Swasth hind, Vol. 29, No.5, May 1985.pdf
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swasth
■. i
nino
JUNE 1985
ENVIRONMENT AND HEALTH
In this Issue
swasth
hind
Environment and health
125
International Year of Shelter for the Homeless —1987
126
Big changes in city projections
128
june 1985
Jyaistha-Asadha
Saka
Page No.
Vol.
1907
XXIX
No. 6
Hugh O'Haire
OBJECTIVES
Swasth Hind (Healthy India) is a monthly journal
Published by the Central Health Education Bureau,
Directorate General of Health Services, Ministry of
Health and Family Welfare, Government of India,
New Delhi. Some of its important objectives and aims
are to :
REPORT and interpret the policies, plans, pro
grammes and achievements of the Union Ministry of
Health and Family Welfare.
ACT. as a medium of exchange of information on
health activities of the Central and State Health
Dwindling forests and human survival
K.R. Swadeshi
130
Schistosomiasis
— A human parasitic disease
134
Extending basic services to the Urban poor
138
Asian Governments respond to environment
challenge
140
Environmental education
143
Unprecedented threat posed by drug abuse
145
Asthma . . . What is it?
146
Organizations.
attention on the' major public health
problems in India and to report on the latest trends
in public health.
*
FOCUS
KEEP in touch with health and welfare workers and
agencies in India and abroad.
REPORT on important seminars, conferences,
dis
cussions, etc., on health topics.
Editorial and Business Offices
Central Health Education Bureau
(Directorate General of Health Services)
Your Ear and noise pollution
147
Meningococcal Meningitis is curable
148
Conference on strengthening of State Health
Education Bureaux
150
Making small family a way of life — A
success story
S.C. Jain
151
Medical Officers’ Course on Health Education — participants view
Third
inside
cover
Kotla Marg, New Delhi-110 002.
SUBSCRIPTION RATES
..
Single Copy
Articles on health topics are invited for publication in this
25 Paise
Journal.
Annual
Rs. 3.00
State Health Directorates are requested to send reports of
their activities for publication.
(Postage Free)
The contents of the Journal are freely reproducible.
acknowledgement is requested.
ASSTT. EDITOR
D. N. Issar
- -
The opinions expressed by the contributors are not necessarily
those.of the Government of India.
Sr. SUB-EDITOR
M. S. Dhillon
Due
SWASTH HIND reserves the right to edit ths articles sent
I
for publication.
ON WORLD ENVIRONMENT DAY-5 JUNE
ENVIRONMENT AND HEALTH
XT o nation—rich or poor—can ever afford to neglect environment. The
-*■ price we have to pay for the neglect is virtually undermining the very
growth we strive to attain. In the beginning man was shaped by an environment
which acted as a selecting agent and controlled the evolution of his present fea
tures. Throughout the period man, like other animals, could afford to maintain
a balance with his environment. But then something happened which changed
the face of the world, completely and irreversibly, man developed culture and there
by shattered this equilibrium. From that time on man has been exerting an ever
increasing influence upon his environment. Initially, he simply increased the am
plitude of already existing environmental traumas. Smoke from natural fires or
polluted water from animal carcasses or mineral seeps, for example, was magnified
in proportion to man’s numbers and cultural diversity.
Nature’s assets need to be preserved not only for future benefit of man, not
only on grounds of love and compassion, but because every form of manifestation
has evolved through the ages and has a particular role in the time-space perspective.
The three-way link between basic health, economic growth and the environ
ment is not often recognised.
“Poverty is an environmental disaster”. By this pungent adage, environ
mentalists are drawing attention to another of mankind’s grave problem: an en
vironment sending signal on its dwindling capacity to support the human
population.
But the statement has a third, hidden dimension. When the topsoil starts
to be swept away, or alternate floods and droughts make farming almost impossible,
the ensuing poverty will inevitably bring with it malnutrition. Very soon,
farmers will be sapped of energy to tend their fields as well as they should. The
women will be forced to scour an increasingly barren landscape for fuel and water.
The children’s mental and physical growth will suffer and, as a consequence, will
neither learn easily nor perform a full day’s work. The whole population will
become highly susceptible to diseases.
Poverty-related diseases arc generally easy to prevent, at least in the clinical
sense. Indicative of the state of the environment in the ESCAP region is the
fact that some three million children die each year from simple illnesses like
diphtheria, diarrhoea, whooping cough, measles, polio and tuberculosis. A host
of water-borne diseases, also largely preventable provided that clean water is
accessible, is likewise common. Typhoid and cholera, trachoma and scabies,
schistosomiasis and guinea worm, malaria, hookworm and jaundice all threaten
the region. If only the environment could be improved, many of these diseases,
or at least their severity, would disappear.
A
JUNE 1985
125
INTERNATIONAL YEAR OF SHELTER
FOR THE HOMELESS—1987
The objective of the International Year of Shelter for the Homeless is to
devise and demonstrate the strategies for improvement of shelter and neighbour
hood of the poor and disadvantaged by the year 1987 and to implement all
these programmes to bring forth benefits to the world’s homeless by the
year 2000.
N the last 20 years there has been steady deterio
ration in the shelter conditions of the poor and
disadvantaged sections throughout the world. United
Nations General Assembly felt the urgent need to
attract the attention of the world community to solve
this problem in the developed and developing countries.
Tn a resolution adopted in December 1981, the General
Assembly declared 1987 as International Year of
Shelter for the Homeless (IYSH). Tn some of the
developing countries including India, the problem areas
in providing food and clothing to the citizens have
already been tackled, but the
problem of shelter
remains.
I
The objectives of the International Year of Shelter
for the Homeless is to devise and demostrate the
strategies for improvement of shelter and neighbour
hood of the poor and disadvantaged by the year
1987 and to implement all these programmes to bring
forth benefits to the world's homeless by the year
2000. For achieving these aims a number of steps
have to be taken like consolidating available know
ledge and experience, exchange of ideas and experi
ence and ensuring commitment from people in diffe
rent walks of life to improvement of shelter and
neighbourhood. The time frame has been divided
into three slices the first from now onwards to 1986,
second the year 1987, third from 1988 to 2000.
The approach paper on India’s Seventh Five Year
Plan shows housing as one of the most important
felt needs of India. The number of additional units
required would be at least 17 million during the Plan
126
period and 13.8 million four years thereafter.
In 1981 there was a shortage of 21.1 million houses
all over the country.
Explanation of Terms
‘Shelter' means the provision of shelter on a site
with secured land tenure and facilities like drinking
water, sanitation; etc., at a level affordable by both
Government agencies and members of low income
groups. “The target groups” under IYSH consists of
squatters, slum dwellers, shelterless, and other dis
advantaged sections who are without services like
drinking water, sanitation, health and transportation.
The term “human settlements” will denote the totality
of a human community whether city, town or village
with social, material, organisational, spiritual
and
cultural elements that sustain it.
In the Indian context ‘shelterless’ include the home
less, slum dwellers, squatters, pavement dwellers, house
less rural workers, houseless village artisans
and
other disadvantaged sections who are without basic
facilities like drinking water and sanitation.
