.

f) Ejaculatory duct

These are small tubes of about 2 cm long. Sperms are transferred from seminal
vesicles to urethra by the ejaculatory ducts during the sexual period.

After getting information about reproductive organs, it becomes easy to know
how the reproductive process of male work. The anterior lobe of pituitary gland
secrets FSH (Follicle Stimulating Hormone.. It affects the somniferous tubules
of the testes for the production of sperm. When the sperm becomes matured, it
reaches and travels towards the vas deferens, seminal vesicles, ejaculatory duct
and urethra to be inserted inside the female vagina during sexual period.

8.4.2 Female Reproductive System

The female reproductive organs are divided into two groups; internal and
external organs. The internal organs play main roles in reproduction process.
So, we discuss about the internal organs.

10. Testes : also called ‘testicles’, singular form is ‘testis’

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Female reproductive organs

Internal Organs External Organs
– Vagina – Vestibule
– Uterus – Mons pubis
– Ovaries – Labia Majora
– Fallopian tube – Labia Minora
– Clitoris
Internal organs

a) Vagina

Uterus Fallopian tube

It is like hollow canal or muscular

tube of about 15 cm long from vulva

to the opening of cervix. It is made up

of erectile, circular, and fibrous muscle Ovary
tissues. So, it becomes very sensitive and
emotional during sexual intercourse Cervix

and gives sexual satisfaction. Its

main functions are: receiving sperm Vagina

in sexual period, discharging blood Female reproductive system

during menstruation, passing out

baby in delivery and providing space for penis during sexual intercourse. It is

situated under the lower abdomen and opens between two thighs.

b) Cervix

It lies at the base of vagina. It is the opening of uterus. There are two narrow
constrictions in its lower and upper part. They are known as external os and
internal os.

c) Uterus

It is a hollow, muscular, and pear-shaped organ that holds the fetus during
pregnancy. It is also known as womb. It lies in pelvic cavity between rectum
and urinary bladder. The opening of uterus is called cervix. It has three parts.
The lower part is 'cervix', the middle part is 'body' and the upper part is called
'fundus'. It is about 7.5 cm long and 5 cm wide. Its main functions are:

• Receiving, nourishing and protecting the fertilized ovum.

• Giving place for the fetus to develop

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• Regulation of menstruation cycle
• Pass out the matured baby in delivery
d) Fallopian tube
It is small tube extending from each side of uterus to the ovaries on each side.
Length of fallopian tube is about 10 cm. Its end part has finger-shaped organs
called fimbriae. The main function of fallopian tube is to receive ovum and
to provide place for fertilization. The fertilized egg passes into the uterus for
implantation and further growth and development.
e) Ovaries
There are two small oval-shaped organs of 2.5 to 3.5 cm long, 2 cm wide and
1 cm thick. These are situated on each side of uterus. Each month one ovum
becomes matured and comes out in the fallopian tube. Ovaries produce ova,
estrogen hormone and progesterone hormone.

8.5 Reproductive Rights

The international conference on human rights held in the capital city Teheran of Iran
in 1968 AD had given the first concept of sexual and reproductive rights. It declared
that the parents deserve the right to produce children and to maintain appropriate
birth spacing. The reproductive rights are indispensable part of human rights. The
Cairo conference on “Population and Development” (ICPD) in 1994 AD. and the
World Woman Conference in Beijing in 1995 A.D. raised the issues of reproductive
and sexual rights. Some of the focusing points of the reproductive rights are as below:

i. Right to survival: The survival should not be threatened due to the
problems of reproductive phenomenon and processes.

ii. Right to personal freedom and security: All people are free to utilize

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their rights regarding the personal reproductive matters and to utilize
the reproductive security.
iii. Right to equality: The reproductive facilities and services must be
available for all people regardless of any sorts of discrimination.
iv. Right to privacy: All people deserve their right to maintain privacy
regarding their reproductive and sexual affairs.
v. Right to express the personal opinions: All the people have right to
express their views regardless of any restrictions created by religious,
cultural, and political circumstances.
vi. Right to information and education: No one should be deprived of the
information and education regarding reproductive and sexual health)
vii. Right to marry and make their own family: Everybody has the right to
take decision regarding his/her marriage and to establish a family.
viii. Right to produce a child: The right to produce child basically falls on the
couples who want or do not want to produce children.
ix) Right to reproductive health facilities and services: Basic reproductive
health services and facilities should be provided to all the people.
Government should manage these basic services to all.

x) Right to political participation: Right to political participation in the
establishment and promotion of reproductive health rights.

xi. Right to be free from misbehaviour and torture related to sexual and
reproductive health: This right assures the torture-free life with respect
and self-confidence.

