Importing US food Risk Research Paper Example | Topics and Well Written Essays - 1000 words

Importing US food Risk - Research Paper Example In 2008, there were some reported cases where cats and dogs were stricken by tainted pet food while people died from contaminations in certain drugs. In both incidents, the ingredients were found to have been imported from China (In Curtis, 2013).   In response to this, the Public Health Security through the Bioterrorism act directs the Food and Drug Administration (FDA) to take additional measures to protect the public from all terrorist attacks on food supply and all other food related emergencies. FDA is the food regulatory agency of the department of Health and Human Services and has the mandate to receive prior notification of food that is imported, including animal feed, in the United States. Prior notice of import shipments give chance to the FDA, through the support of the U.S Custom and Border Protection to focus on import inspections with much effectiveness and help protect the state’s food supply against acts of terror and all other public health emergencies. The FDA food safety act was signed in 2011 with aims to ensure that the U.S food supply is safe by directing the focus of the federal regulations from taking action on contamination to prevent it (Kastner, 2011).   The FDA signed a regulation that required all persons to submit prior notices of imported food. Close to fifty million people get sick while three thousand die each year from food borne diseases. This is according to a data collected by the Centers for Disease Control and Prevention. This was mentioned as a public health burden which is largely preventable. The FDA Food Safety Modernization Act enables the FDA to strengthen the systems of food safety by giving them new authorities and tools to make all new imported foods meet the same safety standards as those produced in the U.S. However, building a new system of food safety beside on prevention would take time. FDA focuses on implementing the safety acts with open grounds for all stakeholders to give their contribution. T he FDA has therefore some laid down responsibilities and authorities which are aimed at improving food safety in the United States. The FDA’s new import mandates and authorities include the following (Hinkelman and Ebrary, 2004); Import accountability. During the first time, the importers have an explicit mandate to verify that their suppliers have sufficient preventive controls to make sure that the food they produce is safe. Third party certification: The FDA Food Safety Modernization (FSMA) initiates program through which third parties can verify that foreign food capacities comply with the U.S food safety standards. The certification is very significant in facilitating the entry of imports (Zaring et al., 2009). Cortication for high risk foods: as a condition of entry into America, FDA can authorize that the high-risk imported foods be accompanied by a trustworthy third party certification or with an assurance of compliance. Voluntary qualified importer program: a volunta ry program must be established for the importers. This would provide for the expedited entry and review of foods from importers. Entitlement is limited to importers who offer food from certified facilities. Authority to deny entry: foods from a foreign facility can be denied entry into the U.S by FDA. FDA has also a

Lenin's Cultural Policy and the Persecution of the Arts Essay

Lenin's Cultural Policy and the Persecution of the Arts - Essay Example However, things were not the same as shown to the world. The growing experimentation in the arts and cultural aspects of Russia forced Lenin to embrace more conservative and traditional ways and it was because of this reason that since his early days, Lenin started to control cultural institutions of the country. This control of culture in the country further worsened as the Lenin’s Communist party started to target those musicians and artisans who were relatively against the Communist thought. Lunacharsky- Lenin’s main person behind controlling the Cultural Revolution in the country put forward his own aesthetic theories which largely redefined the socialist art, however; this was often criticized by the later scholars for the reasons of curtailing the artistic creativity. â€Å"In the late 1920s, the term was taken up and transformed by young communist cultural militants who sought the party leaders' approval for an assault on "bourgeois hegemony" in culture; that is, on the cultural establishment, including Anatoly Lunacharsky and other leaders of the People's Commissariat of Enlightenment, and the values of the old Russian intelligentsia. For the militants, the essence of Cultural Revolution was "class war" - an assault against the "bourgeois" intelligentsia in the name of the proletariat - and they meant the "revolution" part of the term literally. In the years 1928 through 1931, the militants succeeded in gaining the party leaders' support, but lost it again in 1932 when the Central Committee dissolved the main militant organization, the Russian Association of Proletarian Writers (RAPP), and promoted reconciliation with the intelligentsia.† (Encylopedia).

Factors Influencing Sanitation Conditions

Factors Influencing Sanitation Conditions ABSTRACT This thesis examines the socio-cultural and demographic factors influencing sanitation conditions, identifies the presence of Escherichia coli in household drinking water samples and investigates prevalence of diarrhoea among infants. It is based on questionnaire interviews of 120 household heads and 77 caretakers of young children below the age of 5years, direct observation of clues of household sanitation practice as well as analyses of household water samples in six surrounding communities in Bogoso. Data collected was analysed using SPSS and the Pearson Product Moment Correlation Value(R) technique. The findings revealed that the sanitation condition of households improved with high educational attainment and ageing household heads. On the contrary, sanitation deteriorated with overcrowding in the household. Furthermore, in houses where the religion of the head of household was Traditional, sanitation was superior to those of a Christian head and this household also had better sa nitary conditions than that with a Moslem head of household. Water quality analysis, indicated that 27 samples out of the 30 representing 90% tested negative for E. Coli bacteria whilst 17(56.7%) samples had acceptable levels of total Escherichia coli. Finally, it was found out that diarrhoea among infants were highly prevalent since 47 (61.04%) out of the 77 child minders admitted their wards had a bout with infant diarrhoea. Massive infrastructural development, supported by behavioural change education focussing on proper usage of sanitary facilities is urgently needed in these communities to reduce the incidence of public health diseases. Intensive health education could also prove vital and such programs must target young heads of household, households with large family size and households whose heads are Christians and Moslems. CHAPTER ONE INTRODUCTION BACKGROUND TO THE STUDY Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality by two thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water- linked diseases which kill thousands of children every day (United Nations, 2006). According to the World Health Organization (2004), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got poorly from diseases caused by unhygienic water. Each year 1.8 million people pass away from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004). Ghana Water and Sewerage Corporation (GWSC) had traditionally been the major stakeholder in the provision of safe water and sanitation facilities. Since the 1960s the GWSC has focussed chiefly on urban areas at the peril of rural areas and thus, rural communities in the Wassa West District are no exception. According to the Ghana 2003 Core Welfare Indicators Questionnaire (CWIQ II) Survey Report (GSS, 2005), roughly 78% of all households in the Tamale Metropolis, 97 percent in Accra, 86% in Kumasi and 94% in Sekondi-Takoradi own pipe-borne water. Once more, the report show that a few households do not own any toilet facilities and depend on the bush for their toilet needs, that is 2.1%, 7.3%, and 5% for Accra, Kumasi, and Sekondi-Takoradi correspondingly. Access to safe sanitation, improved water and improved waste disposal systems is more of an urban than rural occurrence. In the rural poor households, only 9.2% have safe sanitation, 21.1% use improved waste disposal method and 63.0 % have access to improved water. The major diseases prevalent in Ghana are malaria, yellow fever, schistosomiasis (bilharzias), typhoid and diarrhea. Diarrhea is of precise concern since it has been recognized as the second most universal disease treated at clinics and one of the major contributors to infant mortality (UNICEF, 2004). The infant mortality rate currently stands at about 55 deaths per 1,000 live births (CIA, 2006). The Wassa West District of Ghana has seen an improvement in water and sanitation facilities during the last decade. Most of the development projects in the district are sponsored by the mining companies, individuals and some non-governmental organisations (NGOs). Between 2002 and 2008, Goldfields Tarkwa Mine constructed 118 new hand dug wells (77 of which were fitted with hand pumps) and refurbished 48 wells in poor condition. Also, a total of 44 modern style public water closets, were constructed in their catchment areas. The company also donated 19 large refuse collection containers to the District Assembly and built 6 new nurses quarters. The Tarkwa Mine has so far spent 10.5million US dollars of which 26% went into health, water and sanitation projects, 24% into agricultural development, 31% into formal education and the remaining went into other projects like roads and community centre construction ( GGL, 2008). Golden Star Resources (consist of Bogoso/Prestea Mine and Wassa Min e at Damang) also established the community development department in 2005 and has since invested 800 thousand US dollars. Their projects include 22 Acqua-Privy toilets, 10 hand dug wells (all fitted with hand pumps) and supplied potable water to villages with their tanker trucks (BGL, 2007). Other development partners complimenting the efforts of the central government include NGOs WACAM, Care International and Friends of the Nation (FON). WACAM is an environmentally based NGO which monitors water pollution by large scale mining companies. They have sponsored about 10 hand dug wells for villages in the district. Care International sponsors hygiene and reproductive health programmes in schools and on radio. They have also donated a couple of motor bicycles to public health workers in the district who travel to villages. The aims of all these projects were to improve hygiene and sanitation so as to reduce disease transmission. Despite efforts by the development partners, water supply and sanitation related diseases are highly prevalent in the district. Data obtained from the Public and Environmental Health Department of the Ministry of Health (M.O.H., 2008) showed that the top ten most prevalent diseases in the district include malaria, acute respiratory infections, skin diseases and diarrhoea. The others are acute eye infection, rheumatism, dental