Health, Population and Environment Education 9

masturbation, boys fondle their penis with their hand and ejaculate semen whereas girls
move clitoris and vaginal fluid is discharged. Masturbation does not cause harm in the
body and is safe to practise. Adolescents have neither fear of pregnancy nor transmission
of STIs by practising/doing masturbation.
ii. Abstinence
Abstinence is not getting involved into sexual relationship. Adolescents should have self
control for not getting involved into sexual relationship. When they do not involve in
sexual relationship, there is no consequence of unsafe sexual behaviours. Adolescents can
get involved into creative works so as to divert their mind from sexual thinkings.

iii. Faithful to a single partner
Sex is basic need and people need to have fulfillment of sexual desires. If adolescents
cannot control their sexual desires by other means, they can have sexual relationship
only with a single partner. Being faithful to a single partner helps to avoid various sexual
problems. If they are not faithful with a single partner, they have multiple chances of
transmission of sexual problems. Even they will be making other people at risk.

iv. Use of condom
Condom is very effective temporary contraceptive device developed for both male and
female. It prevents pregnancy and transmission of different STIs like HIV/AIDS, Hepatitis
B and C, Gonorrhoea, Chancroid, etc. Boys can use male condom whereas girls can use
female condom before sexual intercourse. However, both of them should not use condom
together. Only one, either boy or girl can use condom.

Activity: 1

Make groups in your class and discuss among each other regarding your problems and
ways you have adopted for solution of those problems.

Activity: 2

In order to solve your problems, have you taken support from friends, parent, teachers
and seniors? Discuss in your class about the role of various individuals for the solution
of your problems.


8.2 Sex Education

Sex is very important in our life. It is as equally important as food, clothes and shelter
in our life. People need to have fulfillment of sexual desires. When the married couple
gets involved into sexual relationship, a female may become pregnant and she bears
a child. That is how there is continuity of generation. There has been continuity of life
and generation by sexual relationship on the Earth. But in our context, sex is taken as
some what different thing. People know sex is basic need, but they hesitate to talk about
sex openly. It is regarded as totally private matter. They may have several sex related
problems and diseases. But they do not want to expose them rather; they keep on
transmitting the diseases silently from one person to another. Adolescents have a lot of
GREEN Environment Population and Health Education Book-9 201

curiosities regarding sex and sexual matters. They cannot get their curiosities addressed
from the parents, neither they feel easy to discuss about them with others. Hence, they
are compelled to adopt unhealthy means to satisfy their sexual desires. It is most essential
that they should be provided with ideas on sex education.
Sex education is an educational process that provides knowledge, skills and attitudes
about the reproductive system, its organs and their structure, sexual matters and helps to
bring change in the attitudes and behaviours towards the healthy sexual activities.
According to WHO, “Sex education is an educational programme designed to provide
the learners adequate and accurate knowledge of biological, socio-cultural and moral
dimensions of human sexuality. Human sexuality is the core of sex education and is a
function of the total personality which includes the human reproductive system and
processes, individual feelings of being a woman or a man, embraces the biological, socio-
cultural and ethical aspects of human sexual behaviour.”

Importance of sex education

Sex education is equally important as other types of education. It helps people to deal
with several sexual matters and get answers for them. People can have many advantages
from sex education. The importances of sex education is mentioned below:
a. Sex education provides necessary skills, knowledge and understanding about various
sexual behaviours.
b. It helps to remove misconception regarding sex and reproduction.
c. It helps to understand the sexual behaviours in terms of society and family.
d. It helps to develop the practice of healthy and safe sexual behaviour.
e. It helps to maintain sexual hygiene.
f. It awares people about various sexually transmitted infections and ways to protect
against them.
g. It helps men and women to understand their sex roles and emotional relationships.
h. It provides appropriate answers to the curiosities and queries of the adolescents
regarding the sexual behaviour.
i. It promotes positive attitudes among adolescents for richer and happier living.
j. It provides information on reproduction process and helps to reduce birth rate.
k. It emphasizes on knowledge, skills and understanding on contraceptive devices and
their use.
l. It awares people about sexual malignancy and its impact in the society.

Activity: 3

Visit a health post or health centre and prepare a report on the following questions:
a. What is sex education and why do people need it?
b. How is sex education taken in our society?
c. Which types of sexual cases approach to you?
d. What is the common concept of people on sex education?
202 GREEN Environment Population and Health Education Book-9

8.3 Reproductive Health
Reproduction is related to giving birth to children. Giving birth to children is very
important in our life. In the course of giving birth to children, a female should have better
care during pregnancy, delivery period and in postnatal period. Reproduction should be
safe and effective. When we discuss about reproduction, it is related with reproductive
health as well. Reproductive health is the basic right of every individual.
According to WHO, reproductive health can be defined as, “A state of complete physical,
mental and social well being and not merely the absence of disease or infirmity in all
matters relating to the reproductive system and its functions and processes.”
This definition clearly says that every individual should have proper development of
reproductive organs and parts. There should not be defects in the functions of reproductive
organs as well as the individuals have right to take necessary steps regarding birth
spacing, use of contraceptives, size of family and for the happy and satisfied sexual life.

Reproductive health deals with human health from pregnancy till the death of a person. It
provides information to young people regarding reproductive health process. It provides
services on maternal health care, safe motherhood, child care, human reproduction,
immunization, infertility, nutrition, transmission and prevention of sexually transmitted
infections, family planning and other related activities. In reality, the reproductive health helps
to improve the quality of life of people. The concept of reproductive health was introduced in
International Conference on Population and Development held in Cairo, Egypt, in 1994 AD.

Aspects of reproductive health

Reproductive health is the condition of improvement of human health. It is related with
physical, mental and social well being of people. It is affected by reproduction and happy
married life. There are various aspects of reproductive health. They are described below:

a. Planning of family
The main motto of family life is to ensure happiness, peace, prosperity and satisfaction
among the family members. It can be possible only when people plan effectively for the
management of family resources as well as income of the family. It is even most essential for
planning family size, child education and health care, birth spacing, use of contraceptive
devices, marriage and conception at appropriate age, etc. This type of planning no doubt
supports in improvement of living standard of people. Planning of family can ensure
various aspects of reproduction like pregnancy, child birth, maternal and child care as
well.


b. Safe motherhood
Safe motherhood is the condition in which a mother can deliver a healthy baby without
any complication. It is very important aspect of reproductive health. It is not simply
related with child birth. It is even related with maternal and child care after delivery,

GREEN Environment Population and Health Education Book-9 203

proper nutrition for mother and child. Hence, safe motherhood ranges from pregnancy
till 42 days after delivery. In the context of Nepal, there is lack of health services and
people are ignorant about health care services. So, the safe motherhood is quite poor.
Majority of females have first marriage at the age of (15-19) years. More than 50%, three
out of five females deliver in home and about 15% females deliver a baby without health
check ups even once with medical practitioners. There is high maternal mortality rate as
well. Nearby three females die out of 1000 deliveries.

c. Infant and child health care

It is most essential to care a pregnant lady for delivery of a healthy baby. Even after birth,
there should be proper care of infant. Special attention should be given for sanitation,
cleanliness, breast feeding, clothing as well as sleep and rest of infant. The infant should be
given appropriate nutrition and immunization as well. As a result, there can be reduction
of infant and child mortality rate.

d. Unsafe abortion and treatment of its consequences

The termination of growing foetus before birth either
naturally or artificially is called abortion. There can
be termination of growing foetus naturally during
accident, infection in uterus, defirmity of uterus,
carrying heavy loads, excessive stress and anxiety,
falling down etc. It is called as miscarriage. There can
be termination of growing foetus artificially by using
medicines or with the support of medical personnel. It
is called abortion. In the context of Nepal, there is lack Fig: 17
of health services and health manpower. Moreover,
people are ignorant about health services and health matters. Generally, females in the
rural areas tend to adopt various traditional and unscientific methods for abortion than
visiting to health centres or health personnel for safe abortion. In rural areas, females
consume some traditional medicines keeping in roti, pieces of bangles, hit the belly by
stick, insert stick with cow dung into vagina, etc. for the abortion. These types of unsafe
activities create excessive bleeding, infection in reproductive parts, rupturing of uterus,
permanent infertility and sometimes death of females. Actually, abortion has been legalized
in Nepal. With the consensus of both husband and wife, abortion can be done in (6-12)
weeks pregnancy. In case of raping, it can be done till 16 weeks of pregnancy. Actually,
females should not be encouraged for abortion. But in case of unwanted pregnancy, they
should be encouraged to visit health centres or take help of authorized medical personnel
only. By this, the problems caused by unsafe abortion can be solved.

e. Infection of reproductive parts
Females may have infection in reproductive parts due to various reasons. Generally,
females who have more sexual intercourse or sexual relationship with multiple partners
are prone to infection in reproductive parts. Infections in reproductive parts are due to
development of bacteria, virus and fungi. They are even caused by sexually transmitted
infections, use of surgical equipments and surgical activities. These infections are
204 GREEN Environment Population and Health Education Book-9

transmitted from one person to another and can cause cervical cancer and infertility.
Hence the adolescents should be awared about those infections by means of reproductive
health.

f. Control and treatment of infertility
The inability to bear children is called infertility. Both male and female have infertility
problems. In case of males, less secretion of sperms, no sperm production, infection in
testes, closure of epididymis, etc. can cause infertility whereas infection or problem of
ovary, less production of ovum, closure of fallopian tube, infection in reproductive tract,
etc. can cause infertility in females. Problem in any one of them causes problem in bearing
children. This creates lots of mental tension and other psychological problems in both
male and female. Hence, they need to seek treatment from medical experts in hospital
or infertility clinics. Nowadays, people having infertility can bear children by means of
hormone therapy, IVF (In Vitro Fertilization), sperm bank, surrogacy, etc.

g. Reproductive health problems of adolescents
Adolescents have development of reproductive system and high curiosity regarding sexual
matters due to physical, mental and emotional changes. But they lack proper knowledge
to deal with their sexual problems and to satisfy their curiosities regarding sexual matters.
Reproductive health gives knowledge and information on changes in adolescence, safe
sexual behaviours, marriage and conception at appropriate age, effects of early marriage,
etc. Hence, adolescents need to discuss about sexual matters and problems with their
parents rather than adopting unhealthy measures. Moreover, parents, teachers and
seniors should provide appropriate knowledge on reproductive health to the adolescents
so that they can have improvement of living standard and reduction of mental stress.

h. Reproductive health problems of adult women
Females have menopause after 49 years. Generally, after menopause, females have various
reproductive problems. Females who bear more children can have prolapse. Females can
have cervical cancer and breast cancer. These problems create a lot of mental stress on
them. Reproductive health provides necessary information on those problems. Females
should be counseled and encouraged for necessary medications and regular health check
up. There can be proper health care of adult females by providing reproductive health for
adolescents during adolescence.


