Environment and human health: Human Rights, Value Education, HIV/AIDS - Women and Child Welfare - Role of Information Technology in Environment and human health - Case Studies

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Environment and human health: Human Rights, Value Education, HIV/AIDS - Women and Child Welfare - Role of Information Technology in Environment and human health - Case Studies

 

As per WHO definition, Environmental health comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that adversely affect the health of present and future generations.

Globalization is a world-wide process which includes the internationalization of communication, trade and economic organization. It involves parallel changes such as rapid social, economic and political adjustments. Whilst globalization has the potential to enhance the lives and living standards of certain population groups, for poor and marginalized populations in both the non-formal as well as formal economic sectors of developing countries, globalization enhances economic inequalities.

Tuberculosis (TB) kills approximately 2 million people each year. In India the disease has reemerged and is now more difficult to treat. A global epidemic is spreading and becoming more lethal. The spread of HIV/AIDS and the emergence of multidrug-resistant tuberculosis is contributing to the increasing morbidity of this disease. In 1993, the World Health Organization (WHO) declared that tuberculosis had become a global emergency. It is estimated that between 2002 and 2020, approximately 1000 million people will be newly infected, over 150 million people will get sick, and 36 million will die of TB – if its control is not rapidly strengthened.

TB is a contagious disease that is spread through air. Only people who are sick with pulmonary TB are infectious. When infectious people cough, sneeze, talk or spit, they emit the tubercle bacilli into the air. When a healthy person inhales these, he gets infected by the disease. Symptoms include prolonged fever, coughing spells and weight loss.

It is estimated that, left untreated, each patient of active tuberculosis will infect on an average between 10 to 15 people every year. But people infected with TB will not necessarily get sick with the disease. The immune system can cause the TB bacilli, which is protected by a thick waxy coat, to remain dormant for years. When an individual’s immune system is weakened, the chances of getting active TB are greater.

• Nearly 1% of the world’s population is newly infected with TB each year.

• It is estimated that overall, one third of the world’s population is likely to be infected with the tuberculosis bacillus at some point in time.

• Five to ten percent of people who are infected with TB (but who are not infected with HIV) become sick or infectious at some time during their life. (WHO, 2002).

Factors Contributing to the rise in tuberculosis

• TB kills about 2 million people each year (including persons infected with HIV.

• More than 8 million people become sick with TB each year, one person in the world every second!

• About 2 million TB cases per year occur in sub-Saharan Africa. This number is rising rapidly as a result of the HIV/AIDS epidemic.

• Around 3 million TB cases per year occur in South-east Asia.

• Over a quarter of a million TB cases per year occur in Eastern Europe.

HIV is accelerating the spread of TB

The link between HIV and TB affects a large number of people, each disease speeding the other’s progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB is many times more likely to become seriously sick with TB rather than someone infected with TB who is HIV-negative. Tuberculosis is a leading cause of death among people who are HIV-positive, accounting for about 11% of AIDS deaths worldwide.

Poorly managed TB programs are threatening to make TB incurable

Until 50 years ago, there were no drugs to cure tuberculosis. Now, strains that are resistant to one or more anti-TB drugs have emerged. Drugresistant tuberculosis is caused by inconsistent or partial treatment, when patients do not take all their drugs regularly for the required period, when doctors or health workers prescribe inadequate treatment regimens or where the drug supply is unreliable. From a public health perspective, poorly supervised or incomplete treatment of TB is worse than no treatment at all. When people fail to complete standard treatment regimens, or are given the wrong treatment regimen, they may remain infectious. The bacilli in their lungs may develop resistance to anti-TB drugs. People they infect will have the same drug-resistant strain. While drug-resistant TB is treatable, it requires extensive chemotherapy that is often very expensive and is also more toxic to patients.

Malaria is a life-threatening parasitic disease transmitted by mosquitoes. The cause of malaria, a single celled parasite called plasmodium, was discovered in 1880. Later it was found that the parasite is transmitted from person to person through the bite of a female Anopheles mosquito, which requires blood for the growth of her eggs.

Today approximately 40% of the world’s population, mostly those living in the world’s poorest countries, risk getting malaria. The disease was once more widespread but it was successfully eliminated from many countries with temperate climates during the mid 20th century. Today malaria has returned and is found throughout the tropical and sub-tropical regions of the world and causes more than 300 million acute illnesses and at least one million deaths annually (WHO).

There are several types of human malaria. Falciparum malaria is the most dangerous type of infection and is most common in Africa south of the Sahara, where it accounts for extremely high mortality rates. There are also indications of the spread of P. falciparum malaria in India and it has reappeared in areas where it had been eliminated.

The malaria parasite enters the human host when an infected Anopheles mosquito bites an individual. Inside the human host, the parasite undergoes a series of changes as part of its complex life-cycle. Its various stages allow plasmodia to evade the immune system, infect the liver and red blood cells, and finally develop into a form that is able to infect a mosquito again when it bites an infected person. Inside the mosquito, the parasite matures until it reaches the sexual stage where it can again infect a human host when the mosquito takes her next blood meal, 10 or more days later.

Malaria symptoms appear about 9 to 14 days after the mosquito bite, although this varies with different plasmodium species. Malaria produces high fever, headache, vomiting and body ache. If drugs are not available for treatment, or the parasites are resistant to them, the infection can progress rapidly to become life-threatening. Malaria can kill by infecting and destroying red blood cells (anaemia) and by clogging the capillaries that carry blood to the brain (cerebral malaria) or other vital organs.

Malaria parasites are developing unacceptable levels of resistance to drugs. Besides this, many insecticides are no longer useful against mosquitoes transmitting the disease. Good environmental management by clearing pools of stagnant water during the monsoons is effective in reducing the number of mosquitoes.