carries, hypertension, pregnancy related complications and home/occupational accidents. A lot more illnesses occur but on a lower scale and these include intestinal worms, coughs and typhoid fever. A complete data on the top ten diseases prevalent in the district is attached as Appendix D but below is a selection of the illnesses that directly result from bad water and sanitation practices. The number of malaria cases decreased from 350 in 2006 to 300 cases per 1000 population in 2008. Despite the decrease, the values involved are still quite high. The incidence of diarrhoea among infants and acute respiratory infection remained 30 and 60 cases per 1,000 populations respectively. This can be attributed to several reasons, including population boom, lack of uninterrupted services and inadequate functioning facilities. In fact, according to the World Health Organization (WHO, 2004), an estimated 90% of all incidence of diarrhoea among infants can be blamed on inadequate sanitation and unclean water. For example, in a study of 11 countries in Sub-Saharan Africa, only between 35-80% of water systems were operational in the rural areas (Sutton, 2004). Another survey in South Africa recognized that over 70% of the boreholes in the Eastern Cape were not working (Mackintosh and Colvin, 2003). Further examples of sanitation systems in bad condition have also been acknowledged in rural Ghana, where nearly 40% of latrines put up due to the support of a sanitation program were uncompleted or not used (Rodgers et al., 2007). The author had a personal communication with the District Environmental Officer and he estimated that, approximately there are 224 public toilets, 560 hand dug wells, 1,255 public standpipes and 3 well managed waste disposal sites in the district. According to the 2006 projection, the population of the district is expected to reach 295,753 by the end of the year 2009 (WWDA, 2006). Development partners in the past have concentrated their efforts on facilities provision only. They have not looked well at the possible causes of the persistence of disease transmission despite the effort they are making. Relationships between households socio cultural demographic factors and peoples behaviour with respect to the practice of hygiene could prove an essential lead to the solution of the problem. The fact is, merely providing a water closet does not guarantee that it could be adopted by the people and used well to reduce disease transmission. Epidemiological investigations have revealed that even in dearth supply of latrines, diarrhoeal morbidity can be reduced with the implementation of improved hygiene behaviours (IRC, 2001: Morgan, 1990). Access to waste disposal systems, their regular, consistent and hygienic use and adoption of other hygienic behavioural practices that block the transmission of diseases are the most important factors. In quite a lot of studies fro m different countries, the advancement of personal and domestic hygiene accounted for a decline in diarrhoeal morbidity (Henry and Rahim, 1990). The World Bank, (2003) identifies the demographic characteristics of the household including education of members, occupation, size and composition as influencing the willingness of the household to use an improved water supply and sanitation system. Education, especially for females results in well spaced child birth, greater ability of parents to give better health care which in turn contribute to reduced mortality rates among children under 5years (Grant, 1995). In a study into water resource scarcity in coastal Ghana, Hunter (2004) identified a valid association between household size, the presence of young children and the gender of the household head. It was noted that, female heads were less likely to collect water in larger households. Furthermore, increasing number of young children present increased the odds of female head/spouse being the household water collector. Cultural issues play active part in hygiene and sanitation behaviour especially among members of rural communities. For example, women are hardly seen urinating in public due to a perceived shame in the act but men can be left alone if found doing it. Also, the act of defecation publicly is generally unacceptable except when infants and young children are involved. The reason is that the faeces from young people are allegedly free from pathogens and less offensive (Drangert, 2004). Ismails (1999) work on nutritional assessment in Africa, detected that peoples demographic features, socioeconomic and access to basic social services such as food, water and electricity correlate significantly to their health and nutrition status. Specifically, factors such as age, gender, township status and ethnicity, which are basic to demography, can play a role in the quality of life especially of the elderly. This research assessed peoples practice of personal hygiene in Bogoso and surrounding villages. It also identified the common bacteria present in household stored water sources. Furthermore, the research identified the relationships between some socio-cultural demographic factors of households and the sanitation practice of its members. THE PROBLEM STATEMENT The Wassa West District in the Western Region is home to six large scale mining companies and hundreds of small scale and illegal mining units. Towns and villages in the district have been affected by mining, forestry and agricultural activities for over 120 years (BGL EIS, 2005). Because of this development, the local environment has been subjected to varying degrees of degradation. For example, water quality analysis carried out in 1989 by the former Canadian Bogoso Resources (CBR) showed that water samples had Total coliform bacteria in excess of 16 colonies per 100ml (BGL EIS,2005). Most of the water and sanitation programs executed in the district exerted little positive impact and thus, diarrhoeal diseases are still very high in the towns and villages (See Appendix D on page 80). However, in order to solve any problem it is important to appreciate the issues that contribute to it; after all, identifying the problem in itself is said to be a solution in disguise. Numerous health impact research have evidently recognized that the upgrading of water supply and sanitation alone is generally required but not adequate to attain broad health effects if personal and domestic hygiene are not given equivalent prominence (Scherlenlieb, 2003). The troubles of scarce water and safe sanitation provisions in developing countries have previously been dealt with by researchers for quite some time. However, until recent times they were mostly considered as technical and/or economic problems. Even rural water and sanitation issues are repeatedly dealt with from an entirely engineering point of view, with only a simple reference to social or demographic aspects. Therefore, relatively not much is proven how the socio-cultural demographic influences impinge on hygiene behaviour which in turn influences the transmission of diseases. The relationship between household socio cultural factors and the sanitation conditions of households in the Wassa West District especially the Bogoso Rural Council area has not been systematically documented or there is inadequate research that investigates such relationship. THE RESEARCH QUESTIONS The following research questions were posed to help address the objectives; Why are the several sanitation intervention projects failing to achieve desired results? Why is the prevalence of malaria and diarrhea diseases so high in the district? What types of common bacteria are prevalent in the stored drinking water of households? OBJECTIVES The main aim of this research was to investigate peoples awareness and practice of personal hygiene, access to quality water and sanitation and the possible causes of diarrhoeal diseases and suggest ways to reduce the incidence of diseases in the community. The specific objectives were; To assess the quality of stored household drinking water To establish the extent to which sanitation behaviour is affected by household socio-cultural demographic factors like age and education level of the head. To investigate the occurrence of diarrhoea among young children (0-59 months old) in the households. To identify and recommend good intervention methods to eliminate or reduce the outbreak of diseases and improve sanitation. HYPOTHESIS In addition to the above objectives, the following hypotheses were tested; Occurrence of infant diarrhoea in the household is independent on the educational attainment of child caretakers. There is no relationship between households background factors and the sanitation conditions of the household. CHAPTER TWO LITERATURE REVIEW In this chapter, various literature related to the subject matter of study are reviewed. Areas covered are sanitation, hygiene, water quality and diarrhoeal diseases. Theories and models the study contributed to include USAIDs Sanitation Improvement Framework, the F diagram by Wagner and Lanois and the theory of Social learning. SANITATION Until recently, policies of many countries have focused on access to latrines by households as a principal indicator of sanitation coverage, although of late there has been a change and an expansion in understanding the term sanitation. Sanitation can best be defined as the way of collecting and disposing of excreta and community liquid waste in a germ-free way so as not to risk the health of persons or the community as a whole (WEDC, 1998). Ideally, sanitation should end in the seclusion or destruction of pathogenic material and, hence, a breach in the transmission pathway. The transmission pathways are well known and are potted and simplified in the F diagram (Wagner and Lanois 1958) shown below by figure 3.1. The more paths that can be blocked, the more useful a health and sanitation intervention program will be. It may be mentioned that the health impact indicators of sanitation programmes are not easy to define and measure, particularly in the short run. Therefore, it seems more reasonable to look at sanitation as a package of services and actions which taken together can have some bearing on the health of a person and health status in a community. According to IRC (2001:0), issues that need to be addressed when assessing sanitation would include: How complete the sanitation programme is in addressing major risks for transmitting sanitation-related diseases; Whether the sanitation programme adopted a demand driven approach, through greater peoples participation, or supply driven approach, through heavy subsidy; Whether it allows adjustment to peoples varying needs and payment; If the programme leads to measurably improved practices by the majority of men and women, boys and girls; If it is environmentally friendly. That is; if it does not increase or create new environmental hazards (IRC, 2001) Sanitation is a key determinant of both fairness in society and societys ability to maintain itself. If the sanitation challenges described above cannot be met, we will not be able to provide for the needs of the present generation without hindering that of future generations. Thus, sanitation approaches must be resource minded, not waste minded. HYGIENE Hygiene is the discipline of health and its safeguarding (Dorland, 1997). Health is the capacity to function efficiently within ones surroundings. Our health as individuals depends on