HPE Book 9_2076 Edition

Minerals Copper • Function: needed for synthesis of haemoglobin, proper iron metabolism, and maintenance of blood vessels. • Sources: seafood, nuts, legumes and green leafy vegetables. Vitamin Daily Requirement for an Adult Person Types Vitamins Daily Requirement Fat Soluble A D 600-700 mu E 10 mu K 3-4 mu 60-70 mu Water Soluble B1 B2 0.8-1 mg B3 1-1.3 mg B6 1.2-1.4 mg B12 1.5 mg C 200 mu 40 mg E. Minerals and Salts Minerals are inorganic micronutrient. We need them in small amounts to help our body function properly. There are 16 types of minerals, which are essential nutrients and must be supplied by the diet. They are essential for the growth and development of our body and protection from various diseases. They are mostly found in fruits, Sources of Minerals vegetables, fish, meat, eggs, grains, etc. Calcium, magnesium iron, copper, fluoride, iodine, zinc, sulphur, chloride, sodium and potassium are some examples of minerals that are required for our body. Functions Minerals play vital role in carbohydrate, fat and protein metabolism Minerals control and balance water in the body 251

Minerals play important role for the function of vital organs like heart, kidney, etc. Minerals maintain good health It helps in the maintenance of bones and teeth, etc. F. Water Water is another essential element for our life. It is needed to maintain the temperature, to absorb the food in the body and to excrete human excreta as well. The water we drink should be potable without any germs. Water itself is not nutrient however, it is essential for the utilization of those nutrients by our body. Therefore, water is essential to our body. To live a normal life there must be around (65 to 70%) water in the total weight of our body. A person may Drinking Water die if there is deficiency of water by more than (20%) of the total requirement of our body. Functions Water regulates the body temperature It regulates the electrolyte balance It helps in the elimination of waste products It protects from dehydration It helps to transport, nutrients and waste materials Regulates internal and external temperature of the body Helps to make skin and hair soft and moist Helps to balance PH value of the body Daily Requirement of Water Generally, a person needs about 3 to 5 liters of water in a day. The need of water in the human body depends upon the age, climate, physical structure, and physical activity. Consequences of Dehydration in the Body In winter and summer; intake and output ratio of water in the body should be equal. The condition of more output of the water from the body than the intake of water into the body is called dehydration. When more than (5%) water is deficient in our body it demonstrates the dehydration signs and symptoms like dryness of skin, 252

thickness of blood and inadequate blood circulation may appear. Dehydration leads to severe problem to the small children. In the context of our country, most of the child death occurs due to diarrhea and dehydration. 9.2.2 Characteristics of Quality Food Quality food refers to those foodstuffs that have nutritional values, free from adulteration, toxic substances and appropriately prepared. If adulteration and dilution are found in the foodstuffs, they are called low quality food. At the same time, junk food like noodles, biscuits, chocolates, potato chips, cheese balls etc are also called as low quality foods or tainted food. Quality food does not have ill-effects on health. Quality food is essential for the growth and development of the body. In the absence of quality food people suffer from malnutrition and various other complications. Some characteristics of quality food are mentioned below: Proper nutritional values Appropriately prepared Tasting palatable Fresh Hygienic Free from unwanted mix-up Supply fuel for energy to the body Production formula according to government regulation Free from toxic substances Some of the Factors that play important role to determine quantity and quality of food are mentioned below: i. Age ii. Sex iii. Occupation iv. Physical Condition v. Climate vi. Health Condition vii. Economic Condition viii. Education and Awareness ix. Food Habit x. Availability of Food Materials xi. Urban or Rural Settlement xii. Size of Family xiii. Norms, Values and Traditions 253

Generally, there must be any one variety from the following groups of foods in our everyday meal: 1. Any one item from meat, egg, fish, etc. 2. Any one item from milk and milk products 3. Any one item from rice, wheat, barley and millet 4. Any one item from mango, grapes, papaya, apple, banana and guava 5. Any one item from bean, gram, cowpea, peas, rajmah and almond 6. Any one item from spinach, kurilo, cabbage, lettuce and mustard leaves Activity Prepare a chart paper by writing the names of various types of vitamins and minerals along with their sources and functions. Cling it on the classroom wall and discuss with your friends. Low Quality Food Unhealthy food, commonly known as junk food or tainted food generally contains less nutrients and large proportion of unhealthy ingredients such as sugar, salt and saturated fats. In other words, food with high concentration of sugar, salt, fats and additives are considered as unhealthy food. The food becomes unhealthy due to contamination, adulteration and ways of preparation or use of artificial means. These types of tainted food have negative effect on the health and create health hazards among consumers. Such food is also known as low quality food. But noodles, biscuits, sweets, ice-cream, coke, etc are being common food in the modern society. Thus, to protect the health of society and nation healthy eating habits must be encouraged. At the same time awareness among the consumer regarding selection, preservation, and handling of food should be developed in massive level. Reasons of Low Quality Food ^ Making food more oily, spicy, and deep-fried ^ Adding harmful colours ^ Imbalanced diet due to poor economy ^ Mixing of low quality substances in food ^ Food prepared by decomposed and stale food substances ^ Food adulteration ^ Addition of preservatives like sorbic acid, ammonium fluoride, sodium benzoate, etc. 254

Measures to Avoid Low Quality Food ^ Avoid the dried and packed food as far as possible. ^ Avoid street food. ^ Do not run after tasty food but go for healthy food. ^ Take green vegetables, fruits and freshly cooked food to stay healthy. ^ Do not go for expensive imported food which may not have high nutritive values because they may contain harmful chemicals. ^ Do not get attracted towards attractive advertisement of tainted food because they are entirely for business purpose. 9.3 Harmful Products and Healthy Living The goods available in the market may be adulterated, misbranded, and false labeled. These types of goods may have low quality and quantity. The adulterated food cannot supply necessary nutrients to the consumer. Some of the items may be injurious to health. Therefore, people need to be conscious about the quality of the products for their health. 9.3.1 Harmful Products in Everyday Use We are using various kinds of goods to fulfill individual and family needs. Manufacturers produce those goods and sellers sell them in the market. Among them, some goods are fairly good and fresh whereas some of them are injurious to health. The substances like alcoholic substances, tobacco substances and narcotic drugs are also harmful to human health. The false social beliefs about the food also may cause the food products substandard. People are compelled to use harmful products due to interest for new taste, colourful and attractive presentation, consumption style and ignorance. Uncontrolled and indiscriminate use of unauthorized colours and food additives may pose health hazards among the consumers. The culture of adding colour and food additives in the foodstuffs is increasing day after day. Majority of the processed foods such as breads, biscuits, cakes, sweets, confectionery, jams, jellies, soft drinks, can foods contain food additives and colours. Consumers become victim of adulteration in food, production and distribution of low quantity and quality goods and black marketing. Some of the causes that make our food tainted or low quality are mentioned below: i. Substitution of food by low quality food substances ii. Consuming foods even after crossing the expiry date iii. Making food tainted by mixing up low quality substances to sell in low price iv. Eating deep fried food for taste v. Use of chemicals in food products 255

vi. Adding inedible substances and harmful colouring in the food materials vii. Packaging the food substances in the tin can and plastics. Food Adulteration Adulteration of food consists of a large number of practices like mixing, substitution, false labeling, misbranding, addition of toxicants etc. Some forms of adulteration are injurious to health. Such foods harm our health and sometimes it may be fatal too. Some examples of adulteration in foods are mentioned below: e Adulteration in milk: Addition of water, removal of cream, addition of paper pulp, skimmed milk powder. e Adulteration in ghee: Mixing of animal fat, Vanaspati ghee, addition of tributaries. e Adulteration in cereals: Rice and wheat are mixed with stones, sand, grits, mud, etc. e Edible oil: Addition of Argemone Maxicana and Soybean oil in the Mustard oil. e Tea and coffee: They are adulterated with black gram husk and saw powder. e Adulteration in honey: Addition of sugar boiled with empty bee hives, etc. These are just few examples of food adulteration. The ill intension of making fast money among the producers and shopkeepers drive them in such social crimes. Therefore, the joint effort of individuals, community and the government is essential to control this social crime. Attractive and Coloured Foods The culture of adding colour and food additives in the foodstuffs is increasing day after day. Majority of the processed foods such as breads, biscuits, cakes, sweets, confectionery, jams, jellies, soft drinks, can foods contain food additives and colours. Food additives and colour can be defined as:- non-nutritious substances, which are added in food generally in small quantity to improve its appearance, flavor or storage properties. Uncontrolled and indiscriminate use of unauthorized colours and food additives may pose health hazards among the consumers. The colouring of food may cause allergy food, poisoning, vomiting, malnutrition, mouth infection and sometimes it may be fatal also. In addition; along with the food materials, the other daily consuming goods like belts, bags, radio, mobile, rope, cement, iron rod, clothes, electronic gazettes, home appliances, etc also should Cosmetics Items 256

