23. Unsafe abortion may be risky for the pregnant woman. It may cause infection,
continuous bleeding, damage in the uterus, unconsciousness and death of the
victim. Therefore, unsafe abortion should be discouraged providing proper health
education.
24. Spontaneous abortion is defined as the unintentional expulsion of an embryo or
foetus before the 24th week of gestation.
25. The intentional termination of pregnancy by using medicine or with the help of
skilled health personnel is called induced abortion.
26. An abortion is referred to as an elective or voluntary abortion when it is preformed
at the request of the woman for non-medical reasons.
27. Maternal health is the health of a woman during pregnancy, childbirth and the
postpartum period.
28. The main objective of maternal and child health care is to improve maternal and
newborn health by raising the level of motivation of health care workers to provide
high quality maternal and newborn care is essential to detect high risk cases of
mother and child and give them special care, to identify complications and prevent
them to educate the mother and to promote, protect and maintain health of both
mother and child.
29. Due to lack of proper and adequate maternal and child health care, many mother
and infant die. The mortality rate of mother and infant can be reduced by proper
maternal and child health care services.
30. In order to raise the standard of health of the people living in a country, we should
improve the condition of maternal and child health care.
31. The pregnancy period of a woman is about 40 weeks or 280 days. This period is
considered as a sensitive and risky period for a woman.
32. In rural areas of Nepal, less care is being paid to pregnant woman due to poverty,
ignorance, lack of proper health eduction and superstitions.
33. She must drink sufficient amount of water so as to avoid constipation.
34. She can have morning or evening walk as well as do normal day to day activities.
However, she should not lift heavy loads and do heavy works in agriculture land.
35. Natal care is during the delivery period.
36. The period of two months after delivery is regarded as maternity period or post
natal period.
37. The baby should be given first milk (yellow milk called colustrum) rather than
throwing it out.
38. The normal weight of baby at the time of birth should be (2.7-3.4) kg and height 50
cm. The baby grows upto 75 cm and its weight increases 3 times within 1 year of age.
39. The act of feeding breast milk to the baby is known as breast feeding.
40. The first milk produced immediately after delivery is yellow in colour which is
called colustrum.
GREEN Health, Population and Environment Education Book-10 201
41. Breast feeding increases very harmonious and close relationship between baby and
mother.
42. The extra food provided to baby except mother’s milk is called as supplementary
food.
43. In the rural areas, lito is prepared by mixing various cereals and legumes like rice,
wheat, maize, soyabeans, gram, etc.
44. Vaccines act as protecting shield against several diseases.
Exercise
A. Write very short answer to the following questions.
1. What are sexually transmitted diseases?
2. What is the full form of AIDS?
3. Write any two causes of spread of AIDS in Nepal.
4. Write any two methods of transmission of HIV/AIDS.
5. What is window period?
6. Name the causative agent of syphilis.
7. What is gonorrhoea?
8. Name the causative agent of gonorrhoea.
9. What is chancroid?
10. Name the causative agent of chancroid.
11. Write any two major symptoms of chancroid.
12. Define safe motherhood.
13. Mention any four simple problems during pregnancy.
14. What is abortion?
15. Define induced abortion.
16. What is maternal and child health care?
17. What is immunization?
18. What is first milk produced from breast of mother called?
19. What is the normal weight of baby during birth?
20. What is the height of baby after a year?
21. When should the first dose of vaccine of DPT given to a baby?
22. When is measles vaccine given to a baby?
23. What is supplementary food?
202 GREEN Health, Population and Environment Education Book-10
2. Write short answer to the following questions.
1. Write down the various modes of transmission of HIV/AIDS.
2. Write down the preventive and control meaures of AIDS.
3. Write down the major symptoms of syphilis.
4. Give a brief introduction to motherhood.
5. What is meant by maternal and child health care? Describe in brief.
6. Write a short note on “care of pregnant woman”.
7. What care should be given to postnatal mother?
8. Write in brief about “breast feeding and nutrition”.
3. Write long answer to the following questions.
1. Write down the modes of transmission, major symptoms and preventive
measures of HIV/AIDS.
2. Write down the modes of transmission, major symptoms and preventive
measures of gonorrhoea.
3. Explain in detail about rapid spreads of HIV/AIDS in Nepal.
4. What is abortion? Explain its types.
5. Explain the general complications that occur during pregnancy.
6. Explain the concept of safe motherhood.
7. Explain in detail about infant and child health care.
8. “Unsafe sexual intercourse increases the rapid spread of sexually transmitted
diseases.” Justify the statement.
9. “To give birth to a child between the age of 20-30 years is considered better from
the perspective of health science.” Justify this statement.
GREEN Health, Population and Environment Education Book-10 203
unit Consumer’s Health and
9 Community Health
Estimated Teaching Periods: 18
Learning Outcomes
Learning Objectives
After completing the study of this unit, students will be able to:
i. introduce consumer’s health and community health.
ii. state the types of heath services.
iii. list the health problems in Nepal.
iv. explain the effects of drugs, tobacco and alcohol.
Course Outline
9.1 Concept of Community Health
9.2 Health Services Providing Agencies
9.3 Major Health Problems in Nepal
9.4 Policies and Programmes of Health Sectors
9.5 Unhygienic Health Habits, Effects and Preventive Measures
9.6 Smoking and Narcotic Drugs
Glossary
consumer : a person who buys goods and services
inspection : the act of looking at something closely in order to learn more about it, find
problems, etc.
malnutrition : the unhealthy condition that results from not eating enough food or not
eating enough healthy food
curative : able to cure diseases or heal people
rehabilitate : to bring (someone or something) back to a normal, healthy condition after
an illness, injury, drug problem, etc.
narcotic : a drug that affects the brain and that is usually dangerous and illegal.
nook : a small space or corner that is inside something
famine : a situation in which many people do not have enough food to eat
detrimental : causing damage or injury
204 GREEN Health, Population and Environment Education Book-10
9.1 Concept of Community Health
Introduction to Community Health
We live in a community. Our community consists of people of different ages, groups,
sexes, caste people engaged in different occupation, etc. Due to different reasons, we find
that the people in the community are affected with different health problems. In order to
prevent diseases or to live in good health, the people in the community work together.
The joint effort made by the people to prevent diseases and promote the health condition
of the community is called community health.
Different types of health services are made available in our community. Some of these
services are provided by the government, some by private organizations and some
by individuals. The main objective of all these health services is to promote the health
condition of the people in the community. Community health is defined as the science
of preventing disease, prolonging life and promoting health and efficiency through
organized community effort. It focuses on the health problems seen in the community
rather than that of an individual or a family. In the past, it just emphasized on sanitation
but now with the development of science and technology, it emphasizes on preventive,
curative, promotive as well as rehabilitative aspects of health. In this aspect, the joint effort
of individual, family, society and the nation is essential to promote community health.
Community health is a social activity in which the health problems prevalent in the
community are identified. At the same time, the preventive measures for the disease
are also identified to prolong the life and promote health condition of the community
members. It encourages people to change the health behavior and follow the habits of
personal hygiene, intake of balanced diet, exercise and rest, etc. to gain good health.
In brief, community health is an organized effort of the community people in the
identification of the existing health problems and providing health services to the people
to improve health of community people’s as well as environmental health.
Concept of Community Health
An individual’s effort may not be sufficient to gain good health in the community.
It requires a joint effort of the individuals, family, society and the nation. When the
community is healthy, the different diseases that affect the health of the people can
be easily prevented. The experts say that 80% of health is driven by socio-economic
factors, health behaviors and environmental factors. The product of mind cannot
function properly unless we have a healthy body. The importances of community can
be described as follows.
a. Creation of Healthy Environment
Dirty environment is the cause of different types of diseases. It causes different types of
communicable diseases. Community health studies the health problems of the society and the
nation. In the process of study, it also identifies the problems and helps to organize different
activities to solve such problems. It helps to develop awareness among the people to create
healthy environment which is possible through the knowledge of community health.
GREEN Health, Population and Environment Education Book-10 205
b. Preparation of Healthy Manpower
It is well known that healthy manpower is the foundation pillar for
the development of the nation. One can be healthy by adopting
healthy habits and health rules. Healthy individuals can contribute
in the development of a nation. Community health helps to prepare
healthy manpower. All the members in the community must follow
healthy habits to maintain good community health.
c. Availability of Health Services Fig: 1
Health services should be made easily available in every nook and corner of the country.
At the same time, the community people must be involved in community health so as to
change the traditional concept of people and accept modern health service. Many people
believe in the traditional health practices especially in the rural areas. There is lack of
medical facilities in those places. The available health services and facilities are not easily
accessible. These health services can be made accessible through community health.
d. Encouragement for Social Services
The study of community health helps to understand the problems of community.
It encourages the people and social organizations like Red Cross Society, Paropkar
Association, local heath clubs, clinics, etc. to solve such problems with the joint effort
of different organizations. Different health camps, clinics, awareness programes, adult
literacy classes, etc. can help to solve such health problems. These activities make the
people aware about medical services and facilities, personal hygiene and environmental
sanitation, prevention and control of diseases, etc. When people are benefited from such
programmmes, they are also encouraged in developing community health.
Besides these, community health also helps to study health and diseases scientifically
to take necessary action according to the need for proper maintenance of health. It also
gives knowledge about the importance of personal hygiene, environmental sanitation
and proper and timely treatment of diseases for maintaining good health.
Scopes of Community Health
Different kinds of health services, facilities, awareness raising programmes, health camps,
etc. that are conducted in the community are included under community health. These
areas or the fields related with the health of the people in the community are known as the
scopes of community health. The scopes of community health can be described as follows.
a. Inspection of the Supply of Foodstuffs and Drinks
Food stuffs, drinking water, milk, etc. are consumed by the people for proper growth
and development of the body. The consumption of these materials helps to increase the
immunity power and resist diseases. But these days, the problems of food adulteration is
seen in the market. With the aim of gaining maximum profit, the producers and distributors
mix low quality goods in the food materials. As a result, the required nutrients are not
gained even while consuming nutritious diet. So, there should be proper inspection of
the food stuffs, drinks, etc. before it is distributed in the market. When there is proper
206 GREEN Health, Population and Environment Education Book-10
inspection, the consumers can get quality food. This helps to maintain good community
health. Therefore, it is considered as scope of community health.
b. Prevention and Control of Communicable Diseases
Different types of communicable diseases affect the people in the community frequently.
Some of such communicable diseases may also spread in the form of epidemic diseases
affecting large number of people. These communicable disease may or may not be
easily controlled. If the people are made aware about personal hygiene, environmental
sanitation, healthy behaviors, proper use of latrines, intake of balanced and nutritious
diet, etc. these diseases can be easily prevented and controlled. So, prevention and control
of communicable diseases is considered as a scope of community health.
c. Environmental Sanitation
Environmental sanitation plays an important role in maintaining good health of the
people in the community. Due to lack of environmental sanitation, unhealthy behaviour
of people and due to carelessness, pollution increases in the environment. The polluted
environment becomes a suitable breeding area for germs and diseases. Therefore, a joint
effort of the community members is essential to maintain environmental sanitation.