the healthfulness of our environment. A healthful environment, devoid of risky substances allows the individual to attain complete physical, emotional and social potential. Hygiene is articulated in the efforts of an individual to safeguard, sustain and enhance health status (Anderson and Langton, 1961). Measures of hygiene are vital in the fight against diarrhoeal diseases, the major fatal disease of the young in developing countries (Hamburg, 1987). The most successful interventions against diarrhoeal diseases are those that break off the transmission of contagious agents at home. Personal and domestic hygiene can be enhanced with such trouble-free actions like ordinary use of water in adequate quantity for hand washing, bathing, laundering and cleaning of cooking and eating utensils; regular washing and change of clothes; eating healthy and clean foods and appropriate disposal of solid and liquid waste. Diarrheal Dise ases Diarrhoea can be defined in absolute or relative terms based on either the rate of recurrence of bowel movements or the constancy (or looseness) of stools (Kendall, 1996). Absolute diarrhoea is having more bowel movements than normal. Relative diarrhoea is defined based on the consistency of stool. Thus, an individual who develops looser stools than usual has diarrhoea even though the stools may be within the range of normal with respect to consistency. According to the United States Centre for Disease Control and Prevention (CDC, 2006), with diarrhoea, stools typically are looser whether or not the frequency of bowel movements is increased. This looseness of stool which can vary all the way from slightly soft to watery is caused by increased water in the stool. Increased amounts of water in stool can occur if the stomach and/or small intestine produce too much fluid, the distal small intestine and colon do not soak up enough water, or the undigested, liquid food passes too quickly through the small intestine and colon for them to take out enough water. Of course, more than one of these anomalous processes may occur at the same time. For example, some viruses, bacteria and parasites cause increased discharge of fluid, either by invading and inflaming the lining of the small intestine (inflammation stimulates the lining to secrete fluid) or by producing toxins (chemicals) that also fire up the lining to secrete fluid but without caus ing inflammation. Swelling of the small intestine and/or colon from bacteria or from ileitis/colitis can increase the haste with which food passes through the intestines, reducing the time that is available for absorbing water. Conditions of the colon such as collagenous colitis can also impede the capacity of the colon to soak up water. Escherichia coli O157:H7 is probably the most dreaded bacteria today among parents of young children. The name of the bacteria refers to the chemical compounds found on the bacteriums surface. Cattle are the main sources of E. coli O157:H7, but these bacteria also can be found in other domestic and wild mammals. E. coli O157:H7 became a household word in 1993 when it was recognized as the cause of four deaths and more than 600 cases of bloody diarrhoea among children under 5years in North-western United States (US EPA, 1996). The Northwest epidemic was traced to undercooked hamburgers served in a fast food restaurant. Other sources of outbreaks have included raw milk, unpasteurized apple juice, raw sprouts, raw spinach, and contaminated water. Most strains of E. coli bacteria are not dangerous however, this particular strain attaches itself to the intestinal wall and then releases a toxin that causes severe abdominal cramps, bloody diarrhoea and vomiting that lasts a week or longer. In small children and the elderly, the disease can advance to kidney failure. The good news is that E. coli O157:H7 is easily destroyed by cooking to 160F throughout. Reducing diarrhoea morbidity with USAIDs Framework To attain noteworthy improvement in reducing the number of deaths attributed to diarrhoea, its fundamental causes must be addressed. It is approximated that 90% of all cases of diarrhoea can be attributed to three major causes: insufficient sanitation, inadequate hygiene, and contaminated water (WHO 1997). According to USAID, for further progress to be made in the fight against diarrhoea, the concentration will need to include prevention, especially in child health programs. The first method, case management of diarrhoea, has been tremendously successful in recent years in reducing child mortality. The primary process of achieving effect has been through the initiation and operation of oral rehydration therapy; i.e. the dispensation of oral rehydration solution and sustained feeding (both solid and fluid, including breast milk). In addition, health experts have emphasized the need for caretakers to become aware of the danger signs early in children under their care and to obtain suitable, appropriate care to avoid severe dehydration and death. The second approach, increasing host resistance to diarrhoea, has also had some victory with the enhancement of a childs nutritional status and vaccination against measles, a familiar cause of diarrhoea. The third element is prevention through hygiene improvement. Although the health care system has dealt comprehensively with the symptoms of diarrhoea, it has done insufficiently to bring down the overall incidence of the disease. Despite a drop in deaths owing to diarrhoea, morbidity or the health burden due to diarrhoea has not decreased, because health experts are treating the symptoms but not addressing the causes. Thus, diarrhoeas drain on the health system, its effects on household finances and education, and its additional burden on mothers has not been mitigated . Programs in several countries have confirmed that interventions can and do reduce diarrhoea morbidity. A critical constituent of successful prevention efforts is an effective monitoring and appraisal strategy. In order to reduce transmission of faecal-oral diseases at the household level, for example, an expert group of epidemiologist and water supply and sanitation specialist concluded that three interventions would be crucial. These are: Safer disposal of human excreta, particularly of babies and people with diarrhoea. Hand washing after defecation and handling babies faeces and before feeding, eating and preparing food, and; Maintaining drinking water free from faecal contamination in the home and at the source (WHO, 1993). Studies on hand washing, as reported in Boot and Cairncross (1993), confirm that it is not only the act of hand washing, but also how well hands are washed that make a difference. To prevent diarrhoea, its causes must first be fully tacit. According to the USAIDs hygiene improvement framework, a thorough approach to diarrhoea at the national level must tackle the three key elements of any triumphant program to fight disease. These are; contact with the necessary hardware or technologies, encouragement of healthy behaviours, and assistance for long-term sustainability. The concept is explained by figure 3.3 below; The first part, water supply systems, addresses mutually the issue of water quality and water quantity, which reduces the risk of contamination of food and drink. Similarly, ensuring access to water supply systems can greatly ease the time women spend collecting water, allowing more time to care for young children and more time for income generating activities. The third element, household technologies and materials, refers to the increased accessibility to such hygiene supplies as soap (or local substitutes), chlorine, filters, water storage containers that have restricted necks and are covered, and potties for small children. The second element of the hardware component, toilet facilities, involves providing facilities to dispose off human excreta in ways that safeguard the environment and public health, characteristically in the form of numerous kinds of latrines, septic tanks, and water-borne toilets. Sanitation reporting is important because faecal contamination can spread from one household to another, especially in closely populated areas. WATER QUALITY STANDARDS AND GUIDELINES Water quality is defined in terms of the chemical, physical, and biological constituents in water. The word standards is used to refer to legally enforceable threshold values for the water parameters analyzed, while guidelines refer to threshold values that are recommended and do not have any regulatory status. This study employs the world health organization (WHO) and the Ghana standards board (GSB) standards and guidelines in determining the quality of water. Water Quality Requirements for Drinking Water – Ghana Standards The Ghana Standards for drinking water (GS 175-Part 1:1998) indicate the required physical, chemical, microbial and radiological properties of drinking water. The standards are adapted from the World Health Organizations Guidelines for Drinking Water Quality, Second Edition, Volume 1, 1993, but also incorporate national standards that are specific to the countrys environment. Physical Requirements The Ghana Standards set the maximum turbidity of drinking water at 5 NTU. Other physical requirements pertain to temperature, odour, taste and colour. Temperature, odour and taste are generally not to be objectionable, while the maximum threshold values for colour are given quantitatively as True Colour Units (TCU) or Hazen units. The Ghana Standards specify 5 TCU or 5 Hazen units for colour after filtration. The requirements for pH values set by the Ghana Standards for drinking water is 6.5 to 8.5 (GS 175-Part1:1998). Microbial Requirements The Ghana Standards specify that E.coli or thermotolerant bacteria and total coliform bacteria should not be detected in a 100ml sample of drinking water (0 CFU/100ml). The Ghana Standards also specify that drinking water should be free of human enteroviruses. WHO Drinking Water Guidelines Physical Requirements Although no health-based guideline is given by WHO (2006) for turbidity in drinking water, it is recommended that the median turbidity should ideally be below 0.1 NTU for effective disinfection. Microbial Requirements Like the Ghana Standards, no E.coli or thermotolerant bacteria should be detected in a 100 ml sample of drinking water. Water Related Diseases Every year, water-related diseases claim the lives of 3.4 million people, the greater part of whom are children (Dufour et. al, 2003). Water-related diseases can be grouped into four categories ( Bradley, 1977) based on the path of transmission: waterborne diseases, water-washed diseases, water-based diseases, insect vector-related diseases. Waterborne diseases are caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses. These include cholera, typhoid, amoebic and bacillary dysentery and other diarrhoeal diseases. Water washed diseases are caused by poor personal hygiene and skin or eye contact with contaminated water. These include scabies, trachoma and flea, lice and tick-borne diseases. Water-based diseases are caused by parasites found in intermediate organisms living in contaminated water. These include dracunculiasis, schistosomiasis and other helminths. Water related diseases are caused by insect vectors, especially mosquitoes that breed in water. They include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever. The Theory of Social Learning Learning is any relatively