have standardized quality. We use various kinds of cosmetic items like shampoo, nail polish, hair spray, hair colour, gel, powder, mascara, lotion, etc to look attractive in front of others. Cosmetic Goods Cosmetic goods refers to the articles applied in the body for cleansing, beautifying, attractiveness or altering the appearance. Human beings use various means of cosmetics such as cream, powder, oil, lotion, lipstick, Ointment, Kajal, etc. We find so many cosmetics in the market. The excessive use of these articles may harm our health. Sometimes, the cosmetic goods like cream, powder, lipsticks, Kajal, etc may be of low quality which may cause infections and allergies. Therefore, we should be careful while using these goods for safe and healthy life. We cannot purchase our beauty from the cosmetics goods. For our beauty, we must have balanced diet, physical exercise, adequate water, proper hygiene and free from mental stress. Some consequences of harmful cosmetic goods on human health are mentioned below: e Cosmetic goods may cause allergy e Natural resistance may be lost due to excessive use of powder, cream, etc e Use of Hydrogen Peroxides to the hair invites early baldness and later some skin diseases e Natural beauty and texture of the skin may be lost due to regular use of cosmetics e Frequent use of low quality ‘Kajal’ in the eyes may lead to eye infection e Continuous friction of ornaments damages the skin 9.3.2 Precautionary Measures from the Use of Harmful Products We can observe the attraction of the people towards the low price goods due to poverty and unemployment. There is chance of production and distribution of harmful and low quality products due to the orientation of the consumers towards the low price goods. The fraudulent activities can get more access in deceitful act in this condition. As a result, some manufacturers, wholesalers, and shopkeepers take advantages and conceal the consumers by selling harmful and low quality substances. Realizing this fact, the government has made the provision of consumer protection laws to discourage and control such activities. It is necessary to alleviate poverty, ignorance; and effective implementation of the existing consumer laws as well to protect people from the harmful products. The following precautions should be adopted to bring reduction in the use of harmful products: People should be aware through consumers health education. The products should be launched in the market only after the lab test. 257

There must be effective supervision and monitoring of the godown and warehouse. The manufacturers and shopkeepers producing harmful products must be punished strictly. We need to support the government by giving information if the selling and distribution of the harmful products are noticed in the community. We need to be conscious during the time of war, Landslide, Flood, and natural calamities since there is high chance of selling and distribution of harmful products. There must be provision of effective law for the production and distribution of harmful products and the local authorities should be made more responsible for its implementation. License should be made compulsory for the production, selling, storage, and distribution of the consumer products. Information and notice should be disseminated to the community through the social organizations, NGOs, INGOs, volunteer organizations. 9.3.3 Planning for Healthy Life Healthful life is considered as the state of physical, social, spiritual, and mental wellbeing. The health of an individual and family ultimately helps to promote the health condition of the society. The guardian’s role is very important for healthy living of their children. All family members are equally responsible to make the family happy. The role to be played by the guardians and every member for healthy family life are as follows: i. To build up healthy family relation. ii. Personal interest should be dedicated on behalf of the family. iii. Common goal and activities should be conducted in the family. iv. Fulfillment of family needs through common mutual understanding. v. Involvement in income generating activities to manage family expenditure. vi. To carry out responsibility by every family member according to their capacity. vii. Every family decision need to be taken through the suggestion and consent of all members. Activity Divide your class into different groups and organize a seminar class on the topic “essential commodities, their role in the health and survival” under the guidance of your subject teacher. 258

Summary M Nutrition is the total process of breaking down of food or food substances taken in by the mouth to use for energy in the body. According to Lusk Graham, “nutrition is the sum process concerned with growth maintenance and repair of the living body as a whole or of its constituent parts”. M The nutrients for our healthy life include carbohydrate, proteins, and fats as well as fibers, vitamins, minerals and water which provide fuel for energy to our body. M Nutrition education is essential whereby people get knowledge about the need of proper nutrition for the growth and development of the body and for the maintenance of health as well. M Carbohydrate is a macromolecule consisting of carbon, hydrogen and oxygen atoms. It supplies fuel for energy to our body. M The major sources of carbohydrates are rice, wheat, maize, barley, turnip, potato, sweet potato, yam, sugarcane, fruits, etc. One gram of carbohydrate supplies 4.1 calorie of energy. M Proteins are large complex molecules containing carbon, hydrogen, oxygen and nitrogen. Fish, meat, egg, milk, beans, pulses and green leafy vegetables are the sources of proteins. One gram of protein supplies 4.1 calorie of energy. M Fats are the complex macromolecules that constitute carbon, hydrogen and oxygen. They are classified as unsaturated fat (good fat) and saturated or trans fat (bad fat). In which, saturated fat remains in the solid form at a room temperature whereas unsaturated fat remains in the liquid form at a normal room temperature. M Fish oil, butter, cheese, ghee, adipose tissue, peanut, soya-bean, coconut oil, olive oil, sunflower and mustard oil are some sources of fats. One gram of fat produces 9.3 calorie of energy. M Vitamins are the enzymes that regulate the chemical reactions in the body. There are thirteen types of vitamins essential for human beings. Vitamins are found in fruits, vegetables, fish, meat, eggs, etc. M Minerals are inorganic micronutrients. There are 16 types of minerals, which are essential nutrients and must be supplied by the diet. They are mostly found in fruits, vegetables, fish, meat, eggs, grains, etc. M The condition of more output of the water from the body than the intake of water into the body is called dehydration. When more than 5% water is deficient in our body it demonstrates the dehydration signs and symptoms like dryness of skin, thickness of blood and inadequate blood circulation may appear. M Food adulteration consists of a large number of practices like mixing, substitution, false labeling, misbranding, addition of toxicants, etc. Some forms of adulteration are injurious to health. 259

Exercise A. Very short answer questions. 1. What is nutrition? 2. Name any four body protecting foodstuffs. 3. Mention any two functions of proteins. 4. Give any two characteristics of quality food. 5. Mention any two reasons of low quality food. 6. Give any two examples of adulteration in food. B. Short answer questions. 1. Classify food on the basis of its functions. 2. Mention the functions of water and examine the consequences of dehydration. 3. What is quality food? How can you identify quality food? 4. What makes our food tainted? Analyze the reasons. 5. What precautionary measures do you suggest to the consumers to prevent them from the use of harmful products? 6. Suggest the people for their role for making healthy life. 7. What is balanced diet? How can you prepare balanced diet from locally available food sources? C. Write short notes on: 1. Food and Nutrition 2. Body building nutrients D. Write differences: 1. Minerals and vitamins 2. Fats and proteins 3. Quality food and low quality food 4. Balance diet and unbalanced diet E. Long answer questions. 1. Mention the different reasons of food adulteration? What are their consequences? What measures do you suggest to control this kind of offense? 2. What is low quality food? Mention the reasons of low quality food. What measures do you suggest to control selling of low quality food in the market? Project Work Prepare a chart paper showing the names of vitamins and minerals that are essential to our body along with their food sources. 260

Unit PRIMARY HEALTH CARE AND RISK PRECAUTION AND SAFETY 10 Learning Objective After completing this unit, students will be able to: • Define and tell the characteristics of primary health care. • Explain the components and importance of primary health care. • Explain the concept and types of risk. • Explain the mitigating measures of risk. • Define safety education and explain its importance. • Explain the safety measures on road, school, home and playground. • Tell the process of First Aid of wound, choking, snakebite, allergy, mountain sickness, etc. 10.1 Introduction to Primary Health Care It is the fundamental human right of the people to get basic health services wherever they are. Such health service should be available at the people’s door. However, the existing health services are mostly urban oriented, over sophisticated, costly, and unequally distributed. Moreover, the people at the grass root level in the developing countries are not getting even the basic health service. In the context of Nepal, even Health Post the basic health services are not available to the needy people. Owing to this fact, the International Conference on health held at Alma Ata, Kazakhstan in 1978 AD introduced the concept of Primary Health Care. Representatives from 134 countries participated in that conference. The concept of Primary Health Care involves a systematic effort to provide basic health services for rural people of developing countries at community or grass root level. According to Alma-ata Conference (1978 AD), “Primary health care is an essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford.” 261