8.4 Reproductive System

Reproductive system is the network of all those organs, their structure and functions
which are related to the process of reproduction. There is difference in reproductive
system in both male and female. The reproductive organs, their structure and functions
are also different in both males and females.
Reproductive system is divided into two types. They are:
A. Male Reproductive System
B. Female Reproductive System
GREEN Environment Population and Health Education Book-9 205

A. Male Reproductive System

The network of all organs, their structure and functions which are related for the
reproduction process in males is called male reproductive system.

Male reproductive system is designed in such a way that one organ produces numerous
minute spermatozoa (sperm cells). Another stores them and nourishes them. Then another
organ transfers them into female reproductive organ.
Male reproductive system consists of the following organs:

a. Scrotum

b. Testes Ureter
Bladder
c. Epididymis Vas deferens
d. Vas deferens Seminal vesicle
Prostate gland
e. Seminal vesicles
Erectile tissue
f. Ejaculatory duct Urethra Scrotum
Epididymis
g. Prostate glands
Penis Testis
h. Urethra

i. Penis Fig: 18 Male Reproductive System



A brief description of the organs of male reproductive system is given below:
a. Scrotum
Scrotum is an external organ of male reproductive system which lies in front of lower
abdomen and behind the penis. It is a pouch like structure made up of fibruous and
connective tissues and smooth muscles. It is divided into two compartments each of
which contains one testes, one epididymis and a spermatic cord. It helps to protect testis.

b. Testes
Testes are male reproductive glands. They are oval, white, rubbery and smooth organs
having the size (4.5 cm × 2.5 cm × 3 cm). Each testes is suspended into each compartment
of scrotum by means of spermatic cord. Each testes contains (250–400) lobules. Each
lobule contains (1-4) loops called seminiferous tubules.

The functions of testes are as follows:
i. They produce sperms.

ii. They produce male sex hormones called androgens and testesterone.
iii. They are responsible for the male characteristics in youths and middle aged people.


206 GREEN Environment Population and Health Education Book-9

c. Epididymis
Epididymis is a small organ which lies behind the testes and is attached to it. It consists of
very long extensively coiled up narrow tube. It extends from the base of testes and lies on
the testes. It helps to transfer sperms to the vas deferens.

d. Vas deferens
Vas deferens is a small thick walled tube which extends from the epididymis. It is joined
by the seminal vesicle and together form the ejaculatory duct. It helps to transmit sperms
in the seminal vesicle.


e. Seminal vesicles
Seminal vesicles are two small pouches made up of fibrous muscles. They lie at the
posterior part of urinary bladder. Each seminal vesicle is about (4-5) cm long. They store
the sperms transferred by vas deferens. So, they are also called reservoirs of sperms. They
produce seminal fluid which help to nourish sperms and make them alive.

f. Ejaculatory ducts
Ejaculatory ducts are the ducts which are formed by the union of ducts from vas deferens
and seminal vesicles. There are two ejaculatory ducts, each measuring two centimetres
long. They support to transfer sperms into urethra during ejaculation.


g. Prostate gland
Prostate gland is broad heart shaped organ about the size of large walnut. It lies below
the urinary bladder surrounding urethra. It consists of glands, tubes and involuntary
muscles. It secretes lubricating liquid that neutralizes sperms.

h. Urethra

Urethra is a long tube about 16 to 20 cm long which ends in external orifice of urethra in
glans penis. It helps to ejaculate sperms during ejaculation and discharge urine during
urination. However, there is no possibility of discharge of sperms and urine together at
the same time.

i. Penis
Penis is the external male reproductive organ which lies in front of scrotum between
the thighs in the lower abdominal region of males. It is cylindrical in shape and consists
of spongy erectile tissues and involuntary muscles. Its tip is triangular in shape which
is called glans penis. Urethra is extended upto glans penis. Glans penis is made up of
spongy and sensitive tissues and is covered with double-layered skin called foreskin.
It is supplied with the blood capillaries which get filled in with blood during the time
of erection and becomes large as well as hard. It settles down to normal position due to
constriction of veins after ejaculation. The main function of penis is to deposit sperms into
female reproductive organs and discharge urine. The size of penis in men varies due to
physical structure, nutrition and racial genetics.
GREEN Environment Population and Health Education Book-9 207

B. Female Reproductive System
Mons pubis
The network of all organs, their structure
and functions which are related for the Clitoris
reproduction process in females is called Frenulum of
female reproductive system. clitoris
Vestibule
Female reproductive system is designed in External urethral
such a way that one organ produces minute orifice
ovum, another protects it and another Labia majora
provides favourable place to develop Labia minora
foetus. Vaginal orifice
Female reproductive system consists Perineal area
of external and internal organs. Mons
pubis, labia majora, labia minora, clitoris, Fig: 19 Anus
vestibule, hymen, greater vestibular gland External organs of female reproductive system
and perineum are the external organs of female reproductive system.
The internal organs of female reproductive system are as follows:
a. Vagina b. Uterus
c. Fallopian tube d. Ovaries
In this unit, we will describe the internal organs of female reproductive system only.

a. Vagina
The organ which supports in urination Uterus Fallopian tube
and delivery of baby is called vagina.
Vagina is a muscular tube about (15-25)
cm long which connects the internal Ovary
and external organs. It extends from Ovary
external organ, vestibule to the uterus.
It is made up of fibroelastic muscle, Vagina
epithelial tissues and connective
tissues. There is deposition of Fig: 20
sperms into vagina during the sexual Internal organs of female reproductive system
intercourse and it is the passage through which baby is expelled out during delivery time.

b. Uterus

Uterus is a hollow, thick walled, muscular pear shaped organ which is 7.5 cm long, 5
cm wide and about 2.5 cm thick. It lies in the pelvic cavity between urinary bladder
and rectum. It is made up of elastic muscles and extends with the growth of foetus. It is
divided into three parts as fundus, body and cervix. Fundus is the dome-shaped part of
uterus above the opening of fallopian tube. Body is the main part of uterus and cervix is
the lower narrow neck that leads into vagina.
The functions of uterus are as follows:
208 GREEN Environment Population and Health Education Book-9

i. Uterus receives, nourishes and protects the fertilized ovum.
ii. It provides space for fertilized ovum to get implanted and develop into foetus.
iii. It helps to expel baby/foetus during the delivery time.
iv. If the ovum is not fertilized, it helps in occurrence of menstruation cycle.

c. Fallopian tubes

The two tubes which extend at both sides of uterus between the body and fundus are called
fallopian tubes. Each fallopian tube is about (10-12) cm in length. The end of fallopian
tube contains finger like structure called fimbriae which absorbs the ovum produced
from ovary. It is the place where fertilization between sperm and ovum takes place. After
the fertilization, fertilized ovum travels down the fallopian tube towards uterus. Within
seven days, the fertilized ovum gets implanted to the walls of uterus.

d. Ovaries
Ovaries are two small glands which are placed one on each side of the uterus below
the fallopian tubes. They are about the size and structure of almond and are composed
of connectives tissue. They are about 2.5 cm to 3.5 cm long, 2 cm wide and 1 cm thick.
They contain graffian follicles which start to produce ovum since the puberty stage. There
is production of ovum from ovary in every one month interval throughout the entire
reproductive period. But, ovum production is stopped after a female becomes pregnant
as well as after menopause.

The functions of ovaries are as follows:
i. They produce ovum.
ii. They produce oestrogen and progesterone hormones.


8.5 Menstruation

Menstruation is the process of discharging blood through vagina in every one month
interval since adolescence till pregnancy or menopause. It is a function of uterus in which
there is periodic discharge of blood from its cavity as a result of ovarian activity. It occurs
in every (26-30) days throughout the reproductive period (15-49) years.
The main purpose of menstruation cycle is to prepare the mucus membrane of uterus to
receive the fertilized ovum.
Menstruation cycle is a natural process. It is related with the physiological function of
the pituitary gland. The anterior lobe of pituitary gland secretes Luteining Hormone
(LH) and Follicle Stimulating Hormone (FSH). LH secretes progesterone and helps in
the development of corpus luteum. As a result, the mucus membrane of endometrium
(wall of uterus) is stimulated and there is secretion of watery substance (mucus). This
helps in thickening of endometrium for the preparation of environment for implantation
of fertilized ovum. Similarly, FSH promotes the secretion of oestrogen and maturation
of graffian follicles. This supports in rapid multiplication of endometrium to prepare

GREEN Environment Population and Health Education Book-9 209

environment for implantation of ovum. Then there is ovulation (ovum production). Once
the ovum is produced, fimbriae absorb the ovum and it enters the fallopian tube. At this
time, if there is sexual intercourse, there is chance of fertilization between sperm and ovum.
If the ovum is fertilized, then it travels down the fallopian tube towards uterus. After
fertilization, the endometrium becomes more thickened to protect and nourish fertilized
ovum. Within 7 days of fertilization, the fertilized ovum travels down into uterus and
gets implanted into endomentrium. Finally, there is further development of foetus. But,
if there is no sexual intercourse, there is no chance of fusion between sperm and ovum.
After few days, pituitary gland stops production of LH and there is decrease in level of
progesterone. Ultimately, the endometrium starts to rupture and there is decrease in level
of progesterone. Ultimately, the endometrium starts to rupture and there is discharge of
blood with endometrial cells and dead unfertilized ovum. The blood discharge continues
for 4 days following by various phases. Then the new cycle begins.
Anterior Lobe of Pituitary Gland



Luteinizing hormone (LH) Follicle stimulating hormone (FSH)


Development of corpus luteum Maturation of graffian follicles

Secretion of progesterone hormone Secretion of oestrogen hormone


Stimulates the mucus Proliferation (rapid cell
membrane of endometrium multiplication) of endometrium
to secrete watery substance
(mucus) and helps to thicken
the endometrium Ovulation



If fertilized If not fertilized
Implantation in endometrium Decrease in level of progesterone
and further development of Affects the pituitary gland and
foetus stops production of LH
Less secretion of progesterone
Breaking down of endometrium
Discharge of blood with
endometrial cells and
unfertilized ovum


Things to be Considered During Menstruation

During menstruation, there is periodic discharge of blood. Many people consider it
unnatural, dirty and separate females from others. Females under menstruation have
some physical problems like stomach ache, waist pain, constipation, weakness, dizziness,
210 GREEN Environment Population and Health Education Book-9

etc. But they should not worry about it. Rather, they should adopt the following measures
during menstruation:
i. If someone has her first menstruation, she should not feel shy and hesitate to express
her problem to her mother, sister or friends. They can provide her right information
and suggestions.
ii. Females should use clean and disinfected sanitary pads or a piece of cloth during
menstruation which they should change regularly.
iii. Females should remain active and do light physical exercise.
iv. She should drink warm liquid and keep her feet warm for sometime.
v. If she has excessive abdominal pain, she can use hot water bag, and take pain killer.

vi. She should take a bath daily and clean the reproductive part after urination.
vii. She should avoid constipation and other complexities.
viii. She should not do heavy works and long travelling, rather she must have proper rest.
ix. She should take balanced diet and avoid spicy and fatty foods.