permanent change in behaviour that can be attributed to experience (Coon, 1989). According to the social learning theory, behavioural processes are directly acquired by the continually dynamic interplay between the individual and its social environment (Mc Connell, 1982). For example, children learn what to do at home by observing what happens when their siblings talk back to their parents or throw rubbish into the household compound. The learning process occurs through reinforcement and punishment. Reinforcement refers to any event that increases chances that a response will occur again (Coon, 1989). Reinforcement and punishment can be learned through education where the person can read about what happens to people as a result of actions they make. The elementary unit of society is the household and this can be defined as a residential group of persons who live under the same roof and eat out of the same pot (Friedman, 1992). Social learning is necessary for the household in acquiring the skills pertinent to the maintenance of health promoting behaviour. Most of our daily activities are learned in the household. Individuals begin to learn behaviour patterns from childhood by observing especially the parents and later on their siblings. The environment is understood as comprising the whole set of natural or biophysical and man-made or socio-cultural systems, in which man and other organisms live, work or interact (Ocran, 1999). The environment is human lifes supporting system from which food, air and shelter are derived to sustain human life. Humans interact with the physical and man-made environment and this interaction creates a complex, finely balanced set of structures and processes, which evolve over the history of a people. These structures and processes determine the culture of the society, their social behaviour, beliefs and superstition about health and diseases. Social relationships seem to protect individuals against behavioural disorders and they facilitate health promoting behaviour (Barlow and Durand, 1995; Ho Factors Influencing Sanitation Conditions Factors Influencing Sanitation Conditions ABSTRACT This thesis examines the socio-cultural and demographic factors influencing sanitation conditions, identifies the presence of Escherichia coli in household drinking water samples and investigates prevalence of diarrhoea among infants. It is based on questionnaire interviews of 120 household heads and 77 caretakers of young children below the age of 5years, direct observation of clues of household sanitation practice as well as analyses of household water samples in six surrounding communities in Bogoso. Data collected was analysed using SPSS and the Pearson Product Moment Correlation Value(R) technique. The findings revealed that the sanitation condition of households improved with high educational attainment and ageing household heads. On the contrary, sanitation deteriorated with overcrowding in the household. Furthermore, in houses where the religion of the head of household was Traditional, sanitation was superior to those of a Christian head and this household also had better sa nitary conditions than that with a Moslem head of household. Water quality analysis, indicated that 27 samples out of the 30 representing 90% tested negative for E. Coli bacteria whilst 17(56.7%) samples had acceptable levels of total Escherichia coli. Finally, it was found out that diarrhoea among infants were highly prevalent since 47 (61.04%) out of the 77 child minders admitted their wards had a bout with infant diarrhoea. Massive infrastructural development, supported by behavioural change education focussing on proper usage of sanitary facilities is urgently needed in these communities to reduce the incidence of public health diseases. Intensive health education could also prove vital and such programs must target young heads of household, households with large family size and households whose heads are Christians and Moslems. CHAPTER ONE INTRODUCTION BACKGROUND TO THE STUDY Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality by two thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water- linked diseases which kill thousands of children every day (United Nations, 2006). According to the World Health Organization (2004), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got poorly from diseases caused by unhygienic water. Each year 1.8 million people pass away from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004). Ghana Water and Sewerage Corporation (GWSC) had traditionally been the major stakeholder in the provision of safe water and sanitation facilities. Since the 1960s the GWSC has focussed chiefly on urban areas at the peril of rural areas and thus, rural communities in the Wassa West District are no exception. According to the Ghana 2003 Core Welfare Indicators Questionnaire (CWIQ II) Survey Report (GSS, 2005), roughly 78% of all households in the Tamale Metropolis, 97 percent in Accra, 86% in Kumasi and 94% in Sekondi-Takoradi own pipe-borne water. Once more, the report show that a few households do not own any toilet facilities and depend on the bush for their toilet needs, that is 2.1%, 7.3%, and 5% for Accra, Kumasi, and Sekondi-Takoradi correspondingly. Access to safe sanitation, improved water and improved waste disposal systems is more of an urban than rural occurrence. In the rural poor households, only 9.2% have safe sanitation, 21.1% use improved waste disposal method and 63.0 % have access to improved water. The major diseases prevalent in Ghana are malaria, yellow fever, schistosomiasis (bilharzias), typhoid and diarrhea. Diarrhea is of precise concern since it has been recognized as the second most universal disease treated at clinics and one of the major contributors to infant mortality (UNICEF, 2004). The infant mortality rate currently stands at about 55 deaths per 1,000 live births (CIA, 2006). The Wassa West District of Ghana has seen an improvement in water and sanitation facilities during the last decade. Most of the development projects in the district are sponsored by the mining companies, individuals and some non-governmental organisations (NGOs). Between 2002 and 2008, Goldfields Tarkwa Mine constructed 118 new hand dug wells (77 of which were fitted with hand pumps) and refurbished 48 wells in poor condition. Also, a total of 44 modern style public water closets, were constructed in their catchment areas. The company also donated 19 large refuse collection containers to the District Assembly and built 6 new nurses quarters. The Tarkwa Mine has so far spent 10.5million US dollars of which 26% went into health, water and sanitation projects, 24% into agricultural development, 31% into formal education and the remaining went into other projects like roads and community centre construction ( GGL, 2008). Golden Star Resources (consist of Bogoso/Prestea Mine and Wassa Min e at Damang) also established the community development department in 2005 and has since invested 800 thousand US dollars. Their projects include 22 Acqua-Privy toilets, 10 hand dug wells (all fitted with hand pumps) and supplied potable water to villages with their tanker trucks (BGL, 2007). Other development partners complimenting the efforts of the central government include NGOs WACAM, Care International and Friends of the Nation (FON). WACAM is an environmentally based NGO which monitors water pollution by large scale mining companies. They have sponsored about 10 hand dug wells for villages in the district. Care International sponsors hygiene and reproductive health programmes in schools and on radio. They have also donated a couple of motor bicycles to public health workers in the district who travel to villages. The aims of all these projects were to improve hygiene and sanitation so as to reduce disease transmission. Despite efforts by the development partners, water supply and sanitation related diseases are highly prevalent in the district. Data obtained from the Public and Environmental Health Department of the Ministry of Health (M.O.H., 2008) showed that the top ten most prevalent diseases in the district include malaria, acute respiratory infections, skin diseases and diarrhoea. The others are acute eye infection, rheumatism, dental carries, hypertension, pregnancy related complications and home/occupational accidents. A lot more illnesses occur but on a lower scale and these include intestinal worms, coughs and typhoid fever. A complete data on the top ten diseases prevalent in the district is attached as Appendix D but below is a selection of the illnesses that directly result from bad water and sanitation practices. The number of malaria cases decreased from 350 in 2006 to 300 cases per 1000 population in 2008. Despite the decrease, the values involved are still quite high. The incidence of diarrhoea among infants and acute respiratory infection remained 30 and 60 cases per 1,000 populations respectively. This can be attributed to several reasons, including population boom, lack of uninterrupted services and inadequate functioning facilities. In fact, according to the World Health Organization (WHO, 2004), an estimated 90% of all incidence of diarrhoea among infants can be blamed on inadequate sanitation and unclean water. For example, in a study of 11 countries in Sub-Saharan Africa, only between 35-80% of water systems were operational in the rural areas (Sutton, 2004). Another survey in South Africa recognized that over 70% of the boreholes in the Eastern Cape were not working (Mackintosh and Colvin, 2003). Further examples of sanitation systems in bad condition have also been acknowledged in rural Ghana, where nearly 40% of latrines put up due to the support of a sanitation program were uncompleted or not used (Rodgers et al., 2007). The author had a personal communication with the District Environmental Officer and he estimated that, approximately there are 224 public toilets, 560 hand dug wells, 1,255 public standpipes and 3 well managed waste disposal sites in the district. According to the 2006 projection, the population of the district is expected to reach 295,753 by the end of the year 2009 (WWDA, 2006). Development partners in the past have concentrated their efforts on facilities provision only. They have not looked well at the possible causes of the persistence of disease transmission despite the effort they are making. Relationships between households socio cultural demographic factors and peoples behaviour with respect to the practice of hygiene could prove an essential lead to the solution of the problem. The fact is, merely providing a water closet does not guarantee that it could be adopted by the people and used well to reduce disease transmission. Epidemiological investigations have revealed that even in dearth supply of latrines, diarrhoeal morbidity can be reduced with the implementation of improved hygiene behaviours (IRC, 2001: Morgan, 1990). Access to waste disposal systems, their regular, consistent and hygienic use and adoption of other hygienic behavioural practices that block the transmission of diseases are the most important factors. In quite a lot of studies fro m different countries, the advancement of personal and domestic hygiene accounted for a decline in diarrhoeal morbidity (Henry and Rahim, 1990). The World Bank, (2003) identifies the demographic characteristics of the household including education of members, occupation, size