ENVIRONMENT AND HUMAN HEALTH
Introduction
It is an established fact that environment has a direct impact on the physical, mental and social well-being of those living in it. The environmental factors range from housing, water supply and sanitation, psychosocial stress and family structure through social and economic support systems, to the organization of health and social welfare services in the community.
In fact the occurrence, prevention and control of disease lies in the environment. If the environment is favourable to the individual, he or she can make full use of his or her physical and mental capabilities. On the contrary, if the environment is polluted it can affect the human health and his susceptibility to illness.
Thus, protection and promotion of ‘environment health’ is one of the major global issues today. It includes the issues of urban environmental health, water quality and health, air quality and health, industry and health, and energy and health.
Urban Environment Health
Environmental degradation is especially serious around crowded urban centers. In cities around the world, the living conditions of hundreds of millions of people (especially poor people in developing nations) threaten their health, impose misery, have potentially catastrophic social consequences and contribute to illness, accidents and crime. The crises in the urban environment are causing more immediate effects on human health than the current changes in the natural environment.
In the developing nations, the current rural exodus has led to a rapid increase in the pre-urban populations living in overcrowded conditions with inadequate provisions of infrastructure and services. Though average rate of disease and death for many cities are lower than those of surrounding rural areas because of the presence of a high proportion of the nation’s middle- and upper-income classes who enjoy a relatively good standard of health; but, in contrast, the poor in urban areas usually suffer the same or even high rates of disease and death as their rural counterparts.
Good housing and suitable physical and social environments promote good mental and physical health. The most serious psychosocial health problems are depression, alcohol and drug abuse, suicide, child and spouse abuse, delinquency and target violence (e.g. rape, teacher assault, etc.). However, strong social networks and a sense of community organization can have a mitigating effect on the level of psychosocial health problems. Studies have shown a higher prevalence of mental illness in low-income, rundown areas. Deteriorating inner city areas or urban area with declining economies are characterized by social disorganization and disintegration. They are inhabited by high- risk populations such as migrants, the homeless and street children. It has now been recognized that the environment plays an important role in violent behavior and that the public health sector has a legitimate role within the justice, social and education sectors in reducing the problem or urban environmental health.
Effect of water quality on human health
Water quality can have a significant effect on public health as a result of waterborne diseases. Inadequate supplies of water increase the problem of maintaining water quality, especially when there are multiple sources of water pollution such as sewage, industrial effluents, urban and agricultural runoff. According to an estimate about 170 million urban inhabitants and 770 million rural inhabitants lack access to safe and adequate water supplies. Most urban centers in Africa and Asia have no sewerage system at all; even where there is sewage disposal system, the system rarely serves more than a small proportion of the population. This means that human excrement and household wastes end up untreated in water sources. The problem of maintaining water quality is particularly acute in the more urbanized areas in developing countries due to two main reasons-failures to enforce pollution control and inadequacy of sanitation system and garbage collection and disposal system.
Waterborne diseases are the largest single category of communicable diseases contributing to infant mortality in developing countries (about 1500 million cases of diarrhea and some 4 million deaths per year). It is estimated that safe and sufficient water supplies can reduce infant and child mortality by more than 50 per cent.
Effect of air pollution on human health
Air pollution is a growing menace to health throughout the world. The problem of air pollution was first brought to sharp focus when air pollution epidemics took place in Los Angeles (1948), Donora (1948) and London (1952).In the London epidemic of 1952, thousands of people became ill and some 4000 people died within 12 hours. According to an estimate more than 1000 million urban residents worldwide are exposed to outdoor air pollution levels higher than those recommended by WHO. In many cities, the concentrations of air pollutants are already high enough to cause morbidity in susceptible individuals and premature mortality in the aged, particularly in those with respiratory problems.
Fossil fuels are the largest source of air pollution. The major sources of urban air pollution are overwhelmingly coal-fired (or oil-fired) power stations, motor vehicles, domestic cooking and heating (particularly when coal or biomass fuel is used) and industries. The symptoms are usually referable to the respiratory system. Health may be affected if acidified water (due to Acid Rains) is used untreated in water supplies. Depletion of ozone layer, due to the release of specific air pollutants, increases the incidence of skin cancer and cataracts. The indirect health effects, however, are likely to be more significant, such as changes in rainfall that may decrease agricultural production and the spread of diseases such as malaria to currently unaffected areas.
