Health and Physical Education Book 7_2077 Editioin

infection in liver and spleen. This disease is known as Kalazar since it causes skin to be dark. Mode of Transfusion M Bites of infected female sand fly M Transfusion of infected blood M Transplantation of infected organ M Use of infected needles or syringes Signs and Symptoms Kalazar infection by Sand Fly M Night sweats and fever M Difficulty in breathing M Enlargement of spleen and liver M Darkening of face and arms M Loss of appetite and fatigue M Weakness and weight loss M Anaemia and Liver pain M Dry and rough skin M Enlargement of lymph nodes Preventive Measures M Public awareness about prevention and control measures M Spray DDT powder in surrounding to kill sand flies M Wear long-sleeved clothes M Use insect repellent on any exposed skin M Use net in the windows M Use bed nets while sleeping M Clear the bushes in surrounding M In the case of infection go to health center as soon as possible h. Malaria Malaria is usually spread in tropical climatic region. In Nepal, this disease is caused by a parasite called Plasmodium falciparum. When an infected female Anopheles species mosquito bites a person, the parasites are released into his/ her bloodstream. Then the parasites begin to infect red blood cells. The incubation period of malaria is about 9 days to 18 days. Mode of Transfusion M Bites of female Anopheles mosquito M Transfusion of infected blood 51

M Transplantation of infected organ M Use of infected needles or syringes Symptoms Anopheles Mosquito M Headache and nausea M Sudden onset of high fever especially in the evening M Shaking chills of the body along with fever M Fever subsides after profuse sweating M Infection in the liver and spleen M Pain in the joints and limbs M Anemia and fatigue Prevention M Avoid the outdoors between dusk and dawn M Use mosquito repellent on exposed body parts M Wear long sleeved shirts and pants M Ensure that windows and door screens are secure M Spray surrounding area with insecticide (DDT) M Use bed mosquito nets while sleeping M Fill the ditches with soil in your surrounding M Make proper management of sewage system M Go for blood test routinely i. HIV and AIDS HIV stands for human immunodeficiency virus. It is also known as Retrovirus. It is a virus that affects a type of white blood cells called- T lymphocytes. Over time, HIV can destroy a large number of WBCs called -T lymphocytes so that the body cannot fight against any kind of infectious disease. This condition is called AIDS. After AIDS the patient dies within 6 months to 2 years due to the attack of opportunistic diseases like pneumonia, cancer, tuberculosis, diarrhoea, etc. AIDS cannot be cured. However, with the Anti-Retro viral drugs available today, s/he can live for many more years. There are different stages of HIV and AIDS which are mentioned below: Window Period The window period refers to the time period it takes for the HIV blood test to give an accurate positive result after the invasion by the virus. The window period to some persons lasts for 3 weeks only and to some persons, this period lasts for 12 months also. 52

HIV/AIDS LADDER S HIV- Infection T Window Period (3-12 months) A HIV Positive G Healthy Carrier Stage E (Some months to many years) S AIDS (Attack by multiple opportunistic diseases like PneumoniaC,aDnciaerrr,heotce.a), Tuberculosis, Different Stages of HIV & AIDS HIV Positive Stage In this period, if the infected person goes through the blood test it gives HIV positive result. This stage may last for as short as 5 years to as long as more than 17 years without showing any symptoms. Hence, this stage is also known as a healthy carrier stage. AIDS Stage Generally, an HIV infected person enters into the AIDS stage after 7-10 years of infection by the virus. If the HIV infected person starts the Anti Retro Viral Drugs just before the AIDS stage he/she can live a normal life for many years. Mode of Transmission M Unsafe sexual contact with HIV infected person M Transfusion of infected blood or blood products M Reusing or sharing of infected needles M Mother-to-child transmission Minor Symptoms M Night sweats and sore throat M Upper respiratory tract infection M Swelling of the lymph nodes in the neck, armpits and groin M Occasional fever M Skin rashes and nail infection M General feeling of tiredness M Persistent cough for more than one month 53

Mosquito bites Sharing cups and Living with a Sexual intercourse plates, knives and forks relative or other member of the household who had AIDS Shaking hands or Having your hair cut Eating and drinking blood productsBlood and Modes of HIV/AIDS transmission: touching people Wearing second-hand Looking after animals Sitting next to someone Sharing of clothes who is infected needles/syringes Sharing a toilet or bathtub Playing with someone Coughing, sneezing or who is infected talking From infected Swimming in a pool or river Having an injection with a new mother to her child or clean needle and syringe Mode of Non-transmission Major Symptoms M Loss of weight for more than ten percent of the body weight M Being tired all the time M Continuous fever for more than one month M Continuous diarrhoea for more than one month M Abnormal discomfort, headache M Attack by opportunistic diseases Preventive Measures M Be away from prostitution M Public awareness about reproductive and sexual health M Do not involve in the unsafe sexual activities M Use sterilized or disposable syringe M Blood should not be used without screening M Proper use of condom can control HIV infection M Avoid body piercing and tattooing 54

j. Syphilis Endofla Gella Outer Membrane Axial Syphilis is a sexually transmitted infection caused by the bacteria called Treponema Filament Pallidum. Its diagnosis is made by using blood tests. This disease can be treated with Cell Membrane antibiotics. The incubation period of this Periplasmic Space disease ranges between 10 to 90 days. Structure of Treponema Pallidum Mode of Transmission M Unprotected sexual contact M Transfusion of contaminated blood M Infected mother to the fetus M Use of contaminated syringes and needles Symptoms Coppery Patches caused by Syphilis Primary stage This stage develops approximately 10 to 90 days after the initial exposure. The primary symptoms are as follows: A painless and non-itchy chancre appears in the genitals in male and on vulva and anal area in female The chancre may disappear after 3 to 6 weeks leaving scars Lymph node enlarges 7 to 10 days after the formation of chancre Secondary Stage Skin Rash by Syphilis Secondary syphilis occurs approximately 4 to 10 weeks after the primary infection. The secondary symptoms are as follows: Weight loss Swelling of joints Fever and sore throat Skin rashes appear in the body Enlargement of liver and lymph glands The above mentioned symptoms usually disappear after three to six weeks. If the treatment is not done in time, the third stage begins after some years later. 55

Third Stage (Tertiary Stage) Tertiary Syphilis may occur between 3 to 15 years after the initial infection and may develop the following health problems: There is formation of tumor like masses and affect skin, bone and liver Blindness, general paralysis and insanity may occur Heart and blood vessels are seriously damaged Preventive Measures M Early diagnosis of the cases M Sexual health education at home, school and community M Unprotected sexual activities must be discouraged M Wash and sterilize clothes and pots before using them M Avoid personal belongings of infected persons k. Gonorrhea Gonorrhoea is also a sexually transmitted disease. It is caused by the bacterium called Neisseria Gonococcus. These bacteria can grow in the cervix, uterus and fallopian tube in women and in urethra in both men and women. These bacteria come out with the pus from the genitals. The incubation period of this disease is between 3 to 9 days. Symptoms M Burning sensation and difficulty in urination Neisseria Gonococcus Bacteria M Burning sensation when urinating M Swelling of vulva in women M Thick greenish yellow or white discharge flows out form the vagina or penis M Red spots appear around the genitals M Bleeding may occur between periods in women M Painful or swollen testicles appear in men M Eyes are affected of the newly born baby M In women, lower abdomen or pelvic pain M Genitals and urethra are swollen Mode of Transmission M Unsafe sexual contact 56

M Sharing clothes and handkerchief used by the patients M Transfusion of contaminated blood M Use of infected needles and syringe M Infected mother to child Eye Infection due to Mother Preventive Measures to Child Transmission M Sexual relation between husband and wife only M Girls’ trafficking and prostitution must be banned M If a husband or wife is infected from it, both of them should be treated in time M The patient’s clothes and other belongings should be washed properly M It is needed to keep the genitals neat and clean M Education on sexual hygiene M Early diagnosis and treatment Activity Make posters by writing causative agent, mode of transmissions, symptoms and preventive measures of various kinds of sexually transmitted diseases then stick them in different places in your school surrounding. Word Meaning Cervix : the narrowed, lower end or neck of the uterus, where it opens into the vagina Chancre : a small hard painless lesion that is the first symptom of syphilis DDT power : a toxic compound (C14H9Cl5) used as an insecticide Incubation period : the period taken by the organism to produce symptoms in the host Ingestion : the process of taking something into the body through the mouth Phlegm : thick, slimy liquid brought up from the throat by coughing Profuse : plentiful; excessive Susceptible host : the proportion of the population who are susceptible to a particular disease T-lymphocyte : a type of lymphocyte that matures in the thymus gland and has an important role in the immune response Transfusion : the transfer of whole blood or blood products from one individual to another 57