and composition as influencing the willingness of the household to use an improved water supply and sanitation system. Education, especially for females results in well spaced child birth, greater ability of parents to give better health care which in turn contribute to reduced mortality rates among children under 5years (Grant, 1995). In a study into water resource scarcity in coastal Ghana, Hunter (2004) identified a valid association between household size, the presence of young children and the gender of the household head. It was noted that, female heads were less likely to collect water in larger households. Furthermore, increasing number of young children present increased the odds of female head/spouse being the household water collector. Cultural issues play active part in hygiene and sanitation behaviour especially among members of rural communities. For example, women are hardly seen urinating in public due to a perceived shame in the act but men can be left alone if found doing it. Also, the act of defecation publicly is generally unacceptable except when infants and young children are involved. The reason is that the faeces from young people are allegedly free from pathogens and less offensive (Drangert, 2004). Ismails (1999) work on nutritional assessment in Africa, detected that peoples demographic features, socioeconomic and access to basic social services such as food, water and electricity correlate significantly to their health and nutrition status. Specifically, factors such as age, gender, township status and ethnicity, which are basic to demography, can play a role in the quality of life especially of the elderly. This research assessed peoples practice of personal hygiene in Bogoso and surrounding villages. It also identified the common bacteria present in household stored water sources. Furthermore, the research identified the relationships between some socio-cultural demographic factors of households and the sanitation practice of its members. THE PROBLEM STATEMENT The Wassa West District in the Western Region is home to six large scale mining companies and hundreds of small scale and illegal mining units. Towns and villages in the district have been affected by mining, forestry and agricultural activities for over 120 years (BGL EIS, 2005). Because of this development, the local environment has been subjected to varying degrees of degradation. For example, water quality analysis carried out in 1989 by the former Canadian Bogoso Resources (CBR) showed that water samples had Total coliform bacteria in excess of 16 colonies per 100ml (BGL EIS,2005). Most of the water and sanitation programs executed in the district exerted little positive impact and thus, diarrhoeal diseases are still very high in the towns and villages (See Appendix D on page 80). However, in order to solve any problem it is important to appreciate the issues that contribute to it; after all, identifying the problem in itself is said to be a solution in disguise. Numerous health impact research have evidently recognized that the upgrading of water supply and sanitation alone is generally required but not adequate to attain broad health effects if personal and domestic hygiene are not given equivalent prominence (Scherlenlieb, 2003). The troubles of scarce water and safe sanitation provisions in developing countries have previously been dealt with by researchers for quite some time. However, until recent times they were mostly considered as technical and/or economic problems. Even rural water and sanitation issues are repeatedly dealt with from an entirely engineering point of view, with only a simple reference to social or demographic aspects. Therefore, relatively not much is proven how the socio-cultural demographic influences impinge on hygiene behaviour which in turn influences the transmission of diseases. The relationship between household socio cultural factors and the sanitation conditions of households in the Wassa West District especially the Bogoso Rural Council area has not been systematically documented or there is inadequate research that investigates such relationship. THE RESEARCH QUESTIONS The following research questions were posed to help address the objectives; Why are the several sanitation intervention projects failing to achieve desired results? Why is the prevalence of malaria and diarrhea diseases so high in the district? What types of common bacteria are prevalent in the stored drinking water of households? OBJECTIVES The main aim of this research was to investigate peoples awareness and practice of personal hygiene, access to quality water and sanitation and the possible causes of diarrhoeal diseases and suggest ways to reduce the incidence of diseases in the community. The specific objectives were; To assess the quality of stored household drinking water To establish the extent to which sanitation behaviour is affected by household socio-cultural demographic factors like age and education level of the head. To investigate the occurrence of diarrhoea among young children (0-59 months old) in the households. To identify and recommend good intervention methods to eliminate or reduce the outbreak of diseases and improve sanitation. HYPOTHESIS In addition to the above objectives, the following hypotheses were tested; Occurrence of infant diarrhoea in the household is independent on the educational attainment of child caretakers. There is no relationship between households background factors and the sanitation conditions of the household. CHAPTER TWO LITERATURE REVIEW In this chapter, various literature related to the subject matter of study are reviewed. Areas covered are sanitation, hygiene, water quality and diarrhoeal diseases. Theories and models the study contributed to include USAIDs Sanitation Improvement Framework, the F diagram by Wagner and Lanois and the theory of Social learning. SANITATION Until recently, policies of many countries have focused on access to latrines by households as a principal indicator of sanitation coverage, although of late there has been a change and an expansion in understanding the term sanitation. Sanitation can best be defined as the way of collecting and disposing of excreta and community liquid waste in a germ-free way so as not to risk the health of persons or the community as a whole (WEDC, 1998). Ideally, sanitation should end in the seclusion or destruction of pathogenic material and, hence, a breach in the transmission pathway. The transmission pathways are well known and are potted and simplified in the F diagram (Wagner and Lanois 1958) shown below by figure 3.1. The more paths that can be blocked, the more useful a health and sanitation intervention program will be. It may be mentioned that the health impact indicators of sanitation programmes are not easy to define and measure, particularly in the short run. Therefore, it seems more reasonable to look at sanitation as a package of services and actions which taken together can have some bearing on the health of a person and health status in a community. According to IRC (2001:0), issues that need to be addressed when assessing sanitation would include: How complete the sanitation programme is in addressing major risks for transmitting sanitation-related diseases; Whether the sanitation programme adopted a demand driven approach, through greater peoples participation, or supply driven approach, through heavy subsidy; Whether it allows adjustment to peoples varying needs and payment; If the programme leads to measurably improved practices by the majority of men and women, boys and girls; If it is environmentally friendly. That is; if it does not increase or create new environmental hazards (IRC, 2001) Sanitation is a key determinant of both fairness in society and societys ability to maintain itself. If the sanitation challenges described above cannot be met, we will not be able to provide for the needs of the present generation without hindering that of future generations. Thus, sanitation approaches must be resource minded, not waste minded. HYGIENE Hygiene is the discipline of health and its safeguarding (Dorland, 1997). Health is the capacity to function efficiently within ones surroundings. Our health as individuals depends on the healthfulness of our environment. A healthful environment, devoid of risky substances allows the individual to attain complete physical, emotional and social potential. Hygiene is articulated in the efforts of an individual to safeguard, sustain and enhance health status (Anderson and Langton, 1961). Measures of hygiene are vital in the fight against diarrhoeal diseases, the major fatal disease of the young in developing countries (Hamburg, 1987). The most successful interventions against diarrhoeal diseases are those that break off the transmission of contagious agents at home. Personal and domestic hygiene can be enhanced with such trouble-free actions like ordinary use of water in adequate quantity for hand washing, bathing, laundering and cleaning of cooking and eating utensils; regular washing and change of clothes; eating healthy and clean foods and appropriate disposal of solid and liquid waste. Diarrheal Dise ases Diarrhoea can be defined in absolute or relative terms based on either the rate of recurrence of bowel movements or the constancy (or looseness) of stools (Kendall, 1996). Absolute diarrhoea is having more bowel movements than normal. Relative diarrhoea is defined based on the consistency of stool. Thus, an individual who develops looser stools than usual has diarrhoea even though the stools may be within the range of normal with respect to consistency. According to the United States Centre for Disease Control and Prevention (CDC, 2006), with diarrhoea, stools typically are looser whether or not the frequency of bowel movements is increased. This looseness of stool which can vary all the way from slightly soft to watery is caused by increased water in the stool. Increased amounts of water in stool can occur if the stomach and/or small intestine produce too much fluid, the distal small intestine and colon do not soak up enough water, or the undigested, liquid food passes too quickly through the small intestine and colon for them to take out enough water. Of course, more than one of these anomalous processes may occur at the same time. For example, some viruses, bacteria and parasites cause increased discharge of fluid, either by invading and inflaming the lining of the small intestine (inflammation stimulates the lining to secrete fluid) or by producing toxins (chemicals) that also fire up the lining to secrete fluid but without caus ing inflammation. Swelling of the small intestine and/or colon from bacteria or from ileitis/colitis can increase the haste with which food passes through the intestines, reducing the time that is available for absorbing water. Conditions of the colon such as collagenous colitis can also impede the capacity of the colon to soak up water. Escherichia coli O157:H7 is probably the most dreaded bacteria today among parents of young children. The name of the bacteria refers to the chemical compounds found on the bacteriums surface. Cattle are the main sources of E. coli O157:H7, but these bacteria also can be found in other domestic and wild mammals. E. coli O157:H7 became a household word in 1993 when it was recognized as the cause of four deaths and more than 600 cases of bloody diarrhoea among