Characteristics of Primary Health Care 1. Essential Health Service Primary health care is accepted as essential health service. The health services like health education, supply of food and nutrition, safe drinking water, immunization, etc come under the essential health service. These health services are equally essential to all the people whether living in the remote areas or urban areas. These health Delivery of Essential Health Service services should be easily accessible to all the people without discrimination. 2. Socially Accepted The available health services should be matched as per the need and demand of the community people. At the same time, people should be motivated for their meaningful participation in the utilization of available health services. Similarly, the health services should be brought within the affording capacity of the people at the grass root level. 3. Accessible to All Health services should reach within the access of people. It should be accessible to the people of all geographical areas. It can be made easily accessible to the community people through Sub-health Post, Health Post, and Primary Health Centers. 4. Active Participation of Community The functions of Primary health care are based on the principle of mobilization of all community members. It is possible to protect and promote the health condition of all community members if health programs are carried out by meaningful active participation of the people. Hence, the primary health care has adopted a policy to impart the preventive, promotive and curative health services through full participation of people. 5. Affordable to All One of the primary concerns of the Primary Health Care should be its affordability. Hence, the health services should be brought within the affording capacity of the people at grass root level. This approach supports to achieve the Millennium Development Goal of Nepal by 2015 AD. Thus, basic health services should be available free of cost; if not, it should be made possible at affordable cost. There should be maximum use of locally available resources to make the service 262

affordable. If the service of Primary Health Care is based on the local technology, the local people can manage it easily. Such health programs become viable and sustainable too. Recently, the government of Nepal has been providing basic health services to the people through Sub-health Post, Health Post and Primary Health Centre free of cost. 10.1.1 Importance of Primary Health Care Even though conventional health service practices A child getting immunized have been adopted for several decades the condition of health problem remain the same especially in developing nations. Owing to this fact, WHO developed the concept of Primary Health Care in 1978 AD as an effective health strategy especially for the developing countries. Indeed, Primary Health Care is an essential health care. It is modeled according to the need and requirement of the community people. In developing countries like Nepal, people are suffering from health problems due to the lack of knowledge on hygiene, sanitation, diet and preventive measures of diseases. When they are sick, they cannot go to the sophisticated hospitals in the cities. In this situation, Primary Health Care service is very important for the developing countries. This type of health care system provides health services free of cost at the grass root level. In the context of Nepal, the people living in the remote area, poor economy and deprived get this service easily. Some of the importance of primary health care are mentioned below: It helps to provide essential health service free of cost at the grass root level through the extension of Health Posts and Primary Health Centre even to the remote areas. Local people are mobilized for the production and utilization of local resources while launching these services. Promotes community participation at maximum level in the planning, organization, operation, and control of primary health care programmes. It provides affordable and acceptable health services on the principle of social justice and equality. It provides preventive, curative, promotive and rehabilitative health services at the grass root level. It integrates many sectors of community development programmes like agriculture, animal husbandry, food, industry, education, housing, public works, communications, etc with the health programmes. It helps to change the attitude, behavior and lifestyle of the community people. 263

More than 90% infectious diseases can be prevented through Primary Health Care services. It provides prenatal and natal (delivery) services through trained birth attendants (TBAs). It helps to control endemic and epidemic diseases. It helps to conduct the safe drinking water and sanitation program effective. 10.1.2 Components of Primary Health Care The components of the Primary Health Care are mentioned in the following points: Safe Drinking Water Nutrition Treatment of Common and Basic Sanitation and Balanced Diseases and Injury Management of Health Education Diet Essential Medicines Immunization Prevention Elements and Control of Against Important of Endemic Diseases Infectious Diseases Primary Health Care Family Planning and Maternal Child Health Care Fig: 10.1 Components of Primary Health Care A. Safe Drinking Water and Basic Sanitation Safe drinking water and basic sanitation are one of the major aspects of Primary Health Centre. There must be adequate supply of safe drinking water to ensure hygiene and sanitation of the people. The adequate provision of safe drinking water and sanitation protect people from various infectious diseases like Typhoid, Jaundice, Diarrhea, Cholera, Tuberculosis etc. B. Provision of Nutrition and Balanced Diet It is also one of the important aspects of Primary Health Care. People need balanced diet for sound health. Primary Health Care also provides education to the people about the need and importance of balanced diet for good health. It also gives ideas to the individuals the management of various sources of foods for the balanced diet. Balanced diet keeps away people from malnutrition and prevents them from various nutrient deficiency diseases. 264

C. Treatment of Common Disease and Injury It is also one of the major aspects of Primary Health Care. A large number of people are suffering from common diseases like headache, common cold, diarrhea, stomachache, worm infestation etc. Similarly, people frequently suffer from minor injuries like minor burn, wound, cut, fracture etc. Primary Health Care gives priority for the treatment of common diseases and injuries. D. Management of Essential Medicines Primary Health Care has emphasized the management of essential drugs. Health Posts, Sub-health Post and Primary Health Centers are providing health services including various kinds of essential medicines to the patients free of cost. At present, 135 types of essential medicines are provided free of cost by the PHC and Health post. E. Family Planning and Maternal Child Health Care Family planning is necessary for small and happy family. Family can help to limit the number of babies, birth spacing, proper parenting and making appropriate family size. At the same time, maternal and child health care is also equally important for the welfare of the mother and child. Hence, family planning and maternal child care is the primary concern of Primary Health Care. F. Prevention and Control of Endemic Diseases Endemic diseases refers to those diseases which are found in particular geographical areas within the country. But sometimes, it may spread throughout the country. For instance, Malaria, Kalazar, Japanese Encephalitis etc are the examples of endemic diseases of Terai region. Similarly, Asthma, Pneumonia and Common Cold are considered as the endemic diseases of the mountain region. There must be prevention and control of these endemic diseases on time to promote the health status of people. G. Immunization Against Important Infectious Diseases Various kinds of infectious diseases are killing thousands of infants and children every year in Nepal. Realizing this fact, the government of Nepal is providing free immunization against some infectious diseases like Tuberculosis, Whooping Cough, Tetanus, Diphtheria, Measles, Poliomyelitis etc. H. Health Education Health education is also one of the most important elements of Primary Health Care. It is difficult to maintain our health standard without Health Education. Indeed, Health Education gives insight experiences about the health related issues 265

and helps to change attitudes and behavior accordingly. It also makes individuals to be responsible in health related matters. Activity Visit any one health post or primary health center of your locality. Collect the information about the total number of staffs working over there and types of medicines provided free of cost and health services it renders. Then prepare a report and present it in the class. 10.2 Concept, Types and Mitigating Measures of Risk 10.2.1 Concept of Risk Risk is a probability of damage, injury, loss, or any other negative occurrence that is caused by external or internal vulnerabilities. It is the exposure to the chance of injury, loss or hazard. Risk can be defined as the threatening event in relation to the vulnerability to the damage of life, health and property that may be caused by probability of calamities. For an example, Earthquake may occur at any time and the possible damage of life, property and physical structure resulted by that calamity is considered as risk. Any kind of threatening event or dreadful calamity may increase the vulnerable situation to human health and survival. In this world, many devastating calamities and hazards occur and cause great loss to the human life and property time to time. Magnitude and frequency of risk increases due to the natural calamities like Storm, Hurricane, Precipitation of Hailstone, Tsunami, Earthquake, Volcanic Eruption, etc. Sometimes, vegetation gets dry out due to the long drought. At the same time, Landslide and Flood occurs due to heavy rainfall. Similarly; sometimes, a large number of people are killed by the prevalence of the epidemic diseases. There is high chance of damage of life, house, office building, road, bridge, animal, physical structures, civilization, and different means of livelihood due to those threatening events. Those people and communities who are the victims of those dreadful and devastating calamities should get full support by the government, community, and nongovernmental organizations. The occurrence of this devastating condition resulted by natural and unnatural events is called calamities. Such kinds of calamities make individual’s health and community health vulnerable. We need to be conscious to mitigate the risk resulted by such calamities. Unfavorable condition may occur suddenly while individuals are at work. Various kinds of health problems may occur due to those unfavorable conditions. The labourers working in the factories are vulnerable to the risk of health problems due to the chemicals, which are used in those places. Similarly, the machine operators 266

are also always in the risk of injury. Moreover, there is high risk of Landslide and Soil Erosion in the hilly region whereas the people of the Terai region are at the risk of Flood. Due to advancement in the physical development, there is a great change in the life style of the people. Due to the expansion of the road, vehicles, industries, and other physical facilities, the degree of pollution and the rate of accidents are also sky rocketing day by day. We need to be aware and conscious to be safe from such risks. The task of identification, analysis, assessment, control and minimization of unacceptable risks is called risk management. An organization may use risk assumption, avoidance, retention and transfer or any other strategy for proper management of future events of unacceptable risk. Similarly, systematic reduction in the extent of exposure to a risk and the likelihood of its occurrence is called risk reduction. 10.2.2 Types of Risks Risk is everywhere. Sometimes, accident may occur due to our carelessness also. It increases the probability of risks. For instance, the workers engaged in the mining may have high chance risk of injury if they are less sensitive to safety measures. Similarly, there is more possibility of catching fire in the houses in the rural areas during the dry windy season and increases the risk of life and property. There are some natural disasters, which ultimately increases the risk to human life. The risks induced by disasters can be divided into two groups. They are explained below:- A. Risk induced by Natural Disaster There are continuous geological movements in the Earth. These movements in and on the surface of the Earth is called natural process. The power of geological movements can alter the status-quo in sudden dramatic actions. Consequently, these types of forces of the natural world can cause significant risk to life, property, and economies. Natural risk includes flooding, mudflow, landslides, avalanches, droughts, fires, etc. These devastating events caused by such natural process results into a great loss to life and property. The risks resulted by such kinds of disasters is called risk induced by the natural disaster. The natural disasters like storm, lightning thunder, hurricane, precipitation of hailstone, tsunami, glacial lake outburst flood, soil erosion, cold, forest fire, earthquake, volcanic eruption cause a great loss to life and property. There is no way to avoid natural disasters, but if people know what kinds of disasters are most likely to occur where they are living, they can learn what to do if a disaster happens in order to stay safe. 267