RECAP e Disease is a negative condition of the body that causes pain, dysfunction, distress, disabilities and infection in the body and characterized by identifiable signs and symptoms. e The disease, which transmits from an infected person to another person directly or indirectly through various mediums, is called communicable disease. e Air, water, food, soil, dust particles, insects and animals, are the different mediums through which the germs are transmitted from the infected person to a healthy person. e Tetanus is a communicable disease caused by the bacterium called Clostridium tetani which is commonly found in soil, saliva, dust and manure. The incubation period of tetanus may be up to several months, but is usually about 8 days. e Tapeworm infection is caused by Taenia saginatafrom, Taenia solium and Diphyllobothrium latum. Once a larva move inside the digestive tract, it can grow into a large adult tapeworm. e Hookworm is an intestinal parasite of humans. These worms live in the small intestine and lungs. The two main species of hookworm infecting humans are Ancylostoma duodenale and Necator americanus. e Hookworm infection in pregnancy can cause poor growth, premature birth and a low birth weight of the baby. Hookworms in children can cause intellectual and growth problems. e Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. It typically causes sore throat, fever, swollen glands and weakness. If left untreated, it may cause difficulty in breathing, kidney failure, heart failure, paralysis and even death. e Poliomyelitis is a highly infectious disease caused by Polio virus that attacks the nervous system. This disease is transmitted through faeces, nasal mucus, phlegm, contaminated water or food from one person to another. e Pneumonia is an inflammatory condition of the lung affecting primarily alveoli. Typical signs and symptoms include a varying severity and combination of dry cough, chest pain, fever, and trouble breathing, depending on the underlying cause. e Kalazar is a parasitic disease. This parasite lives and multiplies inside the female sand fly. This disease is caused by the bites from infected sand flies. e Malaria is a life-threatening disease which is caused by the bite of an infected Anopheles mosquito. The infected mosquitoes carry the Plasmodium parasite. When this mosquito bites you, the parasite is released into your bloodstream. The incubation period of malaria is 9 days to 18 days. 58

EXERCISE A. Answer the following questions. 1. What is disease? 2. Mention the causative agents of communicable disease. 3. Mention any two symptoms of Tetanus. 4. What is the causative agent of tape worm? Mention any one preventive measure of it. 5. Mention the mode of transmission of Hook Worm. 6. Mention any two symptoms of Diphtheria. 7. What are the modes of transmission of Poliomyelitis? 8. What is the causative agent of Kalazar? Mention any one preventive measure of this disease. 9. Mention the symptoms of Malaria. 10. What is HIV and AIDS? 11. What is the causative agent of Syphilis? Mention its second stage symptoms. 12. What is Gonorrhea? Mention any two symptoms of it. B. Choose correct option from the bracket. 1. Causative agent of infectious disease denotes............................(pathogens/ environment/reservoir). 2. ............................carries the pathogens of Kalazar (Mosquito/Sand fly/ House flies). 3. Incubation period of Gonorrhea lasts................(2-7 days/3-9 days/9-11 days). 4. Bite of Anopheles mosquito causes.......................(Malaria/Kalazar/Sarcoma). 5. Antiretroviral Drugs are provided to the HIV infected persons just before the ............................(AIDS/Healthy career stage/window period). C. Write short notes on: a. Incubation period b. Healthy carrier stage c. Kalazar Community Work Visit any one sub- health post, health post or a primary health center of your community and collect the data of patients infected by communicable diseases in past six months. Then show the distribution pattern of patients by specific communicable diseases in a pie chart and discuss in your class. 59

5Unit Adolescence, Sexual and Reproductive Health Learning Achievement After completing this unit, students will be able to: [ Define adolescence and tell its stages. [ Explain about sexual orientation. [ Classify people according to sexual identity. [ Tell need of reproductive health education. [ Explain infection in the reproductive tract. [ Describe the sperm production process, wet dream, ovulation, menstruation and conception. A. Definition and Stages of Adolescence Adolescence is the period between childhood and adulthood. According to WHO, “adolescence is the age between 10 to 19 years”. It is called a transitional period of life since rapid change in physical, social, mental, emotional and spiritual aspects take place during this period. Therefore, this period of life is also called as the period of storm and stress. Adolescence is the period in which the onset of sexual maturity occurs and the reproductive organs become functional. This can be observed in both sexes by the appearance of secondary sexual characteristics like; deepening of voice and wet dream in boys and growth of breasts and start of menstruation in girls. During this period, physical, psychological and social changes are taking place. These changes occur due to the secretion of sex hormones. Adolescence period can be classified into three stages such as: i. Early adolescence stage (age between 10 to 13 years) ii. Middle adolescence stage (age between 14 to 16 years) iii. Late adolescence stage (age between 17 to 19 years) Adolescents perform the following characteristics: Ü developing positive or negative perception about his/her physical changes Ü becoming more sentimental and show independent behaviour Ü paying interest in social activities 60

Ü becoming more conscious about the positive and negative implication of social norms, values and beliefs Ü shaping personality similar to adulthood Ü searching for self-dignity and identity Ü showing adult’s personality and choices Ü developing the feelings about future plan Ü enjoying in abstract thoughts which may not be possible in real life Ü showing aggressive and often over ambitious attitude Ü performing experimental behaviour for new thing B. Sexual Orientation Sexual orientation is the pattern of emotional and sexual attraction of a person. It differs from person to person. Different factors like culture, religion, race, socio- economic condition, physical state and sexual identity affect sexual orientation of the people. Expression of sexual orientation depends upon sexual identity. Sexual behaviour performed by an individual is called sexual identity. According to sexual identity, people can be classified into three categories such as: e Heterosexual: People who are attracted to members of the opposite sex (for example, women who are attracted to men or men who are attracted to women) are called heterosexual. e Homosexual: People who are attracted to members of the same sex are often called homosexual. Female homosexuals are called lesbian and male homosexuals are called gay. e Bisexual: People who are attracted to both men and women are called bisexual. C. Need of Reproductive Health Education Ü Reproductive Health Education helps to clarify misconception regarding sexual and reproductive health. Ü It provides correct information about human sexuality and helps to promote sexual hygiene. Ü It helps to understand the role of family and community for shaping healthy and respectful sexual behaviour. Ü It helps to protect adolescents from the infection of STIs, including HIV and AIDS. Ü It helps to avoid high risk sexual and reproductive behaviour. Ü It teaches various life skills related to sexuality. Ü It helps adolescents to demonstrate responsible and safe sexual and reproductive behaviour. 61

Ü It encourages adolescents to consult appropriate health personnel to get service on sexual health. Ü It helps to satisfy the queries about sex and sexuality of the adolescents and growing children. Ü It helps to solve the complications related to sexuality and reproduction such as unwanted pregnancy, early pregnancy, abortion, etc. Ü It helps people for effective use of contraceptive devices. Activity Divide your class into different groups. Ask each group to write likes and dislikes of the adolescents in a piece of paper then tell them to share their opinion about the adolescent’s likes and dislikes they have expressed in class. D. Sperm Formation Process Sperms are the male gametes. They are formed in the testicles within tiny muscular tubes called seminiferous tubules. This sperm production process is called spermatogenesis. There are cells called spermatogonia on the wall of seminiferous tubules. These spermatogonia cells develop into spermatocytes. Spermatocytes gradually develop into spermatids. These spermatids are finally developed into sperms. When sperms are forming in the testicles through the meiosis process, seminal vesicles are producing semen side by side. Usually, it takes about 72 days to develop an initial cell called spermatogonia into a mature sperm. Epididymis Testis Coiled seminiferous Meiosis I Meiosis II tubules Vas deferens Spermatocyte (diploid) Spermatids Sperm cells (haploid) (haploid) Cross-section of seminiferous tubule Sperm Formation Process E. Wet dream There is continuous secretion of semen in the testes when boys enter into adolescence. When the semen is stored for long period in the seminal vesicles, those sperms are released and spilled over outside via the penis during the time 62

of sleep. Indeed, the ejaculation of semen during nightmare or sleep is called wet dream. It is a natural process, so it is not to be worried about wet dream. F. Ovulation The release of ovum from the follicle is called ovulation. It occurs generally about 14 days after the menstrual flow. After ovulation, the ovum leaves ovary and moves towards the fallopian tube. Usually, ova can survive for 24 hours after ovulation. We know that ovulation is necessary for fertilization. 1 12 13 14 15 16 17 185 26 27 28 1 2M3en4st ruat5ion6 7 8 9 10 119 20 21 22 23 24 2 OVULATION Ovulation G. Menstruation 29 30 P M2Pens3trPua4tiPon Ph 1 The discharge of blood, uterine mucus membrane 28 4-6 days aseP and dead endometrial cells from the uterus throughout 14 days 27 5 phase) P 6 25 26 the vagina for 4- 6 days every 7 month is called menstruation. Phase (Iuteal Menstrual Cycle Prolo Fertile Menstruation for the first time of 30 days is called menarche whereas 22 23 24 8 9 10 the last menstruation is called Secretory days 10 Phase menopause. Mense cycle is 0 21 11 12 observed among the females 2 19 phase) (foli from the age of 11-12 years 18 17 16 15 13 14 cular till 45-50 years. Pituitary gland plays important role Ovulation Occurs P= Menstrual Period in menstruation cycle. The menstruation cycle completes in the following three phases. 63