Defferent types of programmes like conducting rally, street dramas, pamphleting, etc.
can be launched to raise awareness among the people. These activities directly affect
community health.
d. Control of Malnutrition
Malnutrition is the condition in which the body
either lacks sufficient amount of nutrients or intake
of maximum amount of nutrients than required
for the body. In the developing country like Nepal,
malnutrition is resulted due to lack of nutrients
required for the body. Due to illiteracy, food habits,
customs, improper feeding, food production and
supply, etc. large number of people become the victim Fig: 2
of malnutrition. The problems of malnutrition can
be controlled or prevented by the development of agriculture, improving the sources of
income, proper distribution of food materials, giving nutritional education, etc. These
programmes help to control malnutrition. So, it is regarded as a scope of community
health.
e. Control of Accidents and Injury
Human beings may meet with accidents at any time
and place. Such events can make the life of people
risky. To prevent the accidents, the people should
be provided with safety education. Safety education
should be provided at local level to save the life of
the people. So, control of accidents and injury is
considered as a scope of community health. Fig: 3
GREEN Health, Population and Environment Education Book-10 207
f. Preparation for the Control and Management of Risk
Natural disasters like flood, landslide, fire, earthquake etc. affect the life and property of
the people. To reduce the effect, the community should be made aware abut the methods
to control their risk. The community itself should organize different programmes to
control the effects of such disasters. The people should be encouraged to take necessary
precautions to reduce the effects.
g. Health Education
Health education plays a vital role in making the community healthy. It encourages the
community members to live healthy life by changing their attitude and behaviour. For
this, the community can launch health education programmes, sanitation camps, mobile
health camps, etc. frequently to develop individual and community health.
h. Immunization Programme
Immunization helps to protect the body against
different communicable diseases. The immunization
programmes should be launched by the government
in such a way that every citizen has access to such
programmes. When the people are timely immunized
with different types of vaccines, they can prevent
communicable diseases and live healthy life.
According to the needs of people in the community,
different types of immunization programmes can Fig: 4
be launched with the joint co-operation of the
government and the community people.
i. Prevention and Control of Drug Abuse
These days drug abuse has become a major problem of young generation. The young
people consume drugs in the name of cultural tradition, worshiping gods and goddess,
gathering, peer pressure, etc. The intake of drugs is very dangerous and hampers the lives
of the users. They should be made aware about the impact of drug use. They should be
encouraged to utilize their leisure time properly by engaging in different activities like
games and sports, yoga, art and literature, music, etc. to live healthy life.
Activity: 1
Identify the different types of health programs in your community and discuss the
solutions for such problems.
9.2 Health Service Providing Agencies and their Activities
Available Health Services
Every citizen has the right to live healthy life. It is the responsibility of the government to
manage necessary heath services for the good health of its citizens. But in our country, due
208 GREEN Health, Population and Environment Education Book-10
to poverty, illiteracy, geographical difficulty, problems of social customs and traditions
etc. the health status of the people is not promoted. Many people in the villages still
believe in the traditional health practices, dhami, jhankri, etc. So, due to lack of proper
treatment of diseases, many people die even due to minor diseases. With the purpose of
making the health services and facilities easily accessible, Nepal Government and the
non-governmental organizations have jointly established different agencies to provide
health services to the people. Health services can be classified into the following fours
types:
a. Preventive Health Services b. Promotive Health Services
c. Curative Health Services d. Rehabilitative Health Services
a. Preventive Health Services
Preventive Health Services are based on the principle “Prevention is better than cure.”
It is better to prevent the diseases than spending a large amount of money on curing the
diseases. The health services provided to prevent diseases and their causes are considered
as preventive health services. Immunization, maintaining environmental sanitation,
personal hygiene, taking balanced diet, providing health education, managing clean
drinking water etc. help to prevent different types of diseases. So, they are included under
preventive health services. Similarly, prevention of diseases from an infected person to a
healthy person in different ways is also included under preventive health services.
Some of the preventive health services available in Nepal are as follows:
1. Family Planning and Maternal and Child Health Care Programme
2. National Immunization Programme
3. Programme to Control Diarrhoea and Respiratory Diseases
4. National Tuberculosis Control Programme
5. Leprosy Control Programme
6. Programmes to Control AIDS and Other Sexual Diseases
7. Programmes to Control Malaria and Kalazar
8. Programes to Raise Awareness
9. Health Education
10. Public Awareness Programmes for Environmental Sanitation
b. Promotive Health Services
Promotive Health Services refer to such health services which help to promote/ improve
the present health of the people. Marriage at appropriate age, maintaining birth spacing,
family planning, safe motherhood, infant and child health care etc. help to promote the
health condition. The programmes of nutrition, reproductive health education, maternal
and child health care, regular health check up programme etc. are included under
promotive health services. These programmes help to promote the health condition of
the people.
GREEN Health, Population and Environment Education Book-10 209
c. Curative Health Services
The health services are provided to the people in order to cure the diseases that they are
affected with are known as curative health services. The treatment of diseases, diagnosis
of diseases, control prevalent disease, etc. come under curative health services. The
curative health services are provided by the hospitals, health posts, sub-health posts,
nursing homes, clinics, etc. Theses health services are expensive in comparison to the
preventive and promotive health services.
d. Rehabilitative Health Services
Rehabilitative health services are given to
the patients of chronic diseases as well as to
those people who are engaged in drug abuse.
Rehabilitative health services help the patients to
return back to normal life or daily activities. In
the course of treatment of chronic diseases like
HIV/AIDS, leprosy, asthma etc. the victims may
not be able to engage in their daily activities. Fig: 5
They may be away from family and social
activities. Rehabilitative health services help them to adjust in their original life and let
them live comfortable life.
Health Service Providing Agencies
Different types of health services are available at the local, regional and centre level in the
country. There are different agencies to provide health services in these levels. The health
services available at different levels are given below.
a. Central Level
The central level health services manage the different types of health services available in
the country. The Ministry of Health and Population controls different agencies providing
health services at different levels. Different health service providing agencies under the
central agency are:
1. Bir Hospital, Kathmandu
2. Kanti Children’s Hospital, Kathmandu
3. Maternity Hospital, Thapathali
4. Mental Hospital, Lagankhel
5. Sukra Raj Tropical and Infectious Disease Hospital, Teku, Kathmandu
6. T.U. Teaching Hospital, Maharajgunj
7. Patan Hospital
8. B.P. Koirala Cancer Hospital, Bharatpur
9. B.P. Koiralal Institute of Health Science, Dharan
210 GREEN Health, Population and Environment Education Book-10
10. Karnali Institute of Health Science
Fig: 6
Bir Hospital TU Teaching Hospital
These central hospitals provide specified health services to the specific diseases. They
provide the facilities of laboratory, X- ray, surgery (major and minor), etc. These hospitals
are provided with specialists to identify and treat different diseases.
b. Regional Level/ Regional Hospital
The regional level health services include
regional hospitals and regional training centres.
The regional hospitals provide curative as well
as referral health services. There are only two
regional hospitals in Nepal though the Ministry
of Health has made the provision of one regional
hospital in each development region. The Western
Regional Hospital (Pokhara) and the Eastern
Regional Hospital (Dharan) are the two regional Fig: 7
hospitals of Nepal. The Eastern Regional Hospital,
Dharan is now known as B.P. Koirala Institute of Health Sciences (BPKIHS). The regional
hosptials contain 50– 250 beds. They perform the following functions.
a. Follow the plans and policies prepared and instructed by the Ministry of Health.
b. Formulate, implement and supervise the health programmes
c. Co-ordinate with the zonal and district level health organizations
d. Provide the facilities of specialists (specialized doctors) in the regional and sub-
regional hospitals
e. Provide the facilities of laboratory and minor surgery
f. Provide referral health services.
c. Zonal level/ Zonal Hospitals
There are 10 zonal hospitals in Nepal. There are
also ayurbedic clinics and ayurbedic dispensaries
in different zones of Nepal. The zonal hospitals
also provide curative and referral health services.
Each zonal hospital has the provision of 50-200
beds. They perform the following functions. Fig: 8
GREEN Health, Population and Environment Education Book-10 211
a. provide specialized health services
b. treat and cure the patients referred from district hospitals. If the treatment is not
possible here, they can be referred to the regional or central hospitals
c. launch programmes of preventive and promotive health services
d. follow the instructions, plans and policies formulated by regional and central offices
d. District Level/ District Hospital
The district level include the District Health
Offices. The district hospitals come under the
district health offices. There are 65 district hospitals
in Nepal at present. These hospitals provide
preventive and curative health services. They also
give necessary support to the health centres and
health posts. These hospitals are equipped with 25
to 50 beds.
The district level health service agencies/ centres Fig: 9
perform the following functions.
a. implement the programmes formulated at the central and regional level
b. supervise and evaluate the health organizations of the particular district
c. organize training , workshop, seminar etc.
d. control the problems of infectious and epidemic diseases in the district
e. implement school level health programmes effectively
f. provide general medicine care in the district hospitals with the help of doctors
g. provide O.P.D, I.P.D and emergency health services
h. provide the facilities of X-ray, laboratory, etc.
e. Electro Constituency Level (Primary Health Centre)
There is provision of at least one primary health
centre in each election constituency. Before 2072
B.S., there were 240 election constituencies in
Nepal. According to the constitution of Nepal
2072 B.S., there is provision of 165 election
constituencies in Nepal. There were 208 Primary
Health Centre in Nepal by 2072 B.S. An MBBS
doctor or person of equivalent qualification is the
In-charge of primary health centre. The primary
health centre provides the basic health services, Fig: 10
treatment and preventive health services. There is
provision of materal health services and emergency services. For these services, 3 beds are
212 GREEN Health, Population and Environment Education Book-10
provided in the primary health centre, one bed for maternal health services and two beds
for emergency services. The Primary Health Centres perform the following functions.
a. provide services for safe motherhood, pregnancy check-up and maternity services
b. prevention and cure of diarrhea
c. provide regular and mobile immunization services
d. launch programmes of environmental sanitation
e. treat injuries
f. launch family planning programmes
g. treat the patients referred from the health posts and sub health posts
f. Ilaka Level (Health Post)
Depending upon the geographical area and
population, there is provision of minimum six
health posts in a district. The main objective of
health posts is to provide the basic health services
to every family. It provides both the mobile as
well as the static health services at the Ilaka level.