Shelter has to be provided in the country thus to
economically weaker sections of the society, houseless
rural workers and artisans and slum dwellers and
squatters who can afford a dwelling unit.
Housing Scenario in India
The provision of house-sites and construction assis
tance has been included in the Minimum Needs
Programme and the revised 20-Poiht Programme
SWASTH HIND
which form the. core of the national plan in India.
Point 9 of the 20-Point Programme aims at allotment
of house-sites to rural families who are without them
and to expand the programme for extending construc
tion assistance to them.
Point 10 of the programme
consists of improving the environment of slums and
implementation of the programmes of house build
ing for economically weaker sections. .
The Sixth Plan placed a high priority on the pro
vision of house-sites and assistance for construction
of houses for rural landless, workers. The number of
eligible families needing housing assistance at the
commencement of the Sixth Five Year Plan
was
estimated around 14.5 million families. It was further
estimated that out of these, 7.7 million landless fami
lies were already allotted house-sites leaving about
6.8 million families to be provided house-sites during
Sixth Plan period. The plan proposed to provide sites to
all the remaining landless families. Out of the fami
lies who were provided house-sites, only about 0.56
million families were given construction assistance
till the time of commencement of the Sixth Plan.
This left about 13.9 million families who needed
housing construction assistance.
During Sixth Plan period (1980-85) the target was
to cover 25 per cent of these eligible families, i.e.,
3.6 million families for construction assistance. The
existing scheme provides for an assistance of Rs. 250
per family for developed plots, approach roads and a
masonry tubewell for each cluster of 30-40 families
in the rural areas and construction assistance amount
ing to Rs. 500 per family. The scheme is based
on participation of beneficiaries and contribution of
labour inputs by them. The outlays during Sixth
Plan amounted .to Rs. 354.00 crores; Rs. 170.00 crores
for the provision of house-sites and about Rs. 184.00
crores for construction assistance. The targets under
the programme are expected to be achieved with
marginal variations. The programme for housing
construction in the country should aim at the con
struction of at least 17 million housing units during
Seventh Plan period and 13.8 million four years
thereafter.
Programme Implementation
No project financing is supposed to be made avai
lable for implementation of 1YSH demonstration pro
jects. The authorities will have to carve out financing
for such projects from existing budgets and plans.
The existing resources of financing shelter programmes
include plan outlays for housing and urban land,
loans from Housing .and Urban Development Corpo
ration (HUDCO), loans from L1C, GIC and commer
cial banks, State level Apex Cooperative Housing
Finance Societies and projects financed by voluntary
organisations.
The concept of a National Focal Point will be a
main part of the implementation programme. This
will be a person or an organisation who is responsi
ble for receiving and distributing information on 1YSH,
JUNE 1985
developing, reviewing and selecting proposed administra
tive projects, interacting and discussing with non-gov
ernmental organisations, stimulating and coordinating
local and national activities^ organising meetings, semi
nars, etc., and reporting periodically on progress and
achievement. In the States/Union Territories, the
Secretary in. charge of Human Settlements is likely
to be designated the Focal Point. An Apex Committee
for the IYSH has already been constituted by the
Ministry of Works and Flousing, Government of India.
This is headed by the Secretary, Works and Housing
and includes the Chairman-cum-Managing Director,
HUDCO; Secretary. National Buildings Organisation;
representatives of the Ministry of Works and Housing
and Finance and commercial banks. Secretary Housing
and Urban Development of Uttar Pradesh, the Special
Secretary Housing. Kerala, and Secretary Planning,
Andhra Pradesh.
•Q
Terms oi reference of the committee include identi
fication of action areas for the Year, drawing plans
and programmes, coordinating activities in the JYSH,
and interacting with state level Apex Committees.
HOUSE-SITES FOR RURAL LANDLESS
Many States have exceeded the target of providing
house-sites to the rural landless workers durin" the
Sixth Five Year Plan, according to a review made
by the Government of India.
A total of about 53 lakh house-sites have been pro
vided to rural families in 18 States during the Plan
period upto February, 1985. The scheme is not in
operation in Manipur, Meghalaya, Nagaland and
Sikkim because the availability of house-sites is not a
problem in these States.
Under item nine of the new 20-Point Programme,
house-sites are provided to rural families who are
without them, and programmes for construction as
sistance expanded.
The States which have exceeded the target of pro
viding house-sites are Andhra Pradesh (14,93,170
house-sites), Uttar Pradesh
(5,55,332), Gujarat
(4,02,814), Karnataka (3,99,138). Rajasthan (3,38,042),
Maharashtra (1,73,873) and Tripura (27,149), against
their plan target of 11.10 lakh; 3.70 lakh; two lakh;
3.50 lakh; 1.90 lakh; 90,000 and 20,000 house-sites
respectively.
In Tamil Nadu also, 13,10,724 house-sites have
been provided to rural landless workers during the
period, which is very near the target of 13.20 lakh
house-sites.
/\
127
BIG CHANGES IN CITY PROJECTIONS
Hugh O’Haire
Some of the world’s largest cities are growing less rapidly than had been
thought. But a few are growing faster, and in any case, by the end of the
century, almost half the world’s population will be living in urban areas.
new data from the latest round of national
censuses, the United Nations has scaled down
its projections for the future populations of some of
the world's largest cities, among them Mexico City,
Shanghai 3nd Tokyo.
sing
U
The reductions in the United Nations projections
are in some cases quite dramatic. Take the largest
cities in China: Beijing and Shanghai. In 1980 the
United Nations estimated the size of Beijing at the
year 2000 as 22.8 million; the revised figure is 10.8
million. Shanghai in the year 2000 shrinks in the
new projections to 13.5 million from the 1980 esti
mate of 25.9.
According to Nancy Chen, who is in charge of
urban and city population projections for the United
Nations Population Division, the reductions may be
dramatic, but they are not surprising: earlier projec
tions for the size of Chinese cities were based on the
1953 census, the only figures available until recently.
Once the results of both the 1964 and 1982 censuses
(which were issued simultaneously) became available,
more accurate estimates became possible. In effect,
the earlier projections were based mostly on specu
lation while the new figures reflect trends actually
experienced by cities up to 1982, said Mrs Chen.
A different case is Mexico City, where projected
population in the year 2000 has been revised down
ward from the 1980 estimate of 27.6 to 26.3 million.
This is a result mainly of the projected long-term
effects of Mexico’s decline in fertility.
Mrs Chen
said rtiat because of the fertility decline, the projec
tions for the total population of Mexico were also
128
revised. According to the 1980 United Nations assess
ment, Mexico would have had 115.7 million inhabi
tants by the year 2000; v the new assessment puts
Mexico’s total population by the end of the century
at 109.2 million.
Up-to-date information based on actual trends also
caused a change in the projections for Jokyo-Yokohama. Data from the 1975 and 1980 Japanese cen
suses, which was not available
when the United
Nations made its urban projections in 1980, now
show that Tokyo/Yokohama grew more slowly re
cently than it did earlier than in the century. The new
projections put the population of Tokyo/Yokohama
by the year 2000 at 17.1 million down from the
1980 assessment of 23.8 million.