8.6 Reproductive Right

Reproductive right is an integral part of human right related to the matter of child bearing,
birth spacing, use of contraceptives and other many sex related matters. It is an important
part of human right.
The reproductive right was not a matter of discussion and was not given much priority
before 20 century. In 1968 AD, in Tehran, Iran an International Conference on Human
th
Right, the issues regarding number of children and their birth spacing were raised. The
conference has accepted that every individual must have right to determine family size
and maintain birth spacing. Likewise, the International Conference on Population and
Development (ICPD) in 1994 AD, in Cairo, Egypt, as well as Fourth Women’s Conference,
Beijing, China, 1995 AD, had focused on various aspects like females and poverty, health,
violence, economy, human right, environment, communication,etc. for the development of
children and women. In the context of Nepal, a program on safe motherhood was initiated
in 1993 AD. There was generation of awareness on female sexuality and reproductive
health by the international conference “Women sexual and Reproductive Health Right”
on 9th April, 2009 AD in Kathmandu.
An international organization, International Planned Parenthood Federation (IPPF) has
produced a charter on reproductive and sexual rights. This chapter has identified 12 core
rights based on international human rights instrument. Those rights are as follows:
i. Right to life
ii. The right to equality and be free from different forms of discriminations.
iii. Right to privacy

iv. The right of liberty and security of the person

GREEN Environment Population and Health Education Book-9 211

v. Right to information and education
vi. Right to freedom of thought
vii. Right to health care and protection
viii. Right to choose whether or not to marry and plan the family
ix. Right to decide when to have children
x. Right to freedom of assembly and political parties

xi. Right to the benefits of scientific progress
xii. Right to be free from torture and ill treatment
Summary

1. Adolescence is the period ranging from (10–19) years. It is regarded as a transition
period from childhood to adulthood.
2. A span of years in which both boys and girls move from childhood to adulthood
physically, mentally, emotionally and socially is called adolescence.
3. Those characteristics which are developed with the development of reproductive
system, its organs and their functions are called secondary sexual characteristics.
4. Mental tension is the feeling of burden that brings anxiety or stress in mind.
5. Nocturnal emission means night fall or wet dream. It is the ejaculation during sleep.
6. Masturbation is a way of erecting reproductive organs by using hand for sexual
pleasure.
7. Sex education is an educational process that provides knowledge, skills and attitudes
about the reproductive system, its organs and their structure, sexual matters and
helps to bring change in the attitudes and behaviours towards the healthy sexual
activities.
8. Reproductive health can be defined as, “A state of complete physical, mental and
social well beings and not merely the absence of disease or infirmity in all matters
relating to the reproductive system and its functions and processes.
9. Safe motherhood is the condition in which a mother can deliver a healthy baby
without any complication.
10. The inability to bear children is called infertility. Both male and female may be
infertile.
11. The network of all organs, their structures and functions which are related to the
reproduction process in males is called male reproductive system.
12. Scrotum is an external organ of male reproductive system which lies in front of
thighs and behind the penis.
13. The network of all organs, their structure and functions which are related to the
reproduction process in females is called female reproductive system.
14. The organ which supports in urination and delivery of baby is called vagina.




212 GREEN Environment Population and Health Education Book-9

15. Uterus is a hollow, thick walled, muscular pear shaped organ which is 7.5 cm long,
5 cm wide and about 2.5 cm thick.
16. Menstruation is the process of blood discharge through vagina in every one month
interval since adolescence till pregnancy or menopause. It is a function of uterus
in which there is periodic discharge of blood from its cavity as a result of ovarian
activity.
17. Reproductive right is an integral part of human right related to the matter of child
bearing, birth spacing, use of contraceptives and other many sex related matters.




Exercise


A. Write very short answer to the following questions.
1. Define adolescence.
2. Mention the phases of adolescence.
3. What is the span of late adolescence for boys and girls?
4. Mention any two characteristics of adolescence.
5. Mention any two physical changes in adolescence.
6. What are secondary sexual characteristics?
7. Which change shows increase of understanding power?
8. Which change indicates increase of infatuation?
9. Why do adolescents like to get involved into sexual activities?
10. What is masturbation?
11. Write the advantages of use of condom?
12. What is safe motherhood?
13. What are the reproductive health problems of adult women?
14. What is the size of testes?
15. Which is the reservoir of sperms?
16. Where is prostate gland situated in males?
17. Where does fertilization between sperm and ovum take place?
18. What is the length of vagina?
19. Mention the parts of uterus.
20. What is the finger-like structure in fallopian tube called?
21. How many days does blood discharge occur during menstruation cycle?
22. When and where was the international conference held that developed the
concept of sexual and reproductive right first?
23. Mention any two reproductive right.
24. Write the full form of IPPF.


GREEN Environment Population and Health Education Book-9 213

B. Write short answer to the following questions.
1. Define adolescence. Explain briefly about the physical changes of adolescents
during adolescence.
2. “Adolescence is the period of stress and storm.” Justify this statement.
3. What are mental changes during adolescence? Explain briefly.
4. What is infatuation? What are the emotional changes during adolescence?
5. Why do people like to remain in friends circle in adolescence?
6. Mention the needs and demands of adolescents.
7. How do unsafe sexual activities and imitation cause problems among adolescents?
8. How do peer pressure and early marriage affect the adolescents?
9. What is sex education? Why do we need it?
10. What is abortion? What are the impacts of unsafe abortion?
11. Draw a well labelled diagram of male reproductive system.
12. Explain briefly about scrotum and testes.
13. What is penis? Explain briefly about penis.
14. Draw a well labelled diagram of internal organs of female reproductive system.
15. What is reproductive right? Mention the reproductive rights of people.
16. What is reproductive health? How does reproductive health solve the problems
of adolescent reproductive health?
17. What is menstruation? What are the things to be considered during menstruation?

C. Write long answer to the following questions.
1. What are the characteristics of adolescence? Explain briefly.
2. “Adolescence is the age of problems and period of change.” Justify this statement.
3. What is mental tension? In what conditions do adolescents get mental tension?
4. Why do we need to solve adolescents problems? How can we manage adolescents
problems?
5. What are the areas of reproductive health? Explain briefly.
6. What is female reproductive system? Explain briefly about the internal organs of
female reproductive system.
7. “Menstruation is a natural process.” Justify this statement.
















214 GREEN Environment Population and Health Education Book-9

UNIT
9 Consumer Health









Estimated Teaching Periods: 18

Learning Objectives
Learning Outcomes

After completing the study of this unit, students will be able to:
i. introduce consumer’s health.
ii. describe how the health of the consumers’ is affected.
iii. state the ways to prevent the harmful effects.
iv. introduce nutritious and balanced diet and describe their importance.


Course Outline

9.1 Consumer and Consumer’s Health
9.2 Food and Nutrition
9.3 Harmful Goods and Healthy Lifestyle



Glossary

consumer : a person who buys goods and services
nutritious : having substances that a person or animal needs to be healthy and grow
properly
provision : the act or process of supplying or providing something
warranty : a written statement that promises the good condition of a product and
states that the maker is responsible for repairing or replacing the product
usually for a certain period of time after its purchase
adulteration : the process of making something such as a food or drink, impure or weaker
by adding something or poor quality
metabolism : the chemical process by which a plant or an animal uses food water, etc. to
grow and heal and to make energy
lifestyle : a particular way of living, the typical way of life of an individual, group or
culture






GREEN Environment Population and Health Education Book-9 215

9.1 Consumer and Consumers’ Health

Introduction to consumers’ health
Human beings need many things in their daily life. Some of the needs are produced by
themselves and some of their needs are purchased from the market. Those things that
are sold in the market are also produced buy some other producers. This shows that
no one in the world can produce all the things needed for his/her life himself/herself.
For fulfilling majority of their needs they have to depend on either the producers or the
distributors. Similarly, the human beings also need different types of services like health,
communication, education, transportation, etc. in their daily life. For these services too,
they need to depend on the service renders. Therefore, we can say that all the people need
to depend upon other people to get the necessary goods and services. So, we can say that
a consumer is a person or persons, institutions that consumes goods and services from the
producers or distributors.
















Fig: 1
Harvesting tomatoes Buying vegetables in grocery

According to the Consumer Protection Act 2054 B.S., “A consumer is a person or institution
that consumes the goods and services available in the market.”

In other words a consumer can also be defined as “A person who buys the products or
services for personal use and not for manufacture or re-sale.”
The consumers consume goods and services from different places. On the basis of the
area of production of goods and the people who consume those goods the consumers are
also classified into different types. For example, in a family, if the goods produced by a
family member is to be consumed buy other members in the family, such consumers are
called family consumers. Similarly, those consumers who consume goods and services
produced only in their own regions/area, they are known as regional consumers. On the
other hand, some consumers consume goods and services produced in Nepal only such
consumers are known as national consumers. Similarly, some consumers consume only
imported goods and services. They don’t consume the goods and services from their own
country. Such type of consumers are called international consumers. In this sense, every
individual is one or different type of consumer because everyone has to buy goods to
fulfill his/her needs and desires.



216 GREEN Environment Population and Health Education Book-9

Consumers’ health
The consumption of goods and services affect the health of the people. Some have positive
effect and some have negative effects. Consumers’ health is described as the status of
health resulted due to the consumption of goods and services from the market. It is also
described as a form of education that aware the people to make the best choice of goods
and services available in the market as they affect the health of the people.
Consumer health refers to that area of health education that is concerned with giving
the consumers a background that enables them to make sound decisions in the selection,
purchase and use of services and products.
The consumption of low quality goods and services have adverse effects on the health of
people. So, they should be encouraged to consume quality goods and services for good
health. The concept of Consumer Health was developed in the 19th century after the
Industrial Revolution.

It is the duty of the government as well as the social organizations to secure the consumers’
health. Different laws were formulated for the protection of consumers’ health in Nepal.
For example, consumer Protection Act 2054 B.S. was formed to protect the health of the
consumers. Similarly, Food Act 2023 B.S., Drug Act 2035 B.S., Standard Measurement
Act 2025 B.S., Black Marketing, Social Crime and Punishment Act 2032 B.S. and Nepal
Standard Act 2037 B.S. were formulated and are being implemented in Nepal.

The quality of all the elements like food, clothes, oil, soap, stationery, construction
materials, etc. also affect the health of the consumers. Therefore, consumers should be
conscious about the selection of quality goods and services from the market.

Right to consumer health

Any one who consumes goods and services from the market is known as a consumer. The
consumption of such goods and services have positive or negative effect on the health
of people. This effect created by the use of goods is said to be consumers’ health. The
consumption of good also includes the use of raw materials, colour, perfume, chemical
substances, etc. The producers must also be conscious about the production of quality
goods and services as well as the effects of low quality goods on the health of the people.
The Essential Goods protection Act 2012 B.S. and Essential Goods Controlling Act 2017
B.S. has defined a list of different essential goods. The distributors or the shopkeepers
who sell these essential good must keep the price list of these food for publicity. The
following is the list of essential goods.

