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WHY
DO WE
BECOME
SICK?
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. . . HEALTH AWARENESS BOOKLET >1
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Booklet prototype
for
Lok Sompork Andolan on Health
&
tor Neoliterate Publications
Pix, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by : Bharat Gyan Vigyan Samithi
West Block-2, Wing-6
R.K. Puram, Sector -1
New Delhi - 110 066
Community Health Cell
Library and Documentation Unit
bangalore
WHY DO WE BECOME SICK?
What is being healthy?. What is being sick?
/ste
Raman is sick. He has vomiting and diarrhoea:
Salim is sick. He has TB.
Mangai goes cycling to school. She plays a lot. She reads. She sleeps
well. She eats well. She is healthy.
■ : :/^^VfflYtX3LWEBECOMESICK,1
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Her friend Sumati has no fever or sickness. But she tires easily and
cannot do all her work. She does poorly in class. She feels unwell all
the time and takes various tonics from her doctor. But does not
improve. Is she healthy? No, obviously not.
Her sister Geetha is happy. And she is pregnant. She doesn't do much
work but has such a big appetite. She goes to a doctor often. But is
she sick? ’Not at all!", says she/l am as healthy as ever!”.
?WH¥ DOWEBECOME^ICK*2^/J.- ■•»
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What is being healthy! What is being sick?
Being healthy is a state of complete physical, mental and social well
being and not merely the absence of disease or infirmity. (WHO
definition)
Then what is good health made of!
1. Adequate nutrition
2. Safe drinking water
3. Clean environment
4. Adequate employment
5. Leisure
6. Basic health services
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WHY DO WE BECOME SICK* 3
NUTRITION
Malnourished persons are more
prone to all diseases.
fir. . . ■
Malnourished persons are sick longer and die easier of disease.
Malnourishment by itself is a major cause of ill-health and death.
What is needed?
MORE NUTRITION
KallugetsRs.l2aday. His wife gets Rupees 8. They have two children.
Unless they have more income, they cannot get more food.
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WHY POWE BECOME SICK* /
BETTER NUTRITION
Aniyappan gets Rs.20 per day. His wife gets Rs. 12. They are able to
buy only rice and some onions and chillies with it for themselves and
their children.
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But Murugesan's family too earns the same. They buy some greens
too. And often groundnuts. They pluck drumstick leaves from a near
by house. And in their small garden there grows a papaya tree! Their
children eat better! The baby gets breast milk.
ADEQUATE NUTRITION, BOTH IN QUANTITY AND QUALITY IS THE MOST
BASIC REQUIREMENT FOR HEALTH.
.. ... WHY do webecomesick; s
SAFE DRINKING WATER
80% of ell diseases is due to dirty water.
The most common dirt in drinking water is infected stools which reach
the water due to lack of safe disposal of faeces.
What are the diseases caused by unsafe water: Cholera, diarrhoea,
dysentery, jaundice, worms.
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CLEAN ENVIRONMENT
Banu lives in a crowded slum, It is dirty here and smoky. There are flies
and mosquitoes. And her single room house has 6 persons staying in
it. There is hardly any sun inside and the roof is leaky!
Overcrowding, lack of proper housing, smoky atmosphere all lead to
greater respiratory infections, especially tuberculosis and pneumonia.
Flies and mosquitoes carry so many diseases.
Can anyone be healthy in such an unhealthy atmosphere?
WHY DO WE BECOME SICK’7
WORK AND LEISURE
Everybody needs gainful, meaningful work.
Without income how to provide for food, clothing, shelter, essential
health care etc?
Without employment how to ensure mental and social health; how to
prevent crimes, drug addictions, suicides, violence?
Leisure is needed to provide;
-opportunity for cultural growth, for human interactions, for family and
friends.
-time for body to rest and recuperate, time for recreation and exer
cise.
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WHYDQWEBECOMEStaea
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BASIC HEALTH SERVICES
In addition to the above, one needs good basic health services to
maintain our health.
What are the functions of basic health services?
The most important function is to prevent diseases and promote
health.
For example,.
a) Immunization - Prevents tuberculosis, diphtheria, whooping cough,
tetanus, polio and measles.
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b) Care for the pregnant women and the lactating mother, safe
delivery conducted by trained assistants as well as availability of
efficient family planning services and care for the child. Provision of
nutritional supplements, especially for pregnant women and children
who need it most!
c) Health education.
d) Ensure safe water and sanitation.
e) Measures to control and prevent locally endemic diseases e.g.
fluorosis, lathyrism, leprosy, guinea worm etc..
d^fe^.^n^’WHYDOWEBECOMESICK *»t<wC:|
BASIC HEALTH SERVICES
But will we able to eliminate all diseases ?
Certainly not!
Therefore basic health services must also provide curative services for
sick people
What are the curative services available in your area?
Is there a government doctor or health centre nearby?
Are there any private doctors? Any homeopaths or indigenous medi
cal practitioners in your area? Are there any nurses or community
health workers. What is the role of each of these people in treating
diseases? But before that let us learn more about sickness:
•
VIMYDOWEBECOMESICK^lO
Why do we become sick?
This child has diarrhoea and dies I
What is the cause?
A local person says that the village god
or spirit is angry I
Some others say that it is a punishment
for some wrongs done by parents.
A doctor says that
it-is due to tiny germs.
The health worker says that it is because
there is no safe water or latrines and
the well water is contaminated.
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A social worker says it is because the mother
is illiterate and uneducated. A political worker
says that it is because the family is poor and has
neither adequate land nor income I
Who is right ? Discuss.
W\WHYDQyigBECOMESlCKril
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Sickness usually results from a combination of causes.
These sicknesses are of various types.
We can think of them as being in two groups.
A. Infectious - That spread from person to person. These can spread
by the air, by water, by direct touch etc.
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Most of these diseases can be prevented if people work together to
do so. But still some may occur if some of the preventive measures
fail.
B.Non-infectious: There are many diseases that occur:
a) because something wears out or goes wrong within the body. eg.
rheumatism, heart attack, epilepsy, strokes, cataract, cancer.
b) because something from outside harms or troubles the body. eg.
poisons, snake-bite, alcoholism, allergies, smoker's cough etc.
c) because there is a lack of some essential part. eg. malnutrition,
anemia, goitre etc.
d) because it is "inborn" - people are born with it. eg. birth marks, hare
lip, cross- eyes, some type of heart diseases etc.
e) because the " mind ' is affected, eg. nervous worry, uncontrolled
fear etc.
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.WHY-DOWEBECOMESICK.* 12
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Most diseases are self-limiting!
Diarrhoea, mild 2 or 3 day viral fevers, common cold, even most types
of jaundice, measles etc., are all diseases that become well on their
own.
Not only these. Many other diseases are also self limiting. One only
needs to ensure that persons with the disease take adequate rest and
adequate food and plenty of drinking water!
The body has a powerful defence mechanism called the immune
system that automatically takes care of these diseases.
We only have to help it by eating well, drinking water and
taking rest!
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WHV DO WE BECOME SICK" 13
Many diseases do not need drugs at all.
Many people think that for every disease we need tablets and injec
tions. This is wrong. There are other forms of treatment. For example, in
fever, sponging with warm water, for cough and cold-steam inhala
tion. For sores, washing with soap and water, for constipation eating
greens etc.
Some home remedies help in minor illnesses like cold, sore throat
indigestion, constipation, sprains, aches etc.
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WHY POWE BECOMESICK/ M
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Some sicknesses need medical help.
- Any trained health worker should be able to let you know
you need to see a doctor at once.
whether
- If there are any signs of dangerous illness like bleeding from any site,
difficulty in breathing, fainting, high fever, fits etc. then see a doctor
at once.
Do not delay.
- If there are any diseases that are persisting for Ibng,
treatments, then see a doctor.
despite local
Within 5 to 10 kilometres, there is usually a government
health centre or a private doctor that one can see.
primary
One needs to go to a bigger hospital only if the local doctor is not
available or the doctor himself suggests it. (Sometimes people have
to go because they are not happy with the local doctor).
WHY DO WE BECOME SICK* IS
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Who is a doctor?
A doctor is a person who has been trained to identify the cause of
your disease. He/She is expected to explain to you the cause of your
problems and what you may need to do to get well.
Giving medicine is only one of a number of ways to get better.
Advise on food, rest, exercise, use of water, etc., may be as important
or even more important than medicine.
There are many diseases which cannot be cured, in which case the
doctor explains this and may help relieve suffering.
When you see a doctor -
a) Insist on knowing what your problem is I
b) Insist on knowing the names and dose of medicines prescribed for
you !
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c) Do not ask for injections:
Most injections given today are totally useless and even harmful. If
injection is given by the doctor ensure that the needle is from afresh
pack not used before or it has been properly cleaned and boiled after
use on the patient before !
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The total number of drugs needed for treating all known diseases in
the world is only about 250. These are called essential drugs.
The drugs needed for treating the common diseases are much less.
Only about 30. Ensure that these 30 drugs are available in your village.
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Remember these guidelines for use of medicine.
a) Use medicines only if necessay.
Remember all medicines can kill if used wrongly or excessively.
b) Know the correct use and precautions and make sure you ask a
doctor or health worker this and read the paper slip or instructions if
any.
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c) Be sure to use the right dose prescribed and for the correct number
of days prescribed.
d) Check the expiry date of the medicine. After this date, do not use
it.
e) When in doubt, or if some new symptoms develop or if there is no
effect - go back and talk to you health worker or doctor I
-WHY DO WE BECOME SICK * 17
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-Health is a basic human right
Everyone, whatever the age, sex or religion, whether rich or poor must
get health care.
- Health is a responsibility of the state
One of the key objectives and functions of any government is to
ensure that people get good food, safe water, a clea^env"°Xrto
alongwith employment and leisure as well as ensure them access to
basic health services.
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- Health is guaranteed only by collective action
Without collective action one cannot ensure food, water and a
healthy environment for all. Without collective action one cannot
ensure access to health services for all.
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WHY DO WE BECOME SICK* 18 '•
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Review/Discussion
1. What are the main reasons for malnutrition in your area? Is it lack of
income or lack of knowledge?
2. What is the relationship between water, environment and disease
in your area?
3. What are the health care facilities available in your area? Are there
health workers and doctors available? What are their essential func
tions and to what extent are they carried out in your area?
4. All people do not have equal access to either the basic require
ments for health (like nutrition) orto curative health care facilities. Who
have access and who do not have access? And why?
5. What are the necessities and possibilities for collective action to
ensure health? What do we have to learn to make such action
possible and successful?
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WHY DO WE BECOME SICK* 19
WATER BORNE
DISEASES
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HEALTH AWARENESS BOOKLET - 2
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BHARAT CYAN VIGYAN SAMITHI
West Block - 2, Wing-6
R.K. Purom, Sector-1
New Delhi-110 066
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Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterate Publications
Pix, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by : Bharat Gyan Vigyan Samithi
West Block - 2, Wing -.6
R.K. Puram, Sector - 1
New Delhi -110 066
WATER - BORNE DISEASES
In Pangur Village there is an outbreak of cholera. More than 20 persons are
affected. Of these 5 have died. All these 5 were children! How did so many
people get affected? Why did the children die?
Last year, Kamala, a woman in a nearby village got jaundice during her
pregnancy, became very sick and passed away. There are many more cases
of jaundice this year.
Last year there were deaths from typhoid in my village. A number of others
got the fever also but some how they managed to recover.
It is like this in most villages and in our slums. What can be done?
----------------- WATER BORNE DISEASES 1----------------- -
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There is a doctor in the village’s government health centre. He is a good
man. He comes daily by 9.00 and leaves by 2.00. He gives tablets or
injections for these diseases. Some recover with the drugs he gives. Some
die despite taking drugs. Even those who recover have suffered a lot. And
lost a lot of money too! Yet more and more people are getting affected.
What is to be done?
WATER BORNE DISEASES 2
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There are many suggestions:
Some suggest that they insist with the government that the doctor stay in the
village. And that the government hospitals provide more and better drugs.
Others suggest that we need to ask for a hospital to be built. They write to
the government asking for this. Nothing happens.
Yet others suggest that a bad man has cast a spell orthe goddess is unhappy.
Nobody believes it but they decide to do a special pooja. Just in case!
All of these suggestions do not help much.
WATER BORNE DISEASES 3
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The health activists visit their village. They say, “All these deaths from
diarrhoea, from jaundice, from typhoid. Do you know, that all of them have
a single cause! It's the water you drink - it is bad .
How can that be, said one villager. We take water from the well orthe nearby
pond. The water is sweet and crystal clear!
In the neighbouring village the water is bitter and often brown. Yet they do
not get these problems.
Another villager said, ‘I have heard that from bad water one gets fever and
colds. But diarrhoea and typhoid from water? This I have not heard I
The health activist says:
'No, one does not get colds (Sputum)because of bad water.
But because of drinking bad water we get a number of other diseases. Let
me list some of these.
------------------ WATER BORNE DISEASES 4------------------
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a) Diarrhoea - Passing plenty of watery stools. If severe, persons affected
become dehydrated and many even die. For children, especially if mal
nourished it is much more dangerous. Diarrhoea is the commonest cause
of death in India. One million of our people die of this, every year.
b) Cholera - This is a severe form of diarrhoea which spreads much more
quickly. Many many people die of cholera every year.
c) Dysentery - This is passing stools associated with blood and mucus.
There is usually a lot of stomach pain also.
WATER BORNE DISEASES 5
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I ROUNDWOKM (AtCMit)
3. WHII^VORM
fl ricburn)
1. THREADWORM
(pinwwm)
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4. HOOKWORM
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S. TArtWORM
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d) Worms - There are more than 20 common worms that one can get. The
pin worm and the round worm are the most common but there are many
others. One of them, hook worm is not easy to see. It enters into our body
and sits in the intestine sucking our blood. It is by farthe most common cause
of anemia in India.
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- This is associated with prolonged fever. Patient becomes
e)■ Typhoid
more and more sick and if untreated dies of internal bleeding or coma. And
treatment today has become very very costly.
WATER BORNE DISEASES 6
f) Jaundice -There are many causes of jaundice . But by far the most
common cause is due to a virus that we get from bad water.
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g) Polio - A disease which tends to affect children mainly. Crippling them,
leaving one limb paralysed and stunted.
WATER BORNE DISEASES 7
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DO YOU KNOW ALMOST 80% OF ALL DISEASES WE GET IS RELATED
TO BAD WATER!
But how does water become bad?
All the above diseases are caused by tiny disease germs. These germa
passed out in stools by persons infected with that disease.
A part of these stools and therefore these gerrps, finds their way to the-wofc^f
you drink. When you drink this water you swallpw the germs. Once theyJfiaN^
entered your body they can cause disease. .The weaker the body (dJufet©
malnutrition etc) the more likely and more severe the disease.
- The more the germs or faeces you drink the more likely and more
the disease.
But remember: All these diseases are essentially because in some wstyoflother you have ingested another person's faeces!
WATER BORNE DISEASES 8
“Ugh! How Horrible!
Impossible!
We take water from the well or the pond. We go for defecation to the fields.
This is impossible. We ensure our water is clear. We ensure that the mud
settles before we collect it”.
“Well, let me tell you the way the faeces enters your drinking water.”
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a) Look at this person washing himself (after defecation). Just because he
is on the other side does not mean the germ cannot swim across. In fact
they do. Even if he passes stools some distance away, when it rains it will
be washed down into the pool! Have you not heard of outbreaks whenever
it rains?