children under 5years in North-western United States (US EPA, 1996). The Northwest epidemic was traced to undercooked hamburgers served in a fast food restaurant. Other sources of outbreaks have included raw milk, unpasteurized apple juice, raw sprouts, raw spinach, and contaminated water. Most strains of E. coli bacteria are not dangerous however, this particular strain attaches itself to the intestinal wall and then releases a toxin that causes severe abdominal cramps, bloody diarrhoea and vomiting that lasts a week or longer. In small children and the elderly, the disease can advance to kidney failure. The good news is that E. coli O157:H7 is easily destroyed by cooking to 160F throughout. Reducing diarrhoea morbidity with USAIDs Framework To attain noteworthy improvement in reducing the number of deaths attributed to diarrhoea, its fundamental causes must be addressed. It is approximated that 90% of all cases of diarrhoea can be attributed to three major causes: insufficient sanitation, inadequate hygiene, and contaminated water (WHO 1997). According to USAID, for further progress to be made in the fight against diarrhoea, the concentration will need to include prevention, especially in child health programs. The first method, case management of diarrhoea, has been tremendously successful in recent years in reducing child mortality. The primary process of achieving effect has been through the initiation and operation of oral rehydration therapy; i.e. the dispensation of oral rehydration solution and sustained feeding (both solid and fluid, including breast milk). In addition, health experts have emphasized the need for caretakers to become aware of the danger signs early in children under their care and to obtain suitable, appropriate care to avoid severe dehydration and death. The second approach, increasing host resistance to diarrhoea, has also had some victory with the enhancement of a childs nutritional status and vaccination against measles, a familiar cause of diarrhoea. The third element is prevention through hygiene improvement. Although the health care system has dealt comprehensively with the symptoms of diarrhoea, it has done insufficiently to bring down the overall incidence of the disease. Despite a drop in deaths owing to diarrhoea, morbidity or the health burden due to diarrhoea has not decreased, because health experts are treating the symptoms but not addressing the causes. Thus, diarrhoeas drain on the health system, its effects on household finances and education, and its additional burden on mothers has not been mitigated . Programs in several countries have confirmed that interventions can and do reduce diarrhoea morbidity. A critical constituent of successful prevention efforts is an effective monitoring and appraisal strategy. In order to reduce transmission of faecal-oral diseases at the household level, for example, an expert group of epidemiologist and water supply and sanitation specialist concluded that three interventions would be crucial. These are: Safer disposal of human excreta, particularly of babies and people with diarrhoea. Hand washing after defecation and handling babies faeces and before feeding, eating and preparing food, and; Maintaining drinking water free from faecal contamination in the home and at the source (WHO, 1993). Studies on hand washing, as reported in Boot and Cairncross (1993), confirm that it is not only the act of hand washing, but also how well hands are washed that make a difference. To prevent diarrhoea, its causes must first be fully tacit. According to the USAIDs hygiene improvement framework, a thorough approach to diarrhoea at the national level must tackle the three key elements of any triumphant program to fight disease. These are; contact with the necessary hardware or technologies, encouragement of healthy behaviours, and assistance for long-term sustainability. The concept is explained by figure 3.3 below; The first part, water supply systems, addresses mutually the issue of water quality and water quantity, which reduces the risk of contamination of food and drink. Similarly, ensuring access to water supply systems can greatly ease the time women spend collecting water, allowing more time to care for young children and more time for income generating activities. The third element, household technologies and materials, refers to the increased accessibility to such hygiene supplies as soap (or local substitutes), chlorine, filters, water storage containers that have restricted necks and are covered, and potties for small children. The second element of the hardware component, toilet facilities, involves providing facilities to dispose off human excreta in ways that safeguard the environment and public health, characteristically in the form of numerous kinds of latrines, septic tanks, and water-borne toilets. Sanitation reporting is important because faecal contamination can spread from one household to another, especially in closely populated areas. WATER QUALITY STANDARDS AND GUIDELINES Water quality is defined in terms of the chemical, physical, and biological constituents in water. The word standards is used to refer to legally enforceable threshold values for the water parameters analyzed, while guidelines refer to threshold values that are recommended and do not have any regulatory status. This study employs the world health organization (WHO) and the Ghana standards board (GSB) standards and guidelines in determining the quality of water. Water Quality Requirements for Drinking Water – Ghana Standards The Ghana Standards for drinking water (GS 175-Part 1:1998) indicate the required physical, chemical, microbial and radiological properties of drinking water. The standards are adapted from the World Health Organizations Guidelines for Drinking Water Quality, Second Edition, Volume 1, 1993, but also incorporate national standards that are specific to the countrys environment. Physical Requirements The Ghana Standards set the maximum turbidity of drinking water at 5 NTU. Other physical requirements pertain to temperature, odour, taste and colour. Temperature, odour and taste are generally not to be objectionable, while the maximum threshold values for colour are given quantitatively as True Colour Units (TCU) or Hazen units. The Ghana Standards specify 5 TCU or 5 Hazen units for colour after filtration. The requirements for pH values set by the Ghana Standards for drinking water is 6.5 to 8.5 (GS 175-Part1:1998). Microbial Requirements The Ghana Standards specify that E.coli or thermotolerant bacteria and total coliform bacteria should not be detected in a 100ml sample of drinking water (0 CFU/100ml). The Ghana Standards also specify that drinking water should be free of human enteroviruses. WHO Drinking Water Guidelines Physical Requirements Although no health-based guideline is given by WHO (2006) for turbidity in drinking water, it is recommended that the median turbidity should ideally be below 0.1 NTU for effective disinfection. Microbial Requirements Like the Ghana Standards, no E.coli or thermotolerant bacteria should be detected in a 100 ml sample of drinking water. Water Related Diseases Every year, water-related diseases claim the lives of 3.4 million people, the greater part of whom are children (Dufour et. al, 2003). Water-related diseases can be grouped into four categories ( Bradley, 1977) based on the path of transmission: waterborne diseases, water-washed diseases, water-based diseases, insect vector-related diseases. Waterborne diseases are caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses. These include cholera, typhoid, amoebic and bacillary dysentery and other diarrhoeal diseases. Water washed diseases are caused by poor personal hygiene and skin or eye contact with contaminated water. These include scabies, trachoma and flea, lice and tick-borne diseases. Water-based diseases are caused by parasites found in intermediate organisms living in contaminated water. These include dracunculiasis, schistosomiasis and other helminths. Water related diseases are caused by insect vectors, especially mosquitoes that breed in water. They include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever. The Theory of Social Learning Learning is any relatively permanent change in behaviour that can be attributed to experience (Coon, 1989). According to the social learning theory, behavioural processes are directly acquired by the continually dynamic interplay between the individual and its social environment (Mc Connell, 1982). For example, children learn what to do at home by observing what happens when their siblings talk back to their parents or throw rubbish into the household compound. The learning process occurs through reinforcement and punishment. Reinforcement refers to any event that increases chances that a response will occur again (Coon, 1989). Reinforcement and punishment can be learned through education where the person can read about what happens to people as a result of actions they make. The elementary unit of society is the household and this can be defined as a residential group of persons who live under the same roof and eat out of the same pot (Friedman, 1992). Social learning is necessary for the household in acquiring the skills pertinent to the maintenance of health promoting behaviour. Most of our daily activities are learned in the household. Individuals begin to learn behaviour patterns from childhood by observing especially the parents and later on their siblings. The environment is understood as comprising the whole set of natural or biophysical and man-made or socio-cultural systems, in which man and other organisms live, work or interact (Ocran, 1999). The environment is human lifes supporting system from which food, air and shelter are derived to sustain human life. Humans interact with the physical and man-made environment and this interaction creates a complex, finely balanced set of structures and processes, which evolve over the history of a people. These structures and processes determine the culture of the society, their social behaviour, beliefs and superstition about health and diseases. Social relationships seem to protect individuals against behavioural disorders and they facilitate health promoting behaviour (Barlow and Durand, 1995; Ho

The Rash Romeo in Shakespeares Romeo and Juliet Essay -- William Shake

The Rash Romeo in Shakespeare's Romeo and Juliet In the play Romeo and Juliet, Romeo’s actions are rash throughout the play. For example, Romeo does not consider the consequences of his actions when he insists on marrying Juliet. Also, Romeo shows rashness when he kills Tybalt. Finally, Romeo is rash when he kills himself. Rashness is a quality that haunts Romeo throughout the play. One of Romeo’s acts that shows his rashness is his marrying Juliet. After Juliet says that she does not want to marry Romeo, he persists and says that he wants â€Å"Th’ exchange of thy love’s faithful vow for mine† (2.2.134). Romeo does not consider the consequences of their marriage. He simply wants his wish fulfilled. He is rash because he wants to rush into a marriage for which he is not ready. Romeo’s rashness persists throughout the play and leads to his downfall. Another example of Romeo’s rash personality is when he kills Tybalt. Romeo’s family is told that if they fight with the Capulet family, they will be killed. Tybalt of the Capulet family fights with Mercut...