1. Rice 2. Wheat 3. Maize
4. Pulses 5. Bitten rice 6. Salt
7. Sugar 8. Ghee 9. Tea
10. Edible oil 11. Milk 12. Vegetables

13. Fruits 14. Meat 15. Spices



GREEN Environment Population and Health Education Book-9 217

16. Medicine 17. Clothes 18. Soap
19. Fuel 20. Fertilizer 21. Cement
22. Iron rod 23. Tin plates 24. GI pipe/Polythene pipe

25. Brick 26. Wood 27. Stationery materials
28. News print
The government must make the above mentioned essential goods easily available to the
consumers. The consumers have the right to obtain these essential goods easily at an
affordable cost. The Consumer Protection Act 2054 B.S. was formulated with the purpose
of making the daily essential goods available to the consumers in a simple and easy
manner. This law has also given certain rights to the consumers. Some of them are:
1. Right to fight against the selling and distribution of such goods which will adversely
affect the health of the consumers
2. Right to get information about the price, quality and quantity of the manufacturing
goods

3. Right to choose the alternatives among the different products
4. Right to maintain privacy in protecting the consumer’s health
5. Right to be informed about consumers’ right
6. Right to get compensation for the harmful effects resulted due to the use of goods and
services
7. Right to consumers’ education

Besides these rights according to the act of 2054 B.S. the consumers should consider the
following things while consuming the goods and services.
1. Be careful in selecting goods and services

2. Check whether the quality, quantity and the price of the material is suitable or not
3. Check whether the name, address, etc. of the producer is mentioned or not in the
packet
4. Check whether the shopkeeper/distributer has kept the price list for publicity
5. Check whether the packing contains market price, manufactured date, expiry date,
etc.
6. Check the composition of goods, i.e. ingredients used in the goods, weight and the
instructions to use
7. Not to use date expired materials
8. Not to purchase any goods that are doubtful in the packing date/expiry date

9. Take the warranty card in case of electronic goods and long-lasting goods
10. Check the directions for using poisonous and inflammable goods


218 GREEN Environment Population and Health Education Book-9

This act has also made the provision of punishment to those producers or distributors
whose activities adversely affect the health of the consumers. They are either sent to the
jail for 14 years or are fined Rs 1.5 million. The punishment may also vary on the basis the
intensity of crime.

Importance of consumer health education

The consumers consume different types of goods and services from the market to meet
their needs. These days, the producers and distributors sell low quality goods, adulterated
food materials and even harmful substances to earn maximum profit. The consumption of
low quality substances adversely affect the health of the consumers. In order to prevent
the various harmful effects that may be resulted due to consumption of low quality goods,
consumers health education is very important. The consumers themselves should be
conscious about their right to preserve their health. The importance of consumer health
education can be described as follows:


a. Helps to choose goods and services in a proper way
Consumer Health Education encourages the consumers to select the goods and services
in a proper way. The consumption of low quality goods from the market adversely affects
the consumers’ health. So, when they know the effect of low quality goods, they will
try to get the alternative for such goods. Thus, consumer health education motivates the
consumers to choose quality goods and services.

b. Helps to protect the health of the consumers
Consumer Health Education develops awareness among the people about the adverse
effects of using low quality goods, adulterated food, coloured food, misbranded medicines,
etc. When they see the effects of low quality substances, they can be united and raise
the voice against the producers and distributors who are involved in selling goods of
low quality. This helps to protect the health of consumers. In this way, consumers health
education is essential for the protection of consumer health.


c. Helps to make the consumers aware of their rights and responsibilities
It is the responsibility of civil society, to protect the health of the consumers. But in our
country, due to lack of the civils’ concerns, the health of the people is being adversely
affected. While purchasing goods and services, we directly rely on the description given
by the shopkeeper or the distributors. Actually, we should see the price, manufactured
date, expiry date, ingredients, direction of use, etc. to obtain good result. Even while
taking medical services, we must be aware about the qualification, experience and ways
how the health worker deals with the patient. Therefore, the knowledge about consumer
health must be disseminated among the people to make them aware about their rights
and responsibilities. Besides these, the consumers must be informed about the following
eight consumers rights.
1. Right to basic needs
2. Right to safety

GREEN Environment Population and Health Education Book-9 219

3. Right to information
4. Right to choose goods and services
5. Right to represent in policy making
6. Right to compensation
7. Right to consumer education
8. Right to healthy environment
In addition to these rights, consumer health education is also important to:
1. make the consumers aware about demands and fulfillment of goods as well as the
price of the necessary substances.
2. analyse the quality of goods and services.
3. supervise the quality of goods and services by the government or the community or
individually.
4. raise awareness about the adverse effects of food adulteration, selling or distribution
of misbranded medicines, etc.
5. raise awareness about consumers rights.
6. make the consumers aware about the essential/basic needs.

7. introduce the organizations working for consumers’ welfare.
8. check the necessary information mentioned on the products.


Measures to protect consumer health
The condition of health of the consumers depend upon the consumption of goods and
services. Their health condition is adversely affected due to consumption adulterated
food, coloured food or low quality food. With the purpose of generating good profit, the
producers and distributors produce such low quality food materials. But if the consumers
are conscious about their health and are aware about consumers’ right, they can compel
the producers and shopkeepers to produce or sell quality goods. This helps to protect the
health of the consumers. Consumer Protection Act 2054 B.S. is one of the acts which is
formed to protect the rights of the consumers. This act focuses on the control, management
and distribution of essential goods. It develops awareness among the consumers about
the price, quality and quantity of useful substances. It has also made the provision of
punishment to those who are involved in the activities that harm the consumers. To protect
the consumers’ right, a guideline for inspection officer has been developed and enforced
in 2058 B.S. The concerned authorities like Nepal Government, Consumer Forum and
general public must be conscious in the implementation of the law.

Objectives of Consumer Protection Act 2054 B.S.
1. To help in the regular supply of consumers goods and services through regular
monitoring
2. To help to protect and promote consumers’ right

220 GREEN Environment Population and Health Education Book-9

3. To attach the price list of goods for providing and distributing quality goods to the
consumers
4. To make people aware about consumer education
5. To help the people in getting the most necessary good at affordable prices by regular
monitoring the distribution and selling system
6. To control the chances of rise in the price of goods that may be caused due to monopoly
or unfair business activities
7. To preserve consumers’ health through health facilities and services

The Consumer Protection Act 2054 B.S. also includes the following topics:

1. To manage consumer protection forum and identify its right, duties and responsibilities
2. To protect and promote consumer rights
3. To help in regular supply of goods and services through regular monitoring
4. To manage and control the supply of useful goods and services

5. To manage the necessary things to be mentioned in the useful goods
6. To avoid the things that should not be done in the goods and services
7. To check quality of goods and services

8. Producers and distributors must mention the price list.
9. Monitoring and evaluation can be done by Nepal government.
10. Appointment of Inspection Officer and point out his functions, eg. observation,
evaluation, checking, etc
11. Check the quality of goods
12. Arrangement of punishment

13. Arrangement of compensation and compensation committee
(Source: Consumer Protection Act 2056)
In addition to these, the Consumer Protection Act 2054 also describes the following points
to be mentioned on the products.
1. Name and address of the producer
2. Description of raw materials used and composition of the products especially in food
and medicines
3. Classification of the standard of food by government
4. Directions of using goods

5. Price, batch number, manufacturing date, expiry date, etc.
6. A warranty card in case of electronic goods and long lasting goods
7. Strict directions for using poisonous and inflammable goods
8. Other provisions according to the nature of goods.
GREEN Environment Population and Health Education Book-9 221

9.2 Food and Nutrition

Food is one of the most important things essential for survival of all living things. Life
of living beings is not possible without having food. Food helps in the growth and
development of living beings as well as gives energy to do different activities.
The human beings also need food to survive as well as to get energy to do different
activities. Lack of sufficient amount of food makes us the victim of malnutrition.
Malnutrition leads to different types of diseases. The food that we eat should contain
different types of nutrients like protein, carbohydrates, calcium, phosphorus, vitamins,
fats, etc. For proper functioning of the organs and systems in the body, we need all these
nutrients in the food. These nutrients of food are transported to all the cells and tissues
of the body by means of blood. Food also helps to keep the body healthy by preventing
different types of diseases. It also helps to run the systems of the body like digestive
system, respiratory system, circulatory system, etc.


Basic objectives of consumption of food
1. To build up the body.
2. To get energy.

3. To regulate the body functions.
4. To prevent diseases.
5. To perform psychological activities.

6. To do social and cultural activities.
7. To work like medicine.
8. To work as a personality indicator.


Classification of food


a. On the basis of its origin
i. Food obtained from animals
Milk and milk products like curd, cheese, ghee, butter, eggs, meat, fish, etc.













Fig: 2
Meat Potato Fish
222 GREEN Environment Population and Health Education Book-9

ii. Food obtained from plants
Cereals like rice, wheat, maize, millet, buckwheat, etc.
Legumes like beans, gram, red pulses, lentils, soyabean, etc.
Fats like oil
Vegetables like green-leafy vegetables, underground vegetables like potato, sweet
potato, yam, etc.
Fruits like apple, mango, guava, papaya, etc.

b. On the basis of major functions
Energy-giving foods like carbohydrate and fats
Body-building foods like protein
Protective foods like vitamins, minerals, etc.
The food that we take undergoes through the process of digestion. The final products of
the food are transmitted to the cells and tissues of the body through the circulatory system
by means of blood. This helps in the growth and development, repair and maintenance of
the body as well as to give energy to do various types of work.


An outline of our essential nutrition
For proper functioning of our body, it requires different types of nutrients. Nutrients are
those chemical components in foods that are used by an organism to grow and survive. So,
in order to supply the essential nutrients required for the body, we must take balanced and
nutrients diet. Our body is composed of the following elements in the given proportion.

Protein 17% Fats 13.8%
Carbohydrates 1.5% Minerals 61.6%
Water 6.1%
The above table doesn’t include vitamin though it is one of the essential nutrients required
for the body. It is because vitamin is not stored in our body. So, the essential vitamin for
the body should be taken through our diet regularly. Some of the required nutrients are
described below:
A. Carbohydrates
It is an essential element of nutrition. It is one of the cheapest, easiest and important
elements gained from the food materials. Nepalese diet provides 70%–80% of carbohydrates
required for the body. It is the chief source of energy and heat for the body.
One gram of carbohydrates provides 4 calories of energy. We can obtain carbohydrates
from plants and animals.
Source of carbohydrates
i. Plant sources

Rice, wheat, maize, millet, buckwheat, sweet potato, yam, sugar, pulses, apple, bread,
vegetables, etc.
GREEN Environment Population and Health Education Book-9 223

ii. Animal sources
Lever, egg, fish, cheese, curd, ghee, butter, etc.













Fig: 3
Cheese Rice Wheat


Functions of carbohydrates
a. To provide energy to the body
b. To keep the body warm
c. Helps in the growth and development of the body

d. Repair and maintain the worn out cells
e. Accelerates the rate of metabolism
f. Helps in the secretion of enzymes and hormones to prevent the body against diseases

g. Helps to maintain balance between acid and base in the body
h. Helps in the stimulation of useful bacteria (probiotics) that helps to break down the
food

i. Helps to spare protein and acts as the source of fats

B. Proteins
Proteins are essential for the survival of all living organisms. They are the essential
nutrients for the human body. They are one of the building blocks of body tissues and also
can serve as a fuel source. As a fuel, proteins provide as much energy as carbohydrates.
Protein was detected by Gerald Mulder in 1838 AD for the first time. Animals’ body
contain approximately 20% of protein. Protein play a vital role in the function of body.
Proteins are composed of oxygen, hydrogen nitrogen, carbon, phosphorus, sulphur, etc.