Mrs Chen said
that at least part of the decline in projected growth
appears to be the result of a greater than expected
reduction in fertility in Japan.
Not all projected city populations have been revis
ed downward. Using data from the 1981 Indian cen
sus, the United Nations now projects the expected
population of Calcutta in the year 2000 at 16.6 million,
up from 15.9 million estimated in 1980.
More recent data has also revised the projection
for Brazil’s largest city, Sao Paulo, upwards by
2.5 million, from 1980 estimates of 21.5 million to
the new projection of 24.0 million by the end of the
century.
The change in the projected size of major cities
illustrates that projections are only as good as the
information on which they are based,
Mrs Chen
said. To ensure that the published projections are as
SWASTH HIND
accurate as possible, the Population Division con
stantly updates its urban data base. However, timely
and reliable information is not always available for
all countries at the same time. As a result, overall
assessment of growth trends for urban agglomerations
is particularly difficult, Mrs Chen added.
Despite lower projections for some cities, the
trend toward larger cities will probably go on. Urbani
zation is continuing worldwide and United Nations
assessments are that it will continue through 2025.
Tn 1950, 29.4 per cent of the world’s total population
lived in urban areas. This proportion climbed to
39.9 per cent by 1980 and will reach almost 50 per cent
by the end of the century. United Nations projections
show three-fifths of the world’s population living in
urban areas by 2025.
The revised urban projections for the year 2000 are
contained in Estimates and Projections of Urban,
Rural and City Population: the 1982 Assessment to be
published shortly by the United Nations Population
Division.
—People News/Feature
HEALTH CARE AND SLUM IMPROVEMENT
nder the scheme to improve environment of
slums, 18.31 lakh slum dwellers have benefited
upto January, 1985, exceeding the annual target of
18.30 lakh people. The scheme of afforestation is
being pursued vigorously and 251.7 crore trees were
planted during the period against the target of 250.97
crore plants, indicating an achievement of 100.3
per cent of the target for the year.
U
Significant progress has also been made in providing
house-sites to 7.9 lakh rural families, achieving 99
per cent of the target of 7.98 families. The number
of villages which have been provided with safe drink
ing water is 37,567 against the target of 41,530 villages,
representing 90.5 per cent of the target. Under the
Integrated Rural Development Programme (IRDP)
about 27.45 lakh families benefited against the target
of over 30.27 lakh families, accounting for 90.7 per cent
achievement of the programme for 1984-85.
Expansion of Integrated Child Development Schemes
(ICDS), setting up of Primary Health Centres, slum
improvement programmes and tree plantations are
some of the schemes of the 20-Point Programme
which have made significant progress during the
first ten months of the current financial year. Achieve
ment in these fields has been more than 100 per
cent of the annual target, according to a review
made by the Planning Commission.
The information has been compiled from reports
received from 20 States and eight Union Territories.
JUNE 1985
The reports give figures upto December 1984 only
in respect of Nagaland, Tripura and Arunachal
Pradesh.
Two hundred and five Primary Health Centres
have been set up upto January, 1985 against a target
of 192 centres for the whole year. The aim of the
scheme is to augment substantially universal primary
health care facilities, and control of leprosy, tuberculo
sis and blindness.
183 ICDS blocks have been sanctioned during the
period against the annual target of even number with a
view to accelerating programmes of welfare for women
and children and nutrition, programmes for pregnant
women, nursing mothers and children, specially in
tribal, hilly and backward areas.
The performance of other schemes which has been
evaluated as ‘very good’ by the Planning Commission
on the basis of achievement of 70 per cent or more
of the annual target are economic assistance to Sche
duled Caste and Scheduled Tribe families, generation
of employment under the National Rural Employment
Programme (NREP), provision of houses for people
of economically weaker sections and setting up of bio
gas plants.
There has also been considerable improvement in the
establishment of rural health sub-centres, energisation
of pumpsets and construction assistance in rural areas.
The States are making special efforts to achieve targets
129
By increasing the forest acreage,
regulating the composition of species and
age structure of forest plantations, mankind will not only be able to halt,
but also conserve the atmospheric contamination process of carbon-dipxide
and restore oxygen which is alarmingly being exhausted.
DWINDLING FORESTS
AND
HUMAN SURVIVAL
K. R. Swadeshi
T"? nvironmentalists are showing great concern
■*—'on the alarming rate of tree-felling. They warn
that a global catastrophe will ensue if forests disap
pear from our planet.. According to an Indian environ
mentalist, if arbitrary deforestation is allowed to con
tinue, 25,000 species out of the world stocks of 10
million would become extinct every year. According
to wild life report of the Government of India, more
than 1,000 animals and 20,000 flowering plants are
on the verge of extinction.
Regrettably, man has not learnt lessions from the
past history. At one time. Europe was covered with
magnificent forests and the Europeans thought that
these were inexhaustible. Today, more than 95 per cent
of them in Britain, 85 to 90 per cent in Italy, France
and other European countries has been felled. The
United States, which once boasted of over 900
million hectares of forests, has now only 262 million
hectares of forests mass.
Indian forests
The intensification of devastating floods and mud
flows, increase in the frequent droughts in various part
of the world, dry winds and the dissemination of deser
tification process are all due to the dimunition of forest
areas. Today, erosion drift of the soil into the seas
and oceans amounts to about 30 billion tons a year,
which is 10 times more than 20 or 30 years ago.
130
The picture of Indian forest mass is getting dismal
and calls for urgent attention. The large-scale defore
station in recent decades has rendered the sensitive
catchment areas in the Himalayan and other hilly
areas vulnerable to soil erosion.
The paucity
of
forest cover in India is apparent from the fact that
of the 75 million hectares classed as forest lands.
SWASTH HIND
less than half is actually under adequate tree cover
and as much as 20 million hectares of forest land
is estimated to be affected by soil erosion. What is
more alarming is that the forest area is progressively
decreasing. The national forest policy of 1952 des
cribed 33 per cent of India's land mass to remain
under adequate forests which at present stands at
12 per cent only. Further, 13 million hectares are
classed as “permanent pastures”.
But these areas
arc in fact generally without any vegetation on account
of cither overgrazing or irrational encroachments.
At the dawn of the scientific and technological re
volution, particularly in the second half of this century,
many people believed that wood as a source of
primary materials would inevitably dwindle into
insignificance, as the Synthetics Age was on the door
step. However, the consumption of wood all over
the world rose from 1,500 million cubic metres in
1950 to 2,500 in 1970. According to an estimate of
the Food and Agricultural Organisation (FAO), the
lumber consumption will further grow by 75 per cent
over the last decade by the end of this century. The
reason is obvious as no branch of production, even
the most advanced, can do without it.
Global situation
The role of forests on the global level was revealed
only recently as a result of the large-scale tree-felling
in various parts of the world.
According to the
recent UN experts’ estimates, the forest cover of our
planet is shrinking rather fast due to man’s economic
activities. The area of tropical rain forests is decreas
ing by 7.5 million hectares per annum. The jungles
are being destroyed at the colossal rate of about 20
hectares per minute, i.e., 28,800 hectares every day.