Table 10.1: Human Casualties/Deaths by Disasters in Nepal 2000 to 2015 AD Year (AD) Flood & Fire Epidemics Thunderbolt Earthquake Avalanche Landslide 2000 37 141 26 00 2001 173 2002 196 26 154 38 10 2003 441 2004 232 11 0 6 00 2005 131 2006 141 16 0 62 00 2007 114 2008 214 10 41 10 00 2009 134 2010 135 28 34 18 0 21 2011 240 2012 263 30 15 00 2013 123 2014 -- 9 3 0 40 6 2015 102 -- 11 10 16 00 35 462 7 02 69 36 70 00 46 9 95 60 77 33 119 1 11 -- -- -- -- -- -- -- -- -- 16 -- -- -- 8,891 18 Source: Ministry of Home Affairs, 2015 AD A natural disaster can cause loss of life or property damage, and typically leaves some economic damage in its wake, the severity of which depends on the affected population’s ability to recover. A natural disaster is a major adverse event resulting from natural processes of the Earth, which include floods, volcanic eruptions, earthquakes, tsunamis, and other geologic processes. The word “natural” is used to note that the disaster is caused by nature. One natural hazard can lead to another. For example, an Earthquake can cause a Tsunami. These kinds of natural disasters bring hazards to human life and hamper the development and civilization process. Some of the natural disasters are explained below: 1. Earthquake Earthquake is the sudden shaking or vibration of the crust of the Earth. An earthquake is the result of a sudden release of energy in the Earth’s crust that creates seismic waves. The earthquake is not a frequent occurrence. However, it can be very disruptive because it occurs suddenly and tend to affect large areas. Earthquake can be a one-time event of a few seconds shaking or a series of events of varying duration. Earthquake comes without warning. On the basis of movement 268

of the earth surface, earthquakes are of two types such as horizontal earthquake and vertical earthquake. Support Support Wire An instrument called Seismograph records the shaking of the Earth’s Rotationg drum Spring Heavy Pen Heavy weight weight Pen Rotationg drum surface. A British Seismologist John Milne invented this device in 1935 AD. The Seismograph is a very Vertical Earth motion Horizontal Earth motion sensitive device that can record Seismograph Measuring Richter Scale Earthquake waves. The magnitude of the earthquake is expressed in Richter Scale. The Seismograph measures the earthquake waves from the range between 0-9 Richter Scale. The earthquake with more than 6 Richter scale becomes devastating. The underground point of origin of the earthquake is called the hypocenter. The point directly above the focus on the surface is called the epicenter. Hypocenter : The Earthquake usually begins deep in the Earth. The place below the Earth surface from where seismic waves are produced is called hypocenter. The hypocenter of the earthquake is always below the surface of the Earth. Most of the earthquakes have their epicenter at depth of less than 60 km. Epicenter: The point on the Earth surface vertically above the hypocenter is called epicenter. The magnitude of the earthquake is more at epicenter than the other places of the surface of the Earth. Earthquakes by themselves rarely kill people or wildlife. It is usually the secondary events that they trigger the disasters such as building collapse, Tsunamis (Seismic Sea Waves) and Volcanoes which cause great loss of life and property. Many of these damage could possibly be avoided by better construction, safety systems, early warning, and planning. Geologically, Nepal lies on a seismic zone so the earthquakes of various magnitudes occur almost every year and have caused heavy losses of lives on several occasions. Recently, our country was hit by the devastating earthquake on 12th Baisakh 2072 BS. The epicenter was Barpak village of the Gorkha District. It was measured 7.8 Richter scale in magnitude. This is one of the deadliest earthquakes in Nepal where around 8,891 people were killed. This devastating earthquake had badly affected the hilly and mountain areas of the western and central Nepal. It triggered an avalanche on Mount Everest; killing around 21 individuals. Moreover, it also triggered another huge avalanche in the Langtang valley, where 250 people were reported missing. Hundreds of thousands of people were made homeless 269

across many districts of the country. Centuries-old buildings were destroyed in Kathmandu Valley, including the Kathmandu Durbar Square, the Patan Durbar Square, the Bhaktapur Durbar Square, the Changu Narayan Temple and the Swayambhunath Stupa. It is said that a magnitude of 6.9 Richter Scale earthquake in 2045 BS caused close to 1,500 fatalities. The Mahavukampa of 1990 BS had also severely damaged Kathmandu, and is believed to have caused around 10,600 fatalities. Causes of Earthquake i. Tectonic Forces JuanPdlaeteFuca AmNPeolarrtitcehan EuPrlaastiean PhPililpatpeine The tectonic forces affect the CarPilbabteean surface of the Earth. The crust APralabtiean PPalcaitfeic of the Earth is divided into CPolactoes AmSPoelaurtitcehan APfrlaictaen AuIPnstldariataelnian several mega plates known as PPalcaitfeic continental plates. They are NPalaztcea floating on the molten mass called mantle (the middle SPcloattiea part of the Earth). Sometimes, Antarctic Plate these plates move towards Major Plates of the Earth each other and sometimes move away from each other due to the tectonic force generated inside the surface of the Earth. Such movement causes the plates faults, bend, fracture, and overlapping eventually results into an Earthquake. The adjoining regions of such plates are mostly affected by the Earthquake. ii. Volcanic Eruption During the Volcanic Eruption, the magma forcibly flows out between the blocks of rocks. This occurrence may form new faults in the earth. In the course of Volcanic Eruption, not only magma but also some rocks are forced out. The flow of such substances in the vent of Volcano creates vibration on the surface of the Earth. Hence, Volcanic Eruption is also considered as the cause of Earthquake. iii. Mine Blast and Nuclear Tests The activities like nuclear test and mine blasts are also considered as the cause of artificial Earthquake. Such activities create high pressure in the inner part of the Earth, which cause contraction, and expansion of the rocks and movement of liquid and gases inside the Earth. It may results into the Earthquake. Effects of Earthquake ^ Earthquake damages life and property. ^ It destroys physical infrastructures like buildings, roads, bridges, canals, towers and other infrastructure. 270

^ It damages the communication system, transportation system, electrification system, etc. ^ It damages sewer pipes and spread of sewage in the surrounding land may spread various kinds of waterborne diseases. ^ It damages invaluable cultural heritages. ^ It may cause cracks in the crust. ^ It may cause Flooding, Landslides. ^ It triggers avalanche in the snow covered mountains. ^ It may cause Glacial Lake Outburst Flood in the Himalaya Region. ^ It may cause Tsunami if it occurs in the Ocean. Taking Earthquake Safety Precautions There is no effective warning system for Earthquakes, which makes preliminary precautions. Knowing how to behave when a quake strikes and what to do after the event is important to staying safe. Before the Earthquake Research the area and find out if you live near an active fault line and whether or not the ground around you is more susceptible to the effects of an Earthquake. If you are in a high-risk area, take steps to reinforce your house. Secure any furniture such as bookshelves and cabinets to the walls to minimize risk of falling over during a quake. Put together an emergency bag. Your bag should include non-perishable food, water, first aid supplies, flashlights, battery-powered lantern, extra batteries, medications, toiletries, clothing, etc. Secure large appliances such as refrigerators, water heaters and other bulky items with straps, bolts, and other stabilizing methods. Do not put heavy, mirrors, or shelves over beds. Firmly secure bookcases, artwork, mounted televisions and other objects to withstand as much shaking as possible. Set up a family meeting location in a safe area. Teach all family members basic first aid, how to behave during a quake, and what to do after a quake. During the Earthquake Stay away from windows and furniture that could potentially fall over. Take cover in a safe place in your house. Get under a sturdy table or desk to avoid being hit by anything. If you cannot take safe cover, protect your head and neck with your arms. 271

Do not try and go outside until after the shaking stops. If you are already indoors, you are safer taking cover inside than attempting to leave your house during an Earthquake. Cover the back of your head and your eyes to minimize injury from flying debris. If cooking, turn off heating elements immediately. If outdoors, stay in open areas away from buildings, power lines, trees, and other potential hazards. If driving, stop quickly but safely and stay in the vehicle. Do not stop near power lines, bridges, overpasses, or other potentially dangerous locations. After the Earthquake Be prepared for aftershocks. These can last for days or even weeks after a major Earthquake. Get treatment for injuries immediately and summon emergency assistance if necessary. Check for structural damage, but do not enter a building that shows damage or has visible cracks in the walls or foundation. Turn off gas, electricity and water supply. Keep phone lines clear for emergency use. It may take hours or days to restore all services depending on the severity of the quake. Check for damaged electrical wiring. Shut off the power if you see damaged wiring in your house. 2. Flood A flood is an overflow of water that submerges land. It can be defined, as “ flood is a temporary covering of land by water”. It is a natural event where a piece of land that is usually dry land, suddenly gets submerged under water. It is extremely dangerous and has the potential to wipe away an entire city Tragedy of Flood or village area, crop land, etc and cause extensive damage to life and property. Some floods can occur suddenly and recede quickly. Others take days or even months to discharge. When floods occur in an area, the water carries along objects like houses, bridges, cars, furniture and even people. It can wipe away farms, trees and many more heavy items. 272