Effect of industrialization on human health
Industrialization has made many positive contributions to health. By and large, as countries move towards industrialization and generate wealth and employment, improved health should follow for their people. However, there are two exceptions to the general correlation between industrialization and human health. One exception is in some developing countries where there has been remarkable success in reducing mortality and improving the health of the poor. The second exception is where industrialization has itself led to significant adverse health effects through failure to properly plan for, and prevent the release of chemical, physical or biological pollutants into the environment. A number of major accidents in developing countries due to release of chemicals or to explosions have caused adverse health effects.
Industrial effluents have polluted many rivers, lakes and coastal environments, especially in developing countries where pollution control is seldom enforced. Furthermore, hazardous wastes are sometimes exported from developed countries to developing countries because the cost of export is lower than the cost of disposal in the country of origin. Usually, there is little concern for the health of the local populations.
Some of the common occupation diseases are silicosis, pneumoconiosis, lead and mercury poisoning, and skin diseases. Continued and frequent exposure to noise, especially in industry, give rise to serious health problems.
Impact of energy on human health
Energy is a pre-requisite for socio-economic development and has direct and indirect benefits for health. The WHO Commission on Health and Environment’s Panel of Energy has identified four major environmental health issues related to energy:
· Urban air pollution resulting from fossil fuel combustion and vehicular exhausts;
· Indoor air pollution resulting from domestic use of coal and biomass fuels for cooking and heating;
· Accident prevention and control; and
· Possible consequences of climate change.
People in developed countries use about ten times more commercial energy than those in developing countries and burn approximately 70% of all the fossil fuel used globally. The combustion of fossil fuels, accounting for about 90% of global commercial energy production, is the largest source of greenhouse gases and atmospheric pollution. Vehicle emissions also contribute to the formation of tropospheric ozone, photochemical smog and acid rain. Though it is possible to mitigate the environmental health effects of fossil fuel combustion, but the technologies are expensive.
Indoor air pollution from the combustion of coal or unprocessed biomass fuels represents the biggest energy-related cause respiratory disease with long-term cardiovascular effects, particularly among women and children especially in developing countries.
In case of nuclear power plants, there are risks to health for present and future generations from accidents and unsafe disposal of nuclear wastes.
Indirect health effects from climatic changes result from increased levels of greenhouse gases produced by the combustion of fossil fuels.
Value Education
The field of value education is as broad as life itself. It touches every aspect of human life, personality and education. Value education, in its full range of meaning, includes developing the appropriate sensibilities-moral, cultural, spiritual and the ability to make proper value judgments and internalize them in one’s life. Simply stated, value education is an education which teaches:
· How to live life well?
· How to find happiness?
· How to make others happy?
· How to behave and communicate with others?
· How to manage all kinds of people as well as happenings?
· How to grow and succeed in the right manner?
Value education, thus, is essentially ‘Man Making’ and ‘Character Building’
The question then arises:”Which is more important-academic or value education?” The answer is simple, both are equally important. Without formal education, a person will not be able to read or write; and thus, without these skills to read or write, he/she cannot get a good job or manage even the simple things of daily living. Value education is equally important because if a highly qualified, well-employed person does not know how to behave properly, then all that he/she does has little meaning and will not serve him/her well. Therefore, fruitful education is the kind used for our welfare as well as that of others. And this can only happen when a person has both academic and value education.
Take the examples of two brilliant and very highly qualified scientists-one invents a life-saving drug, while the other invents a bomb. Though, both have a great deal of academic education but the scientist with character, a love for mankind and certain values, creates something that can save hundreds and thousands of lives; whereas, on the contrary, the other scientist creates something that can take hundreds and thousands of lives and cause pain and deformities even in future generations.
Emperor Asoka “The Great” had his early successes based on much violence. He became the King of Magadha only after killing nearly 90 of his kinsmen. One day, in the middle of the battle of Kalinga, he realised that there were no true victors in war because so many people died on both sides. He immediately renounced war and violence, and became a follower of Buddha and thus changed his entire life. He, then, served his people in wonderful ways. Even today, he is honoured and remembered. On the contrary, many leaders who gave up good values just to gain power met with failure and death in the end. Adolf Hitler, at one time the most powerful man on Earth, misused his power to confiscate land and money of others, tortured and killed millions of people, and caused the Second World War. But when defeat neared, he didn’t face it bravely-he killed himself. His power deserted him when he needed it most because he had gained that power by throwing away all the good values from his life. His power is just an external show, it was not inner strength.