If the current rate of tree-felling continues, the tro
pical forests now covering one-tenth of land mass
will completely disappear by the year 2100. Natu
rally, this will bring about calamitous disaster to
mankind, something that a common man can hardly
think of.
JUNE 1985
Today cities and industrial zones are facing
acute shortage of fresh and pure air. Apart
from polluting the atmosphere, industries are
exhausting its most precious component—
Oxygen.
Fresh and pure air
Even today cities and industrial zones are facing
acute shortage of fresh and pure air in many parts
of the world. This problem is becoming ever acute
like the energy crisis, food and shortage of fresh
water. Apart from polluting the atmosphere, indus
tries are exhausting its most precious component—
oxygen. It is estimated that the technosphere is con
suming 15 times more oxygen today than all the
living organisms of the earth taken together. The
atmosphere is losing nine billion cubic metres oxygen
annually and is replacing the same amount with car
bon dioxide. As a result, the concentration of carbon
dioxide has increased by 15 per cent over the last
50 years in the atmosphere. According to some
forecast, the percentage may further double by the
131
Forests not only clean the air from pollutants, but also from pathogenic
microbes. Thus, the ‘green-filler’ belts if grown around the industrial complexes
and densely populated cities, will ensure healthy micro-climate in such areas.
end of this century. Naturally, such an increase will
vital to mankind, the role of forest vegetation is com
inevitably affect many natural processes, living organi
parable to the World Ocean.
sms and the climate of our planet.
mendous amount of solar energy, which they transform
Forests are natural consumers of carbon dioxide.
which goes to build up wood mass. Every cubic metre
of wood is half a ton of assimilated carbon dioxide.
What is more important, the biosphere stands to gain
from the very process of photosynthesis.
By taking
carbon dioxide from the atmosphere, forests replace
the same with much more precious oxygen.
It
is
probably thanks to forests, which work as oxygen fac
tories, that our planet is not yet gasping for air, which
by photosynthesis.
It has been
90
the forests. This alone is an evidence of the importance
of forests in the formation of organic matter on earth.
It has been established that the forests also
play
principal role in energy and mass exchange in the
biosphere. With forest-related organic matter in
vading vast amounts of moisture, the forests produce
their effects on hydrology.
We know that mankind, at least for the time being,
cannot alter the size of the World Ocean, melt
the
Antarctic or Arctic ice, and increase or decrease the
area of forests.
amount of solar energy.
According to scientists, forests can play a vital role
in saving mankind from this impending
calamitous
disaster. Forests are an excellent medicine against the
diseases—born of our industrial age—of the biosphere.
Thus, planting forests in and around industrial belts
will tantamount to fetching an oxygen pillow to
patient in a critical situation.
estimated that
per cent of the phytomass on land is concentrated in
may happen as a result of the mounting consumption
of oxygen by industry and the continuously decreasing
Forests accumulate tre
According to
a
Soviet
scientists, each hectare of woodland helps in purifying
upto 18 cubic metres of air on an average.
Forests
However, it is within
its
power to improve the forestation of its home—earth.
During the last two-and-a-half decades, Soviet ex
perts have already grown forests over more
than 67
million hectares, including 35 million hectares under
conifers.
The suggestions of forest experts are tem
ptingly quite feasible and simple. They advise planta
tions on each free acre of land all over the world.
Such a measure will prove to be the best ecological
antidote against the anthropogenic contamination of
not only clean the air from pollutants, but also from
the atmosphere.
pathogenic microbes. Thus, the “green-filler” belts
if grown around industrial complexes and densely
age, regulating the composition of species and age
populated cities, will ensure healthy micro-climate in
such areas.
Moreover, the favourable effect of forests
are not only on a local or national scale, but also on
Thus, by increasing the forest acre
structure of forest plantations, mankind will not only
be able to halt, but also can reverse the atmospheric
contamination process of carbon-dioxide and restore
oxygen which is alarmingly exhausting.
global level.
According to Soviet experts’ calculations, a hectare
Formation of Organic matter
Recent Soviet observations by land-study satellites
for study of earth have shown that in many parameters
132
of “well-working” forestry annually absorbs
about
6.5 tons of carbon dioxide and releases 3.5 to five tons
of
photosynthetic oxygen—vitally necessary for all
SWASTH HIND
“Our greatest wealth is our people. We must enable individuals and
families to realise their potential to the full. For this we shall stress
programmes on family planning, nutrition, welfare of women and
children, control of diseases, elementary and adult education, sports
and better communication.”
—Prime Minister, Rajiv Gandhi
living oragnisms.
However, absorption largely de
pends on the species of trees. They have found that
poplar plantations absorb seven times more carbon
dioxide than conifers.
Health and forests
At the same time, forests act as an excellent biolo
gical filter. Like a magnet, they posses the property
of attracting the tiny solid particles suspended in the
air—the products of industrial waste. Scientists have
measured the forests’ antinoise and radiation-protec
tion efficacy and their production of health-build
ing negatively charged ions and phytoncides. It turns
out that forests are the best sanitation workers: one
hectare of pine forest helps in settling down 36 tons
dust annually and for beech the figure is even higher—
68 tons.
It is interesting that phytoncides, aromatic
penetrates them like a tumour. The species of
trees differ from one another in their sensibility. Oak,
maple and poplar have the greatest resistance stamina,
whereas pine is the most easily vulnerable and fragile
species. These distinctive characters should be taken
into consideration as Soviet experts do, while planning
plantation around industrial zones.
Some countries have begun creating “forest plan
tations”, which are attracting increasing attention of
experts. This type of forestry is akin to industrial
type farming, and many see this process a real oppor
tunity for expanding lumber output. The FAO ex
perts propose to create international forest planta
tions by pooling the scientific and technical efforts and
financial resources of various countries. Such planta
tions would provide a centralised supply of wood to
The FAO experts believe
substances contained in forest air, kill
pathogenic
germs “on the spot”. The microbes of dysentery are
consumers the world over.
immediately killed by the remote action of poplar
leaves.
climatic potential of the regions where trees grow
the fastest would thus be put to the best advantage.
Experience shows that in favourable conditions, forest
plantations can yield seven times more timber than
natural forests. In India, the fast timber-production
methods are widely employed in Gujarat.
Experts also maintain that forests create zones
of
moisture concentration above them. Sometimes pre
cipitation over them is upto 30 per cent heavier than
over woodless mass. Thus, this precipitation plays a
major role in washing down industrial lust from the
air in the cities. Moreover, they also clean the atmo
sphere of aerosoles and other technogenic substances.
But what is happening to the health of forests?
Ever growing contamination of air is seriously affect
ing their health and vital functions. It first reduces
their productivity and consequently leads to their
elimination.
In fact, forests do not simply help in
that natural forest would thus be saved and the bio-
Our planet is a “cosmic” body and all human beings
are “cosmonauts” on a prolonged flight around the
sun and together with the sun through the boundless
universe. And if cosmonauts aboard a small space
ship cut wires, withdraw screws and drill holes in the
vehicle, they put a calamitous end to themselves. The
present-day technological progress is doing very much
the same by destroying the ecological equilibrium of
the earth.