The health assistant is the in-charge of the health
post. They provide services for maternal and
child health, family planning, immunization, Fig: 11
nutritional education, health care, health
education, preventive health care and general medical treatment. They also conduct
health programmes with the co-ordination of district health office. At present, there are
1559 health posts in Nepal. Planning is done to promote all the sub-health posts into
health posts. The following functions are performed by a health post.
a. provide door to door maternal and child health services.
b. run camps for vasectomy, minilap, eye check up etc.
c. run school level health programmes in the village ilaka, village council, municipality,
etc.
d. examine and treat minor disease.
e. treat minor cuts or injuries
f. provide preventive health services.
g. Village level (Sub Health Post)
The government has made the provision of at
least one sub-health post in each village counsil.
Community health assistant is the In-charge of
the sub-health post. It emphasizes on preventive
health services. At present, there are 2247 sub-
health posts in Nepal. A sub-health post performs
the following functions.
a. educate the people about the prevention of
different infectious diseases Fig: 12
GREEN Health, Population and Environment Education Book-10 213
b. run door to door educational programmes about environmental sanitation
c. treat cuts and minor injuries
d. provide basic health services
e. run health programmes for adult females, female health worker, mid-wife and non-
governmental organizations
h. Community and Ward Level
With the objective of making the basic health services easily accessible to the villagers,
every ward in the village is provided with a village clinic or immunization clinic. Similarly,
there is the provision of at least one female health worker (volunteer) in each ward. These
volunteers provide health services related to family planning, treatment and prevention
of diarrhoea, respiratory diseases, health education, etc.
Voluntary Health Agencies
Besides the government and private hospitals and health centres, different voluntary
health agencies are also working to solve the existing health problems of the society. These
organizations take health programmes as the major programmes. They may be working
with the joint union of some international agencies. Some voluntary health agencies are
introduced below.
A. Nepal Red Cross Society
Nepal Red Cross Society was established on 19 Bhadra 2020
th
B.S. introducing with the slogan “Where there is sorrow, there is
Red Cross.” It was established after about hundred years of the
establishment of International Red Cross Society (1863 A.D). The
International Red Cross Society was established with the aim of
giving medical treatment to the wounded soldiers in the war. Fig: 13
The main aim of Nepal Red Cross Society is to give relief to
the people during flood, earthquake, epidemic, famine, fire and other disasters. It also
provides maternal and child welfare services. The services provided by Nepal Red Cross
Society are listed below.
a. Service Oriented Activities
The service oriented activities of Nepal Red Cross Society are related with nature and
its conservation. It works to prevent, control and minimize natural disasters, rescue the
people from disasters like flood, landslide, epidemics, famine, fire, etc. It rescues the
people and help in rehabilitation of victims. It also helps the refugees.
b. Health Services
Health services of Nepal Red Cross Society are related with community health to conduct
blood donation, ambulance services, reproductive health, family planning, eye camps,
medicine distribution, etc. It has also established blood bank centres.
214 GREEN Health, Population and Environment Education Book-10
c. Development Activities
Development activities are related with community development. For example, health
and sanitation, income generating programmes, literacy classes, drinking water projects,
community first aid, family planning and reproductive health, etc.
d. Organization Development Activities
Nepal Red Cross Society organizes seminars, workshops, trainings, exhibitions and camps
to impart knowledge about the concerned matters. These activities help to solve health
problems through various national and international organizations. It is also increasing
its members by providing general, life-long, special and honorary membership.
B. Nepal Paropakar Association
Paropkar Association is the oldest national voluntary health
organization in Nepal. It was established by a social worker
Late Daya Bir Singh Kansakar.
In 1994 B.S., there was an outbreak of cholera in Kathmandu.
Many people died due to lack of medicine, health education and
awareness. Late Daya Bir Singh Kansakar along with some co-
workers started to give free health services to the victims. This Fig: 14
group re-started their work in 2003 B.S. But the association was
formally established on 10 Ashwin 2004 B.S. (25 September 1947 A.D.). Its headquarter
th
th
is in Bhimshenthan, Kathmandu. It provides the following types of services.
i. Free medicine distribution to the poor people
ii. Health services to different people in different places of the country through its
primary health depots
iii. Free education upto secondary level through Paropakar Adarsha Madhyamik
Vidhayala since 2010 B.S
iv. Free health treatment for pregnant women through Maternity Hospital since 2016
B.S.
v. Ambulance services
C. Family Planning Asociation Of Nepal (FPAN)
Family planning Association of Nepal was established in 1959
A.D. i.e., 2016 B.S. It first joined the International Planned
Parenthood Federation (IPPF) in 1960 A.D. but became a full
member in 1969 A.D. (2026 B.S). Before the establishment of
FPAN, family planning was just considered as birth control
device. This association helped in changing this narrow concept
among the people. The main objective of this association is
to make the family life happy. Its headquarter is in Pulchok, Fig: 15
Lalitpur. It performs the following functions.
GREEN Health, Population and Environment Education Book-10 215
i. helps the couples to plan for the number of children
ii. protects and promotes maternal and child health
iii. gives counseling and service to infertile couples
iv. gets peoples’ participation-in family planning programmes
v. manage safe abortion
vi. launches family planning programmes (Camps) in different places
D. Nepal Heart Foundation
In order to provide preventive, curative and rehabilitative
health services to the people of heart diseases like high blood
pressure, high blood cholesterol, diabetes, heart attack, etc.,
Nepal Heart Foundation was established in 2045 B.S. (1988 A.D.).
Its headquarter is in Kathmandu and has its branches in various
districts. Since its establishment, it is launching programmes
for the prevention, diagnosis, control and treatment of heart Fig: 16
diseases. It also supports financially weak groups for operation
and treatment of heart diseases. With its pioneer support Sahid Ganga Lal National Heart
Centre was established. Since, 2064 B.S., it has started the services for the prevention and
control of rheumatic fever and rheumatic heart diseases.
E. Nepal Cancer Relief Society (NCRS)
It was established in 2039 B.S. on 21 Bhadra. It has its branches
st
in 42 districts of Nepal. Its headquarter is in Kathmandu. Its
objectives are as follows.
i. creates awareness in the people about cancer
ii. early detection of cancer for its prevention Fig: 17
iii. supports the curative aspects of the cancer sufferer
iv. provides rehabilitative services to those who are likely to suffer or are suffering from
cancer
v. provides information about existing facilities for treatment
F. Nepal Anti-Tuberculosis Association (NATA)
Nepal Anti-Tuberculosis Association was
established in 2010 B.S. with the aim of providing
free health services to the people. In 2022 B.S.,
Tuberculosis Control Project was started with
the joint effort of the government, WHO and Fig: 18
UNICEF to prevent tuberculosis. This project
is now known as Nepal Anti-Tuberculosis Association. Its headquarter is in Kalimati,
Kathmandu. Under this association, German Nepal Tuberculosis Project (GENETUP)
is working to control tuberculosis. It also provides services to the tuberculosis patients
216 GREEN Health, Population and Environment Education Book-10
through DOTS (Direct Observation Treatement Short-course). These days, National
Tuberculosis Centre has been established in Nepal. The major functions of NATA are as
follows:
i. surveys an early diagnosis of tuberculosis patients
ii. provides diagnostic and treatment services
iii. makes people conscious of the menace of tuberculosis through education and
demonstration
iv. provides B.C.G. vaccination and rehabilitation of ex-patients
v. health education, media publicity and publication of literature for the control of
tuberculosis
In addition to these organizations, different organizations like WHO, UNICEF, UNFPA,
Rotary Club, Lion Club, etc. are also involved to provide community health. These
organizations also conduct different programmes at national and regional level to solve
the problems of community health.
Activity: 2
Discuss in a group of five students about the different types of social organizations
active in your society along with their functions.
9.3 Major Health Problems of Nepal
Nepal is a developing country with poor economy, lack of infrastructures of development,
limited number of doctors, hospital, clinics, health workers and maximum health
problems. The rapid population growth is also a cause of health problems in Nepal. The
health problems exist in every part of the country, only the level differs from community
to community. Some major health problems of Nepal are described below:
a. Prevalence of Communicable Diseases
Those diseases which are transmitted from one person to another are known as
communicable diseases. They get transmitted from one person to another by means
of contaminated food, water, air and insects. Due to illiteracy, ignorance and traditional
thinking of people, infectious diseases are still prevalent in our societies. Every year many
people suffer from communicable diseases in Nepal and they die due to lack of medical
facilities and awareness. The diseases like HIV/AIDS, TB, syphilis, leprosy, etc. are kept
hidden by the people due to the fear of social humiliation. As a result, they are transmitted
from on person to another. This also makes the diseases prevalent in our societies.
b. Lack of Health Education
Many people in Nepal are still illiterate. They lack knowledge about balanced diet,
personal hygiene, environmental sanitation and medical treatment. This shows that
Nepalese are weak in health education. Due to lack of health education, they believe in
traditional health practices and superstitions. They think that the diseases are caused due
to the cursing of gods and goddess. They go to the witch doctors for the treatment of
GREEN Health, Population and Environment Education Book-10 217
diseases instead of the medical doctors. So, they die untimely even due to minor diseases
and lack of proper treatment of diseases.
c. Malnutrition
Malnutrition is the condition in which the body
either lacks sufficient amount of nutrients or contains
maximum amount of nutrients than required for
the body. In the developing country like Nepal,
malnutrition is mostly resulted when the body
lacks sufficient amount of nutrients. When there is
lack of nutrients in the diet that we take, it becomes
difficult for the body to fulfill its requirements. As
a result, people suffer from malnutrition resulting Fig: 19
from different deficiency diseases like kwasiorkor, marasmus, goitre, night blindness, etc.
Most of the children below five years are the victims of malnutrition in Nepal. Due to
the geographical topography, poverty, illiteracy, social tradition, culture, lack of health
services, prevalence of infectious diseases, lack of knowledge of balanced and nutritious
diet, many Nepalese are affected by malnutrition. According to the record of 2014 AD,
42% of the children below 5 years suffer from malnutrition in Nepal.
d. High Infant Mortality Rate
High infant mortality rate is another health problem of Nepal. The death of children below
one year of age is known as infant mortality. Due to lack of knowledge about proper pre-
natan and post-natal care, early marriage, lack of child health care and health services, the
infant mortality rate is high in Nepal.
When the infant mortality rate is high, the fertility rate also increases. It is because the
couples lack life guarantee of their children. As a result, they reproduce many children.
According to the Central Bureau of Statistics of 2011 AD, the infant death rate of the
country was 46/1000 live birth. The following table shows the infant mortality rate of the
SAARC countries in different years.