Causes of Flood i. Rain Rain is a cause of flood. Sometimes, there is heavy rain for a very short period that results into flash-flood. In other times, there may be light rain for many days and weeks also can result into Flood. ii. River Overflow Rivers can overflow their banks to cause flooding. This happens when there is more water upstream than usual and as it flows downstream to the adjacent low-lying areas. There is a burst and water gets into the low land. iii. Dam Breaking Dams are man-made blocks mounted to hold water flowing down from a highland. The power in the water is used to turn propellers to generate electricity. Sometimes, too much water held up in the dam can cause it to break and overflow the area. Excess water can also be intentionally released from the dam to prevent it from breaking and that can cause Flood. Precaution Before the Flood Know about your local relief centers and evacuation routes. Avoid building in a floodplain area. Construct barriers (levees, beams, floodwalls) to stop floodwater from entering your home. If a flood is likely in your area, listen to the radio or television for information. Be prepared! Pack a bag with important items in case you need to evacuate. If advised to evacuate your home, do so immediately. If there is any possibility of a flash-flood, move immediately to higher ground. Precaution During the Flood Do not walk through moving water. If you have to walk in water, wherever possible, walk where the water is not moving. Use a stick to check the firmness of the ground in front of you. Do not drive into flooded areas. Do not touch electrical equipment if you are wet or standing in water. Precaution after the Flood Avoid floodwater; water may be contaminated by sewage and harmful materials. Return home only when authorities indicate that it is safe. Stay out of any building if it is surrounded by floodwater. Repair damaged septic tanks, cesspools, pits, etc as soon as possible. Clean and disinfect everything that got wet. 273

Prevention Measures of Flood By constructing the banks on the riverside, Flood area, etc. By planting trees on either side of the stream and rivers. Deforestation and over grazing should be stopped. The direction of river must be confined to fixed path as it protects the surrounding lands. 3. Landslide Landslide is a downward movement of soil, rock or vegetation due to gravitational force. A landslide happens when rocks, debris, and soil move down a slope. It is also known as landslip. They can occur due to natural causes or from the activities of people. Among the natural hazards that occur regularly in Nepal, floods and landslides are by far the most serious ones. They claim many human lives every year and cause other damages such as destruction and blockages of highways, losses of livestock, crops, and agricultural land. A landslide occurs when part of a natural slope is unstable and unable to support its own weight. Similarly, if a slippery material is present below soil then soil can become heavy with rainwater and it becomes prone to landslide. Moreover, the geology or strength of the Earth material itself can also be a factor in landslide. Causes of Landslide Steep sloppy mountains and hills with loosely arranged soil is the major natural factor of it. Weakness in the composition or geological structure of rock or soil formation. Earthquakes or volcanic eruption. Removal of vegetation cover and deforestation. Construction work without environment impact assessment. Intense heavy rainfall. Deposition of loose sediments in certain areas. Consequences of Landslide Landslides may cause death and injury to people and animals. The moving mass can bury people and animals under debris. It may cause loss of property and assets. Earth mass can block or damage infrastructures such as roads, railway, bridges, electrical supply lines, etc. Earth mass can effect water recourses in the area by blocking rivers and irrigation channels and diverting water ways. Productive land area may be covered with debris it may result in the loss of agricultural land. 274

Landslides may cause loss of places of archaeological, historical and cultural importance. Preventive Measures of Landslides Retaining walls should be constructed where Landslides occurs frequently. Terrace farming should be followed in hilly regions. Deforestation, over grazing, etc should be stopped. People should be aware of the causes and preventive measures of Landslides. Bare land should be protected by afforestation. Provisions should be made at community level to prevent people from excavating, removing materials from the soil or cutting trees in a haphazard manner. Trees should be planted on slopes and slope base to prevent erosion. Before building house, information should be gathered about structure of the land. 4. Avalanche A mass of snow, ice, and rocks falling rapidly down a mountainside is called avalanche. The term avalanche generally denotes the descent of mass of snow, compounded with ice and rock down a mountain slope. In winter, avalanches are caused when fresh snow falls and slips off the snow surface. In spring, they are produced when partly Avalanche thawed snow rolls down mountain slopes. Avalanches also occur when edges of glaciers in high mountains break off. These avalanches sometimes achieve velocities as high as 400 km per hour. They can travel sometimes with devastating effects on human life. Causes of Avalanche Avalanche occurs due to various reasons. There is no one reason behind the development of avalanches. The sudden addition of weight can fracture a weak area of snow. Scientific understanding of avalanches shows us that there are many factors. They are mentioned below: i. Snowstorm and Wind Direction: Heavy snowstorms are more likely to cause avalanches. The 24 hours after a Storm are considered to be the most critical. Wind normally blows from one side of the slope of mountain to another side. While blowing up, it will scour snow off the surface which can overhang a mountain. It may eventually cause avalanche. 275

ii. Heavy snowfall: Heavy snowfall deposits snow in unstable areas and puts pressure on the snow-pack. Precipitation of snow during the summer months is the leading cause of wet snow avalanches. iii. Warm Temperature: Warm temperatures that can last several hours a day can weaken some of the upper layers of snow and cause it to slide down. iv. Human Activity: Humans have contributed to the start of many avalanches in recent years. Winter sports that require steep slopes often put pressure on the snow-pack. Further, construction work done with explosives, which tend to weaken the entire surrounding area and ultimately it becomes the cause of avalanche. Effects of Avalanche There is little damage to the overall ecological system due to avalanches. However, they are a major natural hazard for the local human population. People who enjoy skiing and snowboarding are at a greater risk of losing their lives. An avalanche can block anything in its path. Ski business and mountaineering go down until the avalanche decreases and weather conditions become suitable. Preventive Measures of Avalanche Spread of knowledge about the causes and precautionary measures of Avalanche. Disposing the avalanche potential snow packs by artificial triggering. Predicting the occurrence of avalanches through stability analysis. Guiding the residents about the emergency evacuation shelters. 5. Glacier Lake Outburst Flood (GLOF) The high mountains of Nepal, covering about 15 percent of the country, are quite susceptible to Glacial Lake Outburst Floods (GLOF). These mountains, with an average elevation of 4, 500 m above are mostly covered with snow and ice throughout the year. Since the second half of the 20th century, the large glaciers of the high Tilicho Glacier Lake mountains have been experiencing rapid melting, resulting in the formation of a large number of glacial lakes. This may well be a result of global warming. A glacier terminus dammed by moraine forms almost all the glacial lakes in the Himalayas. These moraine dams are not geologically strong enough and a slight disturbance can break the balance of the structure. It may results into an abrupt release of a great amount of water and generates flood. These floods can cause serious damage to infrastructure, houses, and the environment along the flood path downstream. This phenomenon is called a Glacial Lake Outburst Flood (GLOF). 276

A Glacial Lake Outburst Flood (GLOF) is a type of outburst flood that occurs when the dam of the glacial lake collapse. Such floods endanger thousands of people, hundreds of villages, and basic physical infrastructure such as houses, bridges, dams, roads, towers, etc. Recently, global climate change has invited enormous environmental hazards and disasters in the Hindu-Kush Himalayan region including Nepal. Causes of GLOF There are various types of factors which trigger the GLOF events in the snow peaked mountain region. Some of the causes are mentioned below: Climate Change Avalanches Earthquakes Volcanic Eruption Mine Blasting nearby the glacier lake area Nuclear test and explosion etc Trend of GLOF Events in Nepal With the effect of global warming; many big glaciers have melted rapidly and resulted in a large number of glacial lakes. Recently, UNEP and ICIMOD joint research team have identified 2,323 glacial lakes in Nepal. Nepal has experienced at least 24 GLOF events in the past. At present, 20 glacial lakes in Nepal have become potentially dangerous as a result of climate change. Glacial Lake Outburst Floods (GLOFs) are not a new phenomenon but there is evidence that the frequency of such events has risen over the past three decades. The details of those GLOF events are mentioned in the following table: Table 10.2: Glacier Lake Outburst Flood (GLOF) Events in Nepal Date River basin Lake Cause Losses 450 years ago Seti Khola Machha puchchhre Moraine Pokhara valley covered by 3rd Sep 1977 Dudh Koshi Nare collapse 50–60 meter deep debris Moraine Human lives, bridges, collapse others 23rd Jun 1980 Tamor Nagma Moraine Villages destroyed 71 km 4th Aug 1985 Dudh Koshi Pokhari collapse from source Dig Tsho Avalanche 5 human lives, Namche small hydropower station & 14 bridges 277