Mosquito nets treated with insecticide reduce malaria transmission and child deaths. Prevention of malaria in pregnant women, through measures such as Intermittent Preventive Treatment and the use of insecticide-treated nets (ITNs), results in improvement in maternal health, as well as infant health and survival. Prompt access to treatment with effective up-to-date medicines, such as artemisinin-based combination therapies (ACTs), saves lives. If countries can apply these and other measures on a wide scale and monitor them carefully, the burden of malaria on society will be significantly reduced.

Water borne diseases

There are 4 major types of water related diseases:

1. Water borne diseases: These are caused by dirty water contaminated by human and animal wastes, especially from urban sewage, or by chemical wastes from industry and agriculture. Some of these diseases, such as cholera and typhoid, cause serious epidemics. Diarrhoea, dysentery, polio, meningitis, and hepatitis A and E, are caused due to improper drinking water. Excessive levels of nitrates cause blood disorders when they pollute water sources. Pesticides entering drinking water in rural areas cause cancer, neurological diseases and infertility. Improving sanitation and providing treated drinking water reduces the incidence of these diseases.

2. Water based diseases: Aquatic organisms that live a part of their life cycle in water and another part as a parasite in man, lead to several diseases. In India, guinea worm affects the feet. Round worms live in the small intestine, especially of children.

3. Water related vector diseases: Insects such as mosquitoes that breed in stagnant water spread diseases such as malaria and filariasis. Malaria that was effectively controlled in India, has now come back as the mosquitoes have become resistant to insecticides. In addition, anti-malarial drugs are now unable to kill the parasites as they have become resistant to drugs. Change in climate is leading to the formation of new breeding sites. Other vector born diseases in India include dengue fever and filariasis. Dengue fever carries a high mortality. Filariasis leads to fever and chronic swelling over the legs.

Eliminating mosquito breeding sites when pooling of water occurs in the monsoon using fish to control mosquito larval populations, are ways to reduce these diseases without using toxic insecticides that have ill effects on human health.

4. Water scarcity diseases: In areas where water and sanitation is poor, there is a high incidence of diseases such as tuberculosis, leprosy, tetanus, etc. which occur when hands are not adequately washed.

Ground water contamination

Arsenic in drinking water: Arsenic in drinking-water is a serious hazard to human health. It has attracted much attention since its recognition in the 1990s of its wide occurrence in wellwater in Bangladesh. It occurs less frequently in most other countries. The main source of arsenic in drinking water is arsenic-rich rocks through which the water has filtered. It may also occur because of mining or industrial activity in some areas. WHO has worked with other UN organizations to produce a state-of-the-art review on arsenic in drinking water.

Drinking water that is rich in arsenic leads to arsenic poisoning or arsenicosis. Excessive concentrations are known to occur in some areas. The health effects are generally delayed and the most effective preventive measure is supplying drinking water which is free of arsenic. Arsenic contamination of water is also due to industrial processes such as those involved in mining, metal refining, and timber treatment. Malnutrition may aggravate the effects of arsenic on blood vessels.

Water with high concentrations of arsenic if used over 5 to 20 years, results in problems such as colour changes on the skin, hard patches on the palms and soles, skin cancer, cancers of the bladder, kidney and lung, and diseases of the blood vessels of the legs and feet. It may also lead to diabetes, high blood pressure and reproductive disorders.

Natural arsenic contamination occurs in Argentina, Bangladesh, Chile, China, India, Mexico, Thailand and the United States. In China (in the Province of Taiwan) exposure to arsenic leads to gangrene, known as ‘black foot disease’.

Diarrhoea

Though several types of diarrhoea which give rise to loose motions and dehydration occur all over the world, this is especially frequently observed in developing countries. It causes 4% of all deaths. In another 5% it leads to loss of health. It is caused by gastrointestinal infections which kill around 2.2 million people globally each year. Most of these are children in developing countries. The use of contaminated water is an important cause of this group of conditions. Cholera and dysentery cause severe, sometimes life threatening and epidemic forms of these diseases.

Risks due to chemicals in food

Food contaminated by chemicals is a major worldwide public health concern. Contamination may occur through environmental pollution of the air, water and soil. Toxic metals, PCBs and dioxins, or the intentional use of various chemicals, such as pesticides, animal drugs and other agrochemicals have serious consequences on human health. Food additives and contaminants used during food manufacture and processing adversely affects health.

Diseases spread by food: Some foodborne diseases though well recognized, have recently become more common. For example, outbreaks of salmonellosis which have been reported for decades, has increased within the last 25 years. In the Western hemisphere and in Europe, Salmonella serotype Enteritidis (SE) has become a predominant strain. Investigations of SE outbreaks indicate that its emergence is largely related to consumption of poultry or eggs.

While cholera has devastated much of Asia and Africa for years, its reintroduction for the first time in almost a century on the South American continent in 1991 is an example of a well recognised infectious disease re-emerging in a region after decades. While cholera is often waterborne, many foods also transmit infection. In Latin America, ice and raw or underprocessed seafood are important causes for cholera transmission.

Infection with a specific type of Escherichia coli (E. coli) was first described in 1982. Subsequently, it has emerged rapidly as a major cause of bloody diarrhoea and acute renal failure. The infection is sometimes fatal, particularly in children. Outbreaks of infection, generally associated with beef, have been reported in Australia, Canada, Japan, United States, in various European countries, and in southern Africa. Outbreaks have also implicated alfalfa sprouts, unpasteurized fruit juice, lettuce, game meat (meat of wild animals) and cheese curd. In 1996, an outbreak of Escherichia coli in Japan affected over 6,300 school children and resulted in 2 deaths.

Listeria monocytogenes (Lm): The role of food in the transmission of this condition has been recognized recently. In pregnant women, infections with Lm causes abortion and stillbirth. In infants and persons with a poor immune system it may lead to septicemia (blood poisoning) and meningitis. The disease is most often associated with consumption of foods such as soft cheese and processed meat products that are kept refrigerated for a long time, because Lm can grow at low temperatures. Outbreaks of listeriosis have been reported from many countries, including Australia, Switzerland, France and the United States. Two recent outbreaks of Listeria monocytogenes in France in 2000 and in the USA in 1999 were caused by contaminated pork tongue and hot dogs respectively.