Infant Mortality Rate of the SAARC Countries (per 1000)
Countries 1994 2006 2016
Bangladesh 116 65 38
Bhutan 130 40 44
India 79 58 40
Maldives 38 15 8
Nepal 90 64 33
Srilanka 19 11 8
Pakistan NA 78 67
Afghanistan NA NA 68
Sources: World Population Data Sheet 2014, 2016
218 GREEN Health, Population and Environment Education Book-10
The above table shows that Srilanka and Maldives have low infant mortality rate in
comparison to that of the other countries.
e. Maternal mortality rate
The death of females during pregnancy or within 42 day of termination of pregnancy
is known as maternal death. There is high maternal mortality in Nepal due to early
marriage, early pregnancy, lack of birth spacing, lack of regular health check up, lack of
nutritious diet, lack of prenatal and post natal care, lack of effective delivery from trained
health workers etc. According to the demographic and health survey done between 1996
and 2016 AD, the maternal death rate was found to be reduced from 281/1,00,000 to
170/1,00,000 mothers. The high maternal death rate indicates weak health status of the
people in the country.
f. Poverty
The economic status plays an important role
in determining the community health. Good
economic condition helps to decrease mortality
rate. Nepal is one of the poorest countries in the
world. According to the survey done in 2015 AD,
23.8% of population are below the poverty line.
They cannot afford for sufficient food, clothes
and shelter. They lack balanced diet, education,
hygienic diet, health services, etc. As a result,
they become the victim of malnutrition and lead Fig: 20
to different types of diseases. On one hand, they
cannot prevent the diseases and on the other hand, they cannot afford for medical services
when they are sick which results to the death of victims.
g. Population growth
According to the CBS record of 2011 AD, the population growth rate of Nepal is 1.35%.
High population growth rate creates problems of fooding, lodging, drinking water,
employment, etc. It becomes difficult for the government to fulfill the basic needs of the
increasing population. When the basic needs are not fulfilled, it causes the problems of
malnutrition, destruction of the environment, poor health of the people, etc. As a result,
the community health becomes poor.
h. Lack of health services
Due to the poor economic condition, the government has not been able to invest
sufficiently in the health sectors. The health services are very less in comparison to the
total population in the country. At present, only 20% of the population is benefited with
the available health services and the remaining population are deprived of such services.
There is lack of doctors, health workers, hospitals, medicines, etc. for them. The following
table shows the present situation of health services in Nepal.
GREEN Health, Population and Environment Education Book-10 219
Health services available in Nepal
Health services Number
Hospitals (private and community) 403
Primary health centre 208
Health post 3,808
Sub health post 3,176
Ayurbedic dispenseries 305
Doctors 16,854
Nurses 33,293
Helath Assistant / S.A.H.W 7,175
Kabiraj / Baidyas 741
Source: CBS 2015
The above table clearly shows that the available health services are insufficient for the
total population in the country. These health services are not properly managed and
distributed in the rural areas. Due to lack of even the basic health services in the rural
areas, many people die even due to minor diseases. So, lack of health services is considered
as a major health problem in Nepal.
i. Unhealthy lifestyle
Unhealthy lifestyle is also a major cause of health problem. Intake of the diet rich in
carbohydrates, fried food, junk food, drinking alcohol, chewing tobacco and tobacco
products, playing cards, making multiple sexual partners, etc. are some examples of
unhealthy diet unhealthy lifestyle. The intake of these diets causes different types of health
problems. Many people take fatty and spicy food. They take the diet rich in carbohydrates
but do not engage in physical activities. As a result, they become the victims of diabetes,
heart diseases, etc. The habit of drinking alcohol, chewing tobacco and tobacco products,
etc. make people the victims of cancer. Thus, unhealthy lifestyle is also considered as a
major health problem in Nepal.
9.4 Policies and Programmes of Health Sectors
Health Services Policies
To get health services is also a basic need of people. The constitution of Nepal 2072 B.S.
has also declared that every citizen has the right to get free basic health services. The
health policies were introduced only in the 5 five year plan (1975-80 AD) for the first
th
time in Nepal. The government implemented health policies in 2048 BS for the firs time.
These policies were implemented to make the basic health services available to all people.
The 14th plan 2072/73 – 2074/75 has also included the different health programmes. These
programmes can promote the health conditions when they are implemented effectively.
The plans and programmes of the 13th plan are listed below:
a. To make the distribution of medicines from the health post easily
220 GREEN Health, Population and Environment Education Book-10
b. To make the basic health services and safe motherhood services easily accessible at all
levels in the country through health campaigns
c. To increase the number of health workers and the efficiency of the status of health
organizations in the country
d. To promote the status of health organizations in the country
e. To promote and expand health, social security, health insurance, rural and urban
health to make the health services inclusive and equitable
f. To improve the available health programmes
g. To make the new health policies friendly to the handicapped as well as adolescent
girls
h. To run preventive, promotive, curative and rehabitilative health servives as the basic
health services
i. To include promotive and preventive health services in the school curriculum
j. To encourage herbal cultivation, utilization, production of medicines and effective
management
k. To encourage regular health services in the rural and backward areas
l. To make specific criterias to run private and community hospitals
Major Programmes of Health Sectors
The programmes of health sectors are classified as follows:
a. Service Oriented Programmes
Family planning, safe motherhood, infant and child health care, control of HIV/AIDS and
other sexual diseases, control of malaria, kalazar and meningitis; and control of natural
disasters are included under services oriented programmes.
b. Private and Public Co-operative Programme
Under this programme, the basic health services are made free. The public, private and
community level co-operate with each other to provide free basic health services. This
helps to promote the health status of the people in the country.
c. Special Health Services Programmes
This programme aims at providing health services and social security to the poor, disabled
and handcapped people. Similarly, it also aims to provide social security to the victims of
disasters, conflict/war, sexual violence, etc.
Some of the major health programmes running in Nepal for a long time are decribed
below:
GREEN Health, Population and Environment Education Book-10 221
i. Expanded Programmes in Immunization
Immunization helps to prevent different types
of communicable diseases. The expanded
programme of immunization including B.C.G.
and D.P.T. vaccines in Nepal started in 2034 BS.
This programme includes B.C.G., D.P.T., oral polio
vaccine and measles. In the beginning (2034 B.S.), it
was started only in the three districts of Nepal. In
2045 B.S. this programme was extended throughout Fig: 21
the country. The government has launched this
programme from the central to the village level in order to prevent different diseases at
these levels. The objectives and functions of this programme are mentioned below:
Objectives
i. To prevent and save the children from the diseases like diptheria,measles, whooping
cough (pertussis), tuberculosis, polio and tetanus
ii. To immunize the children of targeted groups
iii. To provide T.T. vaccine to the pregnant women
iv. To immunize against the endemic diseases like viral influenza, encephalitis, etc. to
control them
v. To maintain polio free status
Functions
i. encourage the public to be immunized
ii. aware the public about immunization against the six diseases that affect the children
in the community through different media
iii. immunize the children in the village areas through the groups of trained health
workers
iv. launch T.T. vaccination programmes in the school level to prevent tetanus
v. immunize the pregnant women with T.T. vaccine
ii. Community Based Integrated Management of Childhood Illness (CBIMCI)
Community Based Integrated Management of Childhood Illness (CB-IMCI) is an
integrated package of child survival programme. It addresses the major killer diseases
in 2054 B.S. like pneumonia, diarrhoea, malaria, measles, malnutrition in under 5 years
children, etc. This programme was started with the joint union of WHO and UNICEF under
the Ministry of Health in 2054 B.S. (1997 AD). Under this programme, the mobilization
of community health volunteers is done to improve the access to the management of
childhood sickness at the houshold levels. This makes the programme Community Based
Integrated Management of Childhood Illness (CB-IMCI).
222 GREEN Health, Population and Environment Education Book-10
Diseases like diarrhoea, malaria, respiratory diseases, malnutrition, measles, etc. are controlled
and treated which helps to reduce the child death rate. Along with this, they also give proper
councelling services to the mother and the children. They also dsitribute the essential materials
like jeevan jal, zinc tablets, iron tablets, etc. to prevent the common health problems.
Objectives
i. To reduce the death rate of under five years caused due to pneumonia, diarrhoea,
malnutrition, measles, etc.
ii. To help in the overall development of children below five years of age
iii. To change the knowledge and attitude of the family and community in order to
improve child health
iv. To promote the growth and development of children
Functions
i. train the community health workers.
ii. encourage the delivery of babies in the hospitals or the health centres
iii. provide councelling services to the mothers with children under five years
iv. distribute the educational materials related to the information of infections in infants
v. raise awareness among the public to prevent penumonia, diarrhoea, malnutrition,
measles, etc.
iii. Family Planning and Maternal and Child Health
Maternal and child health care has very important
role in maintaining the health status of a community.
But the rapid increment of population, lack of
sufficient investment in the health sectors, etc. have
negative impacts on the health sectors. These days,
the programmes related to the maternal and child
health are launched by different organizations to
promote their health conditions. The programmes
related to maternal and child health care were first Fig: 22
started by Family Planning Association of Nepal.
Later, under the project of family planning and maternal and child health, the health
services are provided. At present, “Department of Family Health” is established in the
central level for such services. Along with this, these days the health posts, sub-health
posts, hospitals, nursing homes, private hospitals, etc. are involved to provide such
services.
Objectives
i. To examine the health of the mother and the baby
ii. To distribute nutritious/balanced diet to the children
GREEN Health, Population and Environment Education Book-10 223
iii. Educate the people about maternal and child health
iv. Provide knowledge about reproductive health
v. To make the family life happy by reducing the family burden
Functions
i. to give counselling about temporary methods of family planning to the concerned
families
ii. to provide family planning services to the couples who don’t want children any more
iii. to help the newly married couples to make their family life happy
iv. to examine the health of both mother and baby
v. to provide prenatal, neonatal and postnatal care
iv. Vitamin A Deficiency and Blindness Control Project
Lack of vitamin ‘A’ in the children below five years
of age is another health problem of Nepal. Due to
lack of vitamin ‘A’ various types of eye problems
are seen in the children. Deficiency of vitamin ‘A’
also affects the physical and mental development
of the children. In order to control the deficiency
of Vitamin ‘A’ , “Vitamin ‘A’ deficiency project”
has been started in Nepal in collaboration with
Nepal government and United Nation Food and Fig: 23
Agriculture Association. Its main objective is
to promote the nutrition level, reduce child death rate and eradicate the problems of
deficiency of vitamin ‘A’ through training and awareness programmes. At present the
Ministry of Health is launching vitamin ‘A’ programme. This programme conducts the
distribution of vitamin ‘A’ to the children below five years twice a year. It also encourages
the victims to take nutritious diet rich in vitamin ‘A’ as well as to get treatment of the
problems immediately.
v. HIV/AIDS Control Programme
HIV/AIDS was seen in 1988 AD for the first time
in Nepal. It is a sexually transmitted disease. It is
chronic as well as fatal disease spreading all over
the world. The number of HIV/AIDS patients are
increasing in Nepal day by day. Though there
is no proper treatment of the disease, different
programmes have been conducted since 1988/89
to control this disease. “National Centre for AIDS
and STD Control” has been established in Nepal to Fig: 24
prevent and control this disease. This organization also launches programmes to raise
awareness among the people to prevent HIV/AIDS.