12th Jul 1991 Tama Koshi Chubung Moraine Houses, farmland, etc. collapse 3rd Sep 1998 Dudh Koshi Chubung Moraine Human lives and more collapse than Rs. 156 million 15th Aug 2003 Madi River Kabache Moraine Not known Lake collapse 8th Aug 2004 Madi River Kabache Moraine Not known Lake collapse Unknown Arun Barun Moraine Not known Khola collapse Unknown Arun Barun Moraine Not known Khola collapse Unknown Dudh Koshi Chokarma Moraine Not known Cho collapse Unknown Kali Gandaki Unnamed Moraine Not known (Mustang) collapse Unknown Kali Gandaki Unnamed Moraine Not known (Mustang) collapse Unknown Mugu Unnamed Moraine Not known Karnali (Mugu) collapse 5th May 2012 Seti River Unnamed Avalanche 20 human lives (Annapurna) Source: ICIMOD, 2012 AD Precautionary Measures to GLOF There should be regular monitoring and survey of the Glacier Lakes. The people in the affected area need to be aware and educated about the causes, impact and precautionary measures against the occurrence of GLOF. There should be proper evacuation system for the affected people in the safe place in advance in the case of accidental GLOF events. There should be provision of essential things to the affected people such as drinking water, food, sanitation services, clothing, medicines and health service, etc. There should be provision of minimum basic health service to that targeted population. B. Risks Induced by Human Activities The risk associated to the loss of life, property and physical structures due to the human activities is known as human induced risk. It causes adverse impact on the 278

socio-economic life of the people. We admit that many impossible things in the past are made possible at present due to the advancement in science and technology but at the same time, there is incomparable loss in the health and wellbeing of the human life. For instance, the number of factories and industries are increasing day by day, however the health risk of the people working in those sectors is also increasing at the same time. Some of the risks resulted by human activities are mentioned below: i. Risk of Flood due to the burst of riverbank. ii. Risk of Landslide due to deforestation. iii. Risk of fire due to the negligence in use of fire. iv. Risk of civil war due to internal conflict. v. Risk of loss of life and property due to explosion in the industries. vi. Risk resulted by social conflict and war. vii. Risk resulted by mine accident. After a certain phase of life, we are engaged in different occupations or professions to make our livelihood. There is high chance of various kinds of health risks in our life when we are working. When we are working, many forms of health hazards may likely to come in our life. At the same time, a hazard is considered as any biological, chemical, mechanical, environmental or physical agent that is reasonably likely to cause harm or damage human health and even life in the absence of its control. Those health hazard agents include electricity, pathogens, motor vehicles, nuclear power plants, pesticides, vaccines, X-rays, chemicals, machineries, etc. Some of the health risks likely to appear among the workers in various occupations and professions are mentioned below: 1. Physical Hazards A physical risk is a type of occupational risk that involves environmental hazards that can cause harm with or without contact. Physical risk is rested by radiation, heat and cold stress, vibration and noise hazards. A physical hazard or risk has the potential to create loss or damage to the human health. Different kinds of health risks or hazards are likely to come among the workers due to the physical condition of the working site. For instance, too much cold and too much high temperature in the work place increases the health risk among the working staffs of that place. Similarly, if there is noise pollution at the work place; the exposure of ears in such a noisy place for a long period causes hearing problem, hypertension, including mental stress and indigestion problems. Moreover, X-rays has been utilized by humans for medical purposes. However, overexposure can lead to cancer. 279

2. Chemical Hazards The workers are supposed to work with various types of chemicals. The workers are vulnerable to health risk because of chemical hazards. A chemical can be considered a hazard if it can cause harm or danger to human health or the environment. Some of the harmful chemicals include products with commercial uses such as agricultural and industrial chemicals as well as products developed for home use. Pesticides, which are normally used to control unwanted insects and plants may cause a variety of negative effects on non-target organisms. The pesticide called Dieldrin has been linked to Parkinson’s disease. Corrosive chemicals like sulfuric acid, which is found in car batteries and research laboratories can cause severe skin burns. Many other chemicals used in industries and laboratories can cause respiratory, digestive, or nervous system problems if they are inhaled, ingested or absorbed through the skin. Moreover, some of the diseases cause allergy also. Therefore, to reduce these risks, they should follow all possible precautionary measures. 3. Biological Hazards There may be presence of various kinds of pathogens like virus and bacteria and parasites. Those pathogens increase health risk among the workers. Many biological hazards are associated with food, including certain viruses, parasites, fungi, bacteria and plants. The farmers working in the field, and working in animal husbandry and poultry farm are prone to various kinds of zoonotic and pathogenic diseases. Good hygiene and sanitation like not working in the field with barefoot and washing hands with soap and water can help to prevent from health risks. 4. Mechanical Hazards A mechanical hazard is any hazard associated with machine and its processing. The workers who are supposed to work with various types of machines are prone to mechanical hazards. They may get injury while working with machines and other apparatuses. This kind of risk may also cause disability and sometimes even may take in the mouth of death. Motor vehicles, aircraft, and other mechanical devices pose mechanical hazards. Therefore, we should be always careful while working with mechanical devices. We should never be careless while working with machines. All of the devices should be kept in proper order in the working site. 10.3 Concept of Safety Education 10.3.1 Introduction to Safety Education Safety Education is an educational process which provides knowledge to the individuals about safety rules and measures. It also encourages them to follow safety rules in order to keep them safe from the danger of incidence of accidents. Safety education educates individuals on various safety rules and measures at 280

work, at school, on the road and in daily life. In other words, Safety Education is an educational process which teaches about the rules, means and measures to keep us safe from the danger of incidence of accidents. In fact, we get knowledge of different preventing measures about the accidents through Safety Education. Safety Education prepares us to have a safe and productive life. Accidents may occur due to lack of knowledge on safety rules and measures as well as carelessness. Generally, teenagers very often meet accidents due to overconfidence and show off behavior. The rate of accidents is increasing with the pace of physical development and modernization. Sometimes, accident may take place due to failure of machines, unfavorable weather also. In this situation, Safety Education helps to get the work done safely. 10.3.2 Importance of Safety Education Safety Education provides us knowledge about how to keep ourselves safe even in dangerous condition. It helps to reduce the rate of incidence of accidents. It helps to prevent people from unnecessary waste of money and time. It helps people to live a safe and productive life. People can be saved from disabilities, injuries and even premature death. 10.3.3 Management of Safety Measures Our home, roads, play ground and class rooms should be safely managed. We can save our lives from the incidence of accidents through safety measures. In this situation, we have to adopt safety rules and measures everywhere for the safe and productive life. In this regard, some safety measures need to be applied at home, courtyard, road, playground and school are discussed below: A. Safety Measures at Home We need a home for a safe life. We need to manage safety measures to keep our home safe from the incidence of the accidents. While making provisions of safety measure at home, we have to consider several aspects such as proper management of electricity, lighting, water supply, furniture, kitchen, etc. If we are able to manage minor safety House for Safe Living measures at home, we can protect ourselves from the incidences from minor to major accidents and can have safe and productive life. Some of the safety measures that have to be followed at home are mentioned in the points that are given below: e Keep the kitchen appliances in proper order 281

e Keep electric wire safe and repair the bare wire timely e Keep medicines in safe place e The sharp instruments like knife, scissors, sickles, spades, shavels, etc should be handled and kept safely e Stairs, balcony, windows and terraces should be well protected with iron bars e Stairs, toilet floor and kitchen floor should not be left wet and slippery e Inflammable objects should be kept safely away from the kitchen e Railing or handrail should be kept on the stairs e Never use slippery sandal in the bathroom e Do not make ditches in the courtyard B. Safety Measures on the Road Road is also a place where the incidence of accidents occur frequently. Indeed, the rate of road accidents is increasing faster than accident in other places. If safety measures are not followed in proper way, we may even loose our life. Therefore, all the citizens of the country should get safety education and should be well prepared with the knowledge A Minor Cycle Accident on the Road and skill of safety measures to be applied on the road. We can follow the following safety measures on the road: e Cross the road at zebra crossing and where there is no such facility, cross the road carefully watching right and left e Use overhead bridge and sub-way to cross the road if they are available e Do not play in the road e Follow the traffic rules while driving e Do not show stunt on the road e Get up and get down carefully in a queue e Do not drive vehicles under the influence of alcohol and drugsof alcohol and drugs e Always walk on the footpath e Do not take out hands, head and any part of the body out of the window from the vehicles e Wear seat belt or helmet while driving e Do not disturb driver’s attention 282

C. Safety Measures at School There is the chance of several kinds of incidence of accidents at school. If we are aware of those possible accidents and follow the safety measures and safety rules accordingly, we can have safe and productive life. So, there should be provision of all possible safety measures to prevent the students and other people from the incidence Safety Training at School of the accidents. Some of the safety measures to be followed at school are as follows: e Keep the materials at safe place e Repair the desk, benches and other furniture in time e Keep the electric wire and devices in proper condition e The condition of window and door should be safe and proper e Be careful while getting up and down the stairs e Laboratory equipment and devices should be properly labelled and kept safely e Hand rail or steel bar should be set on the staircase e There should be facility of fire extinguisher at different corner of the buildings e Dustbins should be placed at different places e There should be adequate light facility in the classroom D. Safety Measures on the School Ground e Playground should be far from school buildings e Playground should be managed safely e Games should be played under the guidance of the teachers only e Games should be played according to the rules of the game and sportsmanship e Warming up exercise must be performed before playing any games e Proper inspection should be made to confirm whether the playing facilities and equipments are in proper conditions e Supervise and clean the playground thoroughly before the game starts e Do not play during unfavourable weather Activity Write down the safety rules on the playground, school and home on different pieces of chart papers and stick on the suitable places at different corners at your school for safety awareness. 283