WATER BORNE DISEASES 9
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b) Orthis person thinks it is safe in this hollow. Besides it is only a well nearby.
But the faeces can travel through the ground as well. For about 50 to 100
feet the germs are alive. If the well lining is damaged the germs enter easier.
c) Or look at this. The flies and cockroaches are sitting on the faeces. Now
they are sitting on his food. They have carried small pieces of faeces to the
food. And he is eating it now!
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WATER BORNE DISEASES 10
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e) Or look at this person. He has stepped on some dry faeces, a few days
old. With bare feet. A small tiny worm has entered. In a few days it will reach
his intestine and multiply. This worm, called the hookworm, will make him
weak.
f) This person has dirty hands. He has not washed it with soap. It has some
faeces sticking on, which is too small to be seen. When he eats, it enters
the food.
WATER BORNE DISEASES 11
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g) This family is very clean. They have a latrine in their home. But they
forget that the dung of animals is equally dangerous. You can get disease
from them also!
h) And from children’s faeces as well. Children’s faeces is as dangerous
as adult faeces. If it is not disposed of safely!
----------------- WATER BORNE DISEASES 12 -----------------
But water is related to disease in other ways also:
See these dirty pools of water on the road. Or in the ditch. Here mosquitoes
and flies breed. These spread infections too.
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Mosquitoes spread :
- Malaria fever
- Filariasis
- Viral fever
- Brain fever
Children get a number of skin diseases, that come of inadequate washing
or bathing or bathing in bad water. This also is a water related disease.
WATER BORNE DISEASES 13
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In Thirumayalam village there is a festival. It is a time of joy and laughter.
What fun!
But in the morning after, hundreds have diarrhoea! Or perhaps many
developed typhoid or jaundice What happened?
Dirty latrines and people defecating all around. Plenty of flies and cock
roaches. Flies sitting on food people are eating. Or servers serving with dirty
hands. Or preparing food in unhygeinic way. Or all the water sources
contaminated. Or drinks made from dirty water! Indeed in the festival
everyone ate sweets and savouries and drank cool drinks and so on. But
they all ate faeces also!
After floods, in refugee camps, in marriages, in temple festivals and on so
many such occasions there is a lot of disease outbreaks.
WATER BORNE DISEASES 14
But what is to be done?
Let us go to the doctor!
Villagers : Doctor, is all that he says true? You have never told us all this!
Doctor : Yes it is true. We call this ‘disease-spread by the faeco-oral route'.
But I can't do anything about it. I only treat people who are affected.
Villagers : But many people die nevertheless. And many cannot afford the
drugs. And people have to spend a lot. And waste so much time. And oh,
suffer so much. Is it not better to prevent it?
Doctor
: But that is not my job. I have no time to explain all this to my
patients, let alone to the general public. It is government’s job.
Villagers
: But are you not the government doctor in charge of our health.
Doctor : No no I am only an employee! My job is to treat diseases. Go ask
the government.There are public health engineers and health educators and
community health workers. It must be their job.
Villagers : Then let us go to the B.D.O
■WATER BORNE DISEASES 15
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BDO : Look. I have my orders. We are doing our best. We have money for
only a few bore wells and a few latrines. We cannot make them everywhere.
And what is the point anyway. People do not use them. And people are so
dirty.
Villager : Why do you not help us prevent these diseases, at least in our
village.
BDO : There is no scheme for your village. You must ask the government.
Villager: Are you not the government.
BDO
policy.
: No I am only an employee. I do what I am told. I do not make the
Villagers: Then who is the government? Who can stop these diseases.
-------------—WATER BORNE DISEASES 16---------------
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Health activist: It is possible to prevent all water borne diseases in ourvillage.
We have only to ensure that no further faeces enters the water we drink or
the food we eat.
These are 3 essential aspects of this :
One : Make sure that all the faeces in our area is
disposed safely. That is, in such a manner that it
cannot reach our drinking water or our bodies in
any way.
Second : Ensure that all our water sources are
protected. So that no faeces can enter the water.
And if one is not sure, treat the water so that all germs
are killed.
4
Third : Ensure by good personal and social hygiene
that germs from faeces do not enter your mouth via
flies or hands or any other means.
WATER BORNE DISEASES 17
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Villagers : But how can this be done? We are not even able to meet the
government authority who is in charge of it.
Activist : We are the government. Our elected panchayat is our authority.
What we need is to sit down and together with some help from persons who
know plan out how to eliminate these diseases. Yet if we decide to see that
no child dies of diarrhea or typhoid or gets polio or jaundice, we can do so.
Let us act together.
Do you know that in many countries and places in the world they have done
just this. There are many countries in the world, where there is no polio and
very little infective hepatitis(jaundice) or typhoid. Almost no child dies of
diarrhoea.
Let us see in the next 2 books as to how we can achieve this in our panchayat!
WATER BORNE DISEASES 18
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Review/Discussion
a) What diseases are spread by water?
b) How does our food and water get contaminated by faeces.
c) If there is an outbreak of cholera in your village who all are responsible?
And in what way is each person responsible?
d) The book says ‘we are the government’. Do you agree? Does your local
panchayat have sufficient will and committment to undertake the task of
preventing water borne diseases?
e) Do a survey to find out how many cases of these waterborne diseases, at
least diarrhoea and jaundice are present in your area. Can you find out the
sources of these infections?
WATER BORNE DISEASES 19
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Nurturing our common wealth - 3
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BHARAT GYAN VIGYAN SAMITHI
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Foreword
This booklet is part of a series of 12 booklets meant for farmers. It is an attempt to
understand the causes of some of the burning problems that farmers in this region are
facing — the declining yields, the wasting of lands, the declining water table and the failure
to control pests, the increasing cost of all inputs and the failure to get an adequate price
at the markets. The booklet series also looks at suggetion for what can be done by farmers
individually and collectively to cope with this crisis. We hope that this scries initiates
a discassion between the people's science movement and the farmers associations which
throws up new possibilities for interventions in rural developments.
A number of scientists with very rich field experience have helped us in writing this
series by their critical review and suggestions on the draft. In particular we would like
to thmk Ed. Giordano, Ardhendu Chatterjee, Vasant Kumar Reddy and Ajay Verma for
their comments. We also thank the entire CIRD team for their assistance at various stages.
Any errors are however our responsibility.
Dr. T. Sundararaman
Nurturing our common wealth - 3
DRIED UP WELL!
First Edition
October 1994
Written by
T. Sundararaman
& Parthibo Basu
C.I.R.D. - Pondicherry
Published by
Bharat Gyan Vigyan Samithi
Tamil Nadu Science Forum &
Pondicherry Science Forum
Illustration and
Design
M. Basheer Ahmed
Typeset at
Ezhil Prints
Production
Fineline
Printed at
Sudharsan Graphics
Drawings
Parthibo Basu
II
DRIED UP WELL
Devraj's well has run dry.
He has been noticing that the volume of water that used to gush out of his bore
well, has been steadily going down during the past one year.
But today it hardly runs for 15 minutes before it trickles.
DevraJ is ayhasti
He has been investing a fortune on these pumpsets with the hope of getting
a big yield.
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DRIED UP WELL
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When ne took up farming from his father,
ne used to draw water
from a dug well like his father did.
It was about that time when he heard that it was possible to grow three crops
of rice a year instead of one crop of rice and one crop of millet that his father
or grand father had practised.
He was told that this would be possible if one uses the high yielding varieties
of seeds, puts more fertilizer and above all has access to enough water to Irrigate
these crops.
He was shown a dream which he wanted to realize.
In 1972, he bought a pumpset at the cost of Rs.20,000 to pump out water from
the well and was soon growing three crops a year!
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BHARATGYAN V1GYAN SAMITHI
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But his happiness was rather shortlived.
This well dried up.
Devraj pulled in some more money and sunk a borewell at 60 feet depth. But
a couple of years ago this too dried up.
Devraj ran to the experts who suggested to him to deepen the bore further. By
now there was electricity in his village. Devraj took out whatever resource he
had and borrowed the rest as a bank loan to buy one electric submersible pump
and deepened the bore upto a depth of 300 feet.
And this is the well that has run dry today.
Devraj feels betrayedl
Devraj is not the only one who has had the same fate. Many other like him feel
that their luck has betrayed them. They are at their wits end. They go to the
government authorities and experts who shrug their shoulders and suggest a
deeper borewell. But they have no money to deepen it.
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D/J/ED UP WELL
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Nor is the problem confined only to irrigation. Take the village of
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•
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K.V. Kuppam in North Arcot. Fifteen years back, this village had 8 wells what
according to local people were "overflowing" with water. Even at lOfeet, every
well had water. Then the water level started falling. Today after 2 successive
deepenings at about 60 feet depth there is a bit of muddy water that comes
•
out of no use to anybody.
Meanwhile to supply drinking water, the government has put in bore wells with
hand pumps. And there is one large boreweil from which water is pumped to
an overhead tank. From the tank, water is supplied through standposts. But there
are frequent repairs; and whereas earlier, everyone would take as much water
as required, there is a strict ration of 5 pots per family today. Soon it will run dry
like many of the other borewells have!
What can be done?
"Government must put in a deeper borewell", the chorus goes in the village.
But this too won't last long. And then?
fl
BHARAT GYAN VIGYAN SAMITHI
u
Devraj goes to the peasants association too. They say "what can
we do? The water table going down is a natural event. The rains are failing! At
best we can try to get you a loan for another deeper borewell". But Devaraj
has not even managed to pay back his last loan.
At least 15 years back, before the pumpsets started, he grew one crop of rice
and one of millets. Now one crop of millets Is all that he grows. His land lies wasted!
r
DRIED UP WELL
o
11
veryon© knows why the wells are running dry!
HLHCTRlC WIE.ES ARE
Sugk ^6 lav
^bll
"RAIN \ $
F/AU bl^il
BHARAT GYAN VIGYAN SAMITHI
u
The weather man rules out the theory of depleting
rainfall firmly.
THERE HAS BEEN NO MAJOR DECREASE IN RAINFALL OVER THE LAST 50 YEARS.
Meher Homji is a famous Bio-climatologist who has been studying the rainfall
pattern of the last 100 years.
The rainfall in Tamilnadu is more than in most countries of the world. And though
there are variations from year to year there has been no general decline" he
says.
0—
HYDROGRAPH
Sf
KARAYAM8UTHUR
(SOUTH WESTERN REGION!
8—
10
IJ —
16 —
(A
a
uj
ie —
ui
3 20 —
z
- 22 —
700—i
J
GOO-
■* 26 —
SOO—
K
“ 28 —
< 00 —
JOO —
32 —
JOO —
J6
. so-. I
1986
J.
1987
.j ,
19BB
1 00 —
<
1989
1 »90
I ’ • - * 1991
FIGURE-4
Well, electric wires and declining rainfall does not seem a correct explanation.
What then is the story behind these dried up wells?
Before we get to the reason for Devraj's plight, let's learn something about
ground water.
DRIED UP WELL
3
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Flow it is formed? Is ground water infinite? Is it possible to improve
the stock of ground water?
A geologist or a climatologist will tell you that the amount of water on the earth
is still the same as It was 5000 million years ago when this earth was created!
It is the same water that fills our lakes, tanks, rivers and the seas and evaporates
from these water bodies up in the sky, - forms clouds and falls back on the surface
of the earth, - flows back into those lakes, tanks, rivers and the seas again!
Only a little portion of this water is usable. If all the water in the earth is filled within
a one gallon jug, the fresh water will be just a spoonful of this. The rest are in
oceans or in the form of ice near the poles. That part that is usable is the part
that circulates as the water cycle.
Let's suppose that there is just 1 litre of water on the earth.Then, of this 1 litre-.
972 milli litre Is in the OCEAN,
21 milli litre is in the ICE CAPS,
6.2 milli litre is UNDER THE GROUND,
0.09 milli litre is in the FRESH WATER UXKES,
0.08 milli litre is in the INLAND SEA & SALT LAKES,
0.01 milli litre is in the ATMOSPHERE,
0.001 milli litre is in the RIVERS.
Again of this small proportion of fresh water only a little is available to us for our
use.
BHARAT GYAN VIGYAN SAMITHI
H
All this water on earth is really a single body imer-connected by what we call the
water cycle.
Heated up by the sun, water evaporates from the sea and forms large water bodies
to form clouds. These clouds move along with the winds, picking up moisture along
the way.
Soon they become heavy. Under certain coditions they fall down as rain.
Then some of the water runs off rapidly into streams and then into rivers and then into
seas or lakes.
But some of the rain Water does not flow back at once. A portion of it is absorbed
into the ground. This water, that does not run off and is absorbed into the ground is
ground water.
Most of this groundwater travels downward underground (roughly like what surface
water does) and soon emerges as springs to form streams which join to form rivers.
/
The rest of the groundwater percolates deeper and is stored in deeper layers of the
ground.
All water we use is therefore from only one source: the rains. The question is how best
we can use every drop of it before it reaches the sea!
c
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DRIFD UP WFII
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BHARAT GYAN YTGYAN SAMITHI
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DRIED UP WELL
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^A/ater also gets absorbed into the ground from ponds, tanks and
rivers. If there are plenty of these ponds, the rain water gets trapped in them
and then lets it into the ground slowly. If on the other hand, these structures are
filled up with slit or, for some other reasons not In use, the water just runs off into
the rivers.
BHARAT GYAN VIGYAN SAMITHI
u
Now, how much water runs off immediately and how much enters
the ground depends on a number of factors. If the soil is covered by vegetation,
the roots create a number of spaces along which water can enter. Such soil
is full of insects and other living forms which make the soil full of pores. Such loose,
living soil absorbs the rain water like a sponge. Only a few drops will run off.
If however, the soil is hard, rocky or clayey and barren, almost all the rain water
runs off and little enters the ground.
DRIED UP WELL
H
Some of the water on entering the ground, moves downward along
a gradient along the superficial layer of the soil (almost like the way water moves
in streams on the surface). This water soon emerges as springs into streams and
from there flows to rivers. Or they feed the nearby ponds and tanks. Earlier, even
about 30 years back, the ground was healthier, the streams in our villages were
full of water for 6 to 9 months a year. Three months from the rain themselves and
6 months from the water let out by the soil. Our grandfathers used to fish and
bathe in them. But now only during the 1 or 2 months of rain there is water in
them. For the rest of the year these streams are dry!
BHARAT GYAN VIGYAN SAMITHI
Once the water enters the ground some of it moves further and
further downward until a layer of impermeable rock is reached. The layer of earth,
just above this layer of impermeable rock is saturated with water. This layer is known
as an aquifer. The top level of the saturated zone is known as the water table
depth. When we say that there is water at 100 ft depth, we mean that at 100
ft the pores of the earth are saturated with water.
But even this water in the aquifer does not stay still. It moves.
S'?
MH er. .
DRIED UP WELL
The water moves in the aquifer, like water flows through the sponge
if it is squeezed. Only the movement is as slow as 1 cm a year. In the aquifer,
water moves slowly through small pores. The movement is mainly due to the
gravitation. Responding to the gravitational force, percolation occurs from areas
where the water table is high toward areas where it is lower. Only a part of the
water travels by the most direct route, down the slope of the water table while
most water travels by the innumerable long curving paths that go deeper through
the ground.
Depending on the type of rock or sand in the aquifer, the water moves faster
or slower. Its direction and extent of travel is also determined by the location
and spread of that layer of rock that constitutes the aquifer.
J/',
/
The accumulation of this underground water is, to a great extent, controlled by
the permeability of the rocks.