224 GREEN Health, Population and Environment Education Book-10
Programmes
a. To identify the victims of HIV/AIDS through blood test and give treatment
b. To raise awareness about the sexually transmitted diseases by means of educational
materials
c. To prepare national policy to control the sexually transmitted diseases
d. To launch rehabilitation programmes for the victims of AIDS
e. To launch counselling programmes to promote the use of condom in order to prevent
HIV/AIDS and STDS
vi. Malaria Control Programmes
National Malaria Eradication Program was launched in 1958 AD with the objective of
eradicating malaria from the country. Malaria is a mosquito-borne disease especially seen
in the hot climate. During summer season, due to heat and pollution in the environment,
the disease spreads rapidly. The disease gets transmitted from one person to another by the
bites of infected female Anopheles mosquito. In Nepal, only 10 districts of the Himalayan
region are free from malaria. The malaria control programme is beng conducted in
the remaining 65 districts. Due to severe problem of malaria in the 13 districts of inner
terai, the government has distributed insect-proof nets. This organization launches the
following programmes.
a. Give timely treatment to the victim
b. Spray insectisides inside and outside the house where there are chances of malaria
infection
c. Immunize against malaria
d. Launch awareness programme for the prevention and control of malaria
vii. National Health Education Information and Communication Centre
National Health Education Information and Communication Centre was established in
2051 BS to change the attitude and behaviour of the people by means of health education.
This centre launches programme to promote the heath status of the people. Its aim is to
make the quality health services easily accessible to the people. Its programmes are as
follows:
a. to give counselling on reproductive health, give information on communicable and
non-communicable disease and to formulate and distribute public health programmes
b. to produce awareness programmes related to health and transmit through radio,
F.M., television, etc.
c. to transmit health education by means of magazines, news paper and other media
d. to make the public aware about the communicable and non-communicable diseases
by postering/pamphleting, street dramas, etc
GREEN Health, Population and Environment Education Book-10 225
9.5 Unhygienic Health Habits, the Effects and Preventive Measures
A pattern of behaviours regarded as detrimental to one’s physical or mental health which is
often linked with lack of self control is known as bad/unhealthy habits. It adversely affects
the physical, mental, social, economical and psychological aspects of an individual. It is
similar to chronic disease. The habits of individual are largely responsible for determining
his/her quality of life. For example, the unhealthy habits like smoking cigarette, drinking
alcohol, taking drugs, eating fried food, junk food, excessive amount of fats, salt, etc.
affect our health. Such habits may lead to different types of diseases like heart disdease,
cancer, high blood pressure, high blood cholestrol, etc. So, such habits must be controlled
to live healthy life. Some of the bad habits are discussed below:
a. Unhygienic food habit
The habit of taking the food materials for taste rather than for health is said to be bad food
habit. For example, taking fast food, junk food, fried food, spicy food, etc. Such habits
adversely affect our health.
b. Habit of playing cards
Many people in our society are engaged in playing
cards instead of engaging in any creative activity
during leisure time. Such habits adversely affect
their life and property. We should avoid such habits
and live a happy family life.
Fig: 25
c. Habit of using mobile/internet
These days mobile has become an easy means of
communication. It has made our life easier. Many
people are habituated to use the internet facility
available in the mobile. We can get necessary
information through the social media. But excessive
use of these facilities results in physical and mental
problems.
Fig: 26
d. Sexual habit
Sex is the biological need of human being. It is required to continue the life of human
beings on the earth. But some people have the habits of making multi-sexual partners
and engage in unsafe sexual activities. Such habits may lead to different types of STDs
including HIV/AIDs.
Effects of Bad Habit
a. It causes loss of life and property.
b. It adversely affects the physical, mental and social health of individuals.
c. It causes various infections and sexually transmitted diseases.
d. It spoils the personality and future career.
226 GREEN Health, Population and Environment Education Book-10
e. It affects the active life of the people.
f. It may lead to misunderstanding between husband and wife.
g. It may drive an individual towards criminal activities like theft, robbery, kidnapping,
rape, etc.
Preventive Measures of Bad Health Habits
a. Avoid bad companions
b. Create healthy and recreational environment in the society
c. Limit the use of mobile, internet, television, etc.
d. Parents should be the examples by creating friendly atmosphere at home
e. Provide training to the people to engage in productive activities
f. Engage in creative activities to spend the leisure time
g. Inform the police for legal action against the people having bad habits
h. Create social awareness through health education against any anti-social activity
9.6 Smoking and Narcotic Drugs
Smoking
Use of tobacco and tobacco products is widely done all over the world. It is also very
commonly done in Nepal. Smoking is the use of tobacco and tobacco products by
burning, chewing or sniffing. Cigarette, bidi, tamakhu, khaini, cigar, gutka, pan parag,
zarda etc. are the different forms of tobacco. Use of tobacco and tobacco products is the
cause of different types of diseases like heart attack, heart stroke, high blood pressure,
asthma, cancer, etc. According to WHO, 50 lakhs of people in the world die every year
due to smoking. The smoker have 3 times more chances of heart disease, 1.5 times more
chances of stroke and also COPD than the non-smokers. Tobacco contains about 4000
toxic chemicals including 43 known carcinogens. Carcinogens are the chemicals that
cause cancer. The use of tobacco not only harms the users but also the non users.
Fig: 27
Smoking cigarette Smoking hukka
a. Causes of Smoking
• Pressure the friends
• Imitation of the family members where all the members smoke
GREEN Health, Population and Environment Education Book-10 227
• Fashion symbol of the modern era
• To fulfill curiosity
• Imitation
• Due to frustration
• Social custom and tradition
• For pleasure
• Lack of proper guidance
Fig: 28
b. Effects of Smoking
The effects of smoking are divided into two types which are as follows:
i. Immediate effects
• It irritates respiratory mucus.
• It increases the pulse rate.
• Body temperature decreases.
• Coughing, chest pain, bad breath occur.
• Appetite is reduced.
• Disturbs the brain waves.
• Affects the digestive capacity.
Fig: 29
ii. Chronic effects Throat cancer
• The skin, teeth and fingers become pale due to the effect of nicotene.
• Pulse rate and blood pressure increase
• Damages the optic nerves resulting in blindness
• Cancer of alimentary canal
• Causes of asthma and lungs cancer
• May lead to infertility
• Leads to economic loss
• Can develop heart attack and stroke
• Leads to premature death
Fig: 30
Prevention of Smoking Throat cancer
Smoking has adverse effects on human health. It can cause premature death. So, the
following preventive measures can be adopted to extend the life of people.
• Avoid the companions who smoke
• Provide health education especially about the bad effects of smoking
• Declare public places as smoking free zones
• Ban the advertisements of smoking in the media
• Develop self-discipline to stop the habit
• Involve in some recreational activities to get rid of this habit
• Never let the children purchase any tobacco products
228 GREEN Health, Population and Environment Education Book-10
Alcohol
In our country many ethnic groups use alcohol as
a tradition or culture. It has been in practice since
ancient time. Wine, whisky, beer, chhyang, rum,
etc. are the different forms of alcohol. Alcohol is
a toxic liquor harmful for our body. It contains
the toxic chemical ‘ethanol’ or ‘Ethyl alcohol.’ It
affects the function of brain reducing its functions.
When alcohol is used in a disordered manner, it is Fig: 31
referred to alcoholism. It is a form of alcohol abuse
that involves the inability to manage drinking habits. The use of excess alcohol may cause
accidents and effect our life and property.
a. Reasons for Alcohol Use
• Peer pressure
• Due to the logic that alcohol helps in
digestion of food
• Attraction due to advertisement
• Due to frustration
• Some use it as a beverage that gives
energy Fig: 32
• Some have the tradition to drink
• For recreational purposes when gathered with friends
• To feel relaxed
• To escape from worries/problems
b. Effects of Alcohol
The effects of alcohol depend on the intensity and frequency of its use. Its effects are
classified into two categories.
i. Immediate effects
• Increases pulse rate and heart beat
• Eyes become red
• Decreases of sensation of touch
• Decreases of memory power
• Body becomes imbalanced and passive
• Family and personal relationships are disturbed
Fig: 33
ii. Chronic effects
• Damages liver, lungs, kidneys, etc.
• Causes cancer of alimentary canal
• May lead to infertility
GREEN Health, Population and Environment Education Book-10 229
• High blood pressure leading to heart attack or stroke
• Loss of social perstige
• Economic loss
iii. Preventions of alcohol use
• Avoid bad companions
• Say ‘No’ to drinking alcohol
• Change the tradition of using alcohol
• Educate the people related to the effects of drinking alcohol
• Ban the advertisement of alcoholic products
• Declare the public places “Alcohol free zones”
• Manage rehabilitation services to the drunkards to quit alcohol
• Engage in recreational activities to utilize the leisure time properly
Drugs
Any chemical substance when taken into the body
changes the functions of organs and systems is known
as drug. Some drugs alter the functions positively and
some negatively. According to WHO, drug is defined
as “any chemical entity or mixture of entities, other
that those required for the maintenance of normal
health, the administration of which alters the biological Fig: 34
function and possible structures”.
People take drugs for various purposes. Some use it in the name of culture, some for
worshipping gods and some for fashion. When unspecified drugs are taken excessively,
they harm the user, such an action is known as Drug abuse.
But some people have the habit of taking drugs frequently. When drugs are taken
periodically and chronically, it is called drug addiction. These days, drug addiction has
become a world wide problem. The most common drugs used by the people are opium,
morphine, heroine cocaine, cannabis (hashish or marijuana), etc.
Fig: 35
Opium Morphine Cocaine Cannabis
a. Causes of Drug Addiction
• Lack of knowledge about the impacts of drugs.
• Peer pressure
230 GREEN Health, Population and Environment Education Book-10
• Due to frustration
• To satisfy curiosity
• To feel relaxed
• Personality problem also makes a person use drug
• Some people use drug to worship lord Shiva
b. Effects of Drugs
• Decreases of memory power
• Increase of blood pressure and heart beat
• Use of infected syringe can cause HIV/AIDS
and other STDs
• Impact on reproductive health
• Can cause death if taken for a long time
• Can drag towards social crimes and Fig: 36
misconduct
• Leads to economic problem
• Loss of appetite and weight
• Leads to respiratory diseases like pneumonia, bronchitis, etc.
• Causes sweating, headache, dizziness, etc.
• Some addicts may try to commit suicide
c. Prevention and Control of Drugs
• Avoid the company of drug addicts.
• Launch awareness programmes against the
effects of drugs.
• Engage in games and sports, music, dance
and other recreational activities to utilize the Fig: 37
leisure time properly. NARCONON Nepal
• Enforcement of laws, rules and regulations to control the supply of drugs.
• Treatment and rehabilitation of the addict.
• Create good understanding within the family members.
• Give proper counseling to the people engaged in drug addiction.
Summary
1. Community health is defined as the science of preventing disease, prolonging life and
promoting health and efficiency through organized community effort. It focuses on the
health problems seen in the community rather than that of an individual or a family.