Methods and strategies of imparting value education
The methods and strategies of imparting value education are many and varied. The selection depends much upon the value chosen, sources of development of these values and other limiting factors. The following approaches can be used for teaching values in character building activities:
1. Telling: It is a process for developing values to enable a pupil to have a clear picture of a value- laden situation by means of his own narration of the situation.
2. Inculcating: It is an approach geared towards instilling and internalizing norms into person’s own value systems.
3. Persuading: it is the process of convincing the learner to accept certain values and behave in accordance with what is acceptable.
4. Modeling: Modeling is a strategy in which a certain individual perceived as epitomizing desirable/ ideal values is presented to the learners as a model.
5. Role playing: acting out the true feelings of the actor/ actors by taking the role of another person but without the risk of reprisals.
6. Simulating: It is a strategy in which the learners are asked to pretend to be in a certain situation called for by the lesson and then to portray the events and also by imitating the character’s personality.
7. Problem solving: It is an approach wherein a dilemma is presented to the learners asking them what decision they are going to take.
8. Discussing situations, stories, pictures, etc: This technique asks the learners to deliberate on and explain the details in the lesson.
9. Studying biographies of great men: This is an approach that makes use of the lives of the great men as the subject-matter for trying to elicit their good deeds and thoughts worthy for emulation.
10. Moralizing: It is the process of working out a sense of morality through active structuring and restructuring of one’s social experiences (e.g. moral reasoning and analysis).
11. Value clarification: It may be considered as learner-centered. It relies mainly on the pupil’s ability to process his beliefs and behave according to his beliefs, and also, to make a decision whenever confronted with the value dilemma.
What is AIDS? What are the Sources and Mode of Transmission of HIV Infection?
AIDS, the Acquired immune-Deficiency Syndrome is a fatal illness caused by a retrovirus known as the Human Immuno-Deficiency Virus (HIV) which breaks down the body’s immune system, leaving the victim vulnerable to a host of life-threatening opportunistic infections, neurological disorders or unusual malignancies. Once a person is infected with HIV, it is probable that the person will be infected for life. Strictly speaking, AIDS refers only to the last stage of the HIV infection. There are two types of HIV- the most common HIV 1 and HIV 2 (commonly found in West Africa). The high risk groups include male homosexuals and bisexuals, hetero-sexual partners (including prostitutes), clients of STD, intravenous drug abusers, transfusion recipients of blood and blood products, haemophiliacs, and medical and paramedical staff. Since the first clinical evidence of AIDS in USA in 1981, the disease has become a more devastating disease than any other disease humankind has ever faced. It has acquired epidemic like proportion as more than 60 million people all over the world have been infected with the HIV (Africa-13.2%, Americans-13.6%, Asia-60.7%, Europe-12.0% and Oceania-0.5%).
Estimates of HIV infection cases in India are about 3.5 million. HIV sentinel surveillance data shows Maharashtra as the most affected state followed by Tamil Nadu, Andhra Pradesh, Karnataka and Manipur.
Sources of HIV Infection
The greatest concentration of HIV has been found in blood, semen and CSF (cerebo-spinal-fluid). Further, lower concentrations have been detected in tears, saliva, breast-milk, urine, and cervical and vaginal secretions. But, till date, only blood and semen have been conclusively shown to transmit the virus.
Mode of transmission
Sexual transmission
AIDS is first and foremost a sexually transmitted disease. Recent researchers have found that deep kissing where saliva is exchanged can also infect the partner.
Blood contact
AIDS is also transmitted by transfusion of contaminated blood. Intravenous drug users are at a high risk because they often share needles and syringes. Any skin piercing (including injections, ear-piercing, tattooing or acupuncture) can also transmit the virus via infected instruments.
Maternal-foetal transmission
An AIDS-infected mother can transmit virus to her child during pregnancy (through the placenta) or during birth or via breast-feeding.
HIV/AIDS is not spread by
· Drinking water or eating food from the same utensils (glasses, cups, plates, etc.) used by infected person.
· Shaking hands.
· Hugging or facial kissing.
· Working with people who are HIV infected.
· Swimming in pools used by infected people.
· Sharing toilets.
· Mosquitoes or any other insects.
· Casual social contact with infected persons even within households. That is, HIV is not spread by sitting next to someone who is infected, coughing or sneezing; but if person has any cuts or sores on his/her hands then make sure they are covered with plasters (band-aids or bandages).