Foodborne nematodes (worms) are increasing in South-east Asia and Latin America. This is related to a combination of intensive aquaculture production in unsanitary conditions, and consumption of raw or lightly processed fresh water fish and fishery products. Foodborne trematodes can cause acute liver disease, and may lead to liver cancer. It is estimated that 40 million people are affected worldwide.

Bovine Spongiform Encephalopathy (BSE), is a fatal, transmittable, neurodegenerative disease of cattle. It was first discovered in the United Kingdom in 1985. The cause of the disease was traced to an agent in sheep, which contaminated recycled bovine carcasses used to make meat and bone meal additives for cattle feed. Recycling of the BSE agent developed into a common source epidemic of more than 180,000 diseased animals in the UK alone. The agent affects the brain and spinal cord of cattle which produces sponge-like changes visible under a microscope. About 19 countries have reported BSE cases and the disease is no longer confined to the European Community. A case of BSE has been reported in a cattle herd in Japan.

In human populations, exposure to the BSE agent (probably in contaminated bovine-based food products) has been strongly linked to the appearance in 1996 of a new transmissible spongiform encephalopathy of humans called variant Creutzfeldt-Jakob Disease (vCJD). By January 2002, 119 people developed vCJD, most from the UK but five cases have been reported from France.

Cancer and environment

Cancer is caused by the uncontrolled growth and spread of abnormal cells that may affect almost any tissue of the body. Lung, colon, rectal and stomach cancer are among the five most common cancers in the world for both men and women. Among men, lung and stomach cancer are the most common cancers worldwide. For women, the most common cancers are breast and cervical cancer. In India, oral and pharangeal cancers form the most common type of cancer which are related to tobacco chewing.

More than 10 million people are diagnosed with cancer in the world every year. It is estimated that there will be 15 million new cases every year by 2020. Cancer causes 6 million deaths every year – or 12% of deaths worldwide.

The causes of several cancers are known. Thus prevention of at least one-third of all cancers is possible. Cancer is preventable by stopping smoking, providing healthy food and avoiding exposure to cancer-causing agents (carcinogens). Early detection and effective treatment is possible for a further one-third of cases. Most of the common cancers are curable by a combination of surgery, chemotherapy (drugs) or radiotherapy (X-rays). The chance of cure increases if cancer is detected early.

HUMAN RIGHTS

Several environmental issues are closely linked to human rights. These include the equitable distribution of environmental resources, the utilisation of resources and Intellectual Property Rights (IPRs), conflicts between people and wildlife especially around PAs, resettlement issues around development projects such as dams and mines, and access to health to prevent environment related diseases.

Equity

One of the primary concerns in environmental issues is how wealth, resources and energy must be distributed in a community. We can think of the global community, regional community issues, national concerns and those related to a family or at the individual level. While economic disparities remain a fact of life, we as citizens of a community must appreciate that a widening gap between the rich and the poor, between men and women, or between the present and future generations must be minimised if social justice is to be achieved. Today the difference between the economically developed world and the developing countries is unacceptably high. The access to a better lifestyle for men as against women is inherent in many cultures. Last but not the least, we in the present generation cannot greedily use up all our resources leaving future generations increasingly impoverished. Rights to land, water, food, housing are all a part of our environment that we all share. However, while some live unsustainable lifestyles with consumption patterns that the resource base cannot support, many others live well below the poverty line. Even in a developing country such as ours, there are enormous economic inequali ties. This requires an ethic in which an equitable distribution becomes a part of everyone’s thinking. The people who live in the countries of the North and the rich from the countries in the South will have to take steps to reduce their resource use and the waste they generate. Both the better off sectors of society and the less fortunate need to develop their own strategies of sustainable living and communities at each level must bring about more equitable patterns of wealth.

The right to the use of natural resources that the environment holds is an essential component of human rights. It is related to disparities in the amount of resources available to different sectors of society. People who live in wilderness communities are referred to as ecosystem people. They collect food, fuelwood, and nonwood products, fish in aquatic ecosystems, or hunt for food in forests and grasslands. When landuse patterns change from natural ecosystems to more intensively used farmland and pastureland the rights of these indigenous people are usually sacrificed. Take the case of subsidies given to the pulp and paper industry for bamboo which makes it several times cheaper for the industry than for a rural individual who uses it to build his home. This infringes on the human right to collect resources they have traditionally used free of cost. Another issue is the rights of small traditional fishermen who have to contend against mechanised trawlers that impoverish their catch and overharvest fish in the marine environment. These people’s right to a livelihood conflicts with the powerful economic interests of large-scale organised fisheries.

There are serious conflicts between the rights of rural communities for even basic resources such as water, and industrial development which requires large amounts of water for sustaining its productivity. The right to land or common property resources of tribal people is infringed upon by large development projects such as dams, mining and Protected Areas. Movements to protect the rights of indigenous peoples are growing worldwide. Reversing actions that have already been taken decades ago is a complex problem that has no simple solutions. In many cases a just tradeoff is at best achieved through careful and sensitively managed negotiations. This needs a deep appreciation of local environmental concerns as well as a sensitivity to the rights of local people.

Nutrition, health and human rights

There are links between environment, nutrition and health which must be seen from a humanrights perspective. Proper nutrition and health are fundamental human rights. The right to life is a Fundamental Right in our constitution. As a deteriorating environment shortens life spans, this in effect has an impact on our fundamental constitutional right.

Nutrition affects and defines the health status of all people, rich and poor. It is linked to the way we grow, develop, work, play, resist infection and reach our aspirations as individuals, communities and societies. Malnutrition makes people more vulnerable to disease and premature death. Poverty is a major cause as well as a consequence of ill-health. Poverty, hunger, malnutrition and poorly managed environments together affect health and weaken the socioeconomic development of a country. Nearly 30% of humanity, especially those in developing countries – infants, children, adolescents, adults, and older persons are affected by this problem. A human rights approach is needed to appreciate and support millions of people left behind in the 20th century’s health revolution. We must ensure that our environmental values and our vision are linked to human rights and create laws to support those that need a better environment, better health and a better lifestyle.