Proliferative Phase (about 10 days) In this phase, pituitary gland secretes follicle stimulating hormone (FSH) then it stimulates follicles in ovary. The growing follicle then produces Oestrogen hormone. Due to the Oestrogen hormone endometrial layer of the uterus becomes thicker. This phase ends after the ovulation. Secretary Phase (about 14 days) In this phase, pituitary gland secrets luteinizing hormone (LH). LH produces corpus luteum in the empty follicle that is left by the ovum after ovulation. Then corpus luteum produces Progesterone hormone. With the help of Progesterone hormone, the endometrium secretes watery mucus. If fertilization does not take place, eventually ovum dies then secretion of Progesterone hormone and watery mucus stops. The Menstrual Phase (4 to 6 days) When ovum is not fertilized, the secretion of progesterone hormone from the ovary is reduced. Then the endometrial layer of the uterus breaks down and menstrual bleeding occurs for 4 to 6 days. Activity Draw a diagram of a complete menstruation cycle and show the different phases of it. Then show it to your friends and discuss in class. H. Fertilization and Conception Conception is the stage just before pregnancy after fertilization. In which a fertilized zygote moves towards the uterine wall and reaches it for embedment by taking six to eight days. Normally, the conception process is completed in six days. When conception period ends then pregnancy period begins. Day 1: Fertilization Zygote Egg Blastocyst Ovary Day 5-9: Blastocyst Implants 64 Conception

I. Reproductive Tract Infection and its Preventive Measures A large number of adolescents are suffering from reproductive tract infections (RTIs) in the world. Most of the reproductive tract infections occur due to our carelessness and unsafe sexual behaviour. Every year, RTIs have been observed among 340 million people around the world. A large number of people are suffering from RTIs due to the lack of proper hygiene and cleanliness of the genitals. Mostly, women are more vulnerable to such infections due to infected sex partners. Moreover, this infection also occurs due to unhygienic sexual intercourse and lack of cleanliness of reproductive organs. If we do not pay attention in this matter, there is high chance of sterility, cervical cancer, prostate cancer, etc. In some conditions, it may become fatal also. Therefore, people should be given proper education and information to prevent these diseases. Reproductive health education could be the best instrument to educate and aware the people of these problems. The following measures can be adopted to mitigate reproductive tract infections: i. Create awareness about the STIs and reproductive tract infections (i.e. infertility, miscarriage, pelvic inflammatory diseases, prostate cancer, cervical cancer, gonorrhea, syphilis, HIV and AIDS, etc) and their consequences. ii. Promote the strength and quality of those institutions which provide health services to control RTIs and STIs. iii. Conduct special programmes that are related to prevention from RTIs and STIs by identifying the risk groups and individuals. iv. Conduct awareness campaign on effective use of condom and control unsafe sexual behaviour. v. Provide information to females about the need of proper cleanliness and hygiene of the genitals to prevent RTIs. vi. Educate people about the preventive measures of RTIs and STIs and disseminate information about the symptoms of RTIs and STIs. vii. Give focus on complete treatment of RTIs and STIs of both sexual partners. Word Meaning Abstract thought : thinking that is coherent, consistent, orderly and logical Queries : questions, inquiries Semen : the thick whitish fluid containing spermatozoa that is ejaculated by the male genital Spermatids : immature gamete that develops into a spermatozoa Vulnerable : unprotected against attack; liable to be hurt or damaged 65

RECAP e According to WHO, “adolescence is the age between 10 to 19 years”. It is called a transitional period of life since rapid change in physical, social, mental, emotional and spiritual aspects takes place during this period. e Adolescence can be observed by the appearance of secondary sexual characteristics like deepening of voice and wet dream in boys and growth of breasts and start of menstruation in girls. e Sexual orientation is the pattern of emotional and sexual attraction of a person to the other person. e Different factors like culture, religion, race, socio-economic condition, physical state and sexual identity affect sexual orientation of the people. e Sexual behaviour and relation performed by an individual is called sexual identity. e The sperm production process is called spermatogenesis. Usually, it takes about 72 days to develop an initial cell called spermatogonia into a mature sperm. EXERCISE A. Answer the following questions. 1. What is adolescence? 2. Mention the different stages of adolescence period. 3. List down any two characteristics performed by adolescents. 4. Write a difference between homosexual and bisexual orientation. 5. Why people need reproductive health education? Give any two reasons. 6. Where does seminiferous tubule lie? 7. What is menstruation? Mention its phases. 8. What is conception? B. Choose correct option from the bracket. 1. Infection in the..................................is called pelvic inflammatory disease. (Spleen/Oviduct/Kidney) 2. ..........................causes syphilis (Gonoccus/Spirochhet/Treponema pallidum). 3. Meiosis cell division is related to.............................(Sperm formation/tissue formation/organ formation) 4. FSH contributes for the secretion of............................hormone. (Luteinizing/ Oestrogen/Progesterone) 5. Seminiferous tubules are found in the.............................(Prostate gland/ Seminal vesicle/Testis) Community Work Invite the people of your locality especially women at your school in a holiday and educate them through a health professional about the role and practice of personal hygiene during menstruation and its impact on reproductive health. 66

6Unit Drugs, Smoking and Alcoholism Learning Achievement After completing this unit, students will be able to: [ Introduce alcoholism, drug abuse and smoking. [ Tell reasons, effects and control measures of alcoholism. [ Tell reasons, effects and control measures of smoking. [ Tell reasons, effects and control measures of drug abuse. A. Introduction to Alcoholism An ethanol containing drink is called alcoholic beverage. Vodka, gin, whiskey, brandy, wine, beer etc are the examples of alcoholic liquors. In the context of Nepal along with the alcoholic liquors local alcohol like jad, raksi, chhyang, Aaila, nigar and tongba are also commonly available in the market. Alcohol is legally consumed in most of the countries around the world. So, its selling and drinking is not an illegal practice in most of the society. Alcohol consumption is injurious to our health. Reasons of Alcoholism The reasons for drinking alcohol may differ from person to person and culture to culture. However, some reasons are listed as follows: e Due to the assumption of reducing tension. e In the name of get together with friends as a recreational purpose. e Some use alcohol under the pressure of his friend circle. e Due to lack of proper guidance. e Broken environment at home. e In some ethnic communities, alcohol is used in social rites and rituals. e Young people start due to curiosity towards its taste and drinking. 67

Immediate Effects e Alcohol acts as both a ‘stimulant’ and a ‘depressant’. e Decrease in thinking capacity. e Results in uncontrolled activities. e Body becomes imbalance and passive. e Family life and personal relationship are disturbed. e It reduces the eye muscle’s ability and causes poor focus, double vision and reduction in night vision. e Impairs memory and judgment. Long-term Effects e Long tome alcoholism causes peptic ulcers, cirrhosis, pancreatitis, gastritis and heart disease. e The gastrointestinal tract is usually affected and digestion becomes worse. e The liver is the principal engine, adversely affected by alcohol. e Alcoholism leads to infertility. e It adversely affects the social prestige of the individual. e Increases the risk of heart failure and stroke. Esophagus Esophageal ulcer Stomach Small Gastric ulcer intestine Duodenal ulcer Alcoholic Cirrhosis Gastric and Duodenal Ulcer Way to Control and be Away from Alcoholism e Avoid the company of alcoholic persons e If there is a culture to drink alcohol, it must gradually be reduced e Drinking alcohol should be prohibited in public places e Health education to aware the adverse effects of alcohol e Advertisement of alcohol must be banned e Increment in the alcohol taxation Activity Collage the pictures related to consequences of consumption of tobacco products in a chart paper and show it in your class. 68