The reproductive and sexual health education can be given to people by formal
education as well as non-formal educational program too. Different media
like newspapers, radio, websites, books, magazines T.V, etc., provide the
knowledge and education related to this part of life. This stream of education
has been included in school educational program as well as higher level of
educational programs in collages too. All these efforts of education have really
been fruitful for the adolescents and other people. Such program should be
promoted in all parts of the world.

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Notes

l Adolescence is also known as fast-growing period, changing period, the
period of storm and stress and maturity period of life.

l Adolescents can shift moods rapidly, wavering between happiness and
distress and self-confidence and worry.

l Adolescents are comparatively more ambitious and make several plans for
their life.

l Adolescents prepare for establishing a new family and take more
responsibilities at adulthood Therefore, it is also called the threshold stage
for adulthood.

l Physical changes in adolescence refer to the changes in body structures,
organs, and tissues due to the effects of new hormonal development and
accelerated physical growth.

l During adolescence, capacity of concentration upon the matter of interests
as well as logical capacity is gained; and they try to solve problems by
logics.

l Different emotions such as love, hate, anger, jealousy, curiosity are
developed in adolescence.

l Social characteristics like social relationships pattern and social behaviours,
etc. are primarily developed during the period of adolescence.

l Adolescents think themselves as matured and capable person. Their
evaluation of themselves should be regarded well by involving them in
decision making process and other social activities.

l According to WHO, "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."

l Safe motherhood is the process of protecting prenatal, neonatal, and
postnatal mother from problematic pregnancy, complicated pregnancy,
and problems of breastfeeding periods.

l The male reproductive system produces male gametes known as sperms.
l Sperms are produced inside small tubules called seminiferous tubules inside

the testes.
l Ovaries produce ova, oestrogen hormone and progesterone hormone. Each

month one ovum becomes matured and comes out in the fallopian tube.
l The concept of sexual and reproductive rights is introduced by the

international conference on human rights held in the capital city Tehran of
Iran in 1968 A.D.

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Exercises

Group "A"

Give very short answers to the following questions.
1. Define adolescence.
2. Mention any one physical change in the adolescence in girls.
3. Write one example of emotional development in the adolescence.
4. Write one example of social change in the adolescence.
5. What problem is created due to the unsafe sexual intercourse in
adolescence?
6. What is peer pressure?
7. Define sex education.
8. When was International Conference on Population and Development
(ICPD) held?
9. When and where was the fourth World Women Conference held?
10. What was infant mortality rate of Nepal in 2011 AD?
11. How many testes are there in male reproductive organ?
12. Write the full form of FSH.
13. What do you mean by 'right to privacy'?

Group "B"

Give short answers to the following questions.
1. What is adolescence? List any five characteristics of adolescence.
2. "Adolescence is the stage of day-dreaming." Elaborate.
3. Describe the physical changes in adolescence briefly.
4. "Adolescents may show anger and annoyance quickly even over small
matters." Give reason.

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5. What are the emotional and mental changes during adolescence?
6. Discuss the demands and needs of adolescents.
7. Write short notes on:
a) Mutual understanding
b) Counselling and service
c) Abstinence.
8. Define reproductive health according to WHO. List out the major aspects

of reproductive health.
9. List any ten sexual and reproductive rights in short.
10. Draw a well-labelled diagram of male reproductive system.
11. What are the functions of: a) Testes b) Vas Deferens c) Penis d) Scrotum
12. Draw a well-labeled diagram of female reproductive system.

Group "C"

Give long answers to the following questions
1. Explain the mental and emotional changes during adolescence.
2. Discuss the major problems of adolescence with respective measures of
their solutions.
3. What is sex education? What are its objectives? Explain.
4. Describe the situation of safe motherhood in Nepal with necessary data.
5. What is reproductive health? Describe different aspects of reproductive
health.