A rock is called permeable when it is loose and granular (eg. sand or gravel)
which allows passage of water through the pores between the sand or gravel
particles.
Water can also be trapped between two layers of impervious rocks like granite
where it remains as if in a closed pipe under the soil. It reaches this zone through
cracks in the impervious rock layer about it.
The water which is there within the deeper aquifer has percolated down over
hundreds of years and is preserved within the aquifer for hundreds of years.
Thus the water Devaraj has been pumping out at 300 feet is probably hundreds
of years of old hidden treasure. When this water fell on the surface as rain, possibly
the pallavas were ruling!
BHARATGYAN VIGYAN SAMITHI
1
Thus, when we sink a submersible pump, we just sink a bore reaching
down to this saturated water bearing rock.
Even a single bore can have pronounced effect on the water table. The well
takes out waterfrom the saturated rock, thus literally drying out part of the saturated
zone.
It would again take another hundreds of years for water to reach and recharge
this region in the aquifer. In fact as-we can imagine, with many other bore wells
in the same area, this area will probably never get a chance to get recharged.
Unless the same amount of water that is taken out is recharged into this aquifer,
the water content in this aquifer is bound to go down.
I
•:/ I ;
DRIED UP WELL
!1
/
T
I he dug wells, that were the main source of irrigation (other than
tanks and their canals); did not go as deep as these bore wells. They were only
about 10 or 20 feet deep. They tapped the flow of subsurface or the superficial
aquifer water. If there were good rains, these wells would fill up and allow enough
water for a second crop of grain.
However, if there was a tank or large pond nearby, the water absorbed into the
subsurface from these would flow down and keep all these wells downstream
of the tanks full of water, right through the year.
Today, in most villages, these wells too, like the village streams and tanks, have
water only for a month or two (when it rains) but are dry for the rest of the year.
This is because any subsurface waterthat is left afterthe rain, is pulled downwards
immediately by the much lower water table.
(N.B: difference between alluvial and other areas. In alluvial areas this is the water
table itself. In other areas it is a distinct aquifer!)
J
/
BHARATGYAN VIGYANSAMITHI
H
Now let us try to understand:
Why are the wells drying up!
We learnt:
1. All water that we use, whether it be from over the ground or under the ground,
whether it is streams, wells, tanks or borewells; are the same water. They come
from the same rains. And the rains have not decreased over the last 100 years.
2. Some of the water we needed, we used to draw from streams or rivers, but
these are now dry for most of the year.
3. Some of the water we needed, we used to draw from shallow wells, but these
too are dry for most of the year.
4. Some of the water we needed, we drew from deep wells which draws the
water that were trapped from rains that fell hundreds of year ago. And since
this deep ground water is like water stored in a tank the pump can only empty
it year after year. We cannot refill this underground tank easily.
5. The cause of the dryiing up of the rivers and streams and for the drying up
of wells Is the lesser amount of ground water available today.
6. There is lesser ground water because:
a) Less water enters the ground than before,
b) More-water is pumped out than before.
DRIED UP WELL
M
O) L.ess
| water enters the ground than before because of
a) decreased vegetation cover.
b) the resultant erosion of the loose spongy top soil, leaves behind only hard,
relatively impermeable earth.
c) the disintegration of all village ponds and tanks that were a major source
of ground water formation.
\
BHARAT GYAN VIGYAN SAMITHI
n
Too much ground water is pumped out because:
THERE ARE TOO MANY TAKERS.
While on the one hand, the recharge of the aquifers has reduced, on the other,
there have been many farmers taking out much more water than before from
the aquifer.
Number of bore wells and submersible pumps have grown enormously over last
20 years.
The availability of ground water throughout the year has meant that all farmers
could move to 3 crops of paddy per year or to sugarcane. These crops give much
more profits but they consume much more water! So on one hand, food produ
ction has gone up, but on the other,water table is falling rapidly.
Table 1
Privately owned wells (000 s).
1960-61
68-69
73-74
79-80
84-85
%
A.P
500
676
775
919
1,067
4.5
Karnataka
135
280
325
415
500
11.0
T.N.
875
1,140
1,140
1,472
1,522
2.9
547
338
1000
59
70
26
Table 2.
Centrifugal submersible pumps (000 s).
A.P
Karnataka
T.N.
52
•27
155
161
123
477
376
229
764
468
307
913
From 'A FORFEITED TREASURE: TANK IRRIGATION IN KARNATAKA' by ST. Somasekhar Reddy
DRIED UP WELL
M
,ffl) D
ls everybody benefitted from all these borewells atleast?
The growth of borewells and submersible pumps have been tremendous. But did
every one — the large and small peasants alike, benefit equally from the bore
wells and submersible pump boom?
NO.
Many rich farmers who could afford to sink a borewell did so. They shifted to new
high yielding crops early. Whenever their well ran dry, they had the capital to
deepen it. Or at least they had the influence needed to get bank loans.
But what happened to those who could not sink one?
Most could not afford it. if they did get a loan once then it was difficult tc get
another loan again to deepen it. And since many of the smaller farmers started
later, the laws regulating number of borewells in an area affected these small
farmers more. The rich farmers had already installed their borewells.
Now, the small farmers have been forced to buy water from those who have
bore well or submersible pumps. Earlier they took water from the tank.
|\Jc> McRE
JTEVJU-S -TO SEUL
FoQ "EM'yiMfo
XAICWER |
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BHARAT GYAN VIGYAN SAMITHI
!1
The water in the tank and the tank itself was common property.
Or they took water from their wells which was charged by the tank water.
Now, they have been compelled to buy the resource over which they have the
same right as the rich farmer.
Worse, everytime one farmer in that area deepens his well, a downward gradient
is established and water in surrounding field, slopes downwards in a cone with
the deepest well in its apex. A number of neighbouring wells thus run dry as the
water table in their field falls. The rich farmer thus sucks water underground from
the common pool including from below the small farmer's land and then sells
it over ground for a fat fee — either 20 rupees an hour or 1/3 of produce or 10
tonnes of sugarcane per acre and so on.
As time goes on and the wells are successively deepened, only the richest
will manage to survive! And grow richer by selling this water!
DRIED UP WELL
T he water in the ground we saw is the same water as the water in the tank
and pond. Ifthetankwateris common property how can ground water become private
property? If the canal from the tank flows by his field the land owner cannot take all
its water!
Then how can the rich farmer take all the water flowing below the ground! And sell
it to others!
And the water deep below is hundreds of years old. It is a precious mineral like coal
or oil which once taken out can never be replaced. So why is it not treated like coal
or oil?
The change from the use of tank water to ground water has meant the privatization
of common property — water! Its privatization meant, the rich can use their resources
to grow richer. The poor who have no resources become poorer.
CAM
CL
(2 Q □
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BHARAT CYAN VIGYAN SAMITHI
(1
The central message of this book is this:
THERE IS ENOUGH FOR EVERYONE’S NEED
BUT NOT ENOUGH FOR EVERYONE’S GREED
> There is enough water for everyone.
There has not been a decrease in rains! And all water comes from the rains.
* But one has to plan collectively to use this water wisely.
* If everyone can do what he pleases and each one tries to grow the most
commercially valuable crops, a handful of the rich with access to resources will
be able to draw away all the water and grow rice and sugarcane, throughout
the year. But most of the landowning families will suffer from water scarcity.
*■ If on the other hand the use of this water is planned carefully then every plot
of land can yield a good amount and in the village the production will be more
as a whole. There will be enough food, fuel and fodder produced for everyone
plus a larger surplus for sales than before.
DRIED UP WELL
n
Even the rich cannot continue like this — growing 3 crops of rice
and sugarcane all round the year. Such heavy irrigation and fertilizer spoil the
soil and soon the yields fall. Some of the rich, aware of this are changing. But
others feel they can make a fast buck and when it becomes worse, sell their
land and move away to industry or a government job etc.
REMEMBER:
— If the food production must remain adequate
— If the food, fuel and fodder needs of every village must be met.
— If agriculture must continue (as it must if human life must survive)
then there is no shortcut but to plan!
Plan to use our water resources equitably and wisely.
fir
BHARAT GYAN VIGYAN SAMITHI
It is possible for us to plan!
Indeed it is not even a new idea.
For hundreds of years now, up to just 30 to 40 years back all the water used for
irrigation was planned collectively. '
We shall see how this was done in our next book on tanks.
And this planning was done by the village panchayats.
Indeed it was the village panchayats main function.
Now again village panchayats must take up this task.
And they have to learn how to draw up a fair and wise plan for both tank water
and ground water!
There are a number of panchayats in our country which do this today. You will
read about it in our next booklet.
Is your village one such village?
Or is yours one where the water table continues to fall?
DRIED UP WELL
I1
>.-< —
SANITATION
WASTE TO WEALTH
K^ET-4
HEALTH AWARENESS BOO
BHARAT GYAN VIGYAN SAMITHI
West BlocJJ - 2, Wing-6
R.K. Puram, Sector-1
New Delhi-110 066
J, (
y
,
//
___
/
Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterate Publications
These facts are largely taken from the book "Facts for Life" published,
jointly by UNICEF, UNESCO, & WHO in partnership with over 100 of the
world s leading medical and children's organisations.
•
Pix, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by: Bharat Gyan Vigyan Samithi
West Block - 2, Wing - 6
R.K. Puram, Sector - 1
New Delhi - 110 066
i
/
7
SANITATION: WASTE TO WEALTH!
Why Sanitation?
Many diseases are spread from person to person through human excreta
exposed by people defecating in the open. Disease- causing germs and
worm eggs are present in the excreta of an infected person. These
harmful organisms, which cannot be seen with the naked eye, continue
to live in the excreta. They are transmitted from one person to another
through water, vegetables, hands and insects like cockroaches and flies.
The diseases that are spread in these ways include.
*
several types of intestinal worms
*
diarrhoea, dysentery and cholera
*
typhoid and hepatitis (jaundice)
*
polio
If one must prevent these diseases one must ensure the proper disposal
of all wastes. Whether it is human excreta or animal dung, whether it is
garbage or waste water it must be disposed of safely.
[SANITATION
:
WASTE
TO
WEALTH^
I
WHERE TO GO?
If thXnh»aVCfk S° °Ut,before dawn °r wait tin after dusk for defecation,
for H»r ,
T"'
g the day’there is n°'vh<!re tha‘ they can go
often they have t0 ~ “■TWs is
a"d
L7ribtetroblenIdiai'‘'h°Ca °r dUring theiV mOnthly Peri°d! they fa“ a
^eiXXo'i? ” 17 ra™land °"’nerS d° not all°'V peop,e t0 defecate on
their agncultural land particularly during the growing seasons.
2.
SANITATION
;
WASTE
f~O
WEALTH
DISPOSAL OF HUMAN EXCRETA - SANITARY LATRINES:
One of the most important steps to check the spread of disease is to build
an use sanitary latrines. For women it is a basic essential demand
and a right.
4i
3VX";
/7>y?/» (b.\ 1,1 .
1
io
Z3Sp_11’ •
People often reject latrines thinking that it will be dirty and smelly. This
is because they have only seen latrines in places like bus stands where
t ey aie not properly maintained. A properly built and well maintained
latnne is very clean and has no smell at all.
There aie many types of latrines. Let us took at two types only.
SANITATION
:
WASTE TO WEALTH
;-3-
1
=
i
POUR FLUSH WATERSEAL LATRINE
This type is more commonly used where water is available and is us-:
for cleaning.
Water from a container is poured into the latrine pan to flush the excre
into a pit. If the pan is wet before it is used for defecation, flushing
more effective, as the excreta will not stick to the pan.
About two or three litres of water are required for flushing. The excreurine and water collect in the pit which is covered.
Some water always remains in the pan. This forms a “waterseal”. '
prevents bad smells for coming out of the latrine pit.
A big pot of water can be kept near the latrine for flushing and cleani:
the latrine.
ill hit
*
(
h...
I
r
A
4
SANITATION
WASTE
■ ■
•’
,,
..JJi
&
T 0
WEALTH
I
This latrine has two pits. For a family of 5 to 6 members each pit is of
1 metre diameter and 1 metre depth. Only one pit is used at any one time
by blocking the inlet of the Y-shaped drain leading to the second pit (as
shown by the arrow in fig. given below). One pit will fill up to the drain
outlet in about three years.
The excreta should remain in the covered pit undisturbed for about two
years to decompose. After that time, the odourless contents of the pit can
be handled safely and used as fertilizer.
Thus the latrine can be used as long as one wants by using each pit
alternately. One can also make this latrine with only one pit. It has to
be cleaned more often but it is easier to build and cheaper.
SANITATION
WASTE
T O
WEALTH
5
/
I
PIT LATRINE
-Where water is very scarce, and solid materials such as leaves, mud
stones are used for cleaning.
For eliminating the nuisance of flies and bad smell, the latrine can
improved to a Ventilated Improved Pit (VIP) latrine. A VIP latrine h
a ventilation pipe which carries the bad smells away. The inside is kc
quite dark so that flies in the pit tend to go up the vent pipe because th
are attracted by light. However a fly screen fitted on top of the pipe tra
them.
I
!
i
1
u
u
L
6 IS A N I T A T I O N
:
WASTE
TO
WEALTI
%
>
I i
I
BUILDING A LATRINE
First, a suitable site is selected. The latrine should not be on a slope or
in a depression. It must be located away from the water source to prevent
the water from being contaminated. If the groundwater level in the area
is more than 5 meters below the bottom of the latrine pit, it should be at
least 10 meters away to prevent water contamination. The safe distance
is 15 meters. If the ground formation is made up of fissured rock through
which the water can flow fast the risk is higher. The advice of the block
or district engineer should be sought.
r---------- 7
J
]
SANITATION
WASTE
v,.
T O
.,1
WEALTH
MATERIALS AND LABOUR REQUIRED FOR WATERSEAL
LATRINE UP TO PLINTH LEVEL(1)
Quantity
Item
Amov
Cost/Unit
(Rs*)(2) '
Bricks
410 units
0.45
184.
Cement
2 bags
55.00(3)
110.
Brick ballast
0.15 M3
75.00
11
Aggregate
0.1M3
110.00
11.
Sand
0.5M3
60.00
30.
Steel (6mm dia)
6 kgs
7.00
42.
Pan & Trap (mosaicl set
40.00
40.
2 man-days
40.00
80.
Unskilled labourer 2 man-days
20.00
40.
Trained Mason
I
Rs.548.
54.
10% contingencies....
Total....
Rs.603.
Say....
Rs.600:
Note: (1) The cost does not include the superstructure -
(2) New Delhi price 1986
(3) Rate based on government price
I
SANITATION
WASTE
T O
WEALTH
MAINTAINING A WATERSEAL LATRINE IN GOOD CONDITION
What needs to be done?
,
- \ v ( \ \U
)I
iz
1. The latrine pan should be cleaned once a day
with a broom, using soap powder or ash.
------.r — u; •
Wwf
\
2. Stones, garbage or other solid wastes
should not be thrown into the pan. This will
block the latrine.
• -• /Aci •:
\\
vv
3. If any part of the latrine is damaged,
repairs should be made promptly.
11>
I”./!
/.I
Who will do it?
1
J.
If it is a private latrine, each family will do it. This is easy. However if
it is a community latrine one must engage some person to look after this.
This employee can either be paid by each user separately or by the village
as a whole. But remember to make this arrangement before you build
the latrine!
[~S~A N I T A T I O N : WASTE T O WEALTH
9
ENVIRONMENTAL SANITATION:
Latnnes are not the only aspect of sanitation.