B. Introduction to Drugs A drug is a substance which may have medicinal and intoxicating performance and is not considered as food. According to WHO, “A drug is any substance that when taken into the living organism may modify one or more of its functions.” The misuse of drugs repeatedly other than the medical purpose is called drug abuse. If drugs are abused, they can severely damage health and well-being. Classification of Narcotic Drugs Uppers (Stimulants) Downers (Depressants) Hallucinogens Benzedrine, Dexedrine, Sleeping Pills, Heroin, LSD, Phencyclidine, Methedrine, etc. Codeine, etc. Mescaline, etc. Methedrine Heroin Phencyclidine While talking about the narcotic drugs, some of them stimulate the body, some of them are depressant and some of them cause hallucination. Cocaine, brown sugar, heroine, opium and hasis are some examples of narcotic drugs. Such drugs can cause severe psycho-social and physical health problem. They can damage the brain, heart, and other vital organs. Cocaine, for Instance, can cause heart attack. While using drugs, people are unable to do well in school, sports, and other activities. Reasons for Drug Abuse e Drugs are taken to forget discomfort and frustration of life. e The addicted friends usually influence their friends to this habit. e Drift towards western culture, sense of pseudo freedom and unmanaged urbanization. e Personality problem also makes a person more prone to drug addiction. e The smugglers trap the persons in drug abuse. e Imitating elders and celebrities. Effects of Drug Addiction e Memory power becomes weak 69

e Looking intoxicated all the time e Increase in heart beat and blood pressure e Loss of appetite and the body becomes exhausted e Social reputation of an individual gets degraded e Sharing of unsterilized syringe may cause STIs like AIDS, Hepatitis ‘B’ and ‘C’ e Reduction in reproductive performance e Increase in social disorder and criminal activities e Immunity power weakens Way to Control and be Away from Drug Addiction e Awareness campaign to the people about the harmful effects of drug addiction through community participation. e There must be effective control mechanism against smuggling of narcotic drugs in the society. e There should be management of sports and other recreational programmes so that in leisure time, young people will involve themselves in such activities. e There should be discussion on the adverse effects of drug addiction among family members and neighbours. e There must be a good relationship among the family members. e Laws against smuggling of narcotic drugs must be implemented strictly. e Encouraging the child to believe in himself. e Advising addicts to seek treatment Awareness Campaign Against from hospitals and counseling Drug Addiction from rehabilitation centers. Activity Organize a talk programme in your school about the causes of drug addiction and its consequences and control measure by inviting experts or activists from drugs rehab center, police personnel and counselors. C. Introduction to Smoking Tobacco smoking directly affects the lungs, heart and brain. In addition to the risk of heart disease, smoking increases the risk of chronic bronchitis, respiratory disorders, retarded fetal development and so on. The tobacco smoke includes 70

vaporized chemicals, gases, particles of tar, nicotine and hundreds of cancer causing substances. All these are harmful substances to health. Among them, carcinogens cause cancer and other fatal diseases too. Reasons of Start of Smoking It is found that smokers fall sub consciously in a habit by imitating the smokers in the society. The smokers give different answers if they are asked the reason of smoking. People start smoking due to multiple physiological, psychological and social factors. However, the main causes for smoking are listed below: e Sometimes as a matter of entertainment and fun and under the pressure of their bad company. e If all senior members at home have the habit of smoking, the children also imitate such habit. e Some people begin to smoke by the influence of smokers in their society and working places. e Some people start smoking for a status symbol. e Children being curious about its taste start smoking. e Some young persons begin to smoke as a fashion. e Many others imitate smoking under the impression of various advertisements. They fall under the false impression that smoking increases their thinking power and it also stops their worries and anxieties. Immediate Effects e Coughing is often the result of smoking 71

e Smoking causes headache, vomiting and stomach pain e Bad breathing e Giddiness and nausea e It causes heart beating faster Long-term Effects e Teeth, skin and fingers become pale because of the direct effect of nicotine e Nicotine is stored in different sensitive organs of our body e Heart beating becomes faster, blood- pressure increases and often the smoker feels irritated e Wounds may appear in the gums and Non-Smoker’s Lung Smoker’s Lung in the mouth e There is a possibility of heart attack and lungs-cancer e Women may become sterile due to smoking e Pregnant women are much affected. Sometimes incidence of miscarriage and still birth may happen as a direct effect of smoking Way to Control and be Away from Smoking e Avoid the company of bad friends and smokers. e Family members must be aware about the bad effects of smoking. e Efforts should be made to declare certain areas as smoke prohibited areas. e At present, Government of Nepal has banned the advertisement of smoking and other intoxicating things from radio, T.V. and other electronic means. The advertisement of smoking from other sources too should be restricted. e Parents should practise healthy habits. If they have smoking habit it should not be in front of the children. e Increment in the tax of tobacco. e Youngsters should be encouraged for other recreational activities. 72

Activity Organize a speech competition programme in your class on the occasion of the world no tobacco day. Word Meaning Alcoholic cirrhosis : inflammation of the liver caused by severe alcoholism which tissue can build up and interfere with the liver’s functioning Carcinogens : cancer-causing substances or agents Depressant : a drug that reduces excitability and calms a person Distilled alcohol : alcohol extracted by the process of distillation Exhausted : extremely wearied or tired Fermented alcohol : alcohol; processed by anaerobic breakdown of sugar into alcohol Gastritis : inflammation of the stomach wall. It can be caused by an excess of Liquor hydrochloric acid and can lead to gastric ulcers : distilled alcohol Pancreatitis : inflammation of the pancreas, caused by alcohol or a viral infection Peptic ulcer : ulcer at the mucous membrane of the lower esophagus, stomach, or duodenum, caused by the corrosive action of the gastric juice Stimulant : a drug or other agents which stimulate the function of nervous system RECAP e An ethanol containing drink is called alcoholic beverage. Vodka, gin, whiskey, brandy, wine, beer, etc are the examples of alcoholic liquors. e In the context of Nepal along with the liquors local alcohol like jad, raksi, chhyang, Aaila, nigar and tongba are also commonly available. e Alcohol is legally consumed in most of the countries around the world. e According to WHO, “A drug is any substance that when taken into the living organism may modify one or more of its functions.” e Cocaine, brown sugar, heroine, opium and hasis are some examples of narcotic drugs. Such drugs can cause severe psycho-social and physical health problem. For instance, narcotic drugs can damage the brain, heart, and other vital organs. e Tobacco smoking directly affects the lungs, heart and brain. In addition, smoking also increases the risk of chronic bronchitis, respiratory disorders, retarded fetal development and so on. e The smoke includes vaporized chemicals, gases, particles of tar, nicotine and hundreds of cancer causing substances. Among them, carcinogens substances cause cancer. 73

EXERCISE A. Answer the following questions. 1. What is alcoholism? 2. Mention any two reasons of start of alcoholism. 3. Mention any two long term effects of alcoholism. 4. What is drug abuse? 5. Mention any two effects of narcotic drugs. 6. What is smoking? 7. What substances are found in tobacco smoke? 8. Mention any two long term effect of smoking. 9. How can you keep yourself away from smoking? B. Write True or False to the following statements: 1. Smoking causes miscarriage in the pregnant woman. 2. The drugs like Codein, Methedrine and Dexedrine are the examples of narcotic drugs. 3. Cirrhosis is a disease of lungs. 4. Youngsters start smoking in proper parental guidance. 5. Alcohol is a recreational drugs. Community Work Visit a chain smoking person in your community. Ask him how did he start smoking and what are the problems he is facing now because of smoking? Does he want to quit or not? Then write a small report and present it in your class and discuss. 74

7Unit Environmental Health Learning Achievement After completing this unit, students will be able to: [ Introduce environmental health. [ Tell impact of polluted water on health. [ Explain the classification of wastes. [ Explain the management methods of wastes. [ Introduce latrine and tell about the use of appropriate latrine. Introduction to Environment Health Environmental health is an important aspect of human life. The relation between environment and health is known as environmental health. The environmental health includes the activities like conservation, management and proper utilization of environmental components around us. The environment around us should be healthy from health perspective. The air, water, soil, forest, river, grassland, mountains, road, culture, social system, plants, animals and so on come under the components of environment. We need to utilize them wisely so that we can have a safe and healthy environment to live. 75