Health and sustainable human development are equity issues. In our globalized 21st century, equity must begin at the bottom, hand in hand with a healthy environment, improved nutrition, and sustainable lifestyles. Putting first things first, we must also realize that resources allocated to preventing and eliminating disease will be effective only if the underlying causes such as malnutrition and environmental concerns, as well as their consequences, are successfully addressed.

Value education

Value education in the context of our environment is expected to bring about a new sustainable way of life. Education both through formal and non-formal processes must thus address understanding environmental values, valuing nature and cultures, social justice, human heritage, equitable use of resources, managing common property resources and appreciating the cause of ecological degradation.

Essentially, environmental values cannot be taught. They are inculcated through a complex process of appreciating our environmental assets and experiencing the problems caused due to our destruction of our environment. The problems that are created by technology and economic growth are a result of our improper thinking on what ‘development’ means. Since we still put a high value only on economic growth, we have no concern for aspects such as sustainability or equitable use of resources. This mindset must change before concepts such as sustainable development can be acted upon.

Unsustainable development is a part of economic growth of the powerful while it makes the poor poorer. Consumerism is one aspect of this process favoured by the rich. As consumption of resources has till recently been an index of development, consumerism has thrived. It is only recently that the world has come to realise that there are other more important environmental values that are essential to bring about a better way of life.

Values in environment education must bring in several new concepts that linked to the quality of human life and go beyond simple economic growth. They deal with a love and respect for nature. These are the values that will bring about a better humanity, one in which we can live healthy, productive and happy lives in harmony with nature.

Environmental Values:

Humans have an inborn desire to explore Nature. Wanting to unravel its mysteries is a part of human nature. However, modern society and educational processes have invariably suppressed these innate sentiments. Once exposed to the wonders of the wilderness, people tend to bond closely to Nature. They begin to appreciate its complexity and fragility and this awakens a new desire to want to protect our natural heritage. This feeling for Nature is a part of our Constitution, which strongly emphasises this value Concepts of what constitutes right and wrong behaviour changes with time. Values are not constant.

While we do need economic development, our value system must change to one that makes people everywhere support a sustainable form of development so that we do not have to bear the cost of environmental degradation.

Environmental values have linkages to varied environmental concerns. While we value resources that we use as food, water and other products, there are also environmental services that we must appreciate. These include Nature’s mechanisms in cleaning up air by removing carbon dioxide and adding oxygen by plant life, recycling water through the water cycle of nature, maintaining climate regimes, etc.

We must equally look at our environment beyond the wild sphere. There is incredible beauty in some man-modified landscapes, the coloured patterns of farmland or the greens of a tea or coffee plantation in the hills.

Urban gardens and open space are also valuable and thus must be of prime concern to urban planners. These green spaces act as not only the lungs of a city, but also provide much needed psychological support. The mental peace and relaxation provided by such areas needs to be valued, although it is difficult to put a price tag on these values. Nevertheless, these centers of peace and tranquility give urban dwellers an opportunity to balance their highly man-modified environments with the splash of green of a garden space.

Environmental values must also stress on the importance of preserving ancient structures. The characteristic architecture, sculpture, artworks and crafts of ancient cultures is an invaluable environmental asset. It tells us where we have come from, where we are now, and perhaps where we should go. Architectural heritage goes beyond preserving old buildings, to conserving whole traditional landscapes in rural areas and streetscapes in urban settings. Unless we learn to value these landscapes, they will disappear and our heritage will be lost.

As environmentally conscious individuals we need to develop a sense of values that are linked with a better and more sustainable way of life for all people. There are several positive as well as negative aspects of behavior that are linked to our environment. The positive feelings that support environment include a value for Nature, cultures, heritage, and equity. We also need to become more sensitive to aspects that have negative impacts on the environment. These include our attitude towards degradation of the environment, loss of species, pollution, poverty, corruption in environmental management, the rights of future generations and animal rights.

Several great philosophers have thoughts that have been based on, or embedded, in pro environmental behavior. Mahatma Gandhi and Rabindranath Tagore are among the many internationally well-known scholars whose thought have included values that are related to environmental consciousness. We need to appreciate these values to bring about a better way of life on earth for all people and all living creatures.

 Valuing Nature:

The most fundamental environmental sentiment is to value Nature herself. Appreciating Her magnificence and treasuring life itself leads to positive feelings that are a manifestation of pro environmental consciousness. The one-ness of our lives with the rest of nature and a feeling that we are only a miniscule part of nature’s complex web of life becomes apparent, when we begin to appreciate the wonders of nature’s diversity. We must appreciate that we belong to a global community that includes another 1.8 million known living forms. Nothing makes us more conscious of this wonderous aspect of our earth’s diversity than a walk through the wilderness, feeling and exploring its beauty and experiencing its infinite variety. The tiny creatures that live complex lives and the towering trees are all a part of this phenomenon we call ‘life’. Today, man does not even know if other complex forms of life exist outside our own solar system in distant space. We may be alone in space or may be accompanied by other, completely different, living forms. But for now we only know for sure that the Earth’s life forms are unique. We thus have a great responsibility to protect life in all its glorious forms and must therefore respect the wilderness with all its living creatures, where man’s own hand has not created changes that have led to perturbing natural habitats. We need to develop a sense of values that lead us to protect what is left of the wilderness by creating effective National Parks and Wildlife Sanctuaries. However this cannot be done to the detriment of the millions of tribal or indigenous people who live in wilderness ecosystems. There are thus conflicting values that need to be balanced carefully. On the one hand we need to protect natural ecosystems, while on the other, we must protect the rights of local people.