Therefore, time has come to realise
the
settling down hazardous substances, but also absorb
vital importance of the forests in the life of mankind
them. As a result, about 50 per cent hazardous matter
as a whole.
JUNE 1985
A
133
Schistosomiasis is one of the most widespread of all human parasitic diseases. It
ranks second in terms of socio-economic and public health importance in tropical
and sub-tropical areas, immediately behind malaria. The disease is caused by
people not snails. People contaminate the environment by their insanitary habits.
SCHISTOSOMIASIS
A Human Parasitic Disease
chistosomiasis,
sometimes called bilharziasis, is
one of the most widespread of all human parasitic
diseases. It ranks second in terms of socio-economic
and public health importance in tropical and subtropi
cal areas, immediately behind malaria. In terms of pre
valence, it takes first place among the water-borne di
seases, representing one of the major health risks in the
rural areas of developing countries.
S
Schistosomiasis is now endemic in 74 tropical de
veloping countries. Over 200 million people residing
in rural and agricultural areas are estimated to be in
fected already, while 500-600 million more run the
risk of becoming infected, living as they do amidst
poverty, ignorance and substandard hygiene in poor
housing, and with few, if any, sanitary facilities.
It is mainly a rural, occupational disease, affecting
people engaged in agriculture or fishing; and in many
areas a large proportion of the children are infected
by the age of 14. Increased population movements
help to propagate the infection. Occasionally tourists
also contract schistosomiasis, sometimes with severe
results, including paralysis of the legs.
Although most people in the endemic areas have
light infections with no symptoms, the economic and
health-effects of schistosomiasis cannot be underesti
mated. In the north-east of Brazil, in Egypt, and in
Sudan, the rural inhabitants claim that their ability
to work is severely reduced due to the weakness and
lethargy caused by the disease.
134
Three parasitic worms
The major forms of human schistosomiasis are
caused by three species of flatworms, or blood flukes,
called schistosomes.
Intestinal schistosomiasis caused by the Schisto
soma mansoni worm occurs in 52 countries in Africa,
the Eastern Mediterranean, the Caribbean and South
America. Oriental or Asiatic intestinal schistosomia
sis, caused by the S. japonicuin group of parasites, is
endemic in eight countries in South-East Asia and in
the Western Pacific region. (Another form of intesti
nal schistosomiasis caused by S. intercalation has been
reported from six central African countries).
Urinary schistosomiasis, caused by S. haematobium,
is endemic in 53 countries in Africa and the Eastern
Mediterranean.
Life history of a worm
Eggs excreted from an infected person’s body break
open on reaching water, releasing a tiny parasite (a
miracidium) which swims frantically through the
water by means of the fine hairs (cilia) covering its
body, in search of a freshwater snail in which it can
develop further. The parasite must find a snail “host”
within 8-12 hours, otherwise it perishes.
Once it has penetrated the snail, the parasite divides
many times until thousands of new forms (cercariae)
break out of the snail into the water. This phase of
development takes 4-7 weeks or longer, depending on
SWASTH HIND
the type of parasite. Outside the snail, the cercariae,
which have a long forked tail, can live for 48 hours
at the longest. They must penetrate a person’s skin
within that time in order to continue their growth
cycle.
2. Heavy infections with schistosome parasites,
occurring mainly in children, cause the actual
disease. The eggs laid by the female parasitic
worm—not the worms themselves—damage the
bladder, intestines or other organs.
The saga of the travels of the parasite inside the
human body is fascinating. As the cerea ria penetrates
the skin using secretions from its special glands, its
tail falls off and within 48 hours it has wriggled its
way completely through the skin into the blood ves
sels. Sometimes this process causes itching, but most
people never notice it.
The new approach to control of the disease caused
by schistosomiasis makes use of rapid and efficient
diagnostic techniques to identify infected persons, and
safe, effective oral drugs to treat the infection. A high
proportion of cases are cured: in the rest, the infec
tion (number of worms) is substantially reduced.
Within weeks, the young parasite transforms itself
into a long worm—either a male or a female. The fe
male can produce eggs only when a male worm is
present. In fact, male and female adult worms re
main joined together for life (less than five years on
average, though they can live for up to 40 years); the
more slender female is held permanently in a groove
in the front of the male’s body. Once eggs are pro
duced, the cycle starts again.
In intestinal schistosomiasis, the worms attach
themselves to the walls of the blood vessels lining the
intestines. In urinary schistosomiasis, they live in blood
vessels of the bladder. Only about half of the eggs
leave the body in the faeces (intestinal schistosomia
sis) or in the urine (urinary schistosomiasis); the rest
remain embedded in the body, damaging important
organs.
The worms were discovered in 1851 by a young
German pathologist, Theodor Bilharz, at Kasr El Aini
Hospital in Cairo. Bilharziasis was the older scienti
fic name for the disease.
WHO’s Control Strategy
The World Health Organization’s schistosomiasis
control strategy now aims to reduce the amount of
disease caused by schistosomiasis, rather than halt
ing transmission entirely. This major change of ap
proach is based on two principles:
1. Schistosomiasis is caused by people—not snails.
People contaminate the environment by their
insanitary habits; they acquire the infection
through repeated daily contact with fresh water
during fishing, farming, swimming, bathing,
washing and recreational activities.
june 1985
Diagnosis is simple and inexpensive
Today’s techniques for detecting schistosome eggs
under the microscope are simple and low-cost. For
diagnosis of urinary schistosomiasis, a simple syringe
filtration technique is now recommended, using filter
paper, or polycarbonate or nylon filters, which makes
it possible to estimate the severity of the infection by
counting the number of eggs in each 10 millilitres of
urine filtered. A team of five can examine up to 200
children in an hour and a half.
Researchers using this technique in Ghana, Kenya,
Liberia, Niger, Tanzania and Zambia report that
children with more than 50 S. haematobium parasite
eggs per 10 ml. of urine nearly always have blood in
their sample (haematuria). This sign, evidence of blad
der disease caused by urinary schistosomiasis, can be
used by primary health care workers to identify chil
dren needing treatment. The diagnosis of intestinal
schistosomiasis by counting the eggs in faecal speci
mens has also been simplified. A small amount of
faeces, pressed through a fine nylon or steel screen
to remove large debris, can be quickly examined by
trained microscopists, under a piece of cellophane
soaked in glycerine, or between glass slides.
The hard currency cost of each of these tests is now
US $ 0.01 or less.
Treatment is safe and effective
Three safe, effective drugs are now available for
schistosomiasis and all can be taken by mouth. Pra
ziquantel, oxamniquine and metrifonate are all in
cluded in the WHO Model List of Essential Drugs.
Their discovery has revolutionized treatment of this
disease.
. 135
Praziquantel, effective against all forms of schisto
somiasis, became available thanks to a unique form
of collaboration between the WHO Parasitic Diseases
Programme and the
manufacturer.
thoroughly tested in laboratories
The drug was
collaborating with
the WHO International Agency for Research on Can
cer. No mutagenic
changes
occurred in human or
animal cells, bacteria or yeasts exposed to the drug,
and no cancer developed in
experimental
which received it constantly
throughout their lives.
animals
Over I million people have been treated with prazi
quantel so far.
the earth’s surface is covered with water; only 1.9
per cent of it is fresh water; less than a quarter of
that occurs in the form of ground water, lakes or
swamps. The world’s expanding population is in
creasingly concentrated in places where surface and
ground waler are available.