2. Community health is an organized effort of the community people in the
identification of the existing health problems and providing health services to the
people to improve of community people health as well as environmental health.
GREEN Health, Population and Environment Education Book-10 231
3. Malnutrition is the condition in which the body either lacks sufficient amount of
nutrients or intake of maximum amount of nutrients than required for the body.
4. The problems of malnutrition can be controlled or prevented by the development
of agriculture, improving the sources of income, proper distribution of food
materials, giving nutritional education, etc.
5. When the people are timely immunized with different types of vaccines, they can
prevent communicable diseases and live healthy life.
6. The Ministry of Health and Population controls different agencies providing health
services at different levels.
7. The central hospitals provide specified health services to the specific diseases. They
provide the facilities of laboratory, X- ray, surgery (major and minor), etc.
8. Three beds are provided in the primary health centre, one bed for maternal health
services and two beds for emergency services.
9. Nepal Red Cross Society was established on 19 Bhadra 2020 B.S. introducing with
th
the slogan “Where there is sorrow, there is Red Cross.”
10. Paropkar Association is the oldest national voluntary health organization in Nepal.
It was established by a social worker Late Daya Bir Singh Kansakar.
11. In 2022 B.S., Tuberculosis Control Project was started with the joint effort of the
government, WHO and UNICEF to prevent tuberculosis.
12. The death of children below one year of age is known as infant mortality.
13. Intake of the diet rich in carbohydrates, fried food, junk food, drinking alcohol,
chewing tobacco and tobacco products, playing cards, making multiple sexual
partners, etc. are some examples of unhealthy lifestyle.
14. HIV/AIDS was seen in 1988 AD for the first time in Nepal.
15. National Health Education Information and Communication Centre was established
in 2051 BS to change the attitude and behaviour of the people by means of health
education.
16. Pattern of behaviours regarded as detrimental to one’s physical or mental health
which is often linked with lack of self control is known as bad/unhealthy habits.
17. The habits of individual are largely responsible for determining his/her quality of life.
18. Smoking is the use of tobacco and tobacco products by burning, chewing or sniffing.
19. According to WHO, 50 lakhs of people in the world die every year due to smoking.
20. Carcinogens are the chemicals that cause cancer.
21. Alcohol is a toxic liquor harmful for our body. It contains the toxic chemical ‘ethanol’
or ‘Ethyl alcohol.’
22. Any chemical substance when taken into the body changes the functions of organs
and systems is known as drug.
23. According to WHO, drug is defined as “any chemical entity or mixture of entities,
other that those required for the maintenance of normal health, the administration
of which alters the biological function and possible structures”.
24. When unspecified drugs are taken excessively, they harm the users of the society,
such an action is known as Drug abuse.
25. When drugs are taken periodically and chronically, it is called drug addiction.
232 GREEN Health, Population and Environment Education Book-10
Exercise
A. Write very short answer to the following questions.
1. Mention any two major health problems of Nepal.
2. When was immunization programme started in Nepal?
3. How many doctors are there in Nepal according to the record of 2015 AD?
4. What is malnutrition?
5. What are carcinogens?
6. Give the full form of DOTS.
7. What is drug abuse?
8. When was FPAN established?
9. What is preventive health service?
10. How many regional hospitals are there in Nepal?
2. Write short answer to the following questions.
1. What kinds of health services are provided at village level? Describe.
2. Describe briefly about Nepal Heart Foundation.
3. “Poverty is a major health problem of Nepal.” Justify.
4. What is alcoholism? Mention its effects and preventive measures.
5. Describe in brief about the importance of community health.
6. How can you control drug addiction in your society?
7. Write a short note on ‘Health Post’.
8. Describe in brief about Nepal Red Cross Society.
9. Why do we need community health?
10. Describe the areas of community health.
3. Write long answer to the following questions.
1. Define community health and explain about its scopes in brief.
2. Discuss briefly about the available health services in Nepal.
3. Explain the roles of individual and community in solving the health problems of
the community.
4. Define drug addiction. Mention its effects. Also describe how you would prevent
yourself from drug addiction.
5. Discuss about the policies and programmes of health sectors.
6. What is alcoholism? How does alcohol affect the user? Mention its preventive
measures.
7. What are the major health problems in Nepal? Explain any two of them.
GREEN Health, Population and Environment Education Book-10 233
unit Primary Health Care,
10 Precaution and Security
on Risk
Estimated Teaching Periods: 16
Learning Outcomes
Learning Objectives
After completing the study of this unit, students will be able to:
i. introduce first aid.
ii. state objectives and importance of first aid.
iii. explain measure methods of first aid.
iv. describe some common injuries with their first aid.
v. explain the concept of human health and safe lifestyle.
Course Outline
10.1 Methods and Ways of First Aid
10.2 Major Methods of First Aid
10.3 Some Injuries and their first Aid
10.4 Human Health and Safe Lifestyle
Glossary
precaution : something that is done to prevent possible harm or trouble from happening
in the future
security : the stale of being protected or safe from harm
risk : the possibility that something bad or unpleasant (such as an injury or a
loss) will happen
revive : to make (someone or something) strong, healthy or active again
consolation : something, that makes a person feel less sadness, disappointment, etc.
blister : a raised area on the skin that contains clear liquid and that is caused by
injury to the skin
paralysis : a condition in which you are unable to move or feel all or part of your body
234 GREEN Health, Population and Environment Education Book-10
10.1 Methods and Ways of First Aid
Meaning of First Aid
An accident may occur at any time and place to any person. An immediate treatment
is needed to the victim before taking him/her to the hospital. Such immediate care or
treatment is called first aid. Thus, an immediate care or treatment given to the victim or
ill person before taking him/her for medical treatment is called first aid. In this sense, first
aid is the spot care provided to the injured person just after the accident in order to keep
him/her safe until the medical treatment is provided. First aid helps reduce the risk of
further complications in the injured person before getting medical treatment. First aid is
not a medical treatment as such.
Objectives of First Aid
The main objectives of first aid are given below:
a. To prevent the victim from further
complications before getting medical
treatment.
b. To provide care, rest and consolation to
the victim.
c. To take the victim for the medical treatment
safely. Fig: 1
d. To save life of the victim.
e. To reduce physical and mental pain of the victim.
Importance of First Aid
Despite of adoption of various safety measures, accidents can happen suddenly. If an
accident happens, immediate care and treatment is essential to the victim before providing
him/her medical treatment. For this purpose, first aid is necessary. The importance of first
aid are pointed out below.
a. First aid reduces psychological fear as well as physical and mental pain of the victim.
b. It saves victim’s condition from further complications.
c. It helps save victim’s life in some cases.
d. It helps doctor to go for medical treatment of the victim/patient.
e. It helps doctor to know history of the accident and victim.
f. It helps the patient be safe to respond doctor’s inquiry.
g. It develops confidence in the victim.
GREEN Health, Population and Environment Education Book-10 235
Points to be Taken into Consideration While Providing First Aid (By the first aider)
a. First aider must reach accident spot as soon as possible to provide first aid to the
victim.
b. First aider should be quick thinker to decide the type of first aid needed to be provided.
c. First aider should be calm and confident with the proper skill of handling the
situation.
d. First aider should be good decision maker to provide the first aid on the priority
basis.
e. First aider should be resourceful. S/he should have necessary materials required for
first aid.
f. First aider should have good leadership skill required for leading and managing
crowd. Also, it is necessary to console the victim and his/her relatives.
g. First aider should be efficient and skillful in his job. S/he should not have doubt,
hesitation and uncertainity.
h. First aider should have good communication skills to communicate with the victim,
his/her relatives as well with the doctor while providing medical treatment.
i. First aider should have team building capacity to work in team. S/he can take help of
people if necessary.
j. First aider should have ability to work in adverse situation under pressure.
k. First aider should be sympathetic and reassuring with caring attitude towards the
victim.
l. First aider should have the knowledge of his/her limits to go. S/he should not go
beyond his/her knowledge and skill while providing first aid to the victim.
m. First aider should be good manager of the situations. S/he should call for the doctor,
police and ambulance as fast as possible if the case is serious.
n. First aider should inform the victim’s relatives about his/her situation.
First Aid Box
First aid kits are necessary for first aid. These kits
are kept in a box so that it can be taken immediately
for the purpose of first aid. The box in which
various kits/materials required for providing first
aid is called first aid box. Various article/materials
that are kept in the first aid box are listed below:
a. Tape Fig: 2
b. Cotton
c. Bandage of various sizes d. Scissors, knives(small and large)
e. Soap f. Handkerchief
236 GREEN Health, Population and Environment Education Book-10
g. Thermometer h. Sterile dressing pads
i. Safety pins j. Small notebook and pencil
k. Clean thick cloth l. Dettol and tincture
m. Asprin, brufin and paracetamol n. Oral rehydrtation solution (Jeevan jal)
o. Disposable gloves p. Spirit
q. Blade r. Torch light
s. Tweezers
10.2 Major Methods of First Aid
Before providing first aid to the victims, it is necessary to observe the condition of the
casualty and nature of the incidence of accident. Generally, airway, breathing and blood
circulation should be observed carefully and first aid should be provided to the victim on
priority basis. For effective first aid, a first aider should have knowledge of ABC (Airway,
Breathing and Circulation). The first aider who has the knowledge of ABC can only
provide effective first aid to the victim to safeguard victim’s life. The activities that fall
under ABC are introduced below briefly.
i. Opening Airway
The airway or mouth of the victim may be obstructed by external objects. The first aider
needs to observe the condition of airway before providing other first aids. If there is any
obstruction on the airway of the victim, the first aider needs to remove the obstruction to
open airway. During opening the airway, the victim should be laid on his/her back and the
first aider should place his/her one hand on the victim’s forehead placing two fingers from
the other hand on the victim’s chin. The head of the victim is gently tilted back raising the
chin slightly upwards.
ii. Adequate Breathing
After making sure victim’s airway open, the first aider observes the breathing of the victim
by placing his/her cheek near victim’s mouth. The breathing can be looked, listened and
felt for 5-10 seconds. Also, it is necessary to watch the rise and fall of victim’s chest. If there
is problem of sufficient breathing in the victim, artificial respiration is provided to the
victim by keeping the victim/patient in proper position.
iii. Sufficient Blood Circulation
After observing the breathing of the victim, the first aider should check the pulse of the
victim. If there is problem in breathing and the victim has no pulse, the first aider should
compress the chest of the victim with providing him/her artificial respiration. It helps
resume circulation in victim’s body. Thus, external chest compression is essential to regain
obstructed blood circulation in the body of the victim.
GREEN Health, Population and Environment Education Book-10 237
iv. Artificial Respiration
Sometimes natural breathing stops if the victim
becomes unconscious due to accidents. In such a case,
artificial breating (i.e. mouth-to-mouth breathing) is
needed to restore the victims’ breathing. A first aid
provided to the victim to restore breathing, if natural
breathing stops, is called artificial respiration. It is
also called expired air resuscitation. In the cases of
heart attack, electric shock, drowning and poisoning, Fig: 3
artificial respiration safeguards life of casualty before Artificial respiration
getting medical treatment.