Yet apart from valuing the diversity of life itself, we must also learn to value and respect diverse human cultures. Many of the tribal cultures of our country are vanishing because those with more dominant and economically advanced ways of life do not respect their lifestyles, that are in fact closer to nature and frequently more sustainable. We believe that our modern technology-based lifestyles are the sole way for society to progress. Yet this is only a single dimension of life that is based on economic growth.

While currently the environmental movement focuses on issues that are concerned with the management of the natural environment for the ‘benefit’ of man, Deep Ecology promotes an approach that is expected to bring about a more appropriate ecological balance on Earth and is akin to a spiritual approach to Nature. This has great long-term implications not only for humans but for the whole of Nature.

Valuing cultures

Every culture has a right to exist. Tribal people are frequently most closely linked with Nature and we have no right to foist on them our own modern way of life. The dilemma is how to provide them with modern health care and education that gives them an opportunity to achieve a better economic status without disrupting their culture and way of life. This will happen only if we value their culture and respect their way of life.

Social justice

As the divide widens between those people who have access to resources and wealth, and those who live near or below the poverty line, it is the duty of those who are better off to protect the rights of the poor who do not have the means to fight for their rights. If this is not respected the poor will eventually rebel, anarchy and terrorism will spread and the people who are impoverished will eventually form a desperate seething revolution to better their own lot. The developing world would face a crisis earlier than the developed countries unless the rights of poor people that are fundamental to life are protected.

Human heritage

The earth itself is a heritage left to us by our ancestors for not only our own use but for the generations to come. There is much that is beautiful on our Earth - the undisturbed wilderness, a traditional rural landscape, the architecture of a traditional village or town, and the value of a historical monument or place of worship. These are all part of human heritage.

Equitable use of resources

An unfair distribution of wealth and resources, based on a world that is essentially only for the rich, will bring about a disaster of unprecedented proportions. Equitable use of resources is now seen as an essential aspect of human well being and must become a shared point of view among all socially and environmentally conscious individuals. This includes an appreciation of the fact that economically advanced countries and the rich in even poor nations consume resources at much greater levels than the much larger poorer sectors of humanity in the developing world. In spite of the great number of people in the more populous developing countries, the smaller number of people in developed countries use more resources and energy than those in the developing world. This is equally true of the small number of rich people in poor countries whose per capita use of energy and resources, and the generation of waste based on the one time use of disposable products, leads to great pressures on the environment. The poor while polluting the environment have no way to prevent it. The rich damage the environment through a carelessness that proves only that they have no appreciation for environmental safety. As we begin to appreciate that we need more sustainable lifestyles we also begin to realize that this cannot be brought about without a more equitable use of resources.

Common Property Resources

Our environment has a major component that does not belong to individuals. There are several commonly owned resources that all of us use as a community. The water that nature recycles, the air that we all breathe, the forests and grasslands which maintain our climate and soil, are all common property resources. When Government took over the control of community forests in British times, the local people who until then had controlled their use through a set of norms that were based on equitable use, began to overexploit resources on which they now had no personal stake. Bringing back such traditional management systems is extremely difficult. However, in the recent past managing local forests through village level forest protection committees has shown that if people know that they can benefit from the forests, they will begin to protect them. This essentially means sharing the power to control forests between the Forest Department and local people.

HIV/AIDS

The Human Immunodeficiency Virus (HIV) causes Acquired Immunodeficiency Syndrome (AIDS) through contact with tissue fluids of infected individuals, especially through sexual contact. As it reduces an individual’s resistance to disease, it causes infected individuals to suffer from a large number of environment related diseases and reduces the ability of infected individuals to go about their normal lives. It affects their income generation and/or their ability to utilise natural resources. As more and more people are affected, this disease will also have impacts on our natural resource base, as utilisation patterns change to unsustainable levels. The inability of these patients to have the strength to access natural resources also affects the outcome of the disease process, as their overall health and well being is likely to worsen the course of the disease when their nutritional status suffers.

In sub Saharan Africa where the infection has become highly prevalent, it is leading to great suffering and worsening poverty. The capacity of these patients to work for their usual sources of income generation is lost. An increasing proportion of the poor are affected. It is evident that it is going to be increasingly difficult to manage environments sustainably, as natural resources on which the poor debilitated patients depend continue to be degraded. Incomes lost due to the stigma of HIV/AIDS must be met by the sufferers by overexploiting their resource base. People affected by the disease inevitably try to get whatever they can from their natural resource base as they are not in any position to think of the long-term future. In Africa, this has led to degradation of the ecosystem and an increase of pressures from other impacts such as overuse of medicinal plants and poaching for wildlife. In South Africa, for example, people have a mistaken belief that turtle eggs can cure HIV/ AIDS, thus leading to the eggs being over harvested. As males die of the disease, work on agricultural land has to be taken over by already overworked women and their children, affecting land management and productivity. Providing balanced diets and nutritional support for these poverty stricken patients can be partially addressed by better natural resource management such as afforestation, access to clean water and wholesome food.

HIV/AIDS seriously affects the patient’s working environment. It creates an incorrect fear in the minds of co-workers. It must be clearly understood that AIDS is not spread by casual contact during work. Patients have a right to continue to work as before along with unaffected individuals. As patients are unable to continue their original hard labour related work, it is essential that alternative sources of work must be created for them.

Educators and extention information, in the formal and non-formal educational sectors, must address the issues related to the linkages between natural resource management and this disease, as well as the need to remove the social stigma attached to it.

HIV/ AIDS has a serious impact on the socioeconomic fabric of society. By 2002, India had an estimated 3.97 million infected individuals. There is a great need to organise AIDS education on prevention and management of the disease. This needs to be done through the formal educational sector and by using non-formal methods. Education is also important to reduce the stigma and discrimination against these patients. In India, women who are not socially empowered are at a great disadvantage as they are powerless to demand safe sex from their partners. Women also have an added burden of caring for HIV infected husbands. This produces enormous economic stresses on their family. HIV in India is rapidly moving from a primarily urban sector disease to rural communities.