Agricultural development must accelerate to keep
pace with the expanding food requirements of our
world population of over 4,000 million. Two-thirds of
the world's potentially cultivable land is located in
the developing regions of Africa, Asia and the
Americas.
Oxamniquine is used exclusively to treat intestinal
schistosomiasis in Africa and South America. Metri-
fonate, originally developed as an insecticide, has now
Symptoms of Schistosomiasis
The symptoms of schistosomiasis include rash,
proved to be safe and effective for the treatment of
coughing and chest pains,
urinary schistosomiasis.
fever, blood in the urine, and an enlargement
cramps, diarrhoea,
of the spleen and liver. With reinfections over
Many doctors feared that reinfection would quick
ly eliminate any benefit from
treatment, but their
fears proved groundless. On the contrary, rapid iden
tification of infected people and prompt treatment of
all cases immediately reduce environmental contami
nation with parasite eggs. In most areas, a reduction
a period of years, it can become a very debili
tating and sometimes fatal disease.
A specific
form of bladder cancer occurring in endemic
areas is also linked with long-term schistoso
miasis infection.
in the overall number of cases is maintained for oneand-a-haIf to two years without further intervention.
During this period other measures can be taken, and
patients who remain infected can be re-treated.
In Brazil, over 7 million doses of oxamiquine have
been administered for intestinal schistosomiasis since
1975. Prevalence of the infection has dropped remar
kably in the north-east of the country. More impor
tantly, independent evaluation by Brazilian tropical
The increasing number of water resource projects
vitally needed in developing countries for industrial
and agricultural expansion is a matter of great con
cern to schistosomiasis experts. Water impoundments
of all sizes, including “man-made” lakes and irriga
tion systems, provide the intermediate host of schisto
somiasis—the freshwater snail—with excellent habi
tats, and encourage close and frequent contacts between people and infected water.
medicine specialists has confirmed a reduction in the
rate of liver and spleen enlargement, a symptom often
found in children with heavy infections.
Water, food and schistosomiasis
In many developing countries scliistosomiasis and
fresh water seem inseparable. Some 71 per cent of
136
Disease-free development
Schistosomiasis and other water-borne diseases,
whether introduced by development projects or spread
by them, can also hold up the completion of projects
when the construction workers, or people living near
by, become infected.
SWASTH HIND
With the new advances, however, it is possible to
control schistosomiasis effectively from the moment
a water development project is planned. Diagnosis’
and treatment of the indigenous population in the pro
ject area, of all employees of the development pro
ject and their families, and of potential migrant
populations,
reduce the risk that schistosomiasis
will become a major public health problem.
Health education and water supplies
It is difficult for people for understand that their
own habits can cause disease in themselves, their
children, their relatives or their friends and neigh
bours. With the new strategy of controlling the
amount of disease in the community, the part played
by people in the disease has become all-important.
The strategy depends heavily on health education
activities in school and community, designed to bring
about a change in behavioural patterns.
To control schistosomiasis, it is essential to reduce
people’s contacts with infected water, and to provide
a potable water supply as a public health amenity if
necessary. The allocation of resources for water sup
plies in the endemic areas has traditionally been ruled
by developmental considerations, rather than by
health priorities. (However, in 1983, the budget for
water supply programmes in the north-east of Brazil
was administered for the first time by the Ministry of
Health).
A Healthier Environment
For several decades schistosomiasis control focused
heavily on mass campaigns to eliminate snails through
chemical spraying. Yet although snails are part of the
disease cycle, spraying has several disadvantages, includ
ing its high cost. However, snail control by chemical
or environmental methods still has its place in control
programmes, although more permanent results are ex
pected from health education in future.
Agricultural and other water resource development
schemes are essential to the economies of the endemic
countries. Effective schistosomiasis control calls for
national intersectoral bodies to coordinate all develop
ment activities which may promote or influence the
spread of the disease. The WHO Expert Committee
commended effective national examples of such collabo
ration in Ethiopia, Kenya and the Philippines.
Schistosomiasis has plagued humanity since ancient
times—visible traces of it in China date back 2,000
years, and in Egypt more than 3,000 years. Theodor
Bilharz identified the parasitic worm in Egypt in- 1851,
giving his name to the older scientific name for the
disease, bilharziasis. With the new possibilities open
today, WHO believes that
Snai! control—a supplementary measure
Only one efficient chemical for destroying molluscs
•is in regular use against the snail. As a sole control
measure, molluscicides have many disadvantages: a
mollusciciding programme is a long-term commitment,
a fact not always appreciated: molluscicides are costly
and require hard currency; they require special appa
ratus and trained personnel: and they may have ad
verse effects on non-target fauna and flora. However,
used in combination with drug treatment, mollusci
ciding can be effective in reducing the risk of infec
tions.
Schistosomiasis-hiiKcd bladder cancer
A specific type of bladder cancer occurs in coun
tries where urinary schistosomiasis is endemic, and
there is a clear link between the two.
June 1985
prospects
for success
in
schistosomiasis control are now better than they have
ever been before.
Patients with bladder cancer linked with urinary
schistosomiasis are usually about 40 years old, pre
dominantly farmworkers, in a ratio of five men to one
woman. Cases of bladder cancer without schistoso
miasis, occurring generally in the industrialised coun
tries, are usually industrial workers aged about 65, in
a ratio of two men to one woman.
In some areas of Africa where S. haematobium is
endemic, the incidence of bladder cancer linked with
schistosomiasis is 32 times higher than the incidence
of simple bladder cancer in the United States.
—W. H. O.
137
New Master Plan
of Operation
Integration of Urban
Basic Services
Abdul Ghafoor
EXTENDING BASIC SERVICES TO THE URBAN POOR
Minister of Works & Housing
I he
provision of basic services is essential io the raising
of the quality of life of the people living in urban and
semi-urban areas. During Seventh Five Year Plan, it is pro
posed to spread out the urban infra-structural facilities judici
ously and equitably among the metropolitan cities and medium
and small towns as also in other centres of growing urbani
sation. The creation of infra-structure in small and me
dium towns and new centres would not only make the life
reasonably attractive in these places, this would also help
in slowing down the growth of metropolitan cities by re
taining the population in these areas.
Crowded houses or huts, open
Some of the other schemes for the urban poor laun
ched by the Government of India are:
sewers, uncollected garbage, poor sanitation, flies, stag
1. Housing for the Economically Weaker Sections
nant water and poor lighting are some of its characteris
2. Sites and Services Programme
3. Squatters’ Settlement Upgradation Scheme
A
and insanitation.
tics.
Money is always scarce amongst the urban poor.
As a result, children remain undernourished and under
weight, with their growth stunted from
food.
insufficient
Diarrhoea, gastro-enteritis and respiratory ail
ments are illnesses which many children suffer chroni
cally and succumb to during the first year of life.