What else is there?
Look at this picture. What do you see?
Try to name all the sources of infection.
-W
GARBAGE
PHes of garbage lying around the house or street provide a breedi
Sts^dor d‘ They can also block roads and drains. They attract pit
ats dogs and other animals. Flies breed in cowdung and garbag
Mosoui o'3
tHe Wat6r bl°Cked by Piles °f garba^e and durq Roes spread malaria and filariasis and many other diseases.
10 |~S A~N I T A T I 0 N
:
WASTE
T O
WEALTH
What can be done to avoid the problems caused by garbage?
a. Keep the house and surroundings clean. Use a dustbin to collect the
garbage. Any empty tin or carton or a wooden crate will do. Keep it
covered and empty it everyday.
b. Convert garbage into compost in a garbage pit. Vegetable peels,
leaves, waste paper and cattle dung can be put into the garbage pit. The
contents of the pit decompose slowly to form compost,. This serves as a
good fertilizer and can be used in the kitchen garden or field.
HOW TO BUILD A GARBAGE PIT
It is quite easy to build a garbage pit for oneself.
1. Select a site at some distance away from the house like the corner of
the backyard and dig a pit 1 meter long, 1 meter wide and o.8 meter deep
m the backyard.
2. Build an earth bank about 10 cm Ihigh
‘ around the pit and compact it
well. This prevents rain water from flowing into a pit"
3. Every week, level the contents in the pit with a rake or stick and cover
with a layer of compacted
earth of about 3 finger thick
ness. This will prevent flies
from breeding into the pit.
When full, the pit should be
covered with a layer of firm soil
and left undisturbed. After 2
to 3 months, the content be
comes good fertilizer.
r
v\
4. Construct a new pit next to
the existing one when the first
one is full.
~s“a n I t a t I o n
/
WASTE
T O
WEALTH
11
DISPOSAL OF WASTE WATER:
-
Stagnant pools of waste water around houses, in streets and in cho
diains are a health hazard. They smell bad, make the area slushy ;
provide a place where mosquitoes can breed. What can be done?
*"■
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THE SOLUTIONS
Iw""
'
.
’ ''“
1. Draining the water away - A good way to use the waste water frc
handpump or well is to lead it through a drain to irrigate a vegetal:
garden (kitchen garden). The vegetables grown in the garden can improthe family’s nutrition.
2. Soaking the water away - The water can be led into a specially prepare
pit from which it is soaked into the ground. This is called a soakage pi
t can also be used to soak the waste water from a bathing cubicle
works well in sandy soil, but cannot be used in a water logged area or sc
with high clay content, like black cotton soil. In the latter case, the watc
has to be drained away.
12 [SANITATION
d
?
WASTE
T O
WEALTH
I
I
11
HOW TO BUILD A SIMPLE SOAKAGE PIT
i
A soakage pit is a pit filled with different sizes of stones or broken bricks.
The stone filling prevents the pit walls from collapsing. As the waste
water flows into the pit, it will gradually seep into the ground.
The sediments in the pot should be removed regularly and fresh coconut
fibre or leaves put back.
1. Dig a pit Im x Im x Im
2. Fill one third with large stones (10-15
cm diam.), then upto two-third with
smaller stones (5-10 cm)
3. Place 20 cm diam. clay pot with many
small (2 cm) holes. Put coconut
fibre/leaves inside. Fill pit upto
ground level with small stones (1 cm
'diam.)
4. Place 5 cm twigs layer and gunny bag.
Put soil on top and compact.
After several years, the soakage pit will become clogged up and oveiflow.
It has to be emptied, the stones washed, dried and put back.
SANITATION
:
WASTE
WASTE
T~O
WEALTH” 13
yv
I
HOW TO BUILD A KITCHEN GARDEN
■
than the outlet
vegetable Plot' » should be at a lower 1
the outlet of the waste water, so that the drain has a slope.
I
togetlwrt bAachannn|
S°'1 S0,that il is “mPacted (packed do'
through The oh
‘S CUt
the
soiI f“- «'<= »ater to :
laid along the charnel™" bc Iefl un,lned lined with stone. A day;
dean sofhnt ,1
alS0 ** USed’ Be sure 'hat the drain is .
clean, so that the water can flow freely to the plot.
|
for a kitchen garden '"it" farm"S ‘° d<ic‘de which ’egotables are suit:
gaidcn. It may
. -x.
y also
also be
be noscihln
possible fn
to grow afruits.
14
WASTE
TO
WEALTH
*>
I
!
I
PERSONAL HYGIENE
Many diseases are spread by poor personal hygiene. Some bad hygiene
habits are discussed.
Human excreta, contains many harmful germs. It is one of the chief
sources from which diseases are spread. Mothers who clean their infants
after the latter defecate, may forget to wash their own hands with soap
or ashes. These germs also collect under long, dirty finger nails. When
mothers then prepare the family’s food, the germs sticking to their hands
can be passed on to the food. In this way the whole family can be infected
with diarrhoea from one sick child.
I
["sanitation
?
WASTE
T O
WEALTH
15
I
'■
I
rin'Z™ Th" reS“'tVn ,Sk'n diSeaS“ s“h as s“^. «2ema and!
ttem aXm “ Tnane<1 regUMy' f00d ParticleS “1I“t ” be‘— '
and ea ” es M^ath
'
throua^thn'11 aV’e “1rnm°n col<i and tuberculosis (TB) are spread !
through the air when ack people cough, sneeze or spit on the ground,
WHAT CAN BE DONE?
Some of the more important aspects of personal hygiene are listed here,
A) Sanitary latrine
It is important to use a sanitary latrine if it is available. Otherwise try
to save money to build a latrine near the house.
■\ I
/
L3ea_
16
SANTt a t i o n
7
WASTE
T 0
WEALTH
I
I.
!
!
B) Washing hands with soap or ash
<3^0
z£S?FF"“—■=•
excreta mH J-T
bef°ie eatlng’ SoaP W111 remove the traces of
use ash R
°n fingGrS and hand- If soaP cannot be afforded one can
use ash. But do not use mud.
O Bathing and washing clothes
to wanJ
CVery,day USing SOap reBularlyis l,srfulis also useful
wash clothes regularly, and to ah- bedding in the sun.
D) Not playing in dirt
Children should not play in the soil
near where people defecate.
Motivate the people to wear slip
pers, so that worms in stools do not
enter via bare feet.
j
E) Cleaning Teeth
P~A~NTT7rTTo~N
WASTE
T O
W E A L T H I 17
I
&
h
I
I
iI
I
SANITATION IN THE HOME
Many village homes are usually damp, dark and stuffy. They lack light
and ventilation. There may be only one room in which the whole family
o ive or six have to live. They may have to cook in the same room, and
the women may also bathe there. Often people and animals have to share
the same roof. Insanitary surroundings attract disease-earners such as
rats, fhes and cockroaches into the house.
The smoke from the conventional chulha (open stove) causes eye irrita10n an respiratory disease, particularly among children and old people,
studies have shown that smoke inhaled by the housewife during daily
coo 'ng is equivalent to smoking 20 packets of cigarettes per day. Hence
pregnant mothers can even give birth to unhealthy babies, if there is
excessive smoke exposure.
18
H'
SANITATION
:
WASTE
T O
WEALTH
d
I
THE SOLUTIONS
1. More than one-third of one’s life is
spent in the home! Try and have
enough openings for light and air
4 2. Use a smokeless chulha. It will
prevent the smoke from filling the
house, because the smoke goes out of a
chimney attached to the chulha. It will
reduce respiratory disease and irrita
tion of the eyes.
3. Keep food and drinking water
covered. Use a cupboard with a
wire mesh door, for storing food to
keep away insects and rats.
SA~drprA~T I O N
WASTE
T O
WEALTH
19
I
H
i
i
4. Have a common ladle to take water out of the water pot, instead of
each person dipping a cup into it to take water.
5. Keep the house clean. Sweep the floor daily and throw the rubbish in
a garbage pit in the backyard. Also keep the surroundings of the house i
clean. Remove piles of garbage, dung and stagnant pools of water. Use
a garbage pit. Grow some vegetables in the kitchen garden and build an
earth drain to divert the waste water from the house to the garden.
20
• t
SANITATION
WASTE
T
WEALTH
•
6. Build a simple bathing cubicle and a soakage pit for the waste water
—IT—==^1
/
Z//A
7- Build a sanitary latrine.
u
SANITATION
:
WASTE
U}
T O
WEALTH
21
• u
WASTE OR WEALTH?
We saw that if it is not properly disposed of human excreta, animal dung,
garbage, waste water are all sources of disease and are very harmful to
us. However if they are properly disposed of they are sources of wealth.
After 3 years in the pit the human excreta becomes totally harmless and
is the best quality fertilizer for fields. Garbage becomes compost. Waste
water can grow vegetables. And so on. Why, if we plan well and get some
more money to invest then we can generate biogas as a fuel and even
generate electricity from it.
Is it not much wiser to make our wastes into wealth instead of into
disease?
’•'.-h'r’:
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m |~S~A~ N I T A T I O N
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:
WASTE
T O
WEALTH
h
WORKING TOGETHER!
<
But why has it not happened so far? What can be done now?
Ske a tkan fh1 ‘T*?'
plfn How
aChieVe thiS' P°rhapS we should nrst
hG V1 3ge cam^ai^n! and then we should draw up a
cXuZ?ar ‘';neS d<> WG nMd?- Shai' “ be pri™la latnnes or
we should find neV S,0"1 maR S°akaBe pits d° we need and 50 °n- Then
panohav 1 r a°
J™1
tOtal plan
fr°ra *e village
panchayats fund we can build it.
S
tavour desi™''01’37",1 haS °nly limited funds and you may
t» “e
the cost or ™ ? V? ?. !”■ And each family ™U have “>
a Part of
be built And
dOmg lab°Ur especially if many ^trines are to
after all’tW?dvo0Ur
maS°n
t0 be trained' PerhaPs even
a lot of w^’iafte^
t0 demand m°re fUnds f°r Pa”d’a*“s- Y«
Be^deX^ d°ne if thC Vi"aEe tOgethe1' decides that
i=
Beedes that our wastes will no longer be the causes of our suffering aS
disease and death but that they will be turned into wealth
I~s a iTTTA~TT~o~N
WASTE
T O
WEALTH | 23
•? ■
/ill
I
i
Health Awareness Booklet No: 5 • /”X
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BOOKLET PROTOTYPE PREPARED FOR
LOK SAMPARK ANDOLAN ON HEALTH
AND FOR
NEO LITERATE PUBLICATIONS.
ILLUSTRATIONS - TROTSKY MARUDHU
DESIGN - M. BASHEER AHMED
TYPESET AT - EZHIL PRINTS, MADRAS-24
BHATAT CYAN VKSYAN SAMITHI
WEST BLOCK 2, WING 6
RK PURAM SECTOR - 1
NEWDELH1-66
1
■.< -
£ -Z- ~
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OF DARKHES5
AHDUGHT
Let me tell you a story
The story is about a village
The village is called Irularai
The village is as dark
as its name suggests.
1
p
OTDARKNms
AND LIGHT
This is not a viUage of criminals
i calHt'a ° eldCrt ‘hey C°mmit a crim=
A Arti 1
me’ because therc « a law
X'y^s^4fica,'yforb-dsthis'’-’This law states that no girl shall
No h^n e/°re ShC is 1 8 ycars oldNo boy shall be married before 21
To do so is to invite punishment by law
11 / ’
‘■I4--' /'
OF ?*RKN£8» ■
:
But the elders say
‘No one has punished us
Nor is ever likely to
What we do is for us essential
And this others will not understand’
A daughter in the house is only trouble
She belongs to another house
It is another house she will serve
Why spend on her. Why educate
Let her go
The earlier the better’.
*1® UQWf
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TAOFDAWNBW
and light
What if they grow up? Say the mothers
And get into trouble with boys
Then who will marry her!
Who will provide for her
And if she gets educated
She will get ideas of her own
And heavens know what that will lead to
Better she is married now
Before she is able to decide
It is true that the law has not punished them
For reasons no one really knows
But a far worse punishment has befallen them
But like worms in a dung heap seldom realize
the brighter world outside
Many are not even aware
of how it would have been,
had only they done otherwise.
9
O
0
4
‘
I
-OF ^ARKHWS I
Ato LIGHT r
Let us see what they suffer in Irularai
The little girls hardly understanding
Reach their in-laws house and get to work
Gone are the days of playing on swings
Or running carefree amongst the fields
Gone arc the days of playing with friends
And reading about mysteries and
fantastic tales
But of, oh, so many books.
0 O
o
O
s
I
dI
I .
OF DARKNESS
ano light
Soon they are with child
They have to take care of another child
When they themselves arc but children.
As well as look after house work
And the husband and his parents.
The house becomes their prison.
They can neither go out nor learn,
Just keep going on and on,
from year to year and day to day,
From five in the morning till late at night,
Till by the time they arc twenty
They have become old and very very weak
‘But that’, nodding his head widely, an elder savs
Is the fate of a girl! *
6
II
J
OF BARKNm >
‘But old man’ say I, ‘Justice will be done
But not think you go scot free
For what you do to your women
Remember all those grandsons you lost
And those daughters too. Just after birth
So many children die in your village of darkness
And in every other such village
/
For if a child is born in another
Who is but a child
Whose body is not ready as yet
t
to give strength and life to another being
‘
then that child is born too soon, too weak
And often enough does not survive’.
\
u
OF.DA.RKNE5S
ANOLtaHT
‘And what of these young mothers
How many of them, quite unable to bear
So many children and so much work, die.
Do you know that in your village
And in villages like yours and in every home
Where girls are treated thus.
Many many days arc spent in mourning
And for every bit of laughter you deny the girl
the family spends many more days in despair!’
‘Nor are these deaths the only price you pay? Old man!
What of their little bodies, wracked by pain
What of their tom parts and weary limbs
What of the stunted growth of
Children who can never go out of doors!
Can such practices be without its cost ?
Can a mother who is thus,
look after your cherished grandsons ?
Can they be well fed and well educated f
Encouraged and stimulated,
To grow up and spread the fame of your family.
If their mother is bent over / with such
pain and trouble f
Will they be able to bring forth girls
who can care after the famlies of the future ?
If not what will happen of your tribe!
But above all, what of the cost
Of the half of society that is lost?
What is the cost, of the talents destroyed
How many musicians have you chocked?
8
u
OF pARXHfW »
How many dancers have been buried?
How many scientists have been imprisoned.
Or P.T.Usha’s have been crippled.
How many flowers wilted,
how many fruits ripend too early,
What right do we have
To deny them their identity.
What right do we have
To push them behind doors
Cover them behind screens
And bury them alive.
9
OF DARKNESS
AND LMHT
But if we look around
(In Kerala for example)
There arc other villages, like this one,
let us call it Arivoli!
Hcfaie girls all go to school
They even get their degrees
They go out to work
And by the time they are married
Are definitely eighteen if not much more!
Yes there are many villages like this
In our own country.
In these villages, like the ones of Kerala
Children die very rarely.
Their mothers are older and give birth
To strong and healthy ones. And they are educated
And know to look after them well
And above all they know
How to bear babies
only when they want to.
10
wa
There are women, who have become doctors,
Policewomen, nurses and health workers
They are women engineers and women masons
Carpenters, mechanics, Sales girls and musicians,
Auto drivers and butchers, Judges and soldiers
All of these jobs can also be done by women!