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9 CONSUMERS' HEALTH

Contents

9.1 Consumers and Consumers' Health
9.1.1 Consumers’ Rights
9.1.2 Essential Goods
9.1.3 Importance of Consumers’ Health Education
9.1.4 Methods of Protecting Consumers’ Health
9.1.5 Objectives of Consumers’ Protection Act, 2054 BS
9.1.6 Legal Provisions of Consumers’ Protection Act, 2054 BS

9.2 Food and Nutrition
9.2.1 Objectives of Foods
9.2.2 Classification of Foods
9.2.3 General Outline of Nutritional
Requirements
9.2.4 Characteristics of Quality Food
9.2.5 Food Adulteration

9.3 Harmful Goods and Precautions against
Such Goods
9.4. Planning for Healthier Life

9.1 Consumers and Consumers' Health

Consumer is a person who consumes goods and services from the market. With
this meaning of consumer, we can say that all the people are consumers because
everybody purchases different sorts of goods and services from the market. According
to consumer protection Act 2054 "consumer is a person or institution who consumes or
uses the services and goods available in the market." In this respect consumer can be an
individual, a family, a community or a nation. A producer of goods or services may
be the consumer of other goods and services. So, every individual and institution of
the world may be the consumer of one or another item.

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Consumers’ health means the state of health determined and affected by the use of goods and
services from the market.

The status of our health is dynamic. There are frequent ups and downs in its level.
There are important roles of the goods and services which we consume in our daily
life. The trend of consumption plays important roles in determining our health level.

If we have the knowledge of consumers' health education, we can make proper decisions
in selection of goods and services from the market and to exercise the consumers'
rights to the maximum level. Except this, it provides the learning experiences that
affect efficient and economical use of different products and services. The concept
of consumers' health came into existence after the industrial revolution of Europe
in 1750-1850 AD. It increased rapid urbanization and density of population. People
had to face unemployment problem as well as existence of individualistic mentality.
Therefore, people were compelled to involve in corruption. As a result, consumable
goods were also affected by adulteration. The first consumers' law was made in the
United States of America. It had various provisions for the legal rights of consumers.
The practice of cheating consumers by adulteration and wrong information is still in
practice in our market. The modern age has increased anti-consumer behaviour due
to excessive competition in every sector. Morality, humanity, honesty and positive
attitudes are displaced by money, crimes, and inhuman behaviours day by day in
many sectors. Producers, distributors, and sellers of various commodities are not
exceptions from such cases. In such situation, consumers must be aware of all sorts of
such fraudulent activities against them.

Life style and living process advances with the advancement of socialization and
development of human beings. In the ancient time, people used to manage all the things
themselves. There was barter system in the ancient time. People used to exchange the
things to fulfil their needs. Nowadays, people spend money in the market to obtain
commodities needed for them. They cannot produce all the things needed for them.
There is specialization in production of commodities. Those commodities are brought
to the market on sale for the consumers. Consumers, then, obtain those goods and
other services from the market.

9.1.1 Consumers’ Rights

Though, the government had made different laws related to consumers' concerns,
Consumers' Protection Act was enforced in the year 2054 BS in Nepal. People use
low quality goods primarily due to three reasons. The reasons are lack of awareness,
poverty, and negligence. The consumers' forum and other related agencies are
raising voice for the consumer's right. This has helped to pressurize the government
to formulate and implement the law relating to consumer's health. Consumer's

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Protection Act 2054 has provision for important rights of consumers. In order to
safeguard consumer interest, eight consumer rights are defined by UN Consumer
Bill of Rights. They are also regarded as the rights of consumers health. The rights are:

i. Right to Safety : safeguarding against goods that are hazardous to life and
property.

ii. Right to Information : consumers have the right to be informed regarding the
price, quality, quantity, etc., of the products they buy.

iii. Right to Choice : consumers should be provided with a wide variety of goods to
choose from.

iv. Right to be Heard : the right of consumers to have their complaints heard)

v. Right to Satisfaction of Basic Needs : this right demands that people have access
to basic, essential goods and services: adequate food, clothing, shelter, health
care, education, public utilities, water, and sanitation.

vi. Right to Redress : consumers have the right to seek redress regarding their
complaints.

vii. Right to Consumer Education - the right of consumers to be educated about their
rights.

viii. Right to a Healthy Environment : this is the right to live and work in an
environment that is non-threatening to the well-being of present and future
generations.