Fig: 4
Egg Meat Fish Milk Pulses




224 GREEN Environment Population and Health Education Book-9

Sources of proteins
i. Animal sources

Egg, fish, meat, butter, cheese, milk, liver, etc.

ii. Plant sources
Peanuts, beans, pulses, cereals, oil seeds, cake, gram, yeast, green leafy vegetables,
legumes, etc.


Functions of proteins
i. They act as the building blocks of the body.
ii. They help to replace the worn-out and dead cells.
iii. They help to form the different types of hormones and enzymes in the body.
iv. They help to regulate metabolism.

v. They help to form antibodies and develop immunity in the body.
vi. They provide structure and support to the cells.
vii. They help to regulate osmotic pressure of the cells.

viii. They help to maintain balance between acid, base and water in the body.
ix. They help to keep the body physically fit and attractive.

Daily requirement of proteins
The daily requirement of proteins depends upon the physical, mental and psychological
condition, age, occupation, etc. It can be described as follows:
a. An adult requires 1 gram proteins per kg of his/her body weight.
b. An adolescent requires 2-2.5 gram proteins per kg of his/her body weight.
c. The infants and children require 3.5 gram protein per kg of his/her body weight.
d. The pregnant and breast feeding females require 100 gram protein per day.
e. Normally, 40-50 gram protein is required for the Nepalese.
f. Additional amount of proteins should be taken during accidents/injuries for quick
recovery.
Deficiency of proteins in the body results in:
a. lack of proper growth and development of the body.,

b. kwashiworkor.
c. improper absorption of other nutrients from the food.

C. Fats
Fats are composed of carbon, hydrogen and oxygen. One gram fat releases 9 calorie
of energy in the body. We consume some amount of fats from our daily diet. It is the
GREEN Environment Population and Health Education Book-9 225

concentrated source of energy. But intake of excessive amount of fats without sufficient
physical exercise is harmful to the body.

Sources of fats
i. Animals sources

Ghee, butter, cream, cheese, fish, milk, meat, etc.
ii. Vegetables sources
Vegetable ghee, oil, ground nuts, mustard, cotton seeds, soyabean oil, etc.













Fig: 5
Ghee Butter Vegetable oil

Daily requirement of fats
Normally a healthy person requires 40-60 grams fats in a day. About 15-20 grams of fats
are obtained from plant sources like oil, vegetable ghee, etc. and the remaining 20-40
grams of fats is obtained from animal sources like milk, ghee, egg, meat, fish, etc.

When the body lacks fats, it causes itching sensation around the anus especially in children,
and dry and itchy skin. But intake of excessive fats affects the heart, blood vessels and
other organs. It also effects the digestive system of human beings.

D. Vitamins
Vitamins are commonly known as protective foods. They help to regulate the body
functions and protect the body against different types of diseases. Vitamins are not stored
in our body. So, we should take vitamins regularly through the diet.


Types of vitamins and their sources
Vitamin A : ghee, curd, milk, egg, liver, cod liver oil, cheese, sweet, potato, broccoli,
spinach, carrot, mangoes, papaya, etc.

Vitamin B : fruits, vegetables, fish, meat, milk, curd, liver, outer part of potato, etc.

Vitamin C : goose berry, citrus fruits like lemon, tomato, mango, papaya, pineaple, etc.
Vitamin D : milk, butter, ghee, fish, liver, egg yolk, sunlight, etc.

Vitamin E : cereals and vegetable oil, green leafy vegetables

226 GREEN Environment Population and Health Education Book-9

Vitamin K : different types of green leafy vegetables


Vitamins are basically classified into two types. They are:
a. Fats soluble vitamins : Vitamin A, vitamin D, vitamin E and vitamin K

b. Water soluble vitamins : Vitamin B and vitamin C

E. Minerals and salts
Minerals are also the essential elements for the body. They are required in very less amount
in our body. We suffer from various disorders and diseases in the absence of minerals and
salts. About 4-6% of the body weight is occupied by minerals. Majority of the minerals
are stored in the bones and teeth of our body and some in the blood, muscles, tissues, etc.
Minerals are soluble in all kinds of body fluids.

Functions of minerals and salts
a. To maintain balance between acid and base in the body
b. Help in maintaining good health as well as the formations of bones/skeleton
c. Help in the formation of blood cells
d. Help in the formation of cells and tissues
e. Help in the normal functioning of heart and nervous system
f. Help in the contraction and relaxation of muscles
g. Help in proper balance of fluid in the body


Sources of minerals and salts
The sources of minerals are classified into four groups. They are:
a. Vegetable sources : All types of fruits and vegetables grown in the soil.
b. Animal sources : Herbivorous animals and birds, milk, egg, etc.

c. Water : Water contains different types of minerals in the soluble
form. So, the human beings can get different types of
minerals from drinking water and food.
d. Metabolic activities : Minerals are also obtained from the metabolism of food
materials.












Fig: 6
Vegetables Eggs Water
GREEN Environment Population and Health Education Book-9 227

F. Water
Water is not a nutrient but it is an essential element without which the other nutrients
cannot be utilized in the body. An adult human being contains 70% of water whereas
the children’s body contain 80% of water. We take water from our diet as well as a drink.
Without water, we cannot survive for more than few days. Absence of water makes the
cells dry up.


Functions of water in the body
a. Water is an element that keeps the cells alive.
b. It acts as a good solvent in the body.
c. It helps in the elimination of waste materials from the body.
d. It helps to regulate body temperature.
e. It helps to regulate the body pressure.
f. It helps in the digestion of food.
g. It prevents the body from dehydration.


Quantity of water required in a day
The quantity of water required for individual depends upon various factors like weather,
age of an individual, body structure, functions of body, etc. Normally, a healthy person
requires 3 to 5 litres of water in a day.

Impacts of dehydration
Lack of sufficient amount of water in the body is considered as dehydration. There should
be a balance between the intake and throwing out of water in and from the body. When
the body lacks 5%-10% of water in the body, people suffer from problems like wrinkles on
the skin, thickening of blood, etc. which makes it difficult to flow, lack of energy to work,
etc.


Features of quality food

Food containing all the essential nutrients like carbohydrates, fats, vitamins, minerals,
etc. is known as balanced and nutritious diet. Many people think that balanced diet and
quality food are synonymous to each other. But all balanced diet may not be of good
quality. For the food to be of good quality, it should also be neat and clean, healthy and
should not be adulterated. Though the food contains all the nutrients, if the food is
adulterated, overcooked, burnt or fried, the nutrients are reduced or lost totally. So, it
can’t be of good quality. Balanced and quality food helps in the physical, mental and
emotional development of every individual. The necessity of food requirement differs
from one person to another. For example, an old person needs less amount of food than
an adult man or woman. Similarly, an active or growing child requires more food than an
old man. The growth and development, production of energy, to do work, etc. depends
upon the quality and quantity of food taken by an individual.



228 GREEN Environment Population and Health Education Book-9

Intake of balanced diet of good quality also helps to protect us from different types of
diseases. Therefore, we should be conscious about the importance of taking quality food.
Some features of quality food are given below:
a. provides energy

b. regulates the body activities
c. develops the body proportionately
d. provides the nutrients regularly
e. prevents the body from diseases

f. regulates the psychological functions of an individual
g. functions like medicines
h. works for maintaining personality

The intake of food by the people should be done only as per the requirement of the body.
All people cannot eat the food of same quality. Some persons need more food while the
others need less. The quality and quantity of food required for the people are affected by
the following factors:

a. Age b. Sources of income
c. Sex d. Education and awareness
e. Weather f. Habit of eating food

g. Occupation h. Availability of food
i. Physical condition j. Size of family
k. Health condition l. Religion, tradition and culture
Our regular diet should contain the following 5 types of food.

a. Milk and any one of the milk product
b. Cereals like maize, rice, wheat, millet, barley, etc.
b. Pulses like beans, peas, soyabean and ground nuts, walnuts, etc. for vegetarians and
fish, meat or egg for non-vegetarians
c. Green leafy vegetables
d. Any one of these - apple, mango, pineapple, guava, etc.


Food of low quality

We need balanced and nutritious diet for healthy life. The food that we take should also
be of good quality. But if we don’t use the quality food properly, i.e. if it is over-cooked, or
adulterated or mixed with non-edible colour or mixed with low quality food materials,
the food loses its quality and becomes of low quality. Consumption of low quality food
doesn’t give required nutrients and at the same time, it may also be harmful to the body.


GREEN Environment Population and Health Education Book-9 229

Some of the causes that make food of low quality are given below:
a. Fried food or food with excessive fats or spices
b. Coloured food or adulterated food

c. Imbalanced diet
d. Food materials prepared from stale or rotten food

Activity: 1
Observe the food materials available in the market locality and identify them as quality
food or food of low quality.



9.3 Harmful Goods and Healthy Lifestyle

We consume different substances from the market. While consuming these substances,
some of such substances may be of low quality, some may be adulterated and some may
be of less weight too. The consumption of low quality and adulterated food doesn’t give
the required nutrients for the body. They may even harm our health. So, we must be very
careful while consuming goods from the market. We will discuss the harmful goods and
healthy living in this topic.


Harmful goods that may be used daily
No one in the world can produce all the required goods himself/herself. We all need to
depend on the market, producers or distributors to get the necessary materials. While
consuming the necessary goods from the market, we may also be consuming goods of
low quality. Some of such goods may be harmful for our health. For example, tobacco,
drugs, alcohol, junk food, etc. are harmful for our health.
These days the people are attracted towards packed and ready-made food. They consume
different types of coloured foods. Especially, the children are attracted towards junk
and coloured foods. But the consumption of such food does not give them the required
nutrients. They may also be affected with different health problems. Some of the causes
of low quality food are given below:

a. Mixing of low quality food with quality food
b. Use of date expired food
c. Decrease in quality of food by mixing low quality substances to reduce its price
d. Frying of food

e. Use of chemical substances in the food and liquor
f. Packing of food in the plastic or tin cans
g. Use of colour in the food materials



230 GREEN Environment Population and Health Education Book-9

Besides quality or low quality food, we also use different substances in our daily life. For
example, clothing materials, cosmetic goods, radio, mobile, utensils, cement, iron rod, etc.
The quality of these materials should also be determined. If we make use of low quality
cosmetic goods, utensils, cement, etc., they may affect us negatively. When low quality
cosmetic goods are used, they may affect our skin causing diseases. It also causes loss of
money and health.