Steps of Mouth to mouth Respiration
a. Victim is placed in supine position (lying on back by looking upwards)
b. Airways is opened if any obstruction is there and mouth is cleared properly.
c. The upward position of the victim is maintained. For this purpose, the head of the
victim should be pressed backward by keeping one hand on the victim’s forehead
and other at the chin.
d. Nostrils of the victim are closed with the fingers.
e. Air is blown into the victim’s lungs by placing the first aider’s mouth over the victim’s
mouth.
f. Air is blown once in every 3/4 seconds and after blowing, it is left for a while to let air
come out.
g. This process is continued until the victim regains breathing or medical treatment
becomes available.
h. After regaining breathing, the victim should be kept warm and is carried for medical
treatment as fast as possible.
v. Cardiac Massage
Sometimes heart beat of victim stops due to accidents.
In this condition, victim gets fainted and may die if
immediate treatment is not possible. Thus, the first
aider should make sure that whether heart of the
victim gets stopped. In the case of stopping, heart beat
of the victim, the first aider should provide cardiac
massage along with artificial respiration. It is essential
to provide cardiac massage to the victim within 3/4
minutes of stopping heart beat in order to revive it. Fig: 4
Generally, heart beat stops due to severe accidents,
electric shock, heart attack, etc. Thus, it is essential to provide cardiac massage to the
victim if he is unconscious, pulse is absent and heart beat is stopped.
238 GREEN Health, Population and Environment Education Book-10
The following steps are taken for cardiac massage:
a. The victim is placed on a firm surface in supine position.
b. By kneeling down at the right side of the victim, the first aider should provide gentle
pressure on the sternum for 4/5 minutes. In this case, the first aider should use his
overlapping palms to provide pressure.
c. After each cardiac massage, the victim should be provided with artificial respiration.
d. Cardiac massage is continued until the victim regains heart beat.
Activity: 1
Discuss the points a first aider needs to consider while providing first aid to victim.
Also, present the conclusion of your discussion in your class turn by turn.
10.3 Some injuries and Their First Aid
a. Wound or Cut
An injury which causes in any part of our body
due to a external force or agent is called a wound.
Wound or cut is the damage in the structure of
the underlying tissues or organs. Wounds may
be open or closed. In open wound, external
bleeding is observed due to the broken or cut
in the structure of skin. But in closed wound,
external bleeding is not visible due to the damage
of internal organs without breaking the external
structure of skin. The wounds are ranged from Fig: 5
simple injury of peeling off of skin to deep cut
with serious injury and heavy bleeding. It is necessary to provide proper care to wound.
For this purpose, first aid of the wound is necessary.
First Aid to Wound or Cut
The following ways are adopted for the first aid of the wound.
a. Victim should be seated in comfortable position.
b. Tight clothes around the wound should be removed.
c. Wound is cleaned properly by removing external object from it. But deep rooted
objects should not be removed from the wound forcefully.
d. Bleeding should be stopped if there is external bleeding from the wound.
e. Sufficient amount of liquid materials should be fed to the victim.
f. The victim should be taken for medical treatment as soon as possible.
GREEN Health, Population and Environment Education Book-10 239
b. Burn
The injury in our body parts due to the heat of fire
or any other hot objects is called burn. The objects
that causes burn are heat of fire, heat of electricity,
sunlight, chemical or nuclear radiations, etc.
Similarly, hot vapour of liquid is also cause of
burning and it produces boil in the skin. Initially,
burn affects our skin only, but deep burning
affects blood vessels and nerves including internal Fig: 6
muscles of our body.
Signs and Symptoms of Burn
a. Burnt area becomes red, boils are produced and it becomes wound.
b. The victim feels thirsty.
c. Pulse rate and blood pressure increase.
d. The rate of urination is reduced.
e. Deep burning may cause unconsciousness.
f. Shaking of the body is observed.
g. The victim becomes weak.
Fig: 7
First Aid to Burn
a. At first, the victim is removed from the source of burning. If fire is burning, it should
be extinguished as soon as possible.
b. Fire should be covered with blanket or thick cloth.
c. Ice pack is used to cool down the blister caused by burning if blisters are not broken.
d. The use of random medicines is avoided.
e. The wound is covered with clean cloth.
f. Tight clothes from the body of the victim are removed carefully.
g. The victim is provided with enough liquid to drink.
h. In case of acid burn, wound is cleaned by clean water and lukewarm salt solution is
applied on the wound.
i. The victim is taken for medical treatment as soon as possible.
c. Snake Bite
Snake bite is a sudden and serious situation which requires immediate first aid to
safeguard the life of victim. Some snakes are poisonous and some may not be. But first
aid to the victim is necessary in the case of snake bite whether the snake is poisonous
240 GREEN Health, Population and Environment Education Book-10
or not. There are various kinds of snakes found in our country. The poisonous snakes
like cobra and krait are found in Terai region of Nepal. We need to observe the marks
of snakebite to identify whether the snake is poisonous or not. There are one or two big
marks of teeth in the case of poisonous snakebite. But there are many small marks of teeth
if the snake is not poisonous. The symptoms and first aid of snake bite are given below.
Signs and Symptoms
a. Teeth marks are observed at the area of the snake bite.
b. Change in colour of the skin can be observed.
c. Difficulty in respiration
d. Nausea and vomiting
e. Sweating and flowing of saliva from the mouth
of victim
f. Sweating and pain in the affected area
g. Bleeding from the wound Fig: 8
h. Slackness in muscles
i. No movement of hands and legs
j. Blood can be seen in urine and legs
k. Dimness in eye sight (Blurred vision)
l. The victim becomes unconscious in the further stage
Fig: 9
Marks due to bite of poisonous snake Marks due to bite of non-poisonous snake
First Aid to Snake Bite
a. The victim is kept calm and still in the relaxation position so that the poison does not
spread throughout the body.
b. The victim’s body is kept warm comfortably.
c. The wound is cleaned with clean water by using soap or potassium. The bitten part is
cooled by ice pack.
d. A small cutting below the wound is made in the bitten area with a sterilized blade or
knife to let flow the poison out the blood.
GREEN Health, Population and Environment Education Book-10 241
e. A tourniquet is used just 2-3 inches above the bitten area to stop the flow of the poison
through out the body by circulation. The tourniquet should be loosened in every 20-
30 minutes for 2-3 minutes.
f. Any kind of acid is not used in the snake bitten wound.
g. Enough liquid should be provided to the victim if s/he is conscious.
h. The victim is taken to the hospital or health centre as fast as possible.
i. The snake is taken to the hospital with the victim to identify whether it is poisonous
or not (If possible).
d. Electric Shock
The sudden situation of passing electric current to any
part of body due to expose of it to the current flowing
electric wire is called electric shock. Generally, the
careless use of electric appliances or working with
electric line carelessly results in electric shock. The
electric shock causes heart beat uncontrolled without
the visibility of severe external wound in our body.
In minor cases, it may damage outer skin and
subcutaneous tissues whereas the victim becomes Fig: 10
unconscious and may die on the spot in severe case.
Signs and Symptoms
a. Face and skin of the victim becomes whitish with dryness in facial skin.
b. Difficulty in breathing, stopping respiration
c. Irregular and uncontrolled heart beat
d. The victim may become unconscious with muscle contraction and paralysis.
e. Mark of burn is observed in the affected area.
f. Severe pain in the affected area.
g. Other external wounds in the body can be observed if the victim is thrown with
strong electric shock.
First Aid to Electric Shock
a. Electric current is switched off and the victim is
detached from electricity carefully.
b. If it is not possible to switch off electricity, the
victim should be detached from the electric
wire with the help of non-conductor object by
wearing rubber shoes and glass.
Fig: 11
242 GREEN Health, Population and Environment Education Book-10
c. Artificial respiration should be provided to the victim if he/she is unconscious due to
stoppage of breathing.
d. The victim should be placed in comfortable place and warmed up with covering him/
her by warm cloth.
e. The burn or wound is cured.
f. Liquid is provided to the victim if he/she is conscious.
g. The victim is taken for medical treatment as fast as possible.
e. Frostbite
The cold temperature below freezing point
causes freezing of our skin and underlying
tissues. Frostbite is a situation of our body parts
in which these parts are injured due to their
exposure to temperature below freezing point.
It causes excessive contraction in blood vessels
so that blood circulation is affected adversely
causing injury in our body parts. Our exposed
body parts like hands, fingers, teeth, toes, ears,
nose, etc. are mostly prone to frostbite in freezing
below temperature. The frostbite area becomes Fig: 12
numb due to the death of cells in that area in case
of serious and deep frostbite.
Signs and Symptoms
a. Frostbite area becomes senseless or numb gradually.
b. Initially, the colour of skin in the affected area becomes whitish or grayish-yellow.
Gradually, it becomes brown and bluish-black.
c. Aching pain and numbness at the affected area in the case of surfacial frostbite and
loss of sensation in deep frostbite.
First Aid to Frostbite
a. The victim is kept in a warm room comfortably.
b. Frostbitten area should not be exposed to fire to warm it up. Massage in this place is
also avoided.
c. Frostbite area/organ should be dipped in lukewarm water.
d. Adequate hot liquid food should be provided to the victim.
e. Light physical exercise can be provided to the victim to ease blood circulation.
f. The victim should be carried for medical treatment as soon as possible.
GREEN Health, Population and Environment Education Book-10 243
f. High Altitude Sickness
Atmospheric pressure decreases as we go upwards
from the sea level. In high altitude, our body cannot
get sufficient oxygen necessary for respiration. As a
result, our brain gets adverse effect due to the lack of
adequate oxygen required for breathing. The situation
of our body characterized by nuasea, rapid heart beat,
difficulty in breathing, headache, etc. as we climb up
high altitude is called high altitude sickness. Generally,
high altitude sickness occurs at the place above 8,000 Fig: 13
feet from the sea level.
Signs and Symptoms
a. Fatigue and insomnia with headache, nausea, dizziness and vomitting
b. Difficulty in moving due to lack of neuro-muscular coordination
c. Short breathing with rapid pulse rate and heart beat
d. Fainting followed by severe headache
e. Bleeding from nose in severe condition
First Aid to High Altitude Sickness
a. Climbing up is stopped if someone gets feeling of nausea and dizziness while
climbing high altitude.
b. If the condition of patient gets worsen, lower him/her at least 500 m downward.
c. The patient is consoled and kept confortably for rest.
d. Oxygen is provided to the victim if it is possible.
e. The victim should be provided with hot drink.
f. The patient is taken to the hospital or health centre for treatment in serious case.
g. Heat Stroke
Generally, heat stroke occurs due to exposure of our body to extreme heat in very hot
places for a long time. The condition of body in which the body temperature rises rapidly
without the ability of cooling down due to overheating of body is called heat stroke. Heat
stroke can damage our vital organs like brain, heart, eyes, etc. As a result, the victim may
be unconscious.