Research in Nepal has shown a linkage between rural poverty, deforestation and a shift of population to urban areas resulting in a rising number of AIDS patients. Prior to 1992, it was mainly seen in males who migrated to urban centers. In more recent times, a growing number of women are moving to Indian cities as sex workers. Women engaged in prostitution find it difficult to make partners take protective measures, such as the use of condoms that provide safe sex. A large proportion became victims of the disease.

Blood transfusion from an infected person can also lead to HIV/AIDS in the recipient, as well as drug abuse by sharing needles with an infected person. In sexually transmitted AIDS, the use of condoms during intercourse is a key to preventing the disease. Behavioural change, where the number of individuals who have multiple partners, towards strictly single partners, reduces the risk of HIV/AIDS and thus reduces incidence of the disease in society. However, the most important measure to prevent AIDS is the proper use of condoms that form a barrier to the spread of the virus during intercourse.

WOMAN AND CHILD WELFARE

There are several environmental factors that are closely linked to the welfare of women and children. Each year, close to eleven million children worldwide are estimated to have died from the effects of disease and inadequate nutrition. Most of these deaths are in the developing world. In some countries, more than one in five children die before they are 5 years old. Seven out of 10 of childhood deaths in developing countries can be attributed to five main causes, or a combination of them. These are pneumonia, diarrhoea, measles, malaria and malnutrition. Around the world, three out of every four children suffer from at least one of these conditions.

The diagnosis of common childhood disease conditions

Presenting complaint	Possible cause or associated condition
Cough and/or Pneumonia	Severe anaemia, P. falciparum malaria
Lethargy or Cerebral malaria	unconsciousness Meningitis Severe dehydration Very severe pneumonia
Measles rash	Pneumonia Diarrhoea Ear infection
“Very sick” young infant	Pneumonia Meningitis Sepsis

 

Respiratory conditions: Most respiratory diseases are caused by or are worsened by polluted air. Crowded ill-ventilated homes and living in smokey households with open fires can trigger respiratory conditions especially in children.

CASE STUDY

Chula issue

The World Health Organisation estimates that 1.6 billion early deaths occur annually from cooking stove pollution. 400,000 to 550,000 children under five and women die each year in India due to indoor smoke. Chula smoke is the third highest cause of disease and death after dirty water and lack of sanitation. Hence by providing access to clean water, sanitation, food and ventilated homes, over half the diseases and premature deaths could be avoided in India.

Pneumonia: Acute respiratory infections (ARI), most frequently pneumonia, is a major cause of death in children under five, killing over two million children annually. Upto 40% of children seen in health centers suffer from respiratory conditions and many deaths attributed to other causes are, in fact, “hidden” ARI deaths. Children may die very quickly from the infection and thus need treatment urgently. Most patients of pneumonia can be treated with oral antibiotics. Correct management could save over 1 million lives per year globally.

Gastro intestinal conditions: Contaminated water and food causes widespread ill health especially in children.

Diarrhoea: Diarrhoea is caused by a wide variety of infections. Urgent diagnosis and treatment of diarrhoea is a priority for saving a child’s life. Treating malnutrition that often accompanies diarrhoea can further reduce mortality. Increasing vigilance to detect other diseases that can occur concurrently with diarrhoea, such as measles or malaria, is an important measure.

Two million children die each year in developing countries from diarrhoeal diseases, the second most serious killer of children under five worldwide. In most cases diarrhoea is preventable and children can be saved by early treatment. Correct management of diarrhoea could save the lives of up to 90% of children who currently die by promoting rapid and effective treatment through standardised management, including antibiotics and simple measures such as oral rehydration using clean boiled water with salt and sugar. In severe cases intravenous fluids must be started. Improved hygiene and management of the home and surroundings is the most important preventative measure, as well as improved nutrition. Increased breastfeeding and measles vaccination have also been observed to have reduced the number of cases of diarrhoea.

Measles: Measles is a rash that appears with fever and bodyache in children and is caused by a virus. It infects over 40 million children and kills over 800,000 children under the age of five. Prevention includes wider immunization coverage, rapid referral of serious cases, prompt recognition of conditions that occur in association with measles, and improved nutrition, including breastfeeding, and vitamin A supplementation. Measles is prevented by a vaccine. Young children with measles often develop other diseases such as acute respiratory infections, diarrhoea and malnutrition that are all linked to poor environmental conditions in their surroundings. Children who survive an attack of measles are more vulnerable to other dangerous infections for several months. Effective prevention and treatment could save 700,000 lives per year.

Malaria: This condition is closely linked to pooling and stagnation of water in tropical environments. Malaria is a widespread tropical disease which is caused by a parasite transmitted to humans by mosquitoes. It has proved difficult to control because mosquitoes have become resistant to insecticides used against them and because the parasite has developed resistance in some areas to the cheap and effective drugs that used to provide good protection in the past. However, alternative newer drug therapies have been developed for use in areas where resistant parasites are found. In India the disease was nearly wiped out a few decades ago but has now re-emerged in many parts of the country. Correct management could save 500,000 lives per year. Approximately 700,000 children die of malaria globally each year, most of them in sub-Saharan Africa. Young children are particularly vulnerable because they have not developed the partial immunity that results from surviving repeated infections.

Deaths from malaria can be reduced by several measures, including encouraging parents to seek prompt care, accurate assessment of the condition of the child, prompt treatment with appropriate anti-malarial drugs, recognition and treatment of other co-existing conditions, such as malnutrition and anaemia, and prevention by using mosquito-proof bednets. Because fever may be the only sign of malaria, it can be difficult to distinguish it from other potentially lifethreatening conditions.

Poverty-environment-malnutrition: There is a close association between poverty, a degraded environment, and malnutrition. This is further aggravated by a lack of awareness on how children become malnourished.