Women have cooperatives and elected representatives
They control business and conduct agitations
Indeed in no way are they lesser to men.
■ \
tr
*
11
x.
i i
OF DARKNESS
AND LIGHT
The men too are very happy for now,
In their house is not only a wife
But there is * {^friend who can give advice
Who is educated and can help
\
In all things from earning an income
To making decisions in times of need
12
H
■
J; OF MWC
Now Arivoli and Irularai are both in India
But look at the great contrast
In Irularai, girls are considered a burden
For they have to spend much on their marriage
And on other rituals - coming of age,
first pregnancy, first diwali and so on
And are married off early and bring no income
Pity the poor girls, whose husband dies early.
Juried in their new homes, unwanted at their parent’s
Incapable of earning, they become white with suffering
SOj often enough these families
Resort to even greater crimes than told above,
like killing the girl child after it is born
Or even finding out in the womb
Whether it is a girl and removing it.
But for all this shame, if you go to Irularai
Or see villages like them^they have not improved.
Indeed they are worse.
And despite wealth, there is poverty and despair
and suffering in each and every house.
13
I
I
V
u
OFOAMWESS
< AN© LIGHT ?
But in Arivoli village, it is different
Girls are welcome, just as for boys
Both are educated and arc capable of earning
And marriage is only if the girl becomes eighteen.
There may be little wealth, but whatever is there
Is used optimally. And laughter and sadness
is well shared.
And if need arises she can
/
support herself and her family.
\
I
14
1'
V
So let us say to the people of Irularai
Or to all those villages which are like that
And indeed to all the houses
Where girls are married before eighteen
And not educated in full and made
capable of earning
Please stop, before it is too late
It is unnecessary, all this suffering
Stifle your women and you damn your society
let them grow, let them bloom
Let them dance, let them sing
And only then will the new dawn be coming.
1
I
15
i
x-A
J
4
Health Awareness Booklet No: 6
A1
BOOKLET PROTOTYPE PREPARED FOR
LOK SAWPARK ANDOLAN ON HEALTH
AND FOR
NEO UTEF.ATE PUBLICATIONS.
II
I
j
I
ILLUSTRATIONS - TROTSKY MARUDHU
DESIGN - M. BASHEER AHMED
r/PESET AT - EZHIL PRINTS, MADRAS-24
5
BHATATGYANV1GYANSAMITHI
WEST BLOCK 2, WING 6
RK PURAM SECTOR - 1
NEWDELHI-66
I
i i’
PREPARING FOR THE NEW ARRIVAL
here is great happiness in Padma’s
louse. Padma is 21 years old and
married for one year now. Her mother in-law says that she must be
pregnant. Her husband says to her,
‘Let us meet the health worker today’
PHEPAHINQrOKTHEKEW AKRIVAL / 1
J
d
How docs Padma's family know?
For one it is 15 days now past
the usual time for her periods. Absence
of menstrual cycle is one indicator
Padma has nausea and a little vomiting
especially in the morning. This is
another sign of pregnancy
Some pregnant woman do not develop
vomiting
|d:- .vPREPARtTIQ FOR THE NEW AKRXVAL/
-
By testing her urine for some changes
a trained person can make out for
certain >
•' whether she is pregnant or not. This
test costs money. So one may also
wait. There are other signs soon.
By the 18th week, if there is still
no periods - and if the mother feels the
child move, one can be certain
By now the breasts are becoming larger
also and by the fourth month the mother s belly
starts to bulge!
/
i
PRBfABINO TOR THE KEW AXRIVAX / 3
il
•
L18RARV
OOCUN* NTATiOM
V
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>
4 ]
How long does a normal pregnancy last?
A normal pregnancy lasts for 9 months
and seven days. You count the days
from the first day of the last menstrual
period. By the lunar calender it is
10 months! Put another way it is about
280 days (It is not exactly 280 days
It can be upto 10 days more or less)
j '
PRSPARING FOR THS NEW AKRTVAL / 4 ■ "?>j
L
u
■■
1
I
In these 9 months the child in the
womb is formed and it grows gradually
The mother’s blood passes nutrition and
air to the child’s blood in the placenta
The umbilical cord connects the placenta to the
child. It brings the nutrition and oxygen
to the child and removes wastes
and carbon dioxide.
The child is surrounded by fluid which
protects it from shock. It survives in this
fluid. From the 16th week, its movements is felt.
a
*
I
f
FOR THE KEW ARKIVA1/ 8-'^B
I
II
d
VISITING HEALTH
or doctor
Padma meets he:^^ for
The hedth worke.
nccds
in Giving wo anu-^un^
hwp^rM,”u,t*” and
BFeparawwfe^ ehi^Wt.
u
NUTRITION
What must every pregnant woman and
her family know about nutrition
(a) The family must ensure that she has extra
food every day. She has to cat both for
herself and for the child.
(b) She should have a variety of best foods. Milk,
green vcgetablcs,,£mcatf fish, cggs|i pulses, grains,
None of these foods need be avoided on any
health grounds.
I
I
I
PRSPARinG FOR THE NBW ARRIVAL/7
:
<I
NUTRITION
c) Every pregnant woman must gain about 10 to 12
kilos weight before baby is born. If possible weigh
the pregnant mother on her first visit and keep a
weight record subsequently. If weight gain is
too much or too little consult the doctor!
j
rOXTHB NSW ARRIVAL / 8
I
I
u
NUTRITION
d) Most Indian women are anaemic. They must
take iron supplements
Iron tablets arc available free of cost in
government health centres and at very cheap
rates in private pharmacies also!
u
EXERCISE AND REST
Pregnant women should not exert too much
No lifting heavy weights
Nor
straining
She needs rest
she also needs light exercise - like walking
j
PREPAXiyG ?0R THE WEW ARRIVAL / 10
u
■
WARNING SIGNS
Danger signals of pregnancy ;
If a woman has these signals seek medical
help at once. Ensure that delivery is
conducted in a hospital. All these signs indicate
greater risk for mother or child.
WARNING SIGNS
. L
a) Warning signs before pregnancy $g£is
(i) Less than 18 years age
(ii) More than 35 years old
(iii) Less than 2 year before previous child
(iv) More than 4 children
— o.
I
i
IMMUNISATION
Must take 2 anti-tetanus injections
These injections should be atleast
four weeks apart. The last injection
must be atleast 2 weeks before delivery.
SOME DO NOTS
(a) Be careful about
taking any medicines. Especially in the first
3 months one must avoid almost all medicines
They can harm your baby.
(ii) Take special care to avoid getting jaundice
(Jj^sc only boiled water to drink) and diseases
like measles (keep away from sick children)
(iii) Smoking and alcho^l must be avoided.
3
SREPABING FOB. THE KTBW ARRIVAL / U
1;
WARNINOSIGNS.
.
______ __
(Warning signs of pregnancy - seek medical help;
(iv) Less than 38 kilogfams■weightTefore pregnancy
(v) Less than 145 cm height
(vi) Previous still birth or miscarriage or an abortion
(vii) Previous premature birth of baby
weighed less than 2 kilograms
(viii) Previous birth was difficult or by operation
WARNING SIGNS
c
(WarningligHT0f pregnancy -j_c_ckjnc^ic^hc!py
Signs during this pregnancy
a) failing to gain weight (less than 6 kilo gain)
b) Anaemia (pallor inside eyelids - should be normally
red or pink)
c) 'Phe^Dsual swelling of legs7arms or face
u J
I
PHEPAHIHG POP THE OW ARRIVAL / 13 ?
.•
u
DANGER SIGNS
Rush to a doctor at once.
a) Bleeding from vagina
b) Severe headache (sign of high blood
pressure)
c) Severe vomiting
d) High fever
Z*
Jv(j)
<•
ItyBJEPARIKG FOB THZ KBW ABRXVAL / 14^:^
trained birth attendant
Ensure that there will be a trained dai to assist
every birth
A trained dai is essential
a) to keep the birth clean and reduce infection
b) to cut the cord cleanly and safely
c) to help begin breast feeding and to dry the babv
and keep it warm
d) To recognize an£ problem in labour and call on
more expert medical help in time
e) to identify any problem in child’s health /z***^'
that need
1 more expert medical help
/
L J?aZPA-W;G?OBTHE NW A5BIVAL~/ 15 XT
J
T
CHOOSE! CHOOSE WELL
Two more essential points to prepare
well for your new arrival
a) Have a baby only when you choose. Use birth
control measures to choose, Do not have a baby
when you arc physically or mentally not ready or
when circumstances arc not alright. Remember
you can choose.
b) It is not enough to prepare only during these nine
months. Good food, good health and education for all
girls from an early age onwards is a must.
And to be fully ready
till they are 18, they must not get married.
SAFE MOTHERHOOD CAN BE ENSURED
If the pregnant woman and her relatives pay
attention to the points mentioned earlier, safe
delivery is ensured.
/
i
PR2PAKING FOR THE 2TEW ARRIVAL / 16
?
WE CAN CHOOSE
HAVING A BABY WHEN WE WANT IT
|ii*-’
HEALTH AWARENESS BOOKLET-7
l
i
BHARAT CYAN VIGYAN SAMITHI
West Block-2, Wing-6
A
R.K. Puram, Sector -1
New Delhi 110 066
**
”
- \\
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v
.....
tA
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Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterate Publications
Pix. Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by : Bharat Gyan Vigyan Samiihi
West Block-2, Wing-6
R.K. Puram, Sector - 1
New Delhi -110 066
*
WE CAN CHOOSE!
-HAVING A BABY WHEN WE WANT 1TIHow wonderful it is to hove a baby!
Have you felt a baby kick inside its mother's womb?
Have you wondered about the marvel of the baby emerging and
growing up?
0
I
I
When the human seed is six days old it is
no bigger than a grain of rice. A plant
seed grows in the loving warmth of
mother earth. The human seed has the
warmth of a mother too.
The little one is formed when the seed
from the father, placed inside the
mother's body, swims its way up to unite
with a tiny egg released inside the
mother's body. Then this little one takes
root in the soft dark and warm bag that
is inside the mother. This is called the
uterus.
WOMB
FALLOPIAN TUBE
/
/
OVARY
LIGAMENT WHICH HOLDS
THE WOMB IN PLACE
VAGINA (THE FRONT WALL
HAS BEEN REMOVED TO
EXPOSE THE CERVIX)
i
*
w
E
C
A
N
i
FUNNEL LIKE MOUTH 01
FALLOPIAN TUBE WHICI
GRADS THE EGG
OPENING OF THE CERVIX
A/HICH IS NORMALLY CLOSED
DY A MUCUS PLUG
*
i
CERVIX
C
H
O
O
s
E
2
ii
u
When the human seed is 3
weeks old, it needs more food.
More air. It has a special part
called the umbilical cord. This
reaches for mother's blood
vessels. The place where the
food and air pass from the
mother to the child's umbilical
cord is called the placenta.
Now mother must have
enough food and air to feed
two. So she must eat more
and do less work. Then, the
baby can grow safely, sur
rounded by a bag of water
where the baby swims. Free
from any dangers or shock.
*
*
W
E
c
A
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H
u
Shcnthi hcs rece^ily been married. She is only eighteel She has to
finish her studies in col'ege ar.d if vn! take two more years.
And she wants to know her husband belt er, spend some lime with him.
She wants a baby very much. But not now. Later, when she and her
husband are ready. To be able to do all for the VIP. Right now she
must study a bit more. She herself must grow a bit more.
i r
- --
b
Pukkumani too is recently married. Also eighteen years of age only.
She finds herself lost in her husband's place. There is so much work to
do in lhe fields and in the house. Her in-laws keep wanting herto have
a child at once. But she needs time to adjust to her new life and this
new family. The health worker says that she can wait longer. Inside
her she also feels, "I want a baby, but please god, not now. Let it be
one or two years later. I'm not ready, I cannot cope now".
*
*
w
E
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A
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c
H
o o
S
E
6
*
u
Saroja has a six month old baby. How demanding she is, and tiring
too. At night, when her husband comes to her she becomes almost
faint with anxiety.
What if she becomes pregnant again? But her husband becomes
impatient. Sometimes he is rude. What is she to do?
/
Though having a baby is such a wonderful thing, for most women it
becomes such a big problem. That is because they are not able to
choose when to have babies. If they could have babies only when
they wanted to and not have babies when they do not want to, then
it would be wonderful.
*
*
VV E
C
A
N
C
H
O
O
S
E
8
*
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u
But they can now.
Women can choose!
Women must choose.
Family planning gives them this power (Shakti).
Family planning is having the number
of children you want, when you want them.
t/
I
IV
How does Reni manage? She talks it over with her husband. Her
husband readily agrees. They decide to use condoms for birth control.
He buys the condoms from the local drug store. After use he flushes
it into the latrine. Or takes it wrapped in paper to the fields and throws
it in a waste area. Except for the small embarrassment in buying it in
the shop, he has no other problems.
it
*
W
E
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A
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C
II
O
0
S
E
1
0
☆
it
d
Rukkumani finds it more difficult to convince her husband. But she is
determined. She goes with her husband to the local doctor. There
she chooses to take Mala-D pills. Her husband is not so cooperative.
But he does not object either. And Mala-D pills can prevent her from
becoming pregnant till she is ready for it. The doctor has warned her
that she may have some morning sickness, or swelling of breasts
initially. This she has for the first two or three months-but it becomes
OK. The only problem is remembering never ever to miss taking her
daily tablet. After 2 years she chooses to have a baby. She tells her
husband and then she stops having the pills. Within three months she
becomes pregnant.
* *
W
E
c A N
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H
O
0
* *
I .
Why does Sorojo not wont to hove a child now? Because her last chi
is only six months old. She feels too weak still. Her body needs time o
recover. Besides the child needs all her care. And her breast milk. If
there is another child now, both children will not get enough attention.
And the second child is likely to have a low birth weight a2d th®refo2®
more likely to fall sick. Indeed all doctors tell her that - THE RIS
DEATH FOR YOUNG CHILDREN IS INCREASED BY ABOUT 50/o IF THE
SPACE BETWEEN BIRTHS IS LESS THAN TWO YEARS"
*
*
W
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c
A
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H
O
0
S E
1
2
☆
*
//
How does she solve her problems? She learns about various birth
control measures. If her husband cooperates he could use a condom.
That would be the best. If not she decides to get a loop inserted. If
there are no problems with it, she can keep it in for 3 years. Of course
she will need regular check ups. Then when she is ready to have
another child it can be easily removed by herself. Then she will have
her second baby. When she, the mother chooses of not before. If by
chance this loop does not agree with her she will take Mala-D, the pill.
r
PACKET OF 21 PILLS
ooooooo
ooooooo
ooooooo
PACKET OF 28 PILLS
ooooooo
ooooooo
ooooooo
*
*
i
*
W E
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A N
c H O O S E
1
3
*
<r
U'
Saroja's friend tells her that if she gets pregnant, she can opt to 'clean
it' i.e., have an abortion.
Before deciding Saroja must know three things, about abortion.
Firstly, never have an abortion unless it is done by a qualified doctor
trained for this. Never never use 'kuchi', or tablets to cause abortion.
These are very dangerous and the mother's health is always affected
seriously. Very often the mother dies.
Secondly, if an abortion is to be done, do it early. Abortion in the first
3 months is relatively safe. In the next 3 months it can be done but
the risks are more. After 28 weeks, abortion is never to be done.
Thirdly, use abortion only if it is a must. Even the best done abortion
has its risks for the mother's health. Do not use it as a method to space.
Better to have the second child and then a sterilization operation.