Signs and Symptoms
a. Headache, dizziness and vomiting
b. Rapid pulse rate
244 GREEN Health, Population and Environment Education Book-10
c. Body temperature rises more than 105°F.
d. Pain in stomach muscles
e. The victim may be unconscious in severe case.
First Aid to Heat Stroke
a. The victim should be taken in a cool place and exposed to cool water shower.
b. Ice packs or wet towels are placed on the forehead, neck, armpits and groin.
c. The victim is covered with cool damp sheets.
d. The victim should be provided with adequate cool water or non-alcoholic beverages
like cold drinks, fruits juice, etc.
e. The tight and warm clothes are taken off and cool clothes are given to wear.
f. Fresh air is provided to the patient.
g. Cardio-pulmonary resuscitation (CBR) is provided to the victim if he/she looses
consciousness.
h. The victim is rushed to the health institutions for medical treatment as soon as
possible.
h. Drowning
Drowning is a condition of sinking a person in water
bodies like pond, well, stream, river, swimming pool,
etc. In drowning, a person has respiratory impairment
due to difficulty in breathing under the water in water
bodies. The drowned person undergoes suffocation
under the water since he/she cannot breathe and water
enters into his/her nose and mouth. Fig: 14
Signs and Symptoms
a. Difficulty in breathing due to water in wind pipe and lungs.
b. Head tilted back with mouth open and floating face down due to the trouble in
breathing and lack of oxygen to the brain.
c. Foam, water and other foreign bodies are found in nose and mouth.
d. Swollen stomach due to filling of water in wind pipe and lungs.
e. Gasping for air, coughing and chest pain with vomitting sometimes.
f. Lips, fingers and tongue become blue.
g. The victim may be semi-conscious or unconscious
First Aid to Drowning
a. The victim should be taken out of water with the help of long rope, wooden stick or
rubber tube in the absence of trained swimmer.
b. Foreign bodies from nose and mouth should be removed, if any.
GREEN Health, Population and Environment Education Book-10 245
c. Artificial respiration is provided to the victim in case of stoppage of breathing.
d. Wet and tight clothes should be removed from the body of victim.
e. The water filled inside the body of the victim should be brought out through vomitting
by pressing the stomach. In this situation, the victim should be laid on the flat surface
by facing the ground.
f. The victim should be rushed to the hospital or health centre for medical treatment.
i. Choking
The situation of partial or complete blockage of
breathing due to constriction or obstruction in the throat
is called chocking. It happens if the foreign bodies like
bone, coin, marble, etc. obstruct our throat. Sometimes,
chocking may be caused if swallowed food gets, stuck at
the windpipe. In severe case, chocking cuts off oxygen
to the brain due to blockage of air way for breathing.
Fig: 15
Signs and Symptoms
a. The victim starts coughing all of a sudden.
b. The victim cannot swallow food.
c. Difficulty in breathing, suffocation, struggling to breath, noisy breathing.
d. Mouth and lips become blue and red due to blockage of breathing.
e. The victim cannot speak and talk.
f. The victim may loose consciousness in severe case.
First Aid to Choking
a. Foreign body is removed from the throat with finger, if possible to open the blockage.
b. The victim should cough forcefully to open the blockage.
c. A light blow on the back of the patient is given if the foreign body cannot be removed
by other efforts. Also, his/her abdomen should be pressurized by bringing his/her
hands front.
d. The victim should be rushed to the hospital if not cured by the first aid.
j. Poisoning
Poisoning is caused if any poison enters our body
through mouth, nose or injection. A substance that
has adverse effect if it enters into the body is called a
poison. Poison is entered in our body through mouth,
respiration or piercing the skin. Various poisonous
chemicals (solid or liquid) enter our body through
mouth. Various poisonous gases enter our body
Fig: 16
246 GREEN Health, Population and Environment Education Book-10
through respiration. Similarly, various insects, snakes, etc. bite and pierce our body skin
for poisoning.
Signs and Symptoms
Signs and symptoms of poisoning depend on nature of poison, taken amount and medium
of poisoning. In general, following symptoms are seen in case of poisoning.
a. Nausea and vomitting
b. Foam in the mouth
c. Burning sensation in the mouth, nose, throat, stomach, etc. and abdominal pain
d. Restlessness and agitating feeling
e. Slow and disordered breathing
f. Dryness in skin
g. Excessive sweating and salivation
h. Variation in the size of eye ball (i.e dilation of eye pupil) and blurred vision
i. Confusion and unconscious with gaining sometimes consciousness.
First Aid to Poisoning
a. The victim is placed in a comfortable position.
b. If the poison is swallowed, we should try to remove it by asking the victim to vomit.
But vomitting is avoided in case of kerosene, petrol, diesel or acid poisoning.
c. The eyes are flushed with clean water in case of eye poisoning.
d. Adequate water or milk is provided to the victim if he/she is conscious.
e. The victim should be immediately taken to the fresh air area in case of inhaled poison.
f. The victim is rushed to the hospital as soon as possible.
g. If possible, victim’s vomit and the poison containing vessels should be taken to the
hospital to identify the nature of poison taken by the victim.
k. Sprain
An injury to ligament caused by tearing tissues while
twisting our body organs is called sprain. In case of
minor sprain, ligament has a partial tearing. But in
severe case, ligament is completely torn apart. Generally,
sprain occurs in wrists, elbows, knees, ankles, palms,
etc. The joints of these parts get swollen in case of
stretching or breaking ligaments.
Fig: 17
GREEN Health, Population and Environment Education Book-10 247
Sign and Symptoms
a. Pain, swelling and tenderness in the peripheri of sprain.
b. Difficulty in moving affected part.
c. Surrounding area of sprain gets discoloured.
First Aid to Sprain
a. The victim is placed comfortably with calmness. Movement is avoided.
b. The affected area is wrapped with cold bandage.
c. Ice pack is applied in the affected area to reduce swelling.
d. The injured person is rushed to the hospital.
Activity: 2
There may be first aider in your community. Invite him/her in your school and organize
a First Aid Training for the students of your class. Prepare a brief content regarding first
aid in groups on the basis of training and present it in your classroom.
Activity: 3
Prepare a first aid box individually and present it in your class. After presentation, keep
it at your home.
Activity: 4
Discuss the symptoms of snake bite and electric shock with your subject teachers. Also,
discuss the first aid provided to these injuries among your friends.
10.4 Human Health and Safe Lifestyle
Human Health
In general sense, human health refers to the condition of a person having physically fit
without any illness. But WHO focuses on physical, mental and social health for a complete
human health. According to WHO, “Health is a state of complete physical, mental and
social well being and not merely the absence of disease and infirmity. This definition
of human health says that the condition of a person free from illness and infirmity is
not complete human health. Physical fitness, mental soundness, social well being and
spiritual growth are the major components of healthy human life. Physical health
includes proper physical development and fitness. Proper mental development and
healthy thinking is related to mental health. Similarly, social behaviour like friendship,
coordination, cooperation, sympathy, etc. are related to social health. Thus, the totality
of physical, mental, social and spiritual development and soundness is called complete
human health of an individual.
248 GREEN Health, Population and Environment Education Book-10
Requirements of Human Health
Besides various components, balanced diet, healthy environment and physical dynamics
are major requirements of human health. These components of human health are
discussed below:
a. Balanced Diet
There are three types of food. They are energy giving food, body building food and body
protecting food. These food are necessary for our body to provide us energy, building
up body and protecting our body. Similarly, our body needs carbohydrates, vitamins,
protein, minerals, fat and water in proper amount to keep us healthy and fit with proper
physical, mental and emotional development. Balanced diet is necessary for the overall
development of our body. A balanced diet is the food that contains all nutrients in proper
quantity and proportion to keep our body fit in all aspects. Balanced diet is essential to
supply energy for maintaining body cells, tissues and organs for proper growth and
development of our body. Balanced diet helps achieve physical, mental and emotional
health of our body. It also provides energy and creates immunity in our body.
Fig: 18
At home, we can prepare balanced diet by using all nutrients in proper amount and
proportion. Market food and junk food are not much rich in nutrient as balanced diet.
Thus, we should take variety of hygienic home-made foods to achieve all nutrients in
right proportion. Seasonal fruits and vegetables, milk, meat, fish, eggs, beans, etc. are
included in balanced diet. These foods have vital role in providing all required nutrients
to our body.
Importance of Balanced Diet
a. Balanced diet keeps our body well-organized and healthy by providing required
energy to our body.
GREEN Health, Population and Environment Education Book-10 249
b. Balanced diet ensures our proper physical and mental development.
c. It keeps our body active with happiness and glow on our face.
d. It maintains body systems by maintaining the cells tissues and organs of our body.
e. It provides immunity power to our body that helps fight against various diseases.
b. Healthy Environment
Healthy environment is one of the major components of human health. Both natural and
artificial environment should be healthy for healthy environment. Natural environment
is healthy itself, but various human activities pollute natural quality of environment.
Air pollution, water pollution, sound pollution, soil pollution, etc. degrade natural
environment. These pollution are major sources of various diseases that attack human
health. Thus, it is essential to keep surrounding neat and clean to keep our environment
healthy and fit for human health. Air in the environment is the source of oxygen. Oxygen
is necessary for our life. Thus, it is necessary to be fresh oxygen in our surrounding. We
have to maintain greenery in our surrounding to get fresh oxygen for respiration. Similarly,
we have to keep water resources neat and clean to get pure drinking water. Likewise, soil
pollution should be reduced to get healthy food from the soil. Noise pollution should be
reduced for our proper mental health. Moreover, it is necessary to keep air, water, soil,
etc. fresh and pure in our surrounding for healthy environment. Healthy environment
ensures good human health in different aspects.
Importance of Healthy Environment
a. Healthy environment helps maintain physical and mental health of human beings.
b. It helps stop spreading various diseases in environment.
c. It maintains good quality environment required for all living beings for their proper
growth and development.
d. It helps maintain healthy social life of human beings.
e. It prevents natural environment in our surroundings.
f. It helps maintain ecosystem and save biodiversity in our environment.
g. It helps control environmental pollution and environmental degradation.
c. Physical dynamics
Physical dynamics refers to keeping our body physically fit and mentally sound through
physical activities and mental exercises. Different physical activities yoga, asanas,
pranayam, meditation, etc. help keep our body healthy and active. Human health and
physical dynamics are closely related to each other. We can be protected from different
kinds of non-communicable diseases if we are physically dynamic. Physical dynamics
includes physical, mental and social health of an individual. It keeps our body organs
healthy and active, mind sound and alert and social behaviour positive and acceptable.
For physical dynamics, various physical exercises and yoga should be the part of our life.
These activities help us keep away from various diseases like blood pressure, heat attack,
250 GREEN Health, Population and Environment Education Book-10
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