Precautions to be taken while using harmful substances
Many people in Nepal are still below the poverty line. These people cannot afford for
their basic requirements. The problems of unemployment is one of the causes of poverty.
The poor people seek for such goods which they can afford though they are of low quality.
The producers and distributors also produce the goods as per the demand of the people.
This encourages the producers to produce low quality goods. But the use of low quality
goods have adverse effects on the health of the people.
In order to discourage the production and use of low quality goods, the government has
formulated Consumer Protection Act. If this law is strictly implemented, the producers
will be forced to produce and distribute quality goods. At the same time the consumers
can also maintain quality health. But to maintain quality health, the problems of
unemployment, poverty and illiteracy must be reduced. It can be reduced by creating new
employment opportunities, skill, oriented training, quality education, etc. The following
precautions should be taken to reduce the effects of harmful goods.
a. Raise awareness among the people through consumers’ health education.
b. The products should be taken to the market only after the test.

c. Frequent checking or supervision in the business stores/godown.
d. Provision of strict punishment to the producers who produce harmful goods.
e. The concerned authority should be informed about the selling or distribution of low
quality goods in the market.
f. People should be aware about the entry and distribution of low quality goods
especially at the time of natural disaster like earthquake, flood, landslide, etc.
g. The concerned authority should be given the responsibility to implement the policies
to control the production and distribution of harmful goods.

h. The local people should be made aware about the impacts of using adulterated food.
Activity: 2

Discuss in groups about the effects of junk food in your health.


Plans of healthy lifestyle

To live a healthy life is the right of every individual. In order to live healthy life, we
need healthy environment and healthy food. Healthy life refers to the life style with good
physical and mental health. When we are physically and mentally healthy, we can also
GREEN Environment Population and Health Education Book-9 231

encourage the other members in the society to live healthy life. As a result, the health
of the people can be promoted. Therefore, every member in the family, society and the
nation should work together to live healthy life. To make members of the family healthy,
the following activities should be done by every members of the family.
a. All the family members should be responsible to the family as per the individual’s
capacity.

b. Create good mutual relationship between the members in the family.
c. Maintain balance between income and expenditure in the family.
d. Work collectively for the family welfare.
e. Division of work can be done to get effective result.
f. Decisions should be made taking suggestions from the family members.
g. The needs and demands of the family should be fulfilled on the basis of mutual
understanding.

Summary
1. A consumer is a person or institution that consumes the goods and services available
in the market.
2. A person who buys the products or services for personal use and not for manufacture
or re-sale.
3. Consumers’ health is described as the status of health resulted due to the
consumption of goods and services from the market.
4. The Consumer Protection Act 2054 B.S. was formulated with the purpose of making
the daily essential goods available to the consumers in a simple and easy manner.
5. The consumption of low quality substances adversely affect the health of the
consumers.
6. The knowledge about consumer health must be disseminated among the people to
make them aware about their rights and responsibilities.
7. Food helps in the growth and development of living beings as well as gives energy
to do different activities.
8. Nutrients are those chemical components in foods that are used by an organism to
grow and survive.
9. Proteins are essential for the survival of all living organisms.
10. They are one of the building blocks of body tissues and also can serve as a fuel
source.
11. When the body lacks fats, it causes itching sensation around the anus especially in
children, and dry and itchy skin.
12. Majority of the minerals are stored in the bones and teeth of our body and some in
the blood, muscles, tissues, etc.
13. Water is not a nutrient but it is an essential element without which the other
nutrients cannot be utilized in the body.
14. Lack of sufficient amount of water in the body is considered as dehydration.

232 GREEN Environment Population and Health Education Book-9

15. Food containing all the essential nutrients like carbohydrates, fats, vitamins,
minerals, etc. is known as balanced and nutritious diet.
16. But all balanced diet may not be of good quality.
17. If we don’t use the quality food properly i.e., if it is over-cooked, or adulterated or
mixed with non-edible colour or mixed with low quality food materials, the food
loses its quality and becomes of low quality.
18. The poor people seek for such goods which they can afford though they are of low
quality.
19. But to maintain quality health, the problems of unemployment, poverty and
illiteracy must be reduced.
20. Healthy life refers to the life style with good physical and mental health. When we
are physically and mentally healthy, we can also encourage the other members in
the society to live healthy life.


Exercise

A. Write very short answer to the following questions.
1. What is consumer health?
2. When was the Consumer Protection Act formed?
3. What are the sources of proteins?
4. What does Food Act explain?
5. What is food adulteration?
6. Define consumer.
7. What are the main functions of fats?
8. Define nutrients.
9. What is the quantity of water required by a person in a day?
10. Who detected protein for the first time?
11. Why do we need to take vitamins daily?


B. Write short answer to the following questions.
1. How can we be prevented from harmful good?
2. What are the considerations to be taken for healthy life style?
3. What are the objectives of Consumers Protection Act 2054 BS?
4. What do you mean by nutrition? Explain about balanced diet.
5. List out the functions of proteins in the body.
6. How can you make your family members healthy?
7. Why do you need food? Explain
8. Differentiate between quality food and nutritious diet.


GREEN Environment Population and Health Education Book-9 233

9. Mention the rights of a consumer.
10. How can you prevent the effects of harmful food?


C. Write long answer to the following questions.
1. Explain the importance of consumer health education.
2. What are included in “Consumer Health” according to consumer protection act?
Explain.
3. Write down the functions of carbohydrates, proteins and fats in our body.
4. Mention the features of quality food and describe five groups of quality food.
5. Explain the long term effects of chemical foods to our body.
6. Explain the factors that affect quality and quantity of food materials.
7. How can you prevent yourself from harmful goods? Explain.
8. Discuss briefly about the rights to consumers’ health.

















































234 GREEN Environment Population and Health Education Book-9

UNIT
10 Primary Health Care,



Precaution and Safety




Estimated Teaching Periods: 18

Learning Objectives
Learning Outcomes
After completing the study of this unit, students will be able to:
i. introduce primary health care and state its characteristics.
ii. explain the importance of primary health care.
iii. describe the elements of primary health care
iv. explain the concept of safety, its types and remedies of risk reduction.
v. explain the ways of threat/risk reduction.

Course Outline


10.1 Introduction to Primary Health Care
10.2 Characteristics of Primary Health Care
10.3 Importance of Primary Health Care
10.4 Elements of Primary Health Care
10.5 Concept of Risk, Its Types and Mitigating Measures
10.6 General Concept of Safety Education

Glossary

precaution : something that is done to prevent possible harm or trouble from happening in
the future
safety : the state of being safe
avalanche : a large amount of snow and ice or of dirt and rocks that slides suddenly down
the sides of a mountain
risk : the possibility that something bad or unpleasant such as an injury or a loss will
happen
mitigate : to make less severe, harmful or painful
endemic : growing or existing in a certain place or region, common in a particular area or
field
contagious : able to be passed from one person or animal to another by touching, capable of
being easily spread to others
hazards : a source of danger

GREEN Environment Population and Health Education Book-9 235

10.1 Introduction to Primary Health Care

Primary health care (PHC) is an essential health care made universally accessible to
individuals and acceptable to them. It is an approach to health beyond the traditional
health care system.
Primary health care (PHC) refers to essential health
care that is based on scientifically sound and socially
acceptable methods and technology which make
universal health care accessible to all individuals
and families in a community. Primary health care is
an approach to health beyond the traditional health
care system that focuses on health equality producing
social policy. Primary health care includes all areas
that play a role in health such as access to health Fig: 1
services, environment and lifestyle. This ideal model Health Post
of health care was adopted in the declaration of the
“International conference on Primary Health Care” held in Alma Ata, Kazakhastan in
1978 which is commonly known as “Alma Ata Declaration”. It has become a core concept
of the World Health organization’s goal of “Health for all.”
The Alma Ata Conference mobilized a “Primary Health Care Movement” of professionals
and institutions, governments and civil society organizations, researchers and grassroot
organizations that undertook to tackle the politically, socially and economically acceptable
health inequalities in all countries.
The ultimate goal of primary health care is the attainment of better health services for
all. It is for this reason that World Health Organization (WHO) has identified five key
elements to achieving this goal. They are listed as follows:
i. reducing exclusion and social disparities in health (universal coverage reforms)

ii. organizing health services around people’s needs and expectations (service delivery
reforms)
iii. integrating health into all sectors (public policy reforms)

iv. pursuing collaborative models of policy dialogue (leadership reforms); and
v. increasing stakeholder participation.
Behind these elements lies a series of basic principles identified in the Alma Ata Declaration
that should be formulated in national polices in order to launch and sustain primary
health care as a part of a comprehensive health system and in co-ordination with other
sectors.


1. Equitable distribution of health care
According to this principle primary care and other services to meet the main health
problems in a community must be provided equally to all individuals irrespective of their
age, caste, gender, rural/urban location and social caste.

236 GREEN Environment Population and Health Education Book-9

2. Community participation
Community participation is essential in order to make the fullest use of local, national and
other available resources. Community participation is considered sustainable due to its
grassroots nature and emphasis on self sufficiency.


3. Health workforce development
Comprehensive health care relies on adequate number and distribution of trained
physicians, nurses, allied health professions, community health workers and others
working as a health team and supported at the local and referral levels.


4. Use of appropriate technology
Medical technology should be provided that is accessible, affordable, feasible and
culturally acceptable to the community. Examples of appropriate technology include
refrigerators for vaccine cold storage.

5. Multi sectional approach

It has been recognized that health cannot be improved by intervention within just the
formal health sector, other sectors are equally important in promoting the health and
self reliance of communities. These sectors include agriculture (e.g. food security),
education communication (e. g. concerning prevailing health problems and the methods
of preventing and controlling them), housing, public works (e.g. ensuring an adequate
supply of safe water and basic sanitation, rural development, industries, and community
organization.
In short, Primary Health Care (PHC) is the heart and soul of medicine. It is the foundation
of every health care system: the first contact and ongoing link between people and their
health providers. Primary Health Care is how individuals and families connect with the
health care system throughout their lives. Every person has right to get primary health
care services and they should be accessible to every part of the country as it is a basic
health service. Similarly, PHC should be accessible to each and every person at affordable
cost.



10.2 Characteristics of Primary Health Care

The major characteristics of primary health care are as follows:
i. Essential health care service
ii. Acceptable

iii. Accessible
iv. Broad public participation
v. Affordable


GREEN Environment Population and Health Education Book-9 237

1. Essential health care service
Primary health care is considered as an essential health service for all. Primary health care
services include a wide range of health services such as health education, safe and pure
drinking water supply of nutritious food, environmental sanitation, medical services,
family planning, maternal and child care services, vaccination and so on. All the people
of every part of the country should get these services whether they are poor or rich.
Similarly, these services should be accessible to all parts of the country.


2. Acceptable
The services provided by primary health care should be acceptable to all people
irrespective of their age, sex, caste, religion locality, etc. primary health care should not
discriminate people and it should not go against social norms and values.


3. Accessible
Primary health care should be with in the reach of the people in all parts of the country
whether rural areas or urban areas. Similarly, it should be accessible to all people who
whether they are poor or rich.