According to WHO ‘environmental health refers to those aspects of human health that are determined by the factors in the environment’. The goal of environmental health is to control possible negative impact and maintain healthy environment for healthy and productive life. Scope of environmental health is as follows: Ü Personal hygiene Ü Proper housing Ü Kitchen hygiene Ü Provision of safe drinking water Ü Protection from insects and rodents Ü Proper disposal of waste materials, sewage and human excreta, etc. a. Impact of Polluted Water on Health e The diseases borne by polluted water like typhoid, hepatitis, diarrhoea, dysentery, cholera, etc may spread as epidemic in the community e Causes direct effect on health due to the prevalence of skin and eye infection e People become unhealthy due to cooking, drinking and bathing with dirty water e There will be adverse impact even in social, industrial and agricultural sectors also Diarrhoea Typhoid Jaundice b. Impact of Dehydration on Health Water constitutes about two-thirds of the human body. Water plays various functions in our body such as lubricating joints and eyes, keeping skin healthy by eliminating toxins; facilitating blood circulation and proper digestion. Dehydration occurs when the body has insufficient water and other fluids to function properly. In fact, the loss of too much water in our body is called dehydration. In dehydration, more water is moving out from our body than what we take in through drinking. Dehydration shows the symptoms like increased thirst, 76

dry mouth, tiredness, sleepiness, decreased urine output, headache, dry skin, dizziness, rapid heartbeat, etc. Mild dehydration can easily be treated but if it reaches extreme level it can be life- threatening and requires immediate medical care. Chronic dehydration may affect kidney, liver and joints. It also causes constipation and muscle damage. c. Solid Waste The term ‘solid waste’ refers to the low Drinking plenty of water to liquid content waste materials. The useless keep away Dehydration materials like weeds, rotten fruits, vegetable residue, leftover food, dead animals, dung, torn out plastics, pieces of metals, broken glasses and useless wrapping papers are the examples of solid wastes. Solid wastes can be classified into organic and inorganic wastes. They are illustrated by the diagram that is given below: Classification of Solid Wastages Organic Inorganic Discarded or Wastages Wastages Disposable Wastages Vegetable Residue Broken Glasses Disposed Mineral Water Bottles Rotten Fruits Torn out Polythene bags Film Reels Left Over Food Broken Plastic Utensils Weeds Discarded Gifts Wrappers Sludge Metal Pieces Broken Ceramics Paddy Husk Damaged Computer Parts Dead Animals Damaged Parts of Vehicles Discarded Laminated Papers Biscuits & Chocolate Wrappers i. Decomposable Wastes (Organic Wastes) 77 All the biodegradable solid wastes are known as organic solid wastes. Agricultural residues, weeds, rotten fruits, vegetable residue, leftover food, dead animals, dung, etc are the examples of organic solid wastes. This kind of solid wastes occupies (70 to 80 %) of the total quantity of solid wastes in our localities. These wastes can be used for making compost manure.

ii. Indecomposable Wastes (Inorganic Wastes) All the non-biodegradable wastes which do not contain carbon compound are called inorganic solid wastes. Torn out plastics, Pieces of metals, broken glasses; useless wrapping papers, etc are the examples of inorganic solid wastes. This kind of solid wastes occupies about (20-25%) of the total volume of generated solid wastages. Activity Keep different bins for the collection of organic and inorganic waste in your school. Make different useful materials from the recyclable waste products under the guidance and supervision of your teacher and demonstrate in class. d. Management of Solid Waste Waste should be managed at the place from where it generates. More wastes are produced in the city areas because of dense population than rural areas. Hence, proper management of waste is essential to save the environment of those localities. The proper management of solid wastes carries different steps from collection of wastes generated from different sources to composting and disposal of those waste materials in a safe manner. Solid waste management carries various activities that are mentioned below: i. Composting Composting is the preparation of compost manure by using biodegradable waste materials like animal dung, plant residue, grasses, sludge, weeds, etc. In composting process, aerobic or anaerobic bacteria decompose the waste materials and after 4-6 months those wastes get converted into compost manure. Pits of different size can be made for composting, according to the quantity of waste materials. 78

ii. Burying In this method, a pit of 4-6 feet diameter and about 2 meters depth is dug for dumping purpose. The pit size depends on the quantity of the wastage. After making a pit, wastage is dumped everyday and it is topped with a thin layer of soil. When the pit is filled up, it is covered with thick layer of the soil. iii. Dumping Unmanaged disposal of solid wastes has created serious environmental problems especially in the urban localities. Scientific way of dumping helps to promote environmental sanitation. It is good to dump wastes into the sanitary landfill. It is the scientifically prepared trench which covers a larger area for dumping of solid wastes. vi. Burning (Incineration) Some wastes are very infectious and hazardous to human health. The wastages like used syringes, gloves, needles, etc are the examples of hazardous wastes. These wastes have to be burnt in the device called incinerator plant. The sensitive wastes are burnt at the temperature of 600°C to 800°C in the incinerator plant. Dumping of Waste at Landfill Burning of Waste at Incinerator e. 3‘R’ Principles of Solid Waste Management i. Reuse Reused refers to the frequent use of articles time and again in the same state without bringing any changes in their physical and chemical properties. It helps to save our resources and helps in management of solid wastes side by side. Reuse of Plastic Bottles 79

ii. Recycle Paper Recycling Process in Recycling Factory Recycle refers to the reuse of articles after recycling process. The used papers, torn out plastics, discarded iron pieces, polythene; broken metal utensils, etc can be recycled. It helps to control the overuse of raw materials in one hand and makes the cost of the material cheaper in other hand. iii. Reduction This principle gives emphasis on less use of things and generating less quantity of wastes. If usage of raw materials is reduced, the generation of waste also gets reduced. For this, we can develop our habits like using jute and paper bags while buying goods from the market to replace polythene bags, by not cooking more food than our requirement. Similarly, we can buy milk from the dairy in our own pot or utensils rather than using polythene. These are the examples of reduction principle. If majority people follow this principle, we can preserve the natural resources and control environmental pollution. The reduction measures can be summarized in the following points: M Using jute/ fabric bag while going to the market for shopping. M By not cooking food more than our requirement. M Reusing and recycling the inorganic wastages. M Making compost from the organic wastages. M Using our own pots/utensils while buying milk and milk products from dairies. e. Latrine The place especially made for the purpose of defecation and urination is called latrine. A proper use of latrine plays a significant role in keeping the environment healthy. It helps us to keep away from various kinds of faecal borne diseases. In rural areas, a latrine is found to be constructed outside the house but in the cities it is constructed inside the house. 80

Use of Appropriate Type of Latrine There are different types of latrines in rural and city areas. According to the place, economic condition and supply of water, appropriate type of the latrine can be constructed. In rural areas we can see simple pit or improved latrine whereas water seal latrines are used in the urban area. Water seal latrine is better since it prevents from foul smell and house fly due to the provision of water seal at the pan or commode. Latrine should be friendly to the disable persons. Latrine should be cleaned with water supply before and after use. We should make sure that mouse and other insects cannot go inside the latrine. There should be provision of soap, towel and brush in the toilet for the cleaning purpose. Impact of Open Defecation M Spreads foul smell M Pollutes soil, water sources, and air M High prevalence of the diseases like diarrhoea, dysentery, typhoid, round worm, cholera, etc. M High chance of transmission of the diseases from one person to another person Activity Conduct awareness campaign against open defecation in your locality if any such tendency prevails there, by forming children club. Word Meaning Residue : what remains after a part has been used or left over Sludge : an offensively dirty substance such as mud, mire, or ooze; 81