Major precautions to avoid AIDS
The three major precautions to avoid AIDS are:
· Use condoms
· Use disposable syringes.
· Avoid multiple partners.
Control of AIDS
There are four basic approaches to control AIDS
Health education
Until a vaccine or cure for AIDS is found, the only means available at present is health education so as to enable people to make life-saving choices (for example, avoiding indiscriminate sex, using condoms). However, there is no guarantee that the use of condoms will give full protection. People should also avoid the use of shared razors and tooth brushes. Women suffering from AIDS or who are at high risk of infection should avoid becoming pregnant since infection can be transmitted to the unborn or new born. Intravenous drug users should avoid sharing of needles and syringes. Educational material and guidelines for prevention should be made widely available. All mass media channels should participate in educating the people on AIDS, its nature, transmission and prevention.
Prevention of blood borne HIV transmission
People in high-risk group should be asked to refrain themselves from donating blood, body organs, sperm and other tissues. All donated blood should be screened for AIDS before transfusion. Strict sterilization practices should be ensured in hospitals and clinics. Pre-sterilized disposable syringes and needles should be used as far as possible.
Treatment
There is no vaccine or cure for AIDS. However, there are certain medicines like ‘Zidovudine (Azt), Lamivudine (3TC) and Saquinavir (SQR) which can delay the onset of AIDS after HIV infection. Strictly speaking-these medicines cannot cure; they can only control/delay the onset of AIDS.
Integration of AIDS control programmes
Due to its wide-ranging health implications, AIDS touches all aspects of primary health care, including mother and child health, family planning and education. Therefore, it is essential to integrate AIDS control programmes into country’s primary health care system. AIDS control programmes will be of no use if they are developed in isolation.
‘Human Rights’?
The term ‘Human Rights’ refers to those basic rights which are essential for the development of human personality such as the right to life, liberty, property and security of an individual. The ‘Universal Declaration of Human Rights’ adopted by the United Nations on December10, 1948, states that-“the inherent dignity of all members of the human family is the foundation of freedom , justice and peace in the world”. This is possible only when each and every human being enjoys fundamental rights, which include:
· The right to life, liberty and security of persons;
· The right to own property;
· The right to freedom of opinion and expression;
· The right to an adequate standard of living;
· The right to seek and to enjoy in other countries asylum from persecution.
· The right to education, freedom of thought, conscience and religion; and
· The right to freedom from torture and degrading treatment, etc.
Some of the important Articles of the Declaration are:
Article 1: deals with reason and conscience in the common spirit of brotherhood.
Article 2: deals with rights and freedoms irrespective of caste, sex, religion, etc.
Article3: deals with right to life, liberty and security of human beings.
Article4: deals with prohibition with slavery.
Article5: deals with prohibition of inhuman tortures and punishment.
Article6: deals with human recognition before law.
Article7: deals with equal protection against any discrimination in violation of human rights.
Article8: deals with the right to a remedy for acts violating the fundamental rights given by constitution.
Article9: deals with the protection against arbitrary arrest, detention and exile.
Article 12: says that none should be subjected to arbitrary interference with his privacy, family, home or correspondence, etc.
Article 13: deals with right to freedom of movement.
Article 12: says that men and women of full age without any limitation due to race, nationality or religion, have the right to marry.
Article 18: deals with the right to freedom of thought, conscience and religion.
Article 19: deals with the right to freedom of opinion and expression.
Article 20: deals with the right to freedom of peaceful assembly and association.
Article 23: deals with the right to work without any discrimination.
Article 26: deals with the right to education.
Problem of human rights
Alarmed by the horrors of the holocausts, the United Nations had adopted ‘Universal Declaration on Human Rights’ in 1948, motivated by the desire to recognize that the same rights belong to all people and every individual. And since then, the UN has been actively monitoring human rights violations in various parts of the world.
But many countries have protested against the UN declaration saying that it is discriminatory in nature as it is used to condemn underdeveloped countries. Many of the developing countries have even accused the West of practicing double-standards. For instance, the US is quite willing to forget China’s human rights violations (e.g., political dissidents are detained, and freedom of speech and expression are kept under considerable restraint in China) in return for a lucrative market. The US has even given China the status of ‘Most Favoured Nation’.
The Malaysian former Prime minister, Dr. Mahathir Mohammad, has even launched a campaign for a review of the ‘Universal Declaration on Human Rights’. He is of the opinion that the Declaration should take into account the Asian cultures in which the interests of the nation and society take precedence over those of the individuals.