4. Broad public participation
Active participation of community members is essential in order to make the fullest use of
local, national and other useful resources to provide primary health care. The principle of
primary health care demands broad public participation and equal contribution of local
people to facilitate preventive, curative, promotive and rehabilitative services.


5. Affordable
The health care services provided by primary health care should be affordable to people
of all level.
These services should be provided to all people free of cost as far as possible. If it is not
so, these services should be provided at minimum cost so that people of low economic
standard can get those health service easily. The government of Nepal is providing primary
health care services free of cost to the local people through primary health centres, sub-
health post and health post.



10.3 Importance of Primary Health Care

Primary health care (PHC) is the front line of the health care system. Primary health care
provides community based, multidisciplinary, patient centred care with a focus on both
the treatment and prevention of various conditions. It provides the essential first point of
contact in our efforts to keep people well and improve their quality of life. Primary health
care is accessed by vast majority of a large number of people throughout the country.
A strong, accessible primary health care system reduces pressure on hospitals by
238 GREEN Environment Population and Health Education Book-9

supporting people to manage their health issues in the community. It is the cornerstone
underpinning population health outcomes and key to ensuring. We have high quality
sustainable health system into the future. The importance of primary health care is
mentioned in the following points.
1. Primary health care provides essential health services free of cost in the rural areas
through primary health centres, health posts and sub-health posts.

2. It provides health services of minor injuries such as cut, sprain, burn, wound, etc. at
local level.

3. It provides health services by using all possible local resources and technologies.
4. It provides medical treatment of simple diseases and minor injuries to the people
having low income in rural area.

5. Primary health care conducts vaccination programs at local level.
6. It generates awareness to prevent and control communicable diseases.
7. It conducts programmes to increase public participation.

8. PHC helps control the spread of endemic and contagious diseases in locality in their
primary stage.

9. PHC generates awareness of safe and pure drinking water in the locality.
10. PHC provides health services by trained health assistant, (HA), community medical
assistants, nurses, midwives, etc. at local level.

11. PHC provides antenatal care (ANC) and post natal care (PNC) through trained
medical personnel .

12. PHC helps change the knowledge, attitude and practice (KAAP) of the people
towards health care services and diseases.
13. PHC helps generate concept knowledge, awareness, preparedness and healthy
behaviours to achieve good health.
14. PHC helps integrate various programs related to health in the community.



10.4 Elements of Primary Health Care

The major elements of primary health care are as follows:

i. Safe drinking water and basic sanitation
ii. Provision of proper nutrition.
iii. Proper treatment of minor injuries
iv. Provision of essential drugs.

v. Maternal and child health care services and family planning.



GREEN Environment Population and Health Education Book-9 239

vi. Control and prevention of endemic and contagious diseases.
vii. Vaccination against infectious diseases.
viii. Health education.

A brief description of each of the elements of primary health care is given below:

1. Safe drinking water and basic sanitation

In order to live a healthy life, there should be adequate supply of safe drinking water
Various diseases like typhoid, hepatitis, diarrhea, dysentery, cholera, etc. are transmitted
through contaminated water. If drinking water is not safe and pure, people suffer from
various diseases. Personal hygiene and environmental sanitation remain incomplete in
the absence of pure and clean water Many insects and germs grow in dirty environment.
Therefore, adequate supply of safe drinking water and environmental sanitation are basis
elements of primary health care.


2. Provision of proper nutrients
Consumption of health and nutritions food is essential
to live a healthy life. We cannot achieve good health
without having balanced diet. Adequate supply of
food and arrangement of nutrients are important to
prepare balanced diet. Due to malnutritions, people
become weak and suffer from various diseases like
anaemia, scurvy, marasmus, night blindness, etc.
Therefore, provision of proper nutrients is considered Fig: 2
as another element of primary health care. Balanced diet

3. Proper treatment of minors diseases injuries

People suffer from minor diseases and injuries like fever, headache, cuts, scratches, minor
burns, diarrhea dysentery, cough, common cold, stomach ache, Sprain, round worm
infection, etc. If minor diseases and injuries are not treated on time, they become servere
and may be life- threatening. There fore proper treatment of minor diseases and injuries
is considered as one of the elements of primary health care.


4. Provision of essential drugs
Management of essential drugs is another element of primary health care. Primary health
centres, health posts and sub-health posts distribute essential medicines to the patients
free of cost. At present, 135 types of essential medicines are distributed free of cost to
the patients through primary health centres, health posts and sub- health posts. There
medicines are essential to cure simple and common disease like fever, headache, diarrhea,
dysentery, cough and cold, cuts, wound etc.





240 GREEN Environment Population and Health Education Book-9

5. Maternal and child health care services and family planning
Maternal and child health care and family planning
also fall under the elements of primary health care.
Family planning is essential for a happy family.
Similarly, maternal and child health care services are
very important to keep mother and child healthy. To
attain a healthy and happy life, family planning is
quaite essential. Family planning helps to determine
the size of the family, education, birth spacing, number
of children, proper care etc. Fig: 3

6. Control and prevention of endemic and contagious diseases

The diseases which are common or prevalent in a particular region are called endemic
diseases. Diarrhea, dysentery, cholera, malaria, kala-azar, encephalitis, typhoid, etc. are
some examples of endemic diseases. These disease may spread through out country if
not prevented and controlled on time. The diseases which are transmitted easily from
the sick person to another through close contact are called contagious diseases common
cold, conjunctivitis, measles, mumps, etc. are some examples of contagious diseases. The
prevention and control of these diseases is very important to keep people healthy.


7. Vaccination against infectious diseases
Diseases like polio, tuberculosis, whooping
cough, diphtheria, measles, etc. occur in
thousands of children in Nepal every year.
These diseases can be prevented/ controlled
through scheduled immunization or
vaccination. The government of Nepal is Fig: 4
providing free vaccination against infections
diseases like polio, tuberculosis, whooping cough, measles, diphtheria, etc. Vaccination
or immunization against infections diseases is another element of primary health care.


8. Health education
Health education gives us idea to live a healthy life. It is one of the
most important elements of primary health care. Health education
helps to generate awareness among people about the causative agent
, modes of transmission, major symptoms and preventive measures
of various diseases. Health education helps to change or modify
knowledge, attitude, behaviour and practice of people regarding
various diseases and their control. Therefore health education is
considered as one of the elements of primary health care. Fig: 5






GREEN Environment Population and Health Education Book-9 241

Activity: 1

Visit a nearby health post, sub- health post or primary health centre. Observe the status
of primary health care services that are being applied then prepare a short report on it
and submit to your subject teacher.



10.5 Concept of Risk, its types and Mitigating Measures

Concept of risk
The treat of damage, injury, loss or any other impact caused by vulnerabilities is called
risk. Risk may be caused by external or interal vulnerabilities. In other words risk is the
threatening event caused by external and internal vulnerabilities which can be prevented
through precautions. Risk may cause damage to life, health and property which may be
caused by calamities or hazards.

Hazard
A natural or man-made situation that possesses threat to lives and properties in
environment is called a hazard. A hazardous situation that has come to pass is called an
incident. Most hazards in nature are dormant or potential. When the hazards come to
their extremity, they become active and show their dangerous and devastating nature by
claiming lives and properties.
Hazards may be both natural and man-made in environment. Similarly, some hazards may
be physical, biological, chemical, etc. Some examples of natural hazards are earthquake,
volcano, landslide, etc.
The conditions or situations that can cause the body physical harm or inverse stress
are called physical hazards. Physical hazards may occur naturally or through human
activities. Some examples of natural hazards are earthquake, volcano, etc. The man-made
hazards occur more due to the human activities. For example, landslide, flood, road
accident, explosion of bomb, etc.
The chemical substances that create threat in environment and harm lives, properties and
environment are called chemical hazards. Chemical hazards may be both natural and
man-made. For example, insecticides, harmful gases, acids, etc. The biological agents that
can cause risk in living beings are called biological hazards. Such hazards are bacteria,
viruses, fungi, foreign toxin, etc. They have adverse impacts in the lives of living beings.
Although, there are many types of hazards, broadly the hazards that occur in nature are
categorized into natural hazards and man-made hazards. The brief description of these
hazards is presented below.

i. Natural hazards
Various natural processes are responsible for occuring different types of destructive and
devastating hazards in nature. The hazards which occur in nature due to the natural
processes are called natural hazards. They occur automatically in nature periodically or all

242 GREEN Environment Population and Health Education Book-9

of a sudden and out of human control. Some examples of natural hazards are earthquake,
volcanic eruption, landslide, glacial flood, cyclone, etc. In comparison to man-made
hazards, natural hazards are more dangerous and devastating.

ii. Man-made hazards
Some hazards in nature are caused due to adverse impact of various human activities
in nature. The hazards which occur as a result of human activities are called man-made
hazards. Some examples of man-made hazards are road occident, collapsing of buildings,
bomb explosion, epidemics, outburst of dams, aeroplane crash, desertification, etc. In
comparison of natural hazards, man-made hazards are less destructive and in the control
of human being to a large extent.
















Fig: 6


Types of Risk

In each and every step of life, we have to face risk. However, we can avoid risk by
adopting precautions or safety measures. There are various types of risks on the basis of
their causes. Risks are broadly classified into following two types.
1. Risks induced by natural disasters 2. Risks induced by human activities

1. Risk Induced by Natural Disasters

The natural events that occur suddenly and cause loss of life and property are called
natural disasters. Earthquake, volcanic eruption, cyclone, Flood, landslide, etc. are
some examples so natural disasters. These disasters seriously disrupt the function of a
community or a society involving economic and environmental losses. Natural disasters
cause massive loss of life and goods.
Disaster risk is widely recognized as the consequence of the interaction between a hazard
and the characteristics that make people and places vulnerable and exposed.
Risk = Hazard × Exposure × Vulnerability

Disasters are somethings considered external Do You Know
shocks, but disaster risk results from the complex • Exposure and vulnerability
interaction between development process that turn a hazard into a disaster.
generate conditions of exposure, vulnerability
GREEN Environment Population and Health Education Book-9 243

and hazard. Disaster risk is therefore considered as the combination of the severity and
frequency of a hazard the number of people and assets exposed to the hazard, and their
vulnerability to damage.

The key to understanding disaster risk is by recognizing that disasters are indicators
of development failures, meaning that disaster risk is a measure of the sustainability of
development. Hazard, vulnerability and exposure are influenced by a number of risk
drivers, including poverty and inequality badly planned and managed urban and regional
development, climate change and environmental degradation.

Disaster and disaster management
We have experienced a variety of disasters like earthquake, flood, landslide, fire, etc. An
event that occurs suddenly and affects life and property is called a disaster. Disasters
seriously disrupt the function of a community or a society involving economic and
environmental losses.












Fig: 7
Flood Landslide Earthquake
Disasters can be divided into two types. They are (i) natural disasters and (ii) human
induced disasters.

i. Natural disasters

The natural events that occur suddenly and cause loss of life and property are called
natural disasters, e.g. earthquake, flood, landslide, cyclone, volcanic eruption, etc.

ii. Human induced disasters

The disasters that occur due to human activities are called human induced disasters, e.g.
road accident, aircraft accident, fire, bomb explosion, oil spills, etc.