The concern for urban poor in the national planning effort
is reflected by the inclusion of the Scheme for Environmental
Improvement of Slums as one of the points in the 20-Point
Programme which forms the charter for the economic de
velopment of the country. The programme in this sector
includes the Scheme for Environmental Improvement of
Urban Slums and Integrated Development of Small
and
Medium Towns. The urban community development pro
gramme with participation of UNICEF is also among the
main schemes in this sector.
The first attempts at tackling the problems related to
slum areas were started in 1956. The emphasis has,
however, shifted from *the policy of slum clearance to
that of environmental improvement of existing slums.
The scheme of Environmental Improvement of Urban
Slums—originally introduced in the Central
Sector in
1972 but subsequently transferred to the State Sector—
provides for certain minimum facilities, like water taps,
The problem of deteriorating standard of life of the
urban poor and lack of basic minimum amenities for them
is a phenomenon in .the developing countries which
is
assuming serious proportionsIn this context its gratify
ing to learn about the keen interest of the UNICEF in the
programme for
improving the lot of the urban
poor.
UNICEF has been actively engaged in the urban develop
ment programme for the benefit of women and children. Dur
ing the Master Plan of Operations (1981-84), UNICEF’s co
operation with India has been extended to cover 40 pro
jects spread over in different cities. This assistance is
extended to urban community development, small and me
dium towns development and low cost sanitation pro
grammes. With a view to enable intensification of the pro
gramme and sharper focus to the problem of the urban
poor, especially women and children, the UNICEF pro
grammes have been merged into a single integrated program
me known as the Programme for Urban Basic Services under
the new Master Plan of Operations
(1985-89). This is
a significant change in the structure of the programme as
also in its focus and in the strategy of operations.
A
138
Secretary, Govt, of India
Ministry of Works & Housing
Government endeavours: a historical perspective
habitat becomes a slum because of its environment
storm-water drains, sewers, community baths-and-latrines, paved roads and street lighting for the urban poor
in slums. The scheme was originally meant to cover
slums in 20 cities, but the scope was later extended:
first, to cover all cities with a population of 3 lakhs and
above and at least one town in each of those States
which do not have any city of this size; and later, to
cover all urban areas in the country.
The scheme is
a part of the Minimum-Needs-Programme and has been
included in the Revised 20-Point Programme.
Prior to the Sixth Plan, about 6-8 million slum dwel
lers were covered under the scheme.
The Sixth Plan
envisaged to cover 10 million slum dwellers during the
Plan period and by December 1984, 8.46 million slum
dwellers had benefited.
SWASTH HIND
4. Integrated Development of Small and Medium
Towns (IDSMT)
5. Urban Community
(UCD)
Development
Programme
The UCD is an excellent example of programmes for
extending basic services to the urban poor, which are
not restricted to housing alone." The success achieved
under this programme, shows that a housing programme
as an integrated part of other welfare-development acti
vity has a much greater chance of success. UCD has
been designed as an effective institutional arrangement
to solicit community participation in the improvement
of the quality of life of the urban poor, with emphasis on
women tnd children. The overall anti-poverty package
that it offers for the urban poor includes the provision
of minimum needs in the areas of health, nutrition, edu
cation, safe drinking water, housing and income-genera
tion training.
The delivery of services to the urban poor is a continu
ing process. An analysis of the various dimensions of
problems faced by the urban poor, suggests that the
cause of slum formation is not industrialisation but urban
poverty. Programmes aimed at poverty alleviation have
been given the necessary priority but poverty eradication
is incomplete without the provision of minimum needs
and levels of satisfaction in the areas of health, nutrition,
education, sanitation and other basic services to the
urban poor. A greater emphasis will be given to the
social and environmental needs of the urban poor under
the Government’s Urban Basic Services strategy during
1985-89.
—UNICEF
JUNE 1985
Ramesh Chandra
the last two decades the growth of urban popu
lation in the developing
countries has shown a lastly
increasing trend. The fast and unregulated urbanisation is
leading to the growth of large slums and squatter settle
ments in urban areas. This phenomenon has created so
cial tensions and inter-regional imbalances and
is also
leading to environmental degradation and deprivation of a
large section of population from basic sendees.
Hence,
’the need for programmes for extending basic minimum
services and infrastructural facilities to the urban poor.
The need for devoting attention to this aspect of deve
lopment has been recognised in the Sixth Plan and the
programme of the Environmental Improvement of Slums
has been included as one of the essential elements of the
20-Point Programme. It has been felt that the programme
would need greater
support and intensification
during
Seventh Plan Period in view of the increasing magnitude
of the problem.
uring
D
It is encouraging . to note that the UNICEF has been
cooperating and assisting in the programme for urban poor.
The programme of Urban Community Development with
UNICEF assistance was started in 1979 in the area of
Municipal Corporation of Hyderabad. The programme was
further extended to other major cities during the period
of the Master Plan of Operations (1981-84) and 40 pro
jects were initiated in different cities in the country. Dur
ing 1985-89, the programme will be extended to a total
of 52 districts.
A significant change proposed for the
operations during Seventh Plan is combining of the three
main UNICEF supported programmes into a single pro
gramme to be known as Urban Basic Services.
This is
in conformity with the concept of viewing the life in ur
ban areas as a whole. The thrust of the programme would
be towards extending the basic services to the urban poor,
particularly the most vulnerable sections e.g. women and
children of the population living in the slum areas. The
programme would cover some of the basic services such as
water, health facilities,- education, nutrition, environmental
sanitation and shelter improvement. In view -of the mag
nitude of the problem this is a colossal task and the need
for evolving cost effective methods is supreme. We have
to evolve solutions which would produce optimal results
by best possible and maximum utilisation of available re
sources.
No programme would succeed without the participa
tion. of beneficiaries.
It is essential to create an abiding
interest and awareness in the community as a whole so
that the system of delivery of basic services succeeds and
is maintained and carried forward on a stable basis. This
would require efforts on the part of local bodies as also
the individuals and voluntary agenciesA
139
ENVIRONMENT IN ASIA
Asian Governments Respond to
Environment Challenge
X/Toderngovernments exercise power in the present
I-*-* often in response to problems that have already
occurred. Yet if they are to have greater chance of
success, they must look 15*20 year ahead to antici
pate major problems that can be acted upon now.
The main thrust of the meeting can be summed up
in the slogan “Development with environmental en
hancement”. What are the strategies needed to ensure
that, as economic development takes place the envi
ronment can be accorded protection?
There are scores of examples. A large power station
can take upto 10 years to plan, design and build so
that a Government should know, a decade in advance.
how much power will be needed, where and for what
main purposes. Or in education, if children not yet of
school age today are to be assured of finding jobs in
future, then decisions must be made now as to what
kind of education they will require so that appropriate
teacher training can begin and courses and facilities
made available by the time these children reach the
secondary school level.
Since population pressure is the root cause of vir
tually all pollution and environmental damage, an
essential preliminary will be to develop a realistic
national time-table for population stabilisation. That
time-table will automatically delineate the size and
scope of the basic environmental problem. It must'
then be discovered how this could be tackled.
As participants in a Ministerial-level Conference on
the Environment in Asia, organised by the United Na
tions Economic and Social Commission for Asia and
the Pacific (ESCAP), are already aware, the environ
ment is one area where future thinking is essential.