RECAP e According to WHO ‘environmental health refers to those aspects of human health that are determined by the factors in the environment’. e The goal of environmental health is to control possible negative impact and maintain healthy environment for healthy and productive life. e Dehydration occurs when the body has insufficient water and other fluids to function properly. In fact, the loss of too much water in our body is called dehydration. e Agricultural residues, weeds, rotten fruits, vegetable residue, leftover food, dead animals, dung, etc are the examples of organic solid wastes. e All the non-biodegradable wastes which do not contain carbon compound are called inorganic solid wastes. e Reused refers to the frequent use of articles time and again in the same state without bringing any changes in their physical and chemical properties whereas recycle refers to the reuse of articles after recycling process. EXERCISE A. Answer the following questions. 1. What is environmental health? 2. Mention any two impacts of polluted water on human health? 3. Mention any two reasons of dehydration. 4. What is solid waste? Give examples. 5. What is the difference between decomposable and indecomposable waste? 6. Write the difference between reuse and recycle of wastages. 7. How can you prepare compost manure from the biodegradable wastage? 8. What is latrine? Mention any two points that need to be considered for the use of appropriate type of latrine. 9. What is incinerator? What is the use of it? Project Work Under the supervision of your subject teacher divide your class into four groups. Then the first group collects the solid waste, second group separates the waste into four different bins (i.e. recycle bin, reuse bin, composting bin and refusable waste bin). The third group starts the composting process with the help of aerobic method and the fourth group prepares compost manure through anaerobic composting method by digging separate small pits. Then observe the time taken by aerobic and anaerobic method for the extraction of compost manure. 82

8Unit Safety and First Aid Learning Achievement After completing this unit, students will be able to: [ Tell precautionary measures from accidents. [ Tell the objectives of First Aid. [ Explain about First Aid and its importance. [ Tell the safety measures and First Aid of burn, choking, heat stroke, frost bite, road accident and tooth break down. A. Safety from Accident and Precautionary Measures Different types of dangers and risks are increasing day by day in modern human life. Lack of safety knowledge, failure of machines, unfavorable weather and our carelessness may increase the risk of accident. The rate of accidents is increasing with the pace of physical development and modernization. Usually, teenagers are more vulnerable to accidents due to overconfidence and show off behaviour. Therefore everybody needs safety education in this modern age. It educates individuals about safety rules to be followed at work place, school, industry, play ground, road, etc in daily life. In this situation, we can save our life from the incidence of accidents through safety measures. Objectives of First Aid e To save the life of casualty. e To protect the condition of the casualty from being worse. e To develop confidence in the victim or casualty. e To provide sympathy to the casualty. e To carry the casualty to the nearest hospital safely as per the need. e To reduce the physical and mental stress of the patient or casualty. B. First Aid in Some Incidence of Accidents i. Burn Burn is the tissue damage due to heat, electricity, sunlight, chemical or nuclear radiation. Similarly, the tissues damaged by moist heat like hot water and steam is called scalding. On the basis of severity; burn can be classified into three categories such as first degree, second degree and third degree burn. In first degree burn, 83

we can observe damage of the superficial layer of the skin (epidermis) along with the symptoms like redness and inflammation on the skin. Similarly, in second degree burn, the outer and inner layer of the skin (epidermis and dermis) are damaged manifesting the symptoms like blisters, pain, swelling and tissues damaged under First Degree Burn the skin at the burn site. In the third degree burn, there is the damage of the skin to its full depth and there is damage of the tissues under the skin such as fat, nerve cells and bone also. Safety Measures M Children should be kept away from the fire and oven M Keep the matches, lighter, kerosene, petrol and other ignited articles away from the reach of the children M The boiled water, milk and other liquids should be given only when they come in lukewarm state M The appliances like heater, iron, and other electric devices should be kept safely after their use M The damaged electric wires and appliances should be repaired in time First Aid M Victim should be separated from the fire or hot objects M Blanket or any thick cloth should be used to put out the fire if the cloth of victim is burning M Immerse the burnt part in cold water in the case of minor burn M Do not destroy the blisters M Do not apply any cream or ointment on the burnt site M Burnt part should be covered with clean cloth to keep it safe M Victim should be provided with adequate liquid to drink M Do not remove the burnt clothes if they are very much attached to the body parts M In the case of third degree burn, carry the victim to the nearby hospital as soon as possible ii. Choking The state of preventing from breathing by obstructing the throat due to the foreign objects like bones, coin, marble, lapsi, toy piece, etc is called choking. Besides this, sometime, swallowed food may get stuck at the windpipe. During choking victim 84

shows the symptoms of suffocation, cough, struggling to breathe and finally become unconscious. Safety measures M Eat fish and meat with bone with precaution M Never hold coin, marble, toy piece, etc in mouth First Aid M Keep the victim in comfortable position M Ask the victim to cough loudly M Sometimes, the foreign object can be removed from the throat by hitting slightly on the back by the palm of hand M If the foreign object cannot come out by the above technique, give 2 to 3 inward and upward thrusts against the abdomen by placing the arms around the victim’s waist from behind with the help of enclosed hands M Once, the foreign object is out, give artificial respiration if necessary M If the foreign object does not come out even after applying all the techniques mentioned above, carry the victim to the nearest health centre or hospital as soon as possible iii. Foreign Objects in Eye, Nose and Ear The foreign objects like coin, marble, pea, dust, sand, pebble, button, insects, etc can get obstructed in ear, nose and eyes in our day to day life. So, we need to be careful while walking, eating food and doing our day to day work. We should follow safety measures to get rid of those incidences. The foreign objects if enter our ear, nose and eyes we need to remove them safely and carefully. These measures are mentioned below: Foreign Objects in Eye Safety Measures M There should be provision of safety measures at the work place and playground to protect eyes M Precaution should be adopted to protect eyes from dust and dirt during cleaning the house M Glasses should be used in the eyes while walking outside to protect from dust dirt and other foreign objects M Sharp and pointed objects should be kept in safe place 85

Way of Removing Foreign Objects from Eye First Aid M Do not rub your eyes M Take foreign objects out with the help of wet cotton swab or clean hanky M If dirt enter your eyes rinse with clean water M If eyes are infected by acid rinse with clean water and carry the victim to the hospital M If the foreign object has been anchored on the pupil take the victim to the ophthalmologist Foreign Objects in Nose Stuck Object Safety Measures M Do not play by keeping pea, gram, eraser, pebbles, marble, etc inside the nose M Nose should be covered with mask to get protection from the dust and dirt First Aid M Forceful attempt should not be done M If foreign object enters inside take it out by sneezing M If cannot come out consult the doctor Foreign Objects in Ear Removing Foreign Object Safety Measures M The foreign objects like pea, gram, eraser, pebbles, etc should not be kept inside the ear M Ears should not be pricked with sharp objects like pencil, matchstick, nail, etc M Ears should be cleaned with ear bud carefully 86

First Aid M Forceful attempt should not be done M If insects enter inside put few drops of mustard oil M If foreign objects cannot come out consult the doctor iv. Heat Stroke Heatstroke is a condition that causes overheating of body as a result of prolonged exposure to physical exertion in high temperature. The heat stroke can occur if our body temperature rises to 104° F or higher. Heatstroke requires emergency treatment. It manifests the following symptoms such as body temperature above 104° F, dizziness and headache, lack of sweating, dry skin, rapid heartbeat and unconsciousness. Safety Measures M Drink plenty of water M Rest regularly in the shade M Stay indoors or in the shade M Take bath with cool water M Reduce activity and avoid exercise in hot weather M Eat smaller meals more often and cold meals such as salad M Wear light-coloured, loose-fitting clothing made from cotton and linen M Keep yourself cool by using wet towels, putting your feet in cold water First Aid M Move the victim to a cool or shady area M Fan air over the patient M Apply ice packs to the patient’s armpits, groin, neck, and back M Provide cool water or fruit juice if the victim is conscious M Apply wet and cool hanky or cloth on forehead M In major case, carry the victim to the nearby health center or hospital v. Frostbite Frostbite is an injury to the body that is caused by freezing of the skin and underlying tissues. It is caused by exposure of parts of our body to the temperature below freezing point. The fingers, toes 87

and feet are mostly affected but other body parts including nose, ears and cheeks can also get affected by frostbite. Frostbite develops the symptoms such as waxy skin, aching pain, numbness and loss of sensation at the affected area. Safety Measures M Do not go outside the house in very cold weather M Do not expose any part of the body M Wear warm clothes like sweater, jacket, mitten, socks, mufflers, hat, headband, etc so that all parts of body can be covered M Take warm food and water that keeps body warm M Keep your room warm as much as possible M Go through normal physical exercise First Aid M Immerse the frost affected body part in warm (not hot) water M Give gentle massage on the frostbitten area to allow blood circulation M Cover the frost bitten body part with warm cloth M Do not supply direct heat to the affected part which may damage cells and tissues M Provide warm drinks to the casualty to prevent from dehydration M Keep the victim’s room warm with heater or through other alternatives M Carry the victim to the nearby health center or hospital if necessary vi. Road Accident Road accident is one of the major causes of injuries and death now a days. Lack of proper roads, drunken and negligent driving, violation of traffic rule are some reasons of such high number of accidents. In this situation, safety education will play an important role to mitigate the incidence of road accident. Safety Measures M Cross the road at zebra crossing and where there is no such facility, cross the road carefully watching right and left M Use overhead bridge and sub-way to cross the road if they are available M Do not play in the road M Follow the traffic rules while driving M Do not show stunt on the road M Get up and get down carefully in a queue M Do not drive vehicles under the influence of alcohol and drugs M Always walk on the footpath M Do not take out any part of the body from the vehicle’s window M Wear seat belt or helmet while driving 88