Fig: 8
Road accident Aircraft accident Bomb explosion
244 GREEN Environment Population and Health Education Book-9

Causes of disasters
Disasters like flood, landslide, etc. occur every year in Nepal. Slopes and fragile
geological structure, deforestation, unmanaged industrialization, population growth,
unmanaged settlement, unmanaged urbanization, unscientific agricultural paractices in
slopes, unmanaged construction, misuse of fire, etc. are the major causes of occurrence of
disasters in Nepal. The disasters that commonly occur in Nepal are flood, landslide, forest
fire, storm, glacial lake outburst, epidemics, lightning, earthquake, etc.

Management and mitigating measures of disasters
Disasters occur due to various causes. We should select disaster management and
mitigating measures on the basis of the causes of disaster. Some disasters and their
management and mitigating measures are described below:

i. Preparedness
ii. Rescue of the affected people
iii. Help, rehabilitation of and relief to the effected people

iv. Mobilization of help in a proper way
v. Development of public awareness
Among many natural disasters, we discuss some of them, viz. earthquake, flood, landslide,
avalanche, glacier lake outburst, their causes and mitigating measures.

Earthquake

Management and mitigating measures for earthquake
An earthquake is the sudden shaking of the
earth’s surface. It occurs due to various reasons.
It damages human constructed works like
buildings, houses, roads, bridges, etc. and kills
human beings and other animals. Earthquake
may occur at any time. So we should adopt
various measures to keep us safe during the
earthquake.
Fig: 9
Preventive measures before earthquake Earthquake

i. We should identify a safe place inside and outside the house.
ii. We should firmly fix cupboards, photo frames, television, mirror, etc. to the wall so
that they do not fall and hurt us during the earthquake.
iii. We should repair the foundation of house, walls, ceilings, windows, windowpanes,
electric wires, etc. on time.

iv. We should keep an emergency bag keeping dry food, radio, mobile phone, torch
light, water bottle and first aid box.


GREEN Environment Population and Health Education Book-9 245

Measures to be adopted during earthquake
i. If we are near the door of the house and if
there is a safe open place, we should move
to the safe place outside the house carefully
and quickly.
ii. If we are sitting inside the house, we should
stay in the safe place.
iii. If we are sitting/working outdoor, we should
stay in the safe open place. But we should
not stay just below electric cables and near Fig: 10
the trees.
iv. If we are riding/driving vehicle, we should stop the vehicle and stay safely.
v. We should switch off electric supply and close the gas stove.

vi. We should not be terrified too much.

Measures to be adopted after earthquake

i. We should stay in a safe place and we should not enter the house immediately after
an earthquake.
ii. We should rescue the victims carefully.

iii. We should give first aid to the injured persons and take them to the hospital
immediately.

iv. If we get injured, we should seek help from others.
v. We should inform the rescue team on time.
vi. If we are inside the house, we should go to the safe open place after the earthquake.

vii. We should check the condition of the house such as pillars, walls, window panes,
doors, etc. before entering.
viii. We should listen to the emergency news of the earthquake broadcast by radio/TV and
take caution accordingly.

2. Management and mitigating measures for flood and landslide
The overflow of water on both sides of a river, stream, etc. due to heavy rainfall, melting of
ice, outburst of glacier lakes, blockade of river, etc. is called flood. Flood destroys life and
property. Flood covers roads, fertile land, crops, human settlement, bridges, etc. Flood
mainly occurs in the Terai region and causing damage to unmanaged cities of Nepal every
year. Similarly, the slide of landmass, soil, rock, etc. down wards due to effect of gravity
is called landslide. The mitigating measures and management of flood and landslide are
given below.




246 GREEN Environment Population and Health Education Book-9

Mitigating measures for flood and landslide
i. We should not panic.
ii. We should stay in a safe be afraid.

iii. We should not try to cross the flooded river.
iv. We should help the affected people.
v. We should inform seniors or rescue team if we see a blocked river or stream.

vi. We should give first aid to victims and rush them to hospital for treatment.
vii. We should manage the dead bodies properly after flood and landslide.















Fig: 11
Flood Landslide


Management of flood and landslide
i. Embankment should be done on the banks of rivers, streams, etc.
ii. Construction of houses and buildings on the slopes and banks of rivers should be
avoided.
iii. We should plant trees having fibrous roots like bamboo, etc. on the bank of rivers and
the places where soil erosion takes place.
iv. We should plant trees on bare land.
v. We should identify flood and landslide prone areas.

vi. Terrace farming should be adopted in slopes.
vii. Proper drainage of water should be done.


3. Glacier flood
Glaciers are essential natural resources and source of river that provide fresh-water in the
Himalayan region of Nepal. Glaciers are receding and glacial lakes are forming due to
global warming. These glacial lakes are the sources of natural disasters also. The outburst
of such lakes lead to floods that may claim lives and properties. In Nepal, there are many
examples of glacial lake outburst floods. There are about 3252 glaciers and 2323 glacial
lakes in Nepal. Few glacial lakes have been outburst so far. Among 2323 glacial lakes in
Nepal, 20 are potentially dangerous. In Nepal, there are many rivers like Arun, Trishuli,
GREEN Environment Population and Health Education Book-9 247

Dudhkoshi, etc. that originate from Tibet. Downstream of these rivers are at the risk of
glacial lake outburst flood. A study has shown that the floods in these rivers has claimed
lives and properties at different times.


Causes of glacier flood
There are many causes of glacier flood. The major causes of glacier flood are given below:
i. Global warming
ii. Melting of snow
iii. Glacial lake outburst
iv. Geographic energy
v. Change in climate
vi. Tectonic shocks
vii. Human encroachment
Fig: 12
Effects of glacier flood

The effects of glacier flood depend on speed of flood, amount of debris in the flood and
duration of the flood. The major effects of glacier flood are given below.
i. Destruction of land structures, natural resources, physical structures and cultural
heritages
ii. Destruction of fertile land
iii. Destruction of lives and properties
iv. Occurrence of landslides and soil erosion
v. Destruction of habitat of the living beings
vi. Destruction of agricultural products that may invite starvation
vii. Outbreak of epidemics and other various diseases
viii. Slow down the economic development of the country


Preventive measures of glacier flood
Glacier flood can be prevented by various ways. Some of the protective measures of
glacier flood are mentioned below.
i. Mapping of glacial lakes by field investigation
ii. Construction of dykes parallel to the rivers to slow down the current of water flow
iii. Identification and ranking of glacial lakes on the basis of their potential danger
iv. Encouraging afforestation and discouraging deforestation
v. Construction of reservoirs to store the flood water
vi. Establishment of flood measuring stations in the flood prone areas
vii. Preparation of flood hazard map in flood-prone areas
viii. Adopting precautions in glacier flood-prone areas
ix. Generating public awareness against glacier flood
248 GREEN Environment Population and Health Education Book-9

Glacial Lake outburst flood (GLOF)
A type of outbrust flood that occurs due to
filling of the dam containing a glacial lake is
called glacial lake outburst flood. The dam
of the glacial lake consists of glacier, ice or
a terminal moraine. Failure of glacial lake
dam occurs due to erosion, water pressure,
avalanche, earthquake, volcanic erruption,
etc. As a result, a large amount of glacier
breaks off and displaces the water in a
glacial lake massively. Catastrophic failure
of the containing ice or glacial sediment can Fig: 13
release the water of the lake by glacier lake Glacier Lake outburst
outburst. Glacier lake outburst floods are
often compounded by a large amount of river bed erosion in the steep moraine villages.
The volume of glacial lakes varies, but may hold millions to hundred millions of cubic
meters of water.
There are many deadly glacial lake outburst floods identified worldwide. In Nepal, the
Tsho Rolpa glacier lake is situated in the Rolwaling valley. The lake is dammed by a 150
m high unconsolidated terminal moraine dam. This lake is growing larger every year due
to the melting and retreat of the Trakarding glacier. It has become most dangerous glacier
lake in Nepal storing 90 to 100 million cubic meters water.


Effects of glacier lake outburst
The major effect of glacier lake outburst flood are given below.

i. Destruction of lives and properties
ii. Destruction of land structures
iii. Sources of floods, soil erosion and landslides

iv. Destruction of fertile land and agricultural products
v. Destruction of physical infrastructures like human settlements, roads, bridges, etc. in
downstream


4. Avalanche
An avalanche is a rapid flow of snow down a
sloping surface. It is commonly called a snow slide.
Avalanches are typically trigged in a starting zone
from a mechanical failure in the snowpack. It occurs
when the forces on the snow exceeds its strength
but sometimes only with gradually widening. After
initiation, avalanches usually accelerate rapidly and
grow in mass and volume as they entrain more snow.
Fig: 14
The load on the snowpack may be only due to gravity Avalanche
GREEN Environment Population and Health Education Book-9 249

or increased load due to precipitation, Avalanches initiated by this process are known as
spontaneous avalanches. Avalanches can also be triggered by other loading conditions
such as human or biologically related activities. Seismic activity may also trigger the
failure in the snowpack and avalanches.
Most avalanches occur spontaneously during storms under increased load due to snowfall.
The second largest cause of natural avalanches is metamorphic changes in the snowpack
such as melting due to solar radiation. Other natural causes include rain earthquakes,
rockfall and icefall. Artificial triggers of avalanches include skiers, snowmobiles and
controlled explosive works.

By their nature, avalanches represent a major danger only in mountainous areas of the
earth where geographic and meteorological conditions give rise to heavy rains and to a
accumulations of snow and ice prone to hurtling down in the valleys inhabited by man. A
distinction can be made between two types of avalanches.
1. Large- scale avalanches caused by very heavy rains, which threaten localities,
buildings and communication links in all or parts of a valley.
2. Avalanches restricted to smaller local areas, which are mostly triggered by man in the
course of his professional or sporting activities.
The damaging effects of avalanches may be widespread or limited depending on the factors
which provoked them. But just as in the case of landslides, a very localised incident can
have consequences beyond its immediate surroundings, notably when communication
links such as roads, railways and cable cars are interrupted or infrastructure is destroyed


Preventive and protective measures of avalanche
Areas at risk from avalanches can generally be identified by observation of the mountain
slopes and by the study of the local records of past disasters.
Preventive measures will consist in identifying these likely zones and in the adhoc layout,
planning and implanting of buildings to prevent the triggering of serious avalanches.

At the community level the consequences of avalanches by the following protective and
preventive measures:

1. Selective monitoring of the snow and the danger of avalanches through the
establishment for this purpose of a national institute of studies.
2. Land surveys and mapping of avalanche zones should be done.

3. Land development and planning regulations forbidding building or residing in
threatened zones.

4. Constructing building which will prevent the triggering of massive avalanches on the
uphill slopes and infrastructures such as walls, barriers, tunnels, and galleries which
will protect threatened property.
5. Depending on the seriousness of the danger from avalanches, forbidding circulation
or the use of certain communication routes, i.e. roads, railways etc.
6. Planning the evacuation of the population and livestock at risk.
250 GREEN Environment Population and Health Education Book-9