Remember some women find abortion psychologically unaccep
table and are racked by guilt. Other women find it acceptable.
Having a child would have been more unacceptable. So let the
woman decide!
Some centres test the sex of the child and if it is a girl, the parents
choose abortion. This is unjust to women. It is against the law. And it
is damaging to the mother's health.
*
So let us tell Saroja's friend:
a) Better to prevent pregnancies than opt for abortion.
b) If an abortion becomes necessary, go to a qualified doctor only!
*
*
W
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A
N
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H
O
0
S
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1
4
*
*
/
Il
To Roni, to Rukkumoni and to Saroja knowledge of how their body
works and how they can control it gives them strength and freedom.
It has given them confidence and self reliance.
Many of our sisters are illiterate. They do not know how to control their
bodies. How to choose? Their husbands decide. Their in-laws decide.
Fate decides. But, she, the woman, the mother, does not decide.
Yet it is her body. Her labour (pain). Her work. Must she not then be
the most important person to decide?
Yes, all our sisters must become the persons to decide how many
children to have and when. For this they must learn. Education is
needed. Also needed is education about birth control. Do read the
nexj few pages. If you want more information meet your nearest
health worker or a doctor who knows about this.
4. MAJOR METHODS OF BIRTH CONTROL
The Condom
Nirodh is the most common
variety.
It costs only 50 poise for three.
And is available in almost all vil
lages.
And in all medicine shops.
How to use it: Tear open the
packet. Take out the rolled up
condom. Hold it by its teat be
tween thumb and forefinger,
thus squeezing out the air.
Place it like that over the erect penis and roll it open and on to the
penis. After sexual intercourse this is taken off and disposed. Use a
fresh one each time. Do not re-use.
It is totally safe and has no side effects at all. It also helps prevent
venereal diseases from spreading. It is especiallyjgood to prevent
AIDS. It is easy to use. Its main disadvantage is that it needs a hign
degree of male motivation. The male must be fully concerned and
interested enough in the decision to implement this measure every
time without a single slip. If such motivation is not there then it is better
for the woman to consider other alternatives.
☆
*
W E
CAN
CHOOS
E
1
6
<r
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I .
The IUD
It is also known as Copper -T.
It is a small metal and plastic
object that is placed inside
the uterus by a nurse or doc
tor. When it is in place it
prevents pregnancy.
Sometimes it falls out. There
fore after every menstrual
period, women must check
if the IUD is still in place.
r
In some women it causes
pain, discomfort and some
times serious problems. These women must stop using it and mdy
change to another method. For others it works fine.
It must never be used in a woman who has extensive white discharge
or pain in that area for it may worsen it.
Its greatest use is for women who have had one child, to delay their
second child for 2 to 3 years. This method is cheaper and for most
women who develop no problems, it is easier to manage. If the male
is not cooperative about using condoms and if her breast feeding is
affected by the pill, this mdy be her only choice!
*
it
W E
C
A
N
C
H
O
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S
E
1
7
it
it
U/
I
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The oral contraceptive pill.
Mala - D is the most common. And the cheapest. Only Rs. 2.00 for a
packet.
This can be taken from health workers, local health centres or from
drug stores.
This usually comes in a packet of 28 pills.
Take the first pill on the fifth day of the period. Take 1 a day. Seven of
the pills will probably be of a different size and color. Take these pills
• last (one a day) after the others have been taken. The day after you
finish the packet of 28, start another packet. Take 1 a day without
ever missing a day, packet after packet for as long as you do not want
to become pregnant.
Side effects: Some women get a little swelling of breasts and morning
sickness in the beginning. After two to three months it become alright.
*
*
W E
c A N
C
H
O
O
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E
1
8
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Mala‘D ,
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Some women may bleed rmore or less during their period. If the
change is not much it does. not --------matter, Rarely they can develop
serious clots that damage the brain or heart. Bui this problem is much
more if a woman becomes pregnant!!
However to be safe, all women taking the pill should:
a) examine their own breasts themselves every month tor lumps.
b) have a medical check up, at least once every 6 months which
Includes checking BP.
c) Watch out for headaches or pain in the leg with swelling or pain in
chest.
Women with any persistent pain anywhere or any serious disease
should check with a doctor before they start taking this drug.
Women who are breastfeeding their babies should not take birth
control pills, at least for the first 6 months.
*
*
W
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C
A
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H
O
0
S
E
1
9
*
*
STERILIZATION
^Ch^sonsfherp,Wh° hfaVe deCided ,0 h0V9 nO mOre children- F°'
operation is
®
safe's'mpte°Perations which are free oiso. The
cmlono in each
and sirnPler for ° "'ate. A small cut about i
g .
9 O,n 15 enoueh to do this operation. It has no ill ertec<
f
f-Y”'i
j
OUtjUST
e same but has no sperm m it. This is therefore the ideal thing to do.
la'? 15 9lS.° a simple operation for women. A small cut is made on
cut and fed The T>e"y T 'T ’he ,UbeS C°min9 from ova,ies Q'e
cu and fed. The operation has no effect on any of the woman's
Se X improve. S'nCe
be“min9
WHICH METHOD TO CHOOSE:
There is not one best method. The choices vary for each, dependina
a
e circumstances. It is best to discuss this with a health worker or
experience*^
hQS Qdequate‘ Pledge and
■ ut the choice must be yours and your husband's.
Especially yours.
*
*
W
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C
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O o S E
2
0
<r *
. u
Discussion questions
a) Is the decision to have a baby consciously made? How is it made?
b) What obstacles are there for women to exert their choice in this?
c) What are the advantages and disadvantages of each method. In
what situation would each choice be more suitable.
d) Are condoms and mala-D available always and easily in your
area?. What arrangements are to be made to ensure it?
c) Are facilities for IUD and sterlization available?. How far is it? How
safe and clean do you feel these facilities are? What are the problems
in your area in utilizing these facilities?.
*
*
W
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A
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C
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Health Awareness Booklet - g
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BOOKLET PROTOTYPE PREPARED FOR
LOK SAMPARK-ANOCLAN ON HEALTH
AND FOR
NEO LITERATE PUBLICATIONS.
ILLUSTRATIONS - TROTSKY MARUDHU
DESIGN - M. BASHEER AHMED
TYPESET AT - EZHIL PRINTS. MADRAS-24
*
BHATAT CYAN VIGYAN SAMfTHI
WEST ELOCK 2, WING 6
RK PURAM SECTOR - 1
NEWDELHI-66
H
Women’s Health and Women’s Rights!
Do you know?
The health of women
in our country
is much worse
than that of the men.
In almost all parts
except the state of Kerala.
WOMEN'S HEALTH AND WOMEN'S RIGHTS I 1
H.
How can we say so?
In most parts of India for every thousand men alve there are only about
932 women alive.
I
I ooo
^32
>4 eN
Why is this so?
It is so largely because the women are dying^more
And many of these deaths are in girls below the aie of 5! And many other
deaths are during their child bearing years.
This is not so in many places of the world and ever m many places in India.
In Kerala and in almost all the advanced countries o’ the world-USA, Britain,
Russia, Japan and so on - the death rates are eci—i and there are as m
y
men as women alive. If anything for biological reasms there are more women
alive than men.
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 2
Why are women sick more often?
Why are women dying more often?
a) Because women have less access to nutrition.
V
Women and even little girls eat last.
Often they have to go to bed hungry.
WOMEN'S HEALTH AND WOMEN’S RIGHTS / 3
b) Because women are subject to
chronic overwork and exhaustion
WOMEN'S HEALTH AND WOMEN'S RIGHTS / 4
u
k: * >
S!
c) Because of women’s habitat
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 5
H
d) Lesser access to health care
MOW C/AM
Lea viNGi
OTUGR
NOW To THC
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WOMEN'S HEALTH AND WOMEN’S RIGHTS / 6
Pho
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e) Lack of education
9
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♦
WOMEN'S HEALTH AND WOMEN'S RIGHTS / 7
H
i
f) Cultural attitudes
(i) Shame about bodily functions
e.g. menstruation, white discharge
(ii) Woman is considered a burden!
1 WouU CAN T TELL /ANy &oDy
problem
THIS NASTy DIRT/
T HAVE
o
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WOMEN'S HEALTH AND WOMEN'S RIGHTS / 8
4BOUT
u-
g) Lack of knowledge and awareness
h) Lack of facilities and correct training of medical professionals to handle
women’s problems.
How CAW
fee
OR.'THESG WOt^EN.
ExAlxAXNEii ■ THERE WHAT A FUSSTHtBy
15 NO SEPARATE
HOW CAN T TeUL
UAKE •
LouDUy REFoRE ALL
■ABOUT My WHITE
PooM .
DISOHAPGiE PROBLEM.
vhlu thex
THINK 5
WOMEN'S HEALTH AND WOMEN'S RIGHTS / 9
11
i) Misuse of medical technology!
TW |£.
tug
IS A
PENAAUE
abortion
vj WA
RS. 5000 1
WOMEN’S HEALTH AND WOMEN'S RIGHTS / 10
FETUS .
COST
j) Or just plain murder
4MOTW6R c/xSE
OF TEMAL6
INF/AWTIODE
<3
<^\RL. CDHHL.P
pocxNp.
WOMEN'S HEALTH AND WOMEN’S RIGHTS / 11
u
k.) Some health administrators’ narrow view of women’s health
/OU ARG. ,ALL UlREO A$ HEALTH
WCRKERS. you HAXjeTo FuLLFIC
THESc
EVERy VAOMTHAtlEASt 30 sterilizations.
VJUAT ABOUT mVlBIR VAE.ALTVA
yes. yer. if THey are PRe&nanjt
you mu«.T help. But you have
To MEET youR TARGETS.
A
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 12
u
It is true that many women die during pregnancy and maternal care needs
special emphasis.
But remember a) Woman is not only a reproductive machine. Women’s
health is not just pregnancy and family planning.
b) One cannot make maternity safe by maternal care alone.
To the healthy woman with adequate food and rest and education, pregnancy
is a joy. She knows to choose when to be pregnant and how not to become
pregnant. To the starving woman who is overworked and undercared for
pregnancy is a great danger!
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 13
u
Hepatitis. TB, malaria, jpelvic
’ ‘ diseases are all diseases that can be cured.
But in pregnancy they are often fatal,
In woman whose health is already
compromised by poor nutrition and care
any disease may prove the last
ptraw!
■Ve mu. ; ensure that pregnant women
~n especially those with poor nutrition
Ego" SUpPOrt 10 ,ide over >he
This means .hat all pregnant
j—food supplements
— iron tablets
*— Rest
- Special visits by health worker to identify high risk cases
WOMEN'S HEALTH AND WOMEN'S RIGHTS / 14
But all these (food supplements
at pregnancy, iron tablets etc.) will not be
enough to save the woman
if she is already stunted in growth by malnutrition
it she is illiterate
if she is not used to attending to her health needs
it after delivery there is not enough care
Maternal health is inseparable from all problems of women’s health at all
stages of her life.
Maternal health is only a part of woman’s health.
L
U
health is a reflection of the quality of life.
Women’s health can be ensured only by ensuring Women’s equality.
The right to equal food.
i Whicn means more food during pregnancy and during breast feeding when
she is feeding two!)
The right to work and equal remuneration for the same.
WOMEN'S HEALTH AND WOMEN'S RIGHTS / 16
I] •
A
— The right to equal education
— The right to equal health care
— The right to choose.
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 17
■ u
For women’s health to be ensured
we need a new society
a better society
Where women have an equal voice
- in their homes
- in their villages & towns
- in their states.
\
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 18
But how to begin?
By ‘LEARNING”
‘knowledge is shakthi*
Women must learn
- to read and write
- to understand their bodies and how it works
- about what is needed to ensure women’s health.
- about how to choose when to have a baby and how to ensure safe
motherhood.
- about how to protect their children
- about how to be self - reliant
- about how to build a new society.
WOMEN’S HEALTH AND WOMEN’S RIGHTS / 19
I
One
Magical
Morning
*
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Health Awareness Booklet No: 10
eal Care
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ite
V. vk
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'sRole
is
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Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterate Publications
This story is adopted with minor changes from "Tamasha'-June 1991
© Katha
Plx, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by : Bharat Gyan Vigyan Samlthi
West Block - 2, Wing - 6
■ . .
R.K. Puram, Sector -1
New Delhi - 110 066
4
ONE MAGICAL MORNING....
z^ne bright summer’s day, Periyasamy of Annaipatti was
Agoing to his fields. Periyasamy was the village panchayat s
president. On his way he found a stone. The stone glowed. It felt
warm like the sun.
“I’m the Sun God", a soft mysterious voice said. "Make a wish .
i
i
I»
I
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1
Ii
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One Magical Morning 1
u
/
Periyasamy had no son.
“1 want a son”, he said.
Soon, Periyasamy’s stomach
began to grow
“Me? Me?” spluttered Periyasamy.
‘‘I don’t want a son!”
“You don’t?”
“No, No... Men do not have babies”
The Sun God laughed.
One Magical Momlng 2
u
Did not Vishnu become Mohini
to have a baby?
Now it’s your turn.
The news spread lilce fire.
“When we had our first girl,
you made such a
big fuss” said Periyasamy,
to his wife Rani.
But soon his stomach began to grow.
He became tired easily
And hungiy
He wondered how Rani had managed.
One Magical Morning 3
When Rani was pregnant
She had fetched pots of water daily
And all the firewood
I
And done the cooking
And even helped in the fields
Till the last month.
But Periyasamy found even attending to
his daily work very tiring.
His wife had to help him a lot
And Periyasamy thought
When she was pregnant, did 1 help?
One Magical Morning 4
i
1
I
He felt he would die.
He was very worried.
He called a panchayat meeting.
A lot of people came to the meeting.
A lot of women also came.
I
The health worker and doctor also came.
An elder got up to say
‘Lots of women in our area
die of childbirth’
A woman said ‘Lot of children also die’
After so much trouble and pain
What a shame to lose the child
And oh what sadness.
The villagers also said,
This must not happen
to our president.
!
I
I
I
i
I
One Magical Morning 5
I
i
£
,4
THE CHILD MUST SURVIVE
NUTRITION
1
rt
health awareness BOOKLET - 12
BHARAT GYAN VIGYAN SAMITHI
West Block - 2, Wing-6
R-K. Puram, Sector-1
New Delhi-110 066
_y A
*-
I
//
A;
Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterate Publications
These facts are largely taken from the book "Facts for Life" published
jointly by UNICEF, UNESCO, & WHO in partnership with over 100 of the
world s leading medical and children's organisations.
Pix, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by: Bharat Gyan Vigyan Samithi
West Block-2, Wing-6
R.K. Puram, Sector - 1
New Delhi - 110 066
*
THE CHILD MUST SURVIVE
Nutrition
Foreword
We know the pain
of giving birth to children
We know
the anxiety
of looking after a sick child
We know
the agony
of a child lost
Far too many children are sick today
Far too many children die:
1
(If only these children survive we can bear less children)
BUT WE CAN PREVENT MOST OF THESE DEATHS
BY JUST 4 MEASURES:
a) Proper child nutrition and growth:
especially breastfeeding
b) Ensuring total immunization
c) Prevention and proper treatment of diarrhoea
d) Prevention and proper treatment of acute
‘
respiratory infection.
This book is about how to ensure
"CHILD NUTRITION AND GROWTH"!
Nutrition/1
u
nutrition
The single most important need of the child is
adequate nutrition!