Summary M Primary health care is an essential health care made universally accessible to individuals and acceptable to them through their full participation and at a cost the community and country can afford. M The concept of Primary Health Care was introduced at the International Conference on Health by WHO in 1978 AD. M Safety education is an educational process which teaches individuals about the rules and encourages them to use the means and resources for the safe and productive life. M Simply, risk can be defined as the threatening event in relation to the vulnerability to the damage of life, health, property, and the environment that may be caused by probability of calamities. M Magnitude and frequency of risk increases due to Storm, Hurricane, Precipitation of Hailstone, Tsunami, Earthquake, Volcanic Eruption, etc. M Those people and communities who are the victims of those dreadful and devastating calamities should get full support by the government, community, and nongovernmental organizations. M The task of identification, analysis, assessment, control, or minimization of unacceptable risks is called risk management. M The risks resulted by the natural disasters is called risk induced by the natural disaster. M The natural disasters like Storm, Lightning thunder, Hurricane, Precipitation of Hailstone, Tsunami, Glacial Lake Outburst Flood, soil erosion, cold wave, forest fire, Earthquake, Volcanic Eruption cause a great loss to life and property. M An Earthquake is the result of a sudden release of energy in the Earth’s crust that creates seismic waves. At the Earth’s surface, Earthquakes manifest themselves by vibration, shaking and sometimes displacement of the ground. M Geologically, Nepal is considered to lie on a seismic zone which experiences frequent Earthquakes. As a result, Earthquakes of various magnitudes occur almost every year and have caused heavy losses of lives on several occasions. M A Flood is an overflow of water that submerges land. M Landslide is a downward or outward movement of soil, rock or vegetation due to gravitational force. A Landslide happens when rocks, debris, and soil move down a slope. It is also known as landslip. M These moraine dams are not geologically consolidated enough and a slight disturbance can break the balance of the structure, resulting in an abrupt release of a great amount of water causes GLOF. 284

Exercise A. Very short answer questions. 1. What do you mean by risk? 2. What is Flood? 3. What is primary health care? 4. When was the Alma-Ata conference held? 5. What is Safety Education? B. Short answer questions. 1. Write any four precautionary measures from natural disasters. 2. List down the aspects of Primary Health Care and explain any two of them. 3. Mention the characteristics of Primary Health Care. 4. Mention the importance of Primary Health Care. 5. What is Earthquake? Explain the precautions to be adopted during and after the Earthquake. 6. What is Avalanche? Mention the causes and precautionary measures of Avalanche. 7. Explain the safety measures to be adopted on the playground. C. Write short notes on: 1. Glacieral Lake Outburst Flood 2. Risk resulted by human induced disaster 3. Safety measures on the road D. Write differences: 1. Risk induced from natural disaster and the human induced risks 2. Landslide and Avalanche 3. Altitude sickness and allergy E. Long answer questions. 1. Mention the safety measures that can be applied on the road, school, home and play ground. 2. What is flood? Examine the causes, consequences and preventive and control measures of landslide. Project Work Prepare a one-day package orientation program on “safety on the playground, school and home”. Divide your class into 4/5 groups and conduct this program to the juniors in your school. 285

286 Specification Grid ljlzi6Ls/0f tflnsf @)&# k\"0ff{ªs\\ M &% ljifo M :jf:Yo, hg;ªV\\ of / jftfj/0f lzIff – sIff ( / !) qm= ;= PsfO kf7o\\ ef/ 1fg -@^=^^ k|ltzt_ jf]w -#)=^^ kl| tzt_ k|of]u -@!=## k|ltzt_ pRr bIftf -@!=## k|ltzt_ Knowledge Understanding Application Higher Ability S.N. Unit Textbook clt 5f6] f] 5f6] f] nfdf] clt 5f]6f] 5f6] f] nfdf] clt 5f6] f] 5f6] f] nfdf] clt 5f]6f] 5f6] f] nfdf] != :jf:Yo hg;V+ of / jftfj/0f !^ !! lzIffsf] cjwf/0ff @= hg;fl+ VosL, hg;V+ of !& !!! kl/jtg{ / Joj:yfkg #= hg;+Vof, jftfj/0f / ljsf; !$ !! $= gk] fnsf] hg;f+lVos l:ylt / !* ! ! jftfj/0f ! %= kf/Ljfl/s hLjg lzIff tyf !* !! u'0f:t/Lo hLjg ^= k|fjm[ lQs ;f| t] tyf h}ljs !* ! ! ! ljljwtf &= jtfj/0fLo :jf:Yo / /fu] x¿ !* ! ! *= lszf/] fj:yf of}g tyf k|hgg\\ !& !! :jf:Yo lzIff (= pkefQ] mf :jf:Yo tyf ;fd'bflos !* !! ! :jf:Yo !)= k|fylds :jf:Yo x]/rfx / !^ ! ! hf]lvd kl| t ;fjwfgL tyf ;'/Iff hDdf !&) % @ ! $ # ! ! @ ! ! @ !

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A set of model question Group A (Very short answer questions) Attempt all the questions from this group (11x 1 = 11) 1. What is population education? 2. Mention any two applications of sample survey. 3. Under which aspect of infrastructure of development do road and buildings come? 4. What is urbanization? 5. Mention any two characteristics of founding stage in a family life cycle. 6. Define relative conservation principle of natural resources. 7. Name any two recyclable waste. 8. Why is proliferative phase of menses cycle also called as follicular phase? Give one reason. 9. Mention any two provisions provided by Drug Abuse Control Act, 2033 BS. 10. What is primary health care? 11. Mention any two causes of avalanche. Group B (Short answer questions) Attempt all the questions from this group (9 x 4 = 36) 1. Why is population education called as a multidisciplinary subject? 2. What is sample survey? Mention its merits and demerits. OR Mention the impact of migration on socio-economic and environmental aspects. 3. Briefly explain about the infrastructures of development. 4. Critically examine the causes and consequences of unequal population distribution in Nepal by ecological region. 288

5. What type of family do you prefer? Why? 6. In what sense absolute conservation of natural resources is essential? Explain with justification. OR Natural resources should be exploited within the limit of carrying capacity of the Earth. Why? 7. Write the difference between aerobic and anaerobic composting method. 8. How is the sex of an unborn baby determined? 9. What is quality food? How can you identify quality food? OR What is balanced diet? How can you prepare balanced diet from locally available food sources? Group C (Long answer questions) Attempt all the questions from this group (4 x 7 = 28) 1. Give an introduction to human resource. Why is it necessary to give priority in human resource development for the development of the nation? Justify with suitable examples. 2. How do you classify the various categories of municipalities in terms of minimum population, average annual revenue, infrastructure facilities and other associated criteria. 3. What is natural resource? Explain the types of forest available in Nepal. 4. Mention the provisions of consumers’ rights provided by Consumer Protection Act, 2054 BS. Are the existing consumer laws strong enough to control artificial scarcity and black marketing in the country? Give your opinion. 289

A Sample of Project Work Level of Knowledge on HIV and AIDS Among the Sajha Yatayat Bus Drivers (A Case Study of Lalitpur, Pulchowk) CHAPTER - 1 (Introduction) 1.1 Background of the Study The worldwide incidence of sexually transmitted infections is high and increasing. The spread of infection by the human immune deficiency virus (HIV) continues to pose in all countries. Thus, there is an argent need for all countries to design, implement, monitor, and continuously improve public health programmes for the prevention and control of these epidemics. AIDS has really become much more than a health crisis. Its effects to nearly every dimension of social and economic life, especially in the most affected countries. Although the magnitude of the epidemic varies, in every country, AIDS primarily strikes adults between the ages of 24 to 45 years. People are generally infected in their adolescents and young adult years. AIDS has become one of the greatest challenges faced by humankind today and is perceived as a dreaded public problem in the world. Never before has so much effort been directed towards a single disease AIDS spread by HIV. AIDS was recognized as an emerging disease only in early 1980s. AIDS has rapidly established itself throughout the world as a major concern in both developed and developing countries. In these countries, the infections are transmitted mainly through hetero sexual intercourse and the number of new cases is rising and rapidly among women. The first case of HIV in Nepal was detected in a foreign visitor in July 1988. The number of HIV/AIDS has been increasing rapidly since then. The WHO/UNAIDS Global Report estimates that there are more than 70,000 HIV infected persons in Nepal. Among all Intravenous drug users (IDUs) in Nepal (estimated to be 70,000), among them approximately (60%) are HIV positive. 1.2 Objectives of the Study i. To assess the level of knowledge on mode of transmission of HIV and AIDS among the respondents. ii. To analyze the level of knowledge on preventive measures of HIV and AIDS among the respondents. 290