The advertising world Essay

The youths are highly influenced when they hit their transitional period from adolescence to the teenage years. They are dealing with the changes in their bodies and minds. Businesses are cashing in on the ability to target these children with their products; companies have focused advertising their products to young girls. The advertising world is also using younger models to sell their products. They are using the youth to sell anything from candy to underwear for their companies. The federal government should ban advertisers from allowing young girls to model as grown women. Advertising companies has used women to model as early back as the 1890’s The ideal of a beautiful woman has changed over the decades. Women and young girls look at magazines, movies, and movie stars and they desire to look like them. This may not be a problem for some women, but it has become a problem for the young girls today. The advertising world should be limited to how the youths are used in advertising. The writer remembers a story, which was overseas, a young model about ten years old was hired to model underwear, and she had on so much make up that it made her look like she was in her twenties, and she was wearing underwear that was for a grown woman. Neither the make-up nor the underwear was appropriate for this young girl to wear and/or to be advertising for other young girls to want to purchase. Young girls should not be exploited in this manner. A lot of young girls have a negative body image of themselves. When they desire to be something or somebody, they are not can or will cause the girls to develop eating disorders such as anorexia, bulimia or binge eating. The young girls want to be beautiful and thin because of the ideal body image that the advertising world is demonstrating in their ads, this how they are supposed to look to be accepted within a glamorous world. The perception of a better life is you are beautiful and thin. Most people are aware of anorexia, and bulimia is eating disorders were a person eats food, and then they use laxatives or force themselves to vomit to become and stay thin. The person who has anorexia or bulimia sees themselves as fat, and they may be very thin. Most people, such as the writer have not heard of binge eating as an eating disorder. Our nation is concerned as being obese. The writer has not heard of binge eating being explained as a cause for some people may be overweight. On the House of Thin website, it talked about binge eating and suggested there is help for these people through a support group. Another eason why advertisers should not use young girls to model as grown women, they put all this make-up on a young girl and have them pose as if they are grown women. There are predators out in the world, and young girls are their targets. The writer believes young girls should look like young girls (youthful and innocent appearance) and should not look like grown women, there may be less of this problem. There are numerous website that is exploiting young girls in various ways. The writer was in disbelief while doing my research. The police are also online looking for these predators of the children. Advertising is big business, and our nation operates on a Capitalism system. The writer likes, the statement from our textbook, â€Å"Citizens are entitled to protection from harmful actions by others† (Lunsford 2010). Using young girls to advertise merchandise like they are grown women is a harmful action. Body image and the media has become big business at the expense of the youth. The children are not happy with themselves, and parents are allowing this to happen. When is enough, enough? Stop exploiting our children for the price of a dollar. Adults have the responsibility to ensure children keep their innocence, and children don’t become an adult before their time. Children must be talked to about themselves, and children should be encouraged to increase their self- esteem. A positive and nurturing environment is what children need to help fight the advertising world. The writer knows that advertising to the young is not going to change overnight, just like the problem didn’t start overnight. Parents do have a voice and can make a change within our households. Parents also need to be aware of what their child is doing. Growing up back in the 60-70’s children was always watched by somebody, whether it was a teacher, parent, family member or just the neighbor. Somebody was involved with the children; parents need to become more involved. Today, adults lead a very busy life, demands on the job, making sure to work hard and not make mistakes for fear of losing a job. The time invested in the children will make difference. The influence of the television, magazines, movie stars or their peers on the youth we will have more and more youth with eating disorders and vulnerable to predators. The United States economic system is a Capitalistic and people will say that the advertiser has the right to make money. People can argue that the parents are responsible for managing their children spending habits. Base on a survey in 1994; found that 40% of 9 years old have been on a diet (Derenne, and Beresin). Parents should limit the amount of time children are exposed to various forms of media. Monitoring the children and talking about what the children are seeing is another method to use with media. Parents are not responsible, and the federal government needs to look out for the well-being of the youth. Every society has a way of torturing its, women, whether by binding their feet or by sticking them into whalebone corsets. The American culture has come up with its designer jeans (Derenne, and Beresin). Nothing else can say it better than this statement.

Meteorological Modeling In Klang Valley Region Malaysia Environmental Sciences Essay

It has been widely known that alterations of the land surface from flora country to urban country can well impact the environing meteoric status. Meteorologic theoretical account was used to measure meteoric status for air quality mold and prediction. One of the inputs for the meteoric and air quality theoretical account is land usage and land screen of the terrain. In this survey, we examined the sensitiveness of land usage and land screen on the predicted meteoric conditions. A meteoric simulation utilizing 5th coevals mesoscale theoretical account ( MM5 ) by Penn State/NCAR was used to compare the effects of land usage from two different old ages on meteoric status. The predicted meteoric conditions are so compared with the several monitoring station onsite. Consequences showed improved of surface wind velocity and temperature simulated utilizing improved land usage map. Findingss suggest land usage map should be taking into consideration in historical meteoric Fieldss to entree f uture air quality if the country of survey expects big alterations in land usage form. Keywords: Meteorologic mold ; Land usage ; MM5 ; Urban. Introduction It has been widely known that alterations of the land surface from flora country to urban country can well impact the environing meteoric status. Urbanization of an country could take to alterations of meteoric parametric quantities such as boundary bed deepness, perpendicular diffusivity, wind stableness category, etc. These meteoric parametric quantities played an of import function in most of the air quality theoretical accounts that predicts the concentration at each grid. Harmonizing to Jacobson ( 2002 ) , one of the factors that affect air pollution is the local air current which ensuing from uneven land warming, variable topography and others. In another word, different land usage type may take to uneven land warming, because land screen affects ground temperature, which affects pollutant concentration finally ( Jacobson, 2002 ) . Meteorologic and air quality theoretical accounts require land usage and surface feature that differ by their land usage and land screen forms ( Civ erolo et. at. , 2000 ) . Another survey carried out by Jazcilevich et Al. ( 2002 ) suggested that alterations of the land usage type could impact its environing meteoric status and scattering of air pollutant. Much of the current apprehension of the urban clime and meteoric status in Malaysia resulted from the research on Kuala Lumpur and Petaling Jaya country begins from 1970s ( Sham, 1973a, 1973b, 1979a, 1979b and 1987 ) . These researches focused on the description of the climatology and meteoric facet such as air current and temperature parametric quantities associated with urban heat island. The meteoric facets of the Kuala Lumpur and the environing metropoliss may alter due to the change of land usage and land screen by urbanisation and development of the metropolis. However, no survey had been done to entree the meteoric status of Klang Valley part with current land usage and land screen. The meteoric theoretical account used in this survey was the Fifth Generation Mesoscale Model ( MM5 ) from PSU/NCAR ( Grell et al. , 1994 ) . In this theoretical account the land usage was simulated from the planetary flora dataset from USGS which available at 1 grade, 30 min, 10 min, 5 min, and 30 unsweet declaration. However, the informations were derived from satellite observations over a period 1992-3 and the flora classs were out of day of the month and non relevant to the country of survey. The aim of the survey is to find to the effects of the land usage and land screen alterations on the meteoric mold system. Land usage map of twelvemonth 2000 obtain from the Town and Country Planning Department ( JPBD ) will be used to better 1992-3 USGS land usage dataset. The Modeling System PSU/NCAR Fifth Generation Mesoscale Model ( MM5 ) was selected as the meteoric simulation patterning system in this survey. The MM5 theoretical account is non-hydrostatic with terrain following co-ordinates, multi-scale, capable of interface with existent conditions prognosis theoretical accounts ( Global Circulation Model ) , contains expressed cloud strategies and dirt