Malnourished children get diseases like diarrhoea,
TB, measles, etc., much more commonly than wellnourished children. A malnourished child is much
more likely to die from these disease.-, .han a wellnourished child.
Without adequate nutrition children cannot grow
well. They remain stunted. They cannot learn well.
They cannot play. What a shame! Should we allow
a single child to go hungry? Never.
Yet, lakhs of children are malnourished and dying.
What is the main reason? Poverty. Parents are not
able to afford food for their children!
Nutrition/2
u
:7
I
V
There is another factor also. Lack of adequate
knowledge. Many parents do not know the best
way to use the limited money they have!
Did you know? A child 1 yean old weighs only
about one-tenth of her mother - but needs half
the amount of calories her mother needs!
This book tells us 7 major facts about child nutrition
Nutrition/3
u
BREAST MILK
For the first four to six months, give Breastmilk
alone.
* Breastmilk alone is the best possible food and
drink for a baby in the first four to six months. It is
the best food a child will ever have. It is superior
to all other foods and milk powders.
* Even in hot climates, breastmilk has adequate
water for all the child's needs.
Breastmilk protects against diarrhoea, coughs
and colds and common illnesses. Protection is
greatest if breastmilk alone is given to the baby.
Start breast feeding within an hour of delivery of
baby.
Remember: The first milk (colostrum) is thick and
yellowish and very good to prevent infections. It
must always be given to the baby.
A
Nutrition/4
u
- Even if the child is sick or mother becomes preg
nant, again upto 1 year or if possible 2 years, child
can continue to get breast milk.
Almost all mothers have enough breastmilk. Let
the child suck as often as he or she wants. The
more it tries, the more milk is produced. If other
foods or milk is given assuming that the mother's
milk is not adequate, then the child sucks the
breast less and less milk is then produced.
Remember: Bottle feeding is dangerous to the
health of the child! And costlier too! If the child
cannot suck, then squeeze milk from breast into a
sterilized cup and give with a clean spoon!
I
•4
Remember: A mother breastfeeding her child
needs support of family and friends, health
workers and women's organizations, especially
when they start breastfeeding.
Remember: If breastfeea^ng is painful or breasts
are engorged, consult a health worker or doctor.
Do not stop breastfeeding. It is usually a minor
problem
Nutrition/5
H
At the age of four to six months, the child needs
other foods in addition to breast milk.
But continue breastfeeding.
- Give breastfeed before giving other foods.
What to give?
- Boiled, peeled and mashed vegetables.
- Gruel or porridge of rice, or ragi.
- Soft idlis, or khichri or rice-dal mixtures
- egg yello^v
Nutrition/6
WEANING
I
u
FREQUENT
FEEDING
A child under 3 years of age requires food five or
six times a day.
Its stomach is small. In body size, it is one- fourth or
even less than the adult's. But in food, it needs to
take half as much as the adult!
♦
But one cannot cook five times a day!
In between meals, give banana or other fruits or
coconut or groundnuts or biscuits and milk!
Do not leave child's food standing for hours after
cooking. Germs may grow in it. Better to give
freshly cooked food.
FATS & OILS
Add a small extra amount of fat or oil to a child's
food:
Why? Because its stomach is small but its needs
are great.
What to add? Butter, ghee, vegetable oil, or
groundnut oil or crushed nuts!
Nutrition/7
u
More greens and more yellows!
Children need vitamin A and other vitamins too
and a number of minerals - like iron!
They can get these from vegetables and fruits.
Which vegetables?
Dark green leafy vegetables: palak (Keerai),
drumstick; orange or red fruits and vegetables:
Carrot, beetroot, papaya, mango, and chikkoo
(sapota)
Remember the more green it is,
the more red it is,
the better it is.
The darker the colour, the better!
N.B. Gur (Jaggery) is more healthy than sugar
It has more iron and calcium!
Nutrition/8
GREENS & YELLOWS
U'
EXTRA. MEALS
FOR THE SICK
After an illness a child needs extra meals to catch
up on growth lost during the illness.
Illnesses are inevitable. But remember to use your
best talents to get the child to continue eating
and drinking water during the illness.
After the illness, give more food to the child for a
week or two!
N.B.: Breastmilk prevents most illnesses.
Immunization also prevents illnesses.
Use of latrines and clean hands and surroundings
prevents illnesses.
Nutrition/9
How does one know whether the child is eoting
enough?
WEIGHT CHART
- The best way is a regular monthly chart of the
baby's weight.
If there is no increase for two months then it is
serious!
- One can also measure the circumference of the
arm. If there is no increase in circumference for
two months it is serious.
Between age 1 and 5, for a normal child, mid- arm
circumference is 16 to 17cm. If it is below 13.5 cm
it indicates malnutrition.
All children must have one of these measurements
done periodically (at least once in 2 or 3 months)
at least upto the age of three!
Your local health worker or your local health
centre can get this done! Is such an arrangement
available in your village?
Nutrition/10
i
/
AFFECTION
& STIMULATION
Talking, playing and showing love are essential for
a child's physical, mental and emotional growth.
Food and shelter is not enough.
A child needs attachment and stimulation.
Every child needs to give and receive affection.
Children need to be bathed in words, cuddled,
smiled to, listened, encouraged. To interact with
people, smile at them, see them respond. Lack of
attention affects growth.
Children need to play. Play is not pointless.
Children learn by doing. Play develops mental,
social and physical skills. Play must be en
couraged. We also need to develop their
creativity - by play, by testing their curiosity, by
songs, rhymes, drawing pictures and stories.
Above all we must ensure that they receive praise
and recognition of their efforts.
Nutrition/11
This child's weight did not increase:
REVIEW
What can the problem be?
Ask the following questions:
Is the child eating frequently enough?
( child should eat 5 or 6 times a day)
Does the food have enough energy?
4
(add small amounts of fat or oil)
Nutrition/12
Is child frequently ill?
(needs persuasion to eat when it is sick, an extra
meal later)
*
Is child getting enough vitamins- especially
vitamin A?
(add more dark green vegetables, give
vitamin A supplement, if not given)
I
Is child being bottle-fed?
I
(bottle and water may not be clean, milk may
be diluted etc.)
Nutrition/13
I
Does child get frequent diarrhoea?
pXx:ro^uTdrlean-faecesmustbe
Does child hove worms?
(needs de-worming medicine from health
worker or health centre)
is child alone too much?
Ji
(needs more stimulation and^attention)
*
amongstchJdm0/’0^ thS Causes °f malnutrition
aboudt? h
'n y°Ur v'l,a9e? What can be done
Nutrition/14
Chart 1
Start These Foods From 4 to 6 Months of Age
DAL
BANANA
KICHRI
BEANS
CARROTS
GREEN LEAFY
VEGETABLES
WHEAT FLOUR
PORRIDGE
Nutrition/15
Chart 2
For a Child of 1 Year
Morni ng
or
125g W
Milk
1 Sugar
1 Slice
or
10 O’clock
1/2 Chapati
or
o
1 Banana
1 Chapati
1/2 Katori
Atta Halwa
1 >2 Chapati
1/2 Katori Dal
Green Vegetables
N oon
or
2 O’clock
1/2Katori Atta Halwa
1 Slice
4 O'clock
or
125gES
Milk
1 SuQar
1 Slice
V2 Chapati
Night
1 Chapati
Wheat-based diet
Nutrition/16
1/2 Katori Dal
Chart 3
For a Child of 1 Year
or
Morning
125g
Milk
1 Sugar
1 Slice
1 Banana
Noon
1 ^2 Katori
Suji
Kheer
1 Katori
Khichri
1/2 Katori
Suji Halwa
1 Katori
Rice
Green
Katori
Vegetables
Dal
or
Khichri
or
or
2 O’clock
1/2 Katori
Rice
or
or
10 o’clock
or
1/? Katori
Khichri
Vp Katori
Suji Halwa
1 Slice
or
4 O’clock
125g
Mjlk
1 Slice
1 Sugar
?2 Katori V^Katori
Rice
Suji Halwa
or
Night
1 Katori Khichri
Ricc-bascd diet
Nutrition/17
1/2 Katori
Rice
1/2 Katori
Dal
Chart 4
For a Child of 2 Years
Morning
or
125 gQgJ
1 Sugar
Milk
10 O’clock
1 Slice
or
1 Banana
Noon
1/2 Chapati
or
1 Chapati
1/2 Katori
Khichri
1 Chapati
Yz Katori
or
1 Katori
Khichri
2 O’clock
Dal
or
Groundnuts
Roasted Gram
'I O’clock
or
125g
Milk
1 Sugar
2 Slices
1 Chapati
Dal
Green
vegetable
Night
1 Katori
Rice
2 Chapatis
Nutrition/18
Chart 5
i
Recommended Food Intake for a Child of 1 to 2 Years
Dry wt
Name of food
(0)
Proteins
Quantity
Dry
Cooked
Calories
(0)
Nutrients supplied
Carbohydrates,
60
206
4*1
WHEAT
88
300
10*6
PULSE
50
167
1V1
MILK
250
168
8-0
15
60
RICE
Proteins
Bv B2«Niacin, e6,
Carbohydrates,
Proteins
, Niacin,
Carbohydrates,
Proteins
A, D, B2, S6 >
SUGAR
OR
JAGGERY
GREEN LEAFY
vegetables
OIL
VEGETABLES
S. FRUITS
Calcium
Carbohydrates
Carotene, 02, Bg»
50
Iron, Calcium
Fat
11
99
(essential fatty acids)
Recommended if
economically feasible
Total value
1000
33-8
1 Katori Rice s 2 Chapatis
'
1 Chapati s 1/2 Katori Rice s 1 Banana s 2 Small slices of bread
1 Katori = 200 ml
Requirements of one year old child : Colories 1000; Proteins 17 g
Chart 1-5 Source: The feeding and care of infants and young children
: Shanthi Ghosh - VHAI.
Nutrition/19
ROAD TO HEALTH CHART (INFANTS WEIGHT RECORD)
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Nutrition/20
» •
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A
[THE CHILD MUST SURVIVE^
I
NATION
IMMUNIS
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A
- zZ-.-::UX A
HEALTH AWARENESS BOOKLET - 13
BHARAT CYAN VIGYAN SAMITHI
West Block - 2, Wing-6
R.K. Puram, Sector-1
New Delhi-110 066
I
i
t ■ r
S
,» t H
A ok
■‘--5
....... )e-> I
iI
Bookie* cototype
for
Lok Samork Andolan on Health
&
for Neolinrate Publications
These fc
are largei? ' '-.en from the book "Facts for Life" published
jointly b; .MICEF, UNESCO, 3< V/HO in partnership with over 100 of the
world's leading medical and children's organisations.
Pix, Desie" M. Basheer Ahmed
Printed a Oomputext, Pondicherry.
Publishes :y: Bharat Gyan Vigyan Samithi
West Block - 2, Wing - 6
R.K. Puram. Sector - 1
New Delhi - 110 066
hie CHILL'MUST SURVIVE
Book 11-Iimnunisation '
F<) re word
'•Vc know she pain
"f giving birth to children;
We know the anxiety
liter a sick child
'Athe agon v
< *t ‘I i Idl’d |o5(
kir' ’<’'natty children arc stck today
' ■-•'•'•’"Mny children are dvinu
........ —.............. ..
’'■''n.CAsnau:vOTs,0ST0FTHCS1;Di;A.rHs/
•<\ Just 4 Measures:
^rpn>pcrc,,i .. ral,y„reKtl^........
7J"”nunizauon.
) Preventing diarrhoea a
IRi Pr<1Per ir-.-itinent of (Jiairliwi.
• 9 Prevention and prop.
of acute respiratory ilin;cli(1IL
I’iiis book is about
I
■‘Innnunisation”
Lo<'k. oh look
the health worker has come.
But why has she come?
My children are healthy and
none of us is sick!
fills this house.
'd
rAT
[LcX
!,. Ram Uularts house last numtlt a child ^as lost
- it was only a scratch
unable to eat
She had
A lot of fits and soon
the child was gone.
Now instead of her laughter
the house is filled
with her mother's despair!
2
< ;'i why Jo ycnj come
V-. :th such e‘. !l thoughts and
tr,ghttT.ing winds;
■ ’o quickly. I must hurry
S'} my pnr.ers quickly
.'mJ u’e in iniukt
*■
‘v .'ud i . f hie evil.
listen to me
eo evil,
true.
• / «-i.e^est is also an amulet,
7/ a much better one
o> S . -/» \'our child well.
ImacMinds of children today
■!l ’ f'" » 'atnecessarily like
< ' 'ti’.d 0/Kam Dulari.
ti ■ niy they would listen
10 these Jew words of mine.
•I3 !
,.,/■■
...
\.
.r.
xX
\ ’
"•JA\
.V
,• ..V
>-\* ; 7<,'z <'-'
%
f" rtx<
>1
r.M:? 'Z>x
1 |l ? ■ ‘' ',
'.1 .- V
:t
•T;:--4'!
!i
i
\/y mesxut’e is .si/npie.
I: Kirill lake .m inju^inni
thill w ill prc\ uni i uhe i’ci i lot is
i Im i discasc o[ cou^h and fever
h bdch kills so many.
When die iiye o/your < hi Id
/v 2 mi nulls and 3 ui< nulls and 4 nu nulls,
ensure dial your child ^eis an injection
and a drop of medicine in the mouih.
(
L4J
The
prevents telum^
’
tkit wan the cause o]Ram L'alari's ^.h;c;-s
</ disease caused by germs
:
K>-r^s in dirty cuts and w.-mnds
md kills.
I
i
I
1
IS.®
-
)
\
i
1
h'i^tion also p^ents
y^ncott^anddipht.^"'^^onatimckUhd
' 'in is now gone
.
Thunks to this injection.
i
f
\■ I
ov' ,
/<£>< ■'...
i-
s
‘r
4
The drop in the mouth
is very much essential
to prevent children from becoming
paralysed and deformed
by the dreaded disease polio.
.0
l'''
l1 ^
/1
At 9 months give another injection
to protect the child against
measles, the silent killer.
fe r
6
’•' ■Bit ;.ru say seems good.'
Ivji should I not wait longer
t my child to grow bigger
and prthaps you could give one
inircfion instead of three.
(1
7/( H
I
'
A a. No.. No.. Never
Before one year ire must
^ive all the injections.
I] we begin by 6 weeks itself
so much the better.
■s
02^
I
I
iVor can one injection do or even two.
Three injections and 5 drops
wiih 4 weeks gap between each
are beyond doubt a must!
If ihoc dread diseases
at all cost we must prevent
Of course ij there is a child
not immunized by one year
Better late than never
there is still lime
But how much belter
to avoid the risks
and gt\ e the doses
■ ell in time.
a
i«
*
H
Hih not now. rot now
My child has acoid and a link k-A r
'J’.'.ivards u hen it is better
w- can consider giving the immunisations
Beiler not mother to wait
Beiler to give, it is quite safe
There may be some crying
Occasionally a fever and even a rash
Bm just continue to give food and liquids
And soon the child will be
Playing and eating just as before.
□
• u
I
A s'i '.hanks be ‘.n ■- ■ 'U
•. b,:> ec fr-e'l ’l-'USe to use
: < ei’.'iite '.h it the laughter and joy
cf i h ippy b-'iise is not h st
r u'd y>>'.i toll me
s -ne more ab-.'Ut ail this.
J
At
6 II
/• o O0«
io
o < ./
I* 0 c 1,
Thc^e injections Lind drops
,\re ‘. died i/nninnisdiion.