M Never disturb driver’s attention First Aid M Check breathing and pulse of the casualties M Do not move casualties. It may cause further injury M If the casualty is not breathing and no pulse then perform immediate cardiopulmonary resuscitation(CPR) by placing the casualty in a flat surface M If there are any open wounds with heavy bleeding, try to control it by applying firm pressure using a clean cloth or soft pad M If the casualty’s body parts are fractured do not move those affected parts M Carry the casualties to the nearby hospital as soon as possible vii. Tooth Breakage Teeth are remarkably strong but they can chip, crack or breakage in some circumstances. This can happen in several ways such as while biting down on something hard, being hit in the face or mouth while playing boxing, falling from height and accidents. We can prevent ourselves from the tooth fracture through safety education somehow. Safety Measures M Wear helmet while riding cycle and motorcycle M If required wear helmet and mouth guard while playing game M Eat the hard food substances carefully First Aid M Apply pressure with a piece of cloth or gauze on bleeding areas until the bleeding stops M Apply a cold pack to the cheek or lips over the broken tooth M Replant the tooth by holding the crown between the thumb and first finger with the smooth, flat surface facing forward and pushing the tooth firmly into the socket M See a dentist as soon as possible Activity Give demonstration in class through role play about the First Aid to choking under the supervision of your subject teacher. Word Meaning Ignited article : lighted, burnt article or matter Inflammation : heat, pain, redness and swelling in infected or injured tissue Mitten : a glove that encases the thumb separately and the other four fingers together 89

RECAP e The rate of accidents is increasing with the pace of physical development and modernization. e Lack of safety knowledge, failure of machines, unfavorable weather and our carelessness may increase the risk of accident. e Safety education educates individuals about safety rules to be followed at work place, school, industry, play ground, road, etc in our daily life. e Burn is the tissue damage due to heat, electricity, sunlight, chemical or nuclear radiation. Similarly, the tissues damaged by moist heat like hot water and steam is called scalding. e The state of preventing from breathing by obstructing the throat due to the foreign objects like bones, coin, marble, lapsi, toy piece, etc is called choking. e Heatstroke is a condition that causes overheating of body as a result of prolonged exposure to physical exertion in high temperature. e Frostbite is an injury to the body that is caused by freezing of the skin and underlying tissues. It is caused by exposure of parts of our body to the temperature below freezing point. EXERCISE A. Answer the following questions. 1. Mention any two objectives of First Aid? 2. Mention any two safety measures of burn. 3. What is choking? Mention First Aid to choking. 4. Mention the First Aid to foreign objects in eyes. 5. Mention the safety measures to foreign objects in an ear. 6. Mention First Aid to frostbite. 7. What is tooth fracture? How can you prevent yourself from tooth fracture? 8. Mention any two safety measures against heat stroke. B. Choose the correct option from the bracket. 1. ............................are more vulnerable to accident. (adults/babies/teenagers) 2. CPR can be given to the casualty whose............................has been stopped. (smell/breathing/breathing and heart beat) 3 Immerse the frost affected area in............................water. (cold/warm/hot) 4. You can apply ice packs to the casualty’s body parts in............................. (Asthma/frostbite/heatstroke) 5. Scalding is caused by.............................(gasoline/dry heat/moist heat) 90

9Unit Family and Community Health Learning Achievement After completing this unit, students will be able to: [ Tell about the concept and importance of family health. [ Explain the major community health problems. [ Explain the solution measures of community health problems. A. Concept and Importance of Family Health Family is the basic social institution. Family having good culture and positive attitude can contribute in solving community health problems. When a family starts to keep the surrounding clean, the neighboring families feel moral pressure and start to maintain healthy habits. So, family can be a key factor to maintain community health. The sound health of family members provides foundation to the healthy society. Then healthy society eventually can help to build up a strong and well developed nation. Nepali Joint Family 91

No matter whether it is a nuclear family or a joint family, there should be mutual understanding, cooperation, respect and communication among the family members. So that family members can foster their physical, mental, social, spiritual and emotional aspects. We know that development of a nation is not possible in the absence of healthy and productive citizen. When the family members are living together with we feeling, they can easily handle the concerns of family planning, nutrition, hygiene, sanitation, sewage, maternal and child health, etc. There is development of positive knowledge, skill and attitude on every individual of a family If s/he gets healthy family environment. We can mention importance of family health in the following points: Ü to take care of infants and children Ü to make planning of family Ü to protect from various kinds of diseases Ü to prevent from possible physical accidents Ü to protect from bad company and bad habits Ü to keep surrounding environment clean Ü to live happy family life Ü to fulfill the needs and aspirations Ü to eradicate superstitions, taboos, bad practices and false beliefs related to health Ü to care for pregnant and lactating mother Ü to make elderly life happy B. Community Health Problems and Management Measures Nepal is the country recognized with the poor economy, low life expectancy, high infant mortality rate and so on. Poor infrastructure, lack of health facility, ignorance, superstition and difficult topographical structure are some factors leading to various forms of health problems in Nepal. Every year many people are losing their life due to malnutrition, diarrhoea, dysentery, common cold, cholera, pneumonia, etc. The various aspects like population management, community environment, control of diseases, economic development, nutrition, games and sports entertainment, etc have to be focused in community health. The major health problems of Nepal can be discussed in the following points: 92

i. Rapid Population Growth Rapid population growth is a major health problem of Nepal. The growth rate of population by more than 1% is considered as rapid population growth rate. The population growth rate of Nepal in 2001 AD was 2.25%. The population growth rate of Nepal has been decreased to 1.35% according to the population census of Nepal 2011 AD. It has created various problems like scarcity of food, lack of health services, unemployment, malnutrition, sanitation problem, environment degradation and socioeconomic and environmental problems as well. If Population growth rate is not controlled in time there will be problem in education, drinking water, cultivable land, residence, etc. It will also create gap between rich and poor which will be sufficient cause to create conflict in the society. So, we should put all the possible efforts to control the rapid population growth with effective plans and programmes. ii. Environmental Pollution Environmental pollution is also accounted as a major problem due to rapid population growth. The increasing level of environmental pollution in urban area is very hazardous when compared with rural area. Deforestation, unplanned urbanization, improper management of solid wastes and sewage, unmanaged traffic system and unmanaged industrialization have deteriorated environment and resulted adverse impact on public health. As a result, community people are suffering from various kinds of communicable and non-communicable diseases. Prevalence of known and unknown diseases and mental and physical disability are also considered as a result of environmental pollution. In this situation, pollution control should be the great concern for all persons and stakeholders. iii. Prevalence of Diseases Communicable disease is such a disease which transmits from an infected person to another healthy person through any kind of medium. The diseases like diarrhoea, dysentery, cholera, typhoid, common cold, pneumonia, measles, etc are the examples of some common communicable diseases prevailed in Nepal. Due to ignorance and sanitation problem, thousands of people are at the risk of communicable and non-communicable diseases. Communicable diseases are the major health burden in our country due to poor environmental sanitation, lack of safe drinking water, poor personal hygiene, superstition and poor diet. Since most of the people are suffering from gastro-intestinal diseases they should be educated about the importance of safe drinking water, personal hygiene, proper use of latrine 93

and sanitation of the surrounding. Since prevalence of disease is the hindrance of development, they should be controlled in time through the joint effort of individual, community and state. iv. Malnutrition Malnutrition is the condition resulted by an improper diet. We know that malnutrition is caused not only due to under nutrition but it is also resulted by over nutrition. Proper nutrition is a prerequisite for the normal health and well being of individuals. Poor nutrition creates problem to the entire population in general and Women and children are more vulnerable in particular. Malnutrition among women results into anaemia, baby born with low weight and vulnerable to various nutrient deficiency diseases like night blindness, scurvy rickets, etc. According to the Nepal Demographic and Health Survey 2011 AD, (29 %) of children under 5 years of age are under weight and (46 %) of children are anaemic. v. Poverty It is needless to say that poverty is the root cause of various problems prevailed in the society. We know that most of the people of our country are still living in poor condition of life. According to Nepal living standard, survey 2011 AD more than (24.6%) people in Nepal are living below absolute poverty line. Because of poverty, people cannot manage balance diet, proper shelter, regular health checkup and proper clothing. As a result, they suffer from various kinds of health problems and are supposed to live poor quality of life. To eliminate absolute poverty and to raise the living standard of the people, it is necessary to create environment for the generation of employment opportunity and income generating activities. These activities should focus the people at grass-root level. Knitting Kiwi Farming Opening Door to Income Generating Activities 94