Malnutrition: Although malnutrition is rarely listed as the direct cause of death, it contributes to about half of all childhood deaths. Lack of access to food, poor feeding practices and infection, or a combination of the two, are major factors in mortality.

Infection, particularly frequent or persistent diarrhoea, pneumonia, measles and malaria, undermines nutritional status. Poor feeding practices - inadequate breastfeeding, providing the wrong foods, giving food in insufficient quantities, contribute to malnutrition. Malnourished children are more vulnerable to disease.

Promoting breastfeeding, improving feeding practices, and providing micronutrient supplements routinely for children who need them are measures that reduce mortality.

The nutritional status and feeding practices of every child under two years of age, and those with a low weight for their age must be intensively managed. Counseling of parents on the correct foods for each age group and helping them to overcome various feeding problems is an essential health care measure.

Children between 6 months and 2 years of age are at increased risk of malnutrition when there is a transition between breastfeeding and sharing fully in the family diet. Changing family habits and the kinds of food offered to children is an important measure. Talking to mothers individually about home care and their child’s feeding, with relatively simple changes to better feeding practices, such as helping them to eat rather than leaving them to fend for themselves, can ensure that a child gets enough to eat.

A minor increase in breastfeeding could prevent up to 10% of all deaths of children under five:

When mothers breastfeed exclusively during at least the first four months and, if possible, six months of life, there is a decrease in episodes of diarrhoea and, to a lesser extent, respiratory infections. Even small amounts of water-based drinks decreases breastmilk intake and lead to lowered weight gain. This increases the risk of diarrhoea. Continuing to breastfeed up to two years of age, in addition to giving complemen tary foods, maintains good nutritional status and helps prevent diarrhoea.

Encouraging maximum support to mothers to establish optimal breastfeeding from birth, equipping health workers with counseling skills, and providing individual counseling and support for breastfeeding mothers are measures that reduce malnutrition. Mothers often give their babies other food and fluids before six months because they doubt their breastmilk supply is adequate. A one-on-one counseling with mothers on breastfeeding techniques and its benefits helps reduce incidence of malnutrition.

There are strong connections between the status of the environment and the welfare of women and children in India. Women, especially in lower income group families, both in the rural and urban sector, work longer hours than men. Their work pattern differs and is more prone to health hazards. The daily collection of water, fuelwood and fodder is an arduous task for rural women. In urban areas, where lower economic group women live in crowded smoke filled shantys in unhygenic slums, they spend long hours indoors, which is a cause of respiratory diseases. In urban centers, a number of women make living by garbage picking. They separate plastics, metal and other recyclable material from the waste produced by the more affluent groups of society. During this process, they can get several infections. Thus they are providing an environmental service of great value, but earn a pittance from this work.

Women are often the last to get enough nutrition as their role in traditional society is to cook the family meal and feed their husband and children. This leads to malnutrition and anemia due to inadequate nutrition.

The sorry plight of women includes the fact that the girl child is given less attention and educational facilities as compared to boys in India. Thus they are unable to compete with men in later life. This social-environmental divide is a major concern that needs to be corrected throughout the country.

Role of information technology in environment and human health

The understanding of environmental concerns and issues related to human health has exploded during the last few years due to the sudden growth of Information Technology. The computer age has turned the world around due to the incredible rapidity with which IT spreads knowledge. IT can do several tasks extremely rapidly, accurately and spread the information through the world’s networks of millions of computer systems. A few examples of the use of computer technology that aid environmental studies include software such as using Geographical Information Systems (GIS). GIS is a tool to map landuse patterns and document change by studying digitized toposheets and/or satellite imagery. Once this is done, an expert can ask a variety of questions which the software can answer by producing maps which helps in landuse planning.

Case study

Karnataka’s GIS scheme, Bhoomi, has revolutionized the way farmers access their land records. Farmers can now get a copy of the records of rights, tenancy and crops from a computerized information kiosk without harassment and bribes. Karnataka has computerized 20 million records of land ownership of 6.7 million farmers in the State.

The Internet with its thousands of websites has made it extremely simple to get the appropriate environmental information for any study or environmental management planning. This not only assists scientists and students but is a powerful tool to help increase public awareness about environmental issues.

Specialised software can analyse data for epidemiological studies, population dynamics and a variety of key environmental concerns.

The relationship between the environment and health has been established due to the growing utilisation of computer technology. This looks at infection rates, morbidity or mortality and the etiology (causative factors) of a disease. As knowledge expands, computers will become increasingly efficient. They will be faster, have greater memories and even perhaps begin to think for themselves.

Case study

Bhopal Gas Tragedy

The siting of industry and relatively poor regulatory controls leads to ill health in the urban centers. Accidents such as the Bhopal gas tragedy in 1984 where Union Carbide's plant accidentally released 30 tones of methyl isocyanate, used in the manufacture of pesticides, led to 3,330 deaths and 1.5 lakh injuries to people living in the area.

Tuberculosis in India

There are 14 million TB patients in India, account for one third of the global cases of TB. Everyday 20,000 Indians contract TB and more than 1,000 die due to this chronic illness. TB attacks working adults in the age group of 15 to 50 years

Arsenic poisoning – Bangladesh

More than half the population of Bangladesh is threatened by high levels of arsenic found in drinking water. This could eventually lead to an epidemic of cancers and other fatal diseases.

Rezaul Morol, a young Bangladeshi man, nearly died from arsenic poisoning caused by drinking arsenic-laden well-water for several years. The doctor advised Rezaul to stop drinking contaminated water and eat more protein-rich food such as fish. Since then Rezaul feels a lot better and is happy that his skin is healing.

 

 

Additional literatures

ENVIRONMENT AND HUMAN HEALTH

30.1 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.

30.2 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.

30.2.1 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.

30.2.2 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.

30.2.3 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.

30.2.4 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.

30.3 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.

30.3.1 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.

30.4 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.

30.5 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.

30.5.1 Mode of transmission

30.5.1.1 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.

30.5.1.2 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.

30.5.1.3 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.

30.5.2 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).