9.1.2 Essential Goods

Essential good is a physical item required by a consumer in order to sustain basic health
status or life. Some essential goods produced by business operators include food,
water, gasoline and heating fuel, as well as residential building materials that can be
used to construct homes for shelter. Essential Commodities Control (Authorization)
Act, 2017 BS has clearly defined the essential commodities. According to section 2 of
this act, "Essential Commodity" means any of the following commodities:

i. Paddy, rice, maize (corn), wheat, millet, barley and their flour, maida or other
identical food items,

ii. Rahar (yellow lentil), mugi, mas (black lentil) lentil, gram, pea, soybean and
flour made there from and other identical food items,

iii. Linseed, mustard seed, sarsiyum (yellow mustard seed. sesame seed and other
oilseed and all kinds of oil,

iv. Milk or any other food item made from the milk,

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v. Sugarcane, molasses, sugar or other identical substances,

vi. Cotton or woolen clothing's, cotton and wool,

vii. Raw jute and goods prepared out of it,

viii. Kerosene, petrol, diesel and all types of lubricant,

ix. Iron and goods made from the iron,

x. Cement, bricks, zinc plate etc. which are essential for the construction works,

xi. Means of transportation and tire, tube and parts essential for such means of
transportation,

xii. Salt,

xiii. Medicines,

xiv. Any other goods or commodities as so prescribed by the Government of Nepal,
from time to time, by a notified order.

9.1.3 Importance of Consumers’ Health Education

There are some fraudulent practices which harm the state of health and other
aspects of consumers. In order to be safe from such effects, consumers must be
aware of their rights and responsibilities. Consumers' health education helps
consumers to identify the harmful practices and to fight against them. The
importance of consumers' health can be mentioned as:

i. Proper choice of consumers' goods and services

When we are aware of the effects of low quality and adulterated food in
our health, we search for quality goods. If we are not getting quality goods
and services, we try for their alternative. For example, when a consumer
knows that some shops sell low quality or adulterated goods, they will not
go to buy things in those shops.

ii. For the protection of personal health and public health

Consumers' health education helps to protect the health of an individual
as well as of a group of people if it is expanded in the community. If
community people are conscious about the adverse effects of using low
quality goods and such practices in the market, they raise voices and take
necessary actions against this. Such activities of people can contribute
in controlling food adulteration, alteration in quality of goods, and fake
services in the market.

iii. Awareness to the right and responsibilities of consumer

Generally, we believe on the shopkeeper's explanations about the goods.

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We consider it as a personal matter and a matter not to be discussed much)
But, it is the duty of consumers to monitor the fraudulent activities and to
protect the consumers' right. While buying goods we must see the brand,
price, expiry date, etc. While getting services, we must see the qualification
and analyze the recommendation provided by them. In addition to these,
the consumers must be aware of the rights of consumers.

9.1.4 Methods of Protecting Consumers’ Health

Consumer rights are afforded when a legislature enacts laws that prevent
fraudulent and unfair business practices. This form of law is called Consumer
Protection Law. In Nepal, Consumers’ Protection Act, 2054 BS helps protect
the consumer rights and consumers’ health. Each country and state has their
own restrictions on business practices; however, most fraud is prevented when
consumers know their rights. Consumers’ protection is also aided by related
research and report of any illegal activities when they happen. It is important
to be a knowledgeable buyer to exercise the consumer’s rights.

Some of the major ways or methods of protecting consumers’ health are discussed
below:

i. Consumers are afforded the right to safety, making any marketing of
products or products themselves unlawful if they are hazardous to
health.

ii. Consumers should be afforded the ability to choose their products. This
has led to legislation against monopolies. If competition and choice are
unavailable for certain products, the consumer must be given a fair price
and quality.

iii. Consumers have the right to correct information to inform their buying
decisions. This means they are protected against fraudulent or misleading
advertising or information.

iv. Consumers are given the right to be heard. They should be given recourse
to file complaints or be heard by a tribunal. They can take action against
illegal, unfair and fraudulent behaviors.

v. Consumers should keep themselves in touch with consumer reports,
price lists, and consumers’ activities.

vi. This is important that the service-trading personnel like medical
personnel, lawyers and contractors must have legal registration with an
authorized agency.

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