C. Measures to Solve Community Health Problems Ü There should be provision of compulsory education for children. Ü There should be non-formal education for the illiterate adults in the society. Ü There should be creation of alternatives for income generating sources. Ü Different kinds of public awareness campaign should be carried out to control Health Service at Community Level rapid population growth. Ü Health, population and environment education should be incorporated in school, college and higher study education. Ü Special programme should be carried out to make nutrition campaign more effective. Ü Free nutritious food should be distributed to the poor persons in community. Ü Environment education should be expanded up to the grass root level. Ü Volunteers and educated persons in the community should be mobilized to make the immunization programme more effective. Ü Superstition, social taboos and false beliefs should be eradicated through scientific education system. Ü Effective laws should be executed to control the alcoholism, smoking, drug abuse, theft, robbery, looting, kidnapping, human trafficking, gambling and other antisocial activities. Ü People should be encouraged to utilize the services provided by the sub-health post, health post, health center and hospitals. Activity Make a list of the activities carried out by different organizations or agencies in your community to solve the community health problems of that place and present it in class for discussion. Word Meaning Aspiration : strong desire to achieve something Eliminate : to remove, take out or get rid of Foster : to promote the growth or development of Prerequisites : something that are required in advance Prevalence : the condition of being usual or widespread Taboos : prohibition, forbidden, unacceptable or exclusion of something in the society from use or practice 95

RECAP e Family having good culture and positive attitude can contribute in solving community health problems. e The sound health of family members provides foundation to the healthy society. Then healthy society eventually can build up an able and strong nation. e Poor infrastructure, lack of health facility, ignorance, superstition and difficult topographical structure are some factors leading to various health problems in Nepal. e We should put all the possible efforts to control the rapid population growth with effective plans and programmes. e Deforestation, unplanned urbanization, improper management of solid wastes and unmanaged industrialization have deteriorated environment and public health. e Communicable diseases are the major health problem in our country due to poor environmental sanitation, poor personal hygiene, superstition and improper diet. e Malnutrition among women results into anaemia, miscarriage, night blindness, scurvy rickets, etc. e Because of poverty, people cannot manage balance diet, proper shelter, regular health checkup and proper clothing. EXERCISE A. Answer the following questions. 1. What is family? Mention any two importance of family. 2. Mention the impact of rapid population growth on social and health sector. 3. What is environmental pollution? Mention any two problems created by environmental pollution. 4. What is malnutrition? Mention any two diseases resulted by malnutrition. 5. Suggest any two measures to alleviate poverty from our nation. 6. Mention any two measures to solve community health problems. B. Match the following: B A Taboos Public health Typhoid Airborne Pneumonia Anaemia 46 percent Restriction Deteriorated environment Waterborne Solid waste 96

PHYSICAL EDUCATION After the completion of Class VII, the students will be able to: [ Do various warm up physical exercises. [ Use drum for drill. [ Use drum or Madal for Physical Training, [ Practice various Yogasanas, [ Play Volleyball, Football and Basketball in a small structure using general skills. [ Do various events of Athletics. 1Unit Physical Exercise Physical Education Physical education is an educational course related to the shape and size of human body. We learn the ways of keeping our body and mind active, healthy and strong through different physical activities in this subject. The main objective of Physical education is to prepare a physically, mentally, socially and emotionally fit citizen through the physical activities. Physical Exercise Physical exercise is any physical activity that keeps our body physically fit, strong, healthy and active. Regular physical exercise makes the different parts of our body active. It helps for the growth and development of our body. It should be done carefully and with a happy and peaceful mind. It is not necessary that the physical exercise needs an open and wide ground; it can be done even at home. Different physical exercises can be done at a spot. We should be careful that sometimes the physical exercise may harm if it is done when we are not feeling well. Physical exercise can be done at any time. It is better to do it in the morning because it provides energy and keeps the body active throughout the day. It is also done to warm up the body before playing the games. The physical exercise can be helpful to develop stamina, strength and flexibility in our body. 97

Importance of Physical Exercise e It develops a handsome/beautiful personality. e It develops social qualities in the individuals. e It helps in the growth and development of organs. e It increases the resistance power. e It keeps the internal and external condition strong and also develops a holy spirit. e It makes us disciplined and mentally sharp. e It provides satisfaction and happiness in life. Things to be considered while doing physical exercise a. We should perform physical exercise only in the presence of teacher, instructor or supervisor. b. We should include warm up and cool down exercise in every physical exercise. c. We should not do physical exercise immediately after meal. d. We should drink enough water before, during and after physical exercise. e. We should decrease the volume of physical exercise if we are tired or the weather is not suitable. 1. Warm-up exercises We need to warm up our body before doing any physical exercises or playing any physical game. There are different warm up exercises according to the games. We should do the exercise of hands, wrist and fingers before playing volleyball. Likewise, we should do exercise of waist, hands etc before playing football. A trainer or teacher should first show the ways to do it. Activities a. Jogging on a spot Jogging is a type of running at a moderate pace often over long distance but in this exercise, Jogging is performed on a spot without covering any distance. b. Jogging on a spot with different movements of hands and legs In this exercise, Jogging is done with different movements of hands and legs. We can do it by joining and separating legs, lifting the legs turn by turn, moving legs and hand like in running, etc. 98

c. Skipping It is the exercise in which we skip over a rope as it swings round over our head and under our feet. It is better to do skipping exercise in the instruction of teacher in a circle. 2. Exercise of Sole Sole is the underside of the foot from the toes to the heel. It holds the weight of our body. We have to do exercise of toe and heel part in an appropriate technique. The exercise of sole makes our other physical movements easier. Activities a. Jumping on sole We can do the exercise of our sole by jumping on a sole. We can even jump in count. In this exercise, we have to jump and support the whole body only with soles while landing. It is better to do exercise in the instruction of teacher. b. Standing on toe and stretching the sole We can do exercise of sole by standing on toe and stretching sole. It is better to do and stop on count 16 in the instruction of teacher. c. Sitting and stretching the sole We can do it by sitting and stretching sole. We have to sit on the ground, straighten one leg and bend another leg over it. Then, the sole of the leg which we bent over another should be stretched with hand moving back and front. 3. Exercise of limbs and spine We have to do the exercise of our hands and legs as they are the most moving parts of our body. Similarly, the rear part of our body between the neck and the pelvis known as spine also needs a careful and enough exercise. The exercise of spine along with hands and legs makes our body flexible. Activities a. Bending front and back For this exercise, we have to stand straight keeping the hands on waist and the legs a bit apart. Then, in the counts, we have to bend down our body alternately frontward and backward like, bending frontward in count 1, being straight in count 2, bending backward in count 3 and being straight in count 4. 99

b. Carrying partner on back This exercise is done in pairs. In the beginning, we have to stand in pairs attaching the back of each other and locking the hands across the elbows backward. With the instruction of teacher, we have to carry each other on back alternately and hold the weight of partner. c. Push-up and modified push-up Push-up is the exercise of raising body from floor. In this exercise, we have to push off the floor until the arms are straight from a position of lying flat on the front with the hands under the shoulder. The body should be raised up slowly supporting on fingers or palm or fist and toes. In the modified push-up, knees are used for supporting instead of toes. Modified push-up is better for females and beginners. 4. Exercise of Abdomen and Thigh Abdomen is a sensitive part of our body that contains the stomach, intestines, liver, kidney and other organs. It is situated between the pelvis and the chest. Likewise, thigh is the top part of leg between the knees and the hip. The exercise of abdomen and thigh helps to make our body fit and strong. Activities a. Rest on knees and raise the thigh For this exercise, we have to rest on knees and elbows. Then, slowly raise one thigh and straighten it up to the height of the upper part of the body. Bring it down in the initial position and raise another thigh. In this way, we can do the exercise of thigh alternately. 100