30.5.3 Major precautions to avoid AIDS
The three major precautions to avoid AIDS are:

·         Use condoms

·         Use disposable syringes.

·         Avoid multiple partners.

30.5.4 Control of AIDS

There are four basic approaches to control AIDS

30.5.4.1 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.

30.5.4.2 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.

30.5.4.3 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.

30.5.4.4 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.

30.6 ‘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.

30.6.1 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.

WOMEN AND CHILD WELFARE

31.1 Various Problems Affecting the Women and Welfare

31.1.1 Malnutrition

Pregnant women, nursing mothers and children are particularly vulnerable to the effects of malnutrition. The adverse effects of malnutrition on women are-maternal depletion, low birth weight, anaemia, toxemias of pregnancy, post-partum haemorrhage, all leading to high mortality and morbidity. Measures to improve the nutritional status of women and children may be broadly divided into two-direct and indirect nutrition interventions. Direct interventions cover a wide range of activities, such as, supplementary feeding programmes, distribution of iron and folic acid tablets, fortification and enrichment of foods, nutrition education, etc. indirect interventions include control of communicable diseases through immunization, improvement of environmental sanitation, provision of clean drinking water, family planning, food hygiene, education and primary health care.

31.1.2 Infections

Women or maternal infections can cause a variety of adverse effects such as threatened abortions, foetal growth retardation, low birth weight, embryopathy and puerperal sepsis. Women of under-developed nations are at high risk. Infections in the child may begin with labour and delivery and increase as the child grows older. Children may be ill with debilitating diarrhoeal, respiratory and skin infections, or the situation is further aggravated by the chronic infections, such as, malaria and tuberculosis. The children also suffer from the severe protein-energy malnutrition and anemia. Prevention and treatment of infections in women and children is being done by adopting the WHO Expanded Programme on Immunization. The children in the developing countries are being immunized against tuberculosis, diphtheria, pertusis (whooping cough), tetanus, measles and polio.

31.1.3 Uncontrolled reproduction

The severe health hazards for the women and children resulting from the unregulated/uncontrolled reproduction have been well recognized, viz., increased prevalence of low birth weight babies, severe infections and a high maternal and perinatal mortality. Statistics have shown that in most countries, a birth rate is associated with a high infant mortality rate and child death rate.

31.1.4 Education and socio-economic status

The dropout rate (from schools) of girls is much higher than the boys. In under-developed nations the educational preference, both at the primary level and at secondary level, is given to the male child as compared to the female child. This also indirectly affects the socio-economic status of the women. This problem is very much under control by making the female education free at the primary level by the several under-developed nations. In India too, the female literacy rate has gone upto 50% from 39.3%.

ROLE OF INFORMATION TECHNOLOGY (IT) IN ENVIRONMENT

32.1 Introduction

Some of the areas in which information technology is playing a vital role in environmental management are briefly discussed as under:

32.1.1 Biodiversity conservation

Use of GIS (Geographic Information System) and Remote Sensing can help in determining the rates, causes and scale of biodiversity loss. Information on deforestation and land use change can be integrated with data on the distribution of biodiversity and existing information on climate, topography, soil, etc. to obtain a comprehensive picture.

32.1.2 Species monitoring

Not only the existence of flora and fauna can be detected, even counting of animals like elephants, tigers, etc. can be done with the help of GIS. The IUCN (International Union for Conservation of Nature) Red Database acts as an aid in appreciating the degree of danger that a species is in.

32.1.3 Site selection

GIS can help in the selection of optimum highway or railway routes, dam or reservoir sites, waste disposal sites, major industrial sites, etc. that can cause minimal disturbance to ecosystems.

32.1.4 Disaster management

Remote sensing data can be effectively used for obtaining near real time information on areas affected by earthquakes, cyclones, floods, landslides, volcanic eruptions, forest fires and other such disasters. Disaster prone areas can be identified where appropriate action can be taken up to reduce the losses and also disasters like cyclones, floods, etc. can be predicted well in advance.

32.1.5 Soil resources

Satellite data depict the nature of problem, degree of salinity, sodicity and spatial extent of the problem in each mapping unit. The information is extensively used to plan for the reclamation of salt affected soils and for adopting post-reclamation production technology.

32.1.6 Water resources

Remote sensing data proved effective in inventorying, monitoring and managing both surface and ground water resources to augment the water use efficiency. Satellite data serves as a unique tool for extracting information on geology, geomorphology, drainage, land use and soils, which are essential in identifying not only the potential segments of agricultural resources, but also the sites suitable for site selection of recharge structures.

32.2 Role of Information Technology in Human Health

Its various applications include:

·         Bioinformatics and osteoporosis

The application of bioinformatics is in the emerging possibility for the cure of osteoporosis-a crippling disease caused by the breakdown of bone, caused by a class of molecules called Cathepsin K. Now the pharmaceutical companies have to find a drug that blocks the Cathepsin K gene only.

·         Role in genome sequencing

Bioinformatics played a key role in the final stages of the Human Genome Project. In just four weeks, James kent (a Ph.D student of California University) produced a computer programmers that helped the public consortium to complete the sequencing in time and to present the draft sequence along with Celera Genomics on June26, 2000.

·         DNA databases or data banks having genetic information about populations together with their personal physical characteristics (eye colour, height, weight, etc.), finger prints, dental records, medical records, financial records, etc. are used by the Government Departments to identify missing persons, by the investigating agencies (e.g., FBI, CBI, RAW, etc.) to identify criminals, and also by the insurance companies to prevent insurance fraud.

·         Many organizations, such as WHO, maintain their web sites with information about endemic, epidemic and communicable diseases to inform people about dangers involving populations.

·         Information about new drug release, their mode of action, indications and risk are also available on web sites.

·         Any new development in the field of surgery is also available on net to be referred by the doctors of any country at any time.

·         Telemedicine and distance medicine is now far-reaching along with documentation and display of human anatomy with the help of internet.