1.3 Significance of the Study The growing incidence of HIV/AIDS demands substantially higher investments in new methods of prevention, diagnosis, and treatment. The prevalence rate of HIV and AIDS among different socio-economic status groups are different. The bus drivers are also an independent group of population having diverse socio-economic characteristics. They constitute a high-risk group because of their marginalized socio-economic background. Hence, the policy makers, development planners, and programme managers cannot ignore this vulnerable sub-group of population if their efforts in preventing and controlling HIV and AIDS are to be made successful. Hence, it is believed that, the present study on this sub-population would definitely provide landmark information on the level of knowledge on HIV and AIDS. 1.4 Limitation of the Study The study has attempted to assess the level of the knowledge of HIV and AIDS among the bus drivers of Sajha Yatyat. However, the followings are the limitations, which may be acceptable to this study. i. This study is limited to bus drivers. The study ignores other occupational groups. ii. This study is limited to bus drivers of Sajha Yatyat at the Pulchowk, Lalitpur Sub- metropolitan City. The result of this study may not be generalized for other places elsewhere in Nepal. CHAPTER - 2 (Methodology) This study was conducted to obtain information about the level of knowledge on HIV and AIDS among the bus drivers of Sajha Yatyat in Lalitpur Sub-metropolitan City. This section elaborates the methods employed to accomplish the study objectives. 2.1 Study Area The study was conducted at Pulchowk, Lalitpur Sub-metropolitan City. It is the most densely populated urban centre in Nepal. In this city, population is increasing in skyrocketing speed. Hence, there is a potential scope of bus driving as an important 291

part of transportation service. In this context, a remarkable population of bus drivers in this sub-metropolis may be in the risk of life threatening disease HIV and AIDS. Considering this fact, this area was selected for the study. Moreover, this area was chosen due to convenience in terms of circumstances, budget, and time. 2.2 Sources of Data The first hand data for the study was obtained from the field survey conducted in the study area. Hence, the data is primary in nature. However, at the same time secondary data were also used from various sources like books, journals, and internets to make the study meaningful. 2.3 Method of Data Collection After confirming the study area, the primary data were collected by face-to- face interview method with the help of question-schedule. A set of question- schedule was developed as a tool for interview to collect the data about the level of knowledge on HIV and AIDS. Along with the primary data, secondary data from different books, journals, newspapers, research reports, and websites were collected as well. CHAPTER - 3 (Findings, Conclusion, and Recommendation) 3.1 Findings 3.1.1 Knowledge Level of the Respondents on HIV and AIDS This section describes the frequency distribution of the responds by their knowledge with regard to what they have heard about HIV and AIDS, sources of knowledge, mode of transmission and level of knowledge on prevention against the infection among the responds have been analyzed in this section. 3.1.2 Hearing of HIV and AIDS The study found that among the total 10 Sajha Yatayat drivers, who had been interviewed, all of them reported that they had heard of HIV and AIDS. The following table illustrates it: 292

Table 1: Distribution of the Respondents by Hearing about HIV and AIDS Heard of HIV and AIDS Population Percent Yes 10 100 No -- 0.00 10 100 Total Field Survey, 2016 AD 3.1.3 Knowledge Level of on Transmission of HIV and AIDS The respondents were asked the question: whether the HIV infection was transmissible. It was found that all of them (100%) reported that HIV and AIDS are transmissible. It shows that all of the drivers of Sajha Yatayat in the study area have correct knowledge on transmission of HIV and AIDS. Table 2: Distribution of the Respondents by their Knowledge Level on Transmission Is HIV a Transmissible Disease Population Percent Yes 10 100 No -- 0.00 10 100 Total Field Survey, 2016 AD 3.1.4 Knowledge Level of Respondents on Modes of Transmission and Non- transmission of HIV and AIDS During the interview, the respondents were asked about the modes of transmission and/or non - transmission of HIV and AIDS. The result shows that (40%) of them wrongly reported that HIV and AIDS could be transmitted through casual contacts (i.e. shaking hands, hugging and kissing). Similarly, (10%) reported that HIV and AIDS do not transmit through clothes. The study also revealed that (70%) of the respondents had misconception about the transmission of HIV and AIDS via insects and mosquito bites. They reported that HIV and AIDS could be transmitted through mosquito and other insect bites. The remaining (3%) opined that transmission of HIV and AIDS by insects and mosquito bites is impossible. Moreover, all of the respondents (100%) believed that infected mothers could transmit HIV and AIDS to babies through breast feeding practice. Among the total 293

respondents, all of them (100%) reported that HIV and AIDS could be transmitted through unscreened blood transfusion. There was correct knowledge of all respondents in the case transmission or/and non-transmission of HIV and AIDS by unsafe sexual intercourse, sharing of infected needles and piercing objects and breastfeeding practice by infected mother. The study reveals that the bus drivers seemed to have relatively higher level of correct knowledge on the mode of transmission of HIV and AIDS. The following table illustrates the level of knowledge on mode of transmission and/ or non-transmission of HIV and AIDS: Table 3: Distribution of the Respondents by their Knowledge on Mode of Transmission Mode of Transmission of HIV and AIDS Population Percent Casual contact 4 40.0 Insect and mosquito bite 7 70.0 Infected mother to unborn baby 10 100.0 Unsafe sexual contact 10 100.0 Transfusion of unscreened blood 10 100.0 Sharing of infected needles 10 100.0 Breastfeeding by infected mother 10 100.0 Sharing of clothes with infected persons 9 90.0 Field Survey, 2016 AD [Note: The total percentage is more than 100 because of multiple responses.] 3.1.5 Knowledge Level of Respondents on Preventive Measures of HIV and AIDS In order to get information about the level of knowledge on preventive measures against HIV infection, the respondents were asked to say whether HIV infection is preventable or not. All of them reported that HIV and AIDS could be prevented. In addition, they were also asked to mention different preventive measures by their own knowledge. In this context, (90%) of them said that HIV infection could be prevented by avoiding multiple sex partners, (100%) of them opined that it could be prevented by using condom during intercourse. Similarly, (80%) of them believed that it could be prevented by avoiding transfusion of unscreened blood. On the other hand, only, by HIV infected women. Moreover, (80%) of the respondents did have wrong 294

perception on preventive measures against this disease such as (90%) of them said that HIV infection can be prevented by not sharing toilet with the infected person and 80% opined that a person can be prevented by not sharing clothes with the HIV infected person. Similarly, all of them (100%) opined that it could be prevented by not eating together with the infected person. In fact, these are the wrong perception about the preventive measures of HIV and AIDS. Table 4: Distribution of the Respondents by their Knowledge Level on Preventive Measures Against HIV Infection. Preventive Measures against HIV and AIDS Population Percent Avoiding multiple sex partners 9 90.0 Avoiding transfusion of unscreened blood 8 80.0 Not getting pregnancy by infected women 5 50.0 Proper use of condom during casual sexual intercourse 10 100.0 By using disposable syringes 4 40.0 By not breastfeeding by infected mother 7 70.0 By not sharing of clothes with infected persons 8 80.0 By not sharing toilets with the infected persons 9 90.0 By not eating together with the infected persons 10 100.0 Source: Field Survey, 2016 AD 3.2 Conclusion and Recommendation This study has obtained information on the knowledge of HIV and AIDS among the Tempo drivers in the Kathmandu metropolis. The drivers’ level of knowledge on HIV and AIDS with regard to modes of transmission or/and non-transmission was insignificant. Certain false beliefs in relation to casuals social contacts may lead to unnecessary fears and discrimination against HIV positive people among these communities. Similarly, a remarkable proportion of the respondents had false positive beliefs that insects and mosquitoes could be carrier of HIV. Hence, there is an urgent need for public campaign and group counseling by the concerned authorities, agencies, and volunteer groups to these target groups about HIV and AIDS. 295

References Bhattarai, M., 1997, “Parkhanus AIDS Rog Tapaiko Pani Aphnai Samasya Ho” (Kathmandu: General Welfare Pratisthan) Pavri, M. Khorsad, 1996, Challenge of AIDS, (New Delhi: National Book Trust India) Rai, Ram Kumar, 2003, “Knowledge and Behavior of Minibus Drivers on HIV and AIDS”: A Case study of Kathmandu Metropolitan City, an unpublished Dissertation (Kathmandu: CDPS) Seddon, David, 1995, “AIDS in Nepal: Issues for consideration”, (Oregon: Portland University) United Nations, 1994, “Sexually Transmitted Disease and HIV/AIDS”, (Cairo: The UN) Appendix I. Respondent’s Personal Identification 1. Age-------------- 2. Caste/ethnicity------------------------- 3. Marital status--------------------------- II. Knowledge on HIV and AIDS 6. Have you heard of HIV and AIDS? a) Yes b) No 7. Can HIV be transmitted? a) Yes b) No 8. If yes, how are they transmitted? a) Shaking hands, hugging and kissing b) Sharing personal belongings c) From insect and mosquito bites d) Unsafe sexual intercourse e) from an infected woman to her unborn baby f) Through breastfeeding g) Transfusion of unscreened blood h) Sharing needles and syringes i) Others (Specify) 9. Can we prevent ourselves from HIV infection? a) Yes b) No 10. If yes, how? a) Avoiding transfusion of infected blood b) Avoiding pregnancy by infected woman c) Avoiding pregnancy by infected woman d) Using condom during intercourse e) Others (Specify) 296