.;,h ..nlyj'or children
Even pregnant mothers need them
To prevent tetanus
w:oman needs three doses,
If already immunized two will do
with a gap r>[atleast
lour weeks between the two doses
die last dose being at least
two h ecks before delivery.
i
^-1
21
And yet another piece
<>f advice to note
Especially nowadays.
Whenever you are given an injection
for immunisation or for anything else
Ensure that the needles are sterile,
that means boiled or opened out fresh.
For each patient, a separate one.
■
■ n
ii
;; . iu'A Qllvit i'/ns
’i
ii
i
/
i
[//er
a. When is nnnr-HUS ••;<■!!
//
/
\
\
tuberculous given?
„ How vnn we ptevunt polio? How many times do we need to gwe
e.We^edueeiniectionsar^, 3rd and 4111 months.
What lln-v diseases do these injections prevent.
,ilc Vh,!,| is n .ninths old. what immunisation is given.'
d. Win n
is io be given lor a pregnant mother?
c. What injection
1’. What side i lluuH
,n the injection have? How do we manage it?
g. What precaution must
i
1
i
l
l
!
we ensure when the injections are given?
ihe di ’ps
u
THE CHILD MUST SURVIVE
DIARRHOEA
*
1.
)h
HEALTH AWARENESS BOOKLET - 14
*
BHARAT GYAN VIGYAN SAMITHI
West Block - 2, Wing-6
R.K. Puram, Sector-1
New Delhi-110 066
■j
u
Booklet prototype
for
Lok Sampark Andolan on Health
&
for Neoliterafe Publications
these facts are largely taken from the-book "Facts for Life" published
world" i7 ^ICEF-UNESCO-&WHO in Partnership with over 100 of the
world s leading medical and children's organisations.
Pix, Design: M. Basheer Ahmed
Printed at Compufext, Pondicherry.
Published by: Bharat Gyan Vigyan Samithi
West Block - 2, Wing - 6
R.K. Puram, Sector - 1
New Delhi - 110 066
u
ti-ie ci-uld must survive
Book III - Diarrhoea
Foreword
We know the pain
ot giving birth to children
We know the anxiety
of looking after a sick child
We know the agony
of a child lost
Far too many children are sick today
■ Far too many children are dying
If only these children survive, less children need be borne.
BUT WE CAN PREVENT MOST OF THESE DEATHS
By Just 4 measures.
i a) Ensuring proper child nutrition especially breastfeeding
: b) Immunization
■ c) Preventing diarrhoea and its proper management
d) Prevention and proper management of acute respiratoiy inf
This book is about
DIARRHOEA
iz-%i
. ... .........
DIARRHOEA 1
■
...
: :.i :
. ....... -
‘ '
.
•.■■■■■ ’..
.
u
PLAY
A Discussion with a Doctor
Scene: A group of neo-Uterates sitting. A doctor talking to them.
Kainala. Doctor, my child gets diarrhoea very often. My neighbour’s child died
of it. I am worried. What must I do?
Raman : Perhaps someone has cast the evil eye on it.
Naresh . What nonsense, there is no such thing. May be it has new teeth emerging.
Kainala : My mother says it’s the local bad ‘spirit’. We must quickly go to the
priest and tie a sacred amulet around its anus.
Shanthi: But ask the doctor here! Doctor, is not diarrhoea due to eating too much
sweets or new teeth emerging? Or perhaps it is the heat. Every summer we get
diarrhoea.
DIARRHOEA 2
Doctor: Well, it is not spirits or evil
eyes that cause diarrhoea. Nor is it
due to heat.
It is a number of tiny organisms that
exist in the water we drink or food we
■ eat. These organisms cause diarrhoea.
There are many such micro-or
ganisms in the food we eat and in the
water we drink and indeed all around
us. Indeed they are too small to be
seen. Except with a microscope. Most of them are not harmful.
However a person with diarrhoea passes watery stools that have many many such
organisms. Now, if these stools with these genus get into our food or water-then,
• and then only do we get diarrhoea.
Food left overnight or not properly cooked may also have tiny organisms that cause
diarrhoea!
ill©
Bi ■
iiffi
DIARRHOEAS
u
s
:
iiJ
1 .
Jtf
w
yii
:'N
. .........
Kamala: But how can infected stools get into our drinking water? It’s quite
impossible.
Doctor: Not impossible. Even a tiny bit carried by a fly or even in your dirty nails
is enough.
And it can pass for some distance, say 25 feet through the ground, thereby entering
even well water!
Unless we ensure that all our faeces is safely disposed in latrines or buried, that
our drinking water is safe, and that our hands are clean and our sorroundings are
clean, we cannot prevent diarrhoea.
I
DIARRHOEA 4
u
Naresh: But does it not have anything to do with teething?
Doctor. Well, when new teeth emerges for a child, it has a deep urge to bite objects.
So it picks up all manner of din and puts it in its mouth. If we provide clean objects,
e.g. wooden toys for it to bite and keep clean the places where the baby would
crawl then it will not get diarrhoea.
Dating too much sweets does not cause diarrhoea or worms!
Shanthi: But why did the neighbour’s child die?
: Doctor: I do not know, because I did not see the case. However usually such
children die for only one reason - dehydration i.e lack of water. Had some water
to drink been given, the child would not have been lost.
DIARRHOEAS
u
Shanthi: Water? How doctor? Already the child is passing water. Will not giving
more water worsen it? Indeed their grandmother advised them to stop giving
water!
Doctor: That is a mistake. A serious mistake. A fatal mistake.
You know that on a hot day a plant loses a lot of water. But that is why you have
to water it, otherwise it will wilt.
A child with diarrhoea is losing all its body water. This body water needs to be
replaced urgently. If not the child will die. The water it loses is from the last part
of its gut. The water the child drinks is absorbed from the gut at its first part itself
and it goes to replace body water. If the child does not drink water it would soon
wilt and die.
Ik
L,
4
4;:
•i:
DIARRHOEA 6
■ 1
■ • III
Il II Naresh: How much water to give? And how is it to be given?
-. •
' ' 3 Doctor: Water alone is better than no fluids at all. However the child loses various
.
J salts also and therefore it is best to give special drinks or solutions.
< What can be given?
a) The best thing is to give ORS solution. In all our pharmacies and health centres
small packets of “ORS” are available. Take a packet and mix it with a litre of clean
water. Stir it and give it to drink.
Do not add ORS to other liquids like milk or soup. Only to water.
Make sure you taste it. It must not be too salty or sweet. That means there is too
little water and that is bad for the child.
DIARRHOEA?
X’X<<%<<%<<<<<<<<<<<<•:
I
b) If ORS is not available or one cannot buy it, here is an alternative.
In one glass of clean water, (about 200 ml.) add a scoop (four fingers full) of sugar
and a pinch (taken with three fingers) of salt. Stir well. Remember to clean your
hands first with soap and water. A drop or two of lemon may make it more tasty.
But lemon is not a must.
Stir well and give.
One can also remember- 8 level teaspoons of sugar and 1 level teaspoon of salt in
one litre of water.
I
One pinch of sail
One glass
(200 cc)
It
i
DIARRHOEAS
•y
One scoop of sugar
u
■ ••- c) Tender coconut water is also very good but perhaps it is too costly.
Then you can also give
'.-R - Rice water
- Soups
- fresh fruit juice
- weak tea
&
hi
Kamala: But doctor how much to give?
Doctor: Give half a cup of water (for children under two) or about one cup of water
(for older children).
One must give this, every' time the child passes a watery Stool.
Give fluids until the child passes plenty of light coloured urine!
Kamala: But my child often vomits everything out.
Doctor: Try giving fluids as a very small sip at a time. However if severe vomiting
persists or water loss is severe, then take the child to the health worker.
DIARRHOEA 9
u
Shanthi: When must we take the child to the health worker or doctor?
Doctor: If a health worker is available you may go to her first. Or if a doctor is
available nearby, you may go to the doctor.
Shanthi: When must we go for help?
Doctor: If the child has severe vomiting or if she has severe loss of water. We can
recognize this by:
•
•'
- Sunken eyes.
- extreme thirst.
- no tears when the child cries.
- sunken forehead (in child below 1 year).
- dry tongue.
- skin when pinched up remains folded.
- scanty, dark coloured urine.
..
.
•
■■■■■■
fit •
One may also go to the health worker if:
a) child has fever.
b) passes blood in stool.
c) passes excessive watery stools within an hour.
: ... .
•I-
DIARRHOEA 10
This
child has diarrhoea
and
is
seriously
When her skin is
The soft spot on
her head is sunken.
ill
She has not
passed urine for
half a day.
pinched, it stays,
folded for two
seconds.
<
LU
Her tongue is dry.
—
----- > She is drowsy.
O
T
tr
cc
<
Her eyes are
sunken.
She vomits a lot.
This
child is
already
in great
danger
Don’t wait for all these things to happen.
Start treatment early
Take her to the health centre if she does not get
better.
She has been
having watery
stools for two
days.
o
u
Shanthi: But is it not important to give tablets or medicines?
Doctor: Most medicines for diarrhoea are either useless or harmful. The diarrhoea
will usually cure itself in a few days. The real danger is the loss of water. Only
in some special situations will a qualified doctor need to give medicines.
Kamala: But my child has lost a lot of weight. Everytime she has diarrhoea she
doesn’t eat her food.
Doctor: A child with diarrhoea needs food! Even if little appetite is there, persuade
the child to eat small amounts frequently. Try her favorite foods. You can give
well washed mixes of cereals with dal or vegetables with a bit of oil. Also good is
• curd (yoghurt) and fruits (e.g banana, mangoes etc.)
When child is recovering do not forget to give extra meals, for her to pick up
'1 weight.
Most important for children on breastfeeding - continue breastfeeding
i
.i without fail.
*
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: K8
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DIARRHOEA 12
11
... < < <......... • • • •
a ■'
&
Naresh: Why is it that some children in our village have diarrhoea muchi more
frequently than others? Kamala’s child has wasted away with it, while Shanthi s
child is quite healthy and normal.
Doctor: Malnutrition itself is a major cause. Children who are malnourished get
i diarrhoea easier and die easier. Healthy children are less likely to get diarrhoea
or be affected by it.
■
lilii
< X"?
■
■
a
1
..■■a
Children on breastfeeding alone are much less likely to get diarrhoea than children
not on breastfeeding or having breastfeeds and other food. Children on bottle
feeding are much more likely to get diarrhoea. Bottle feeding is one of the most
important causes of diarrhoea.
V- •<
DIARRHOEA 13
k
• u
f
s
Cleanliness is also another major factor that prevents diarrhoea. Using clean water,
preferably boiled, using latrines to dispose faeces or at least bury it, washing hands
with soap or ash and water, before touching food and keeping foods and drinking
water covered, preventing flies and insects from proliferating by safe disposal of
garbage and waste water - all these are essential steps also.
A
Ta
■11
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fi
i5K»«tnv
And yes, immunization, especially for measles also helps prevent diarrhoea.
DIARRHOEA 14
u •
Evaluation and Review Questions:
a) What all factors cause diarrhoea?
b) How can one prevent diarrhoea?
c) Why do children die of diarrhoea?
d)What treatment to give a child with diarrhoea?
e) When must a mother seek medical help for a child with diarrhoea?
f) What must a child with diarrhoea eat?
DIARRHOEA 15
THE CHILD MUST SURVIVE
COUGHS AND COLDS
HEALTH AWARENESS BOOKLET - 15 /.
4
BHARAT CYAN VIGYAN SAMITHI
West Block - 2, Wing-6
R.K. Puram, Sector-1
New Delhi-110 066
'u
Booklet prototype
for
Lok Sampark Andolan on Health
&
'or Neoliterate Publications
These facts are largely taken from the book "Facts for Life" published
jointly by UNICEF, UNESCO, & WHO in partnership with over 100 of the
worla's leading medical and children's organisations.
Fix, Design: M. Basheer Ahmed
Printed at Computext, Pondicherry.
Published by: Bharat Gyan Vigyan Samithi
West Block - 2, Wing - 6
R.K. Puram, Sector -1
New Delhi - 110 066
♦
N ■
i
What is one of the most common health problems of children?
Coughs and colds Of course!
Usually it becomes well on its own.
But sometimes
Sometimes it becomes dangerous!
This is when it becomes pneumonia!
Pneumonia is one of the most common causes of death of children
From this book we will learn
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dy y: :
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■ ...
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a) How to distinguish between an ordinary cough and cold and
a dangerous pneumonia?
b) What to do if your child gets either of these problems?
*
' H
Colds come, they go.
A child with a running nose is no cause for alarm
It will stop by itself.
- All you need to do is to drink plenty of waler, continue to eat
good food and get enough rest.
- If nose is blocked a lot, one may inhale
steam, or put a little warm water into our
hands and sniff it into the nose.
In little children one can suck out the mucus
with a suction bulb or syringe, without a
needle
Wipe a running or stuffy nose. Do not blow it. It can lead to ear
infection if you blow your nose.
I 2
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We do not catch cold by getting cold or wet. However a cold, if
already there, becomes worse by getting wet.
A child does not catch cold by being taken into the open air.
We catch a cold from others who have the infections, when they
cough or sneeze the virus into the air! The virus is a very tiny
organism which we cannot see. But this causes the cold.
1 o pi event colds from spreaing to children, persons with the cold
should avoid going near children.
Sometimes a running nose is due to alien■gy i.e. the body not being
able to tolerate certain substances e.g. house dust or feathers or
pollen of certain flowers etc.
. •'•I
□J
——....
Often colds are accompanied by a little cough. And sometimes
little fever as well!
Coughing is the body's way of cleaning the breathing system and
getting rid of mucus in throat or lungs.
So when a cough produces mucus do not stop the cough with
medicine.
Instead loosen it by drinking water or breathing steam so that it
comes out easier.
Most coughs too go by themselves!
However if a cough lasts for more than a month or it is associated
with fever or loss of appetite and weight then one must see a
doctor at once. It may be tuberculosis.
i:
■
■'
<;;
. ..
.
■
For such colds and coughs, medicines are a waste of money.- Some
of the medicines cause harm also. At best one may use a tablet of
paracetamol for the fever but even this is usually unnecessary.
Just water, food and rest will do.
With frequent colds, children may lose appetite. So special care
is needed to ensure that they eat adequately.
Once they are well they need an extra meal a day to 'catch up'
their lost growth for a week atleast.
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W:
COUGHS AND COLDS'- V: V -
W
■
■
But sometimes this cold and cough become dangerous.
What are the signs of danger?
a) If the child is breathing much more
j rapidly (over 50 times a minute)
I
b) If the lower part of child's chest (the
area between the two halves of the
child's rib cage) goes in as the child
breathes in, instead of expanding out! wards as normal.
c) If the child is unable to drink any
thing.
d) If the cough or cold or fever persists
for more than a week.
e) If the cough brings out thick yellow
sputum or blood.
f) If there is high fever.
If any of these signs are there,seek medical help at once!
It may be a serious lung infection like pneumonia. The child will
be prescribed medicines for this, which must be given to the child
regularly.
“6
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•• .8
.. 1® 4/S I
■
Review/Discussion
1. Medicines are not given to treat coughs and colds. But what
treatment can be given?
2. How does one recognise pneumonia? How can it be prevented?
3. Think a bit about your house, your family and other families in
your village. How many are assured of the above five preventive
measures? What can be done to ensure this?
4. Find out from your health worker and doctor whether common
drugs to treat pneumonia are available. How much do they cost?
And share this book with all parents
Let no more children get pneumonia or die of it.
*
9
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