parameterization. MM5 is widely used by the meteoric community and its end product could be coupled together with the Sparse Matrix Operation Kernel Emission ( SMOKE ) theoretical account and Community Multiscale Air Quality ( CMAQ ) theoretical account to imitate the scattering of the air pollutants that take in considerations of the meteoric Fieldss and emanation beginnings. MRF Planetary Boundary Layer ( PBL ) parameterization strategy was selected in this survey. The 4-dimensional informations assimilation ( FDDA ) option was non used was selected in this survey because the purpose of the survey is to analyze the effects of modified land usage on the theoretical account end product. For inputs of informations, land usage datasets from USGS will be used as the default land usage, and land usage map from Town and Country Planning Department as the improved land usage and NCEP FNL ( Final ) Operational Global Analysis information was used in this survey. Domain Setup Four spheres are used as shown in Figure 1 for this survey. The female parent sphere with the declaration 27km covers the most of the Peninsular Malaysia ; 2nd sphere with the 9km declaration screens Selangor province ; 3rd sphere with 3km declaration screens ; finest sphere with 1km declaration will covers the survey country which is Klang Valley. Figure 1: MM5 domain apparatus. Processing of Land Use and Land Cover In the MM5 mold system, each grid cell was assigned one land usage based on the dominant class in the grid cell. 24 classs of Vegetation type by USGS was used in categorization of land usage in MM5. Each land usage categories consists of six surface parameterization, which includes, reflective power, wet handiness, emissitivity at 9 A µm, raggedness length, thermic inactiveness, and surface heat capacity per unit volume giving together with the MM5 theoretical account. Since Malaysia is a tropical state, summertime values are used. Out of 24 land usage types in the MM5 theoretical account ( Guo and Chen, 1994 ) , 14 classs was used to to the full depict the full sphere ( Figure 2 ) , with 22 % classified as H2O organic structures, 0.4 % as urban country and the largest non water-based class is Irrigated Cropland and Pasture ( 39 % ) in sphere 3 and as for sphere 4, 10 % classified as H2O organic structures, 1 % as urban country and the largest non water-based class besides class is Irrigated Cropland and Pasture ( 37 % ) ( Table 1 ) . Figure 2: USGS land usage dataset sphere 3 and domain 4. Since the Land usage dataset from USGS was generated from the twelvemonth 1992/3 orbiter image, the development of the Klang Valley country for the past 15 old ages decidedly changed the land usage and land screen of the survey country. To better the land usage type, updated land usage map from the Town and Country Planning Department was referred in this survey. The updated land usage map was preprocessed from polygon to gridded land usage map based on the categorization of the 24 USGS land usage classs ( Figure 3 ) .The per centum differences of the land usage between the default land usage and the update land usage are shown in ( Table 1 ) . Table 1: Percentage of landuse class for USGS and JPBD land usage Domain 3 and Domain 4. Land usage codification Land usage class USGS Land usage Domain 3 ( % ) USGS Land usage Domain 4 ( % ) JPBD Land usage Domain 3 ( % ) JPBD Land usage Domain 4 ( % ) 1 Urban and Built -Up Area 0.4 1.0 25.1 40.6 2 Dryland Cropland and Pasture 12.1 17.0 0.0 0.0 3 Irrigated Cropland and Pasture 40.2 37.4 0.0 0.0 4 Mixed Dryland/Irrigated Cropland and Pasture 0.0 0.0 20.4 28.0 5 Cropland/Grassland Mosaic 0.0 0.3 0.0 0.0 6 Cropland/Woodland Mosaic 1.0 1.0 0.0 0.0 7 Grassland 0.7 1.7 0.0 0.0 8 Shrubland 3.7 7.6 0.0 0.0 10 Savanna 0.1 0.2 0.0 0.0 11 Deciduous Broadleaf Forest 13.4 16.5 0.0 0.0 13 Evergreen Broadleaf Forest 2.8 1.1 0.0 0.0 14 Evergreen Needleleaf Forest 0.3 0.5 0.0 0.0 15 Assorted Forest 2.7 5.3 34.4 25.0 16 Water Bodies 22.4 10.3 17.8 6.5 Figure 3: Gridded JPBD land usage in 3km and 1km declaration. An ASCII type of input file was generated based on the reclassified land usage map into specific format. This ASCII file contains column, row, land usage type, latitude, longitude, flora fraction, and H2O fraction ( Figure 4 ) . Figure 4: Example of ASCII format input. The FORTRAN codification named â€Å" replace_lulc.f † is used to replace the land usage type, flora fraction and H2O fraction in the TERRAIN_DOMAINx file based on the co-ordinates of the reclassified grid cells and the several land usage type, and other parametric quantities provided in the ASCII file. The FORTRAN codification is compiled utilizing run book â€Å" run.replace † which besides determines the input and end product files to treat, and parametric quantities to be updated ( Figure 5 ) . Figure 5: Example of run.replace book. MM5 Simulation Results MM5 simulation was performed from 1st July 2005 ( 18:00 ) to 3rd July 2005 ( 17:00 ) with entire simulation clip 48 hours utilizing USGS flora dataset for 27km, 9km, 3km and 1km spheres as base instance. The 3km and 1km sphere will be compared with the end product of MM5 simulation using JPBD land usage dataset during for same period. All the physical options used were indistinguishable for both simulations. Observation from the Continuous Air Quality Monitoring ( CAQM ) station from Alam Sekitar Malaysia Sdn. Bhd. ( ASMA ) and Malayan Meteorological Department ( MMD ) was used to formalize MM5 public presentation from the both USGS and improved land usage dataset. Three CAQM site was selected to formalize the MM5 public presentation, which are the monitoring station in Klang and Shah Alam that maintained by ASMA and supervising station in Subang that operated by MMD. The simulations that utilized USGS land usage dataset showed overestimate of the air current velocity and produces sudden extremum at certain hr in the simulation. The improved land usage dataset utilizing JPBD land usage informations reduces the air current velocity and frequence of the sudden extremum, yet still over estimated the overall air current velocity compared to the observation informations ( Figure 6 ) . However, the improved land usage dataset utilizing JPBD do increase the correlativity between the ascertained air current velocity and simulated air currents velocity from all CAQM site ( Table 2 ) . The lowered air current velocity due to the improved land usage informations set could take to increased stableness and decreased perpendicular commixture. This could increase the air pollution concentration in certain country. The temperature profile simulated by both utilizing USGS and JPBD land usage dataset able to imitate the afternoon temperature near surface when comparison with the onsite observation temperature informations. However, both USGS and JPBD land usage dataset tends to overrate the temperature near surface during the dark ( Figure 7 ) . The correlativity between ascertained temperature and fake temperature somewhat increases when use JPBD land usage dataset in the simulation for the all monitoring site ( Table 2 ) . The consequences suggest that improved land usage dataset utilizing JPBD land usage dataset could better the overall simulation consequence ( Table 2 ) . The alterations of the meteoric parametric quantities could impact scattering of air pollutant, energy demand that could impact anthropogenetic emanations. The alterations of the MM5 end product could besides impact the computation of the air pollution patterning package such as CMAQ. Figure 6: Time series comparing of windspeed at 1km sphere for Shah Alam. Figure 7: Time series comparing of 1.5m temperature at 1km sphere for Shah Alam. Figure 8: Correlation between observed and predicted informations at Shah Alam. Table 2: Summary of correlativity between observed and predicted informations for all the location. Parameter Sphere Monitoring Station Klang, ASMA Shah Alam, ASMA Subang, MMD Wind speed 10m Domain 3 USGS 0.034 0.082 0.176 Domain 3 JPBD 0.311 0.318 0.214 Domain 4 USGS 0.015 0.083 0.169 Domain 4 JPBD 0.277 0.273 0.254 Temperature 1.5m Domain 3 USGS 0.673 0.672 0.410 Domain 3 JPBD 0.774 0.788 0.537 Domain 4 USGS 0.666 0.657 0.411 Domain 4 JPBD 0.790 0.759 0.544 Discussion The land usage is merely one of many factors that take in consideration by the meteoric mold system. The consequences showed betterment of the fake air current velocity and temperature near surface. The public presentation of the MM5 on simulation could be improved by modifying the MM5 physical options and strategies depending on the declaration and location of the survey country. Since the land usage and land screen alterations affects the close surface meteorological, it should be included as one of the cardinal factors in the air pollution patterning particularly future air quality scenario. The alterations of the temperature that lead by land usage could increase downwind, and potentially affects the air quality simulation. The alterations of the air current velocity besides affect the dispersion of air pollutants and blending in the ambiance, alterations of the air pollutant concentration are expected. Changing in the land usage and land screen forms due to the urban conurbation, altering of agricultural forms, forestation and deforestation are expected to affects to landscape. The change of landscape will take to alterations in population, energy ingestion, anthropogenetic and biogenic emanations. The consequences suggested that land usage should be taken into consideration when utilizing air quality calculating theoretical account to predicts and measure the air quality. Recognition The writers thank the Ministry of Science and Technology ( MOSTI ) Malaysia for back uping this research, under undertaking no. 04-01-04-SF0674. We besides thank Department of Environment ( DOE ) Malaysia, Malaysian Meteorological Department ( MMD ) and Town and Planning Department ( JPBD ) Malaysia for informations providing. The Positions expressed by the authours do non neccesarily reflect those of the bureau.