Not only is environmental degradation generally a gra
dual process but it also takes time to restore. Improve
ments can only begin after an entirely new dimension
in national awareness, and often in a country’s laws,
has been created.
Most environmentalists agree there is little time.
Only 15 years from now, for example, Asia will, if
development goals arc to be met, have to produce
roughly twice as much food and other needs as at
present from the same, sometimes dwindling, resour
ces. The challenge is how to improve the environment
and, hence, its basic productivity to the point where
it can supply what will be needed.
140
One partial solution could lie, according to ES
CAP’s Environmental Co-ordinating Unit, in trying
to integrate environmental and national accounts.
Thus, if substantive values could be assigned to vari
ous environmental indicators, the general state of the
environment—What in effect would be a country’s
resource capability to support development plans and
goals—would show up in the balance sheet each year.
Exploding asian cities
The recent environmental disaster at Bhopal shock
ed the World. But in less dramatic guises, many a
Bhopal have been happening all the time.
The poisonous gas leak at a Bhopal fertilizer Plant
killed some 2,500 people and seriously maimed thou
sand more. Unfolding so quickly and unexpectedly,
the Bhopal drama caught world-wide attention and
eventual condemnation.
If statistics are available, it can be seen that as
many people, if not more, die or are maimed each
year in any large city through what are considered
ordinary and acceptable events.
SWASTH HIND
Environment around us
— public indifference
Courtesy :
JUNE 1985
PARYAVARAN, October 1984
141
Traffic fatalities, for instance, are in the hundreds
per year in many large Asian cities. Injuries are in the
thousands. Yet, per head of population, they are far
less prevalent in small towns and villages. Polluted
city air from congested traffic and industry can shor
ten life and does cause serious illness. Nervous disor
ders are far more prevalent in cities than in smaller
communities. Most shun dwellers suffer from the
crowded and unsanitary conditions obtaining in their
habitat.
One of the significant medical trends in developing
Asia is the increasing incidence of heretofore ‘‘West
ern” diseases such as heart disease, stroke, and other
stress-related ailments. Their prime cause is now
widely recognised as high pressure city living among
the affluent.
Environmentalists cannot, of course, be held res
ponsible for the prevalent heart disease among weal
thy urbanites. On the other hand, as participants to
a Ministerial level Conference on the Environment in
Asia held from 6-12 February, 1985, have realized,
that there was urgent need for improving the urban
environment, if only because Asia was becoming an
increasingly urban-orienled society.
Organised by the United Nations’ Economic and
Social Commission for Asia and the Pacific (ESCAP),
the Conference was told that by 2000, close to 40 per
cent of the region's population would live in cities.
That the cities themselves, to accommodate both na
tural growth and migration, must grow by 3-4 per
cent per year.
Alarmingly, much of the new population will have
to live in slum and squatter settlements which ESCAP
predicts, will grow twice as fast as the rest of the
cities. In the meantime, the more wealthy sectors of
the population are expected to double urban automo
bile population.
City governments are faced with the problem of
augmenting municipal water supply, sanitation and
electricity services at a fast enough pace to maintain
even present often inadequate services. Twice the
number of cars would require double the number of
roads merely to contain congestion at its current al
ready critical stale.
—U.N. Weekly Newsletter 15 February, 1985
ASIAN JOURNALISTS SET UP FORUM ON ENVIRONMENT
As part of a stepped-up effort to promote environmen
tal awareness, media representatives from nine Asian
countries have agreed to establish a forum aimed at
disseminating extensively information on the environ
ment.
The move to set up the Asian Forum of Environmental
Journalists (AFEJ) by India, China, Malaysia, Bangladesh,
Indonesia, Nepal, Philippines, Sri Lanka and Thailand
followed a suggestion by Minister of State for Information
and Broadcasting, Shri V.N. Gadgil, at a three-day
Regional Mass Media Conference on Environment and
Development, held in New Delhi in February 1985.
At the New Delhi meeting, several recommendations
and suggestions were put forward, among them, the use
of traditional media such as mime, puppetry, street
theatre, etc., which are rooted in the cultures of various
countries and that could be developed as powerful
communication tools for environmental messages. In
142
this regard, ESCAP could play a catalytic role in propa
gating such ideas and programmes at the regional level.
Nation’s ecology ‘imbalanced’
Rampant poverty and the population explosion are the
two greatest “pollutants” which have upset the ecologi
cal balance between man and nature, said Shri V.N.
Gadgil, Minister of State for Information and Broadcast
ing in New Delhi on 18 February, 1985, while inaugurat
ing the ‘Regional Mass Media Conference on Environment
and development’. The Conference was organised by
the Department of Environment, the United Nations
Economic and Social Commission for Asia and Pacific
and the Indian Environmental Society. Delegates from
nine countries attended the Conference.
The Minister said that though the crisis was grave,
an approach in which development was fostered without
destruction could still save the situation. Environmen
tal management calls for an inter-disciplinary approach
and for global co-operaion.
A
SWASTH HIND
ENVIRONMENTAL EDUCATION
R nvironmental Education (EE) has an important
J—7 part to play in general university education as
well as in the training of specialists whose profes
sional activities after graduation are likely to have
an impact
on the environment and its associated
problems, their prevention and solution.
country, but should combine contributions from phy
sics, chemistry, biology, ecology, geography, socio
economic studies, ethics.
education sciences, and
aesthetic education, etc.
In view of this the UNESCO-UNEP International
Environmental Education Programme (1EEP)
will
be giving new emphasis to environmental education
at the university level, particularly in general uni
versity education, over the next few years. The ac
tivities envisaged include a survey as well as studies
of the current situation, regional seminars, ex
perimental projects and training workshops.
This
aspect of the Programme will be conducted in the
light of recommendations and conclusions
of the
Tbilisi Intergovernmental EE Conference of 1977. In
this connection participants at the Conference stress
ed , the importance of EE at the university level and
especially its implementation on the part of univer
sity administrators and teaching staff.
Recommendation 13 specifically states that “the
Conference, considering that environmental
educa
tion in colleges and universities will become in
creasingly different from traditional education
and
will teach students basic knowledge for work in their
future profession, which will benefit their environ
ment, recommends to Member States (Inter alia)”.
To encourage acceptance of the fact that, besides
subject-oriented environmental education, interdis
ciplinary treatment of the basic problems of the initerrelationships between people and their environimcnt is necessary for students in all fields, not only
matural and technical sciences but also social sciences
aand arts, because the relationships between nature,
ttechnology and society mark and determine the deve
lopment of a society:
To develop different teaching aids and text-books
om the theoretical bases of environmental protection
tor all special fields to be written by leading scientists
ass soon as possible:
To develop close co-operation between
different
umiversity institutions (departments, faculties, etc.)
wiith the specific objective of training experts in en
vironmental education:
SSuch co-operation might assume different form in
jinee with the structure of university education in each
jUine 1985
Environmental education should also become a
part of community education
A great deal has been and is being done with re
gard to environmental education at the university
level in a number of countries, both in general uni
versity courses and in course for future specialists.
It is the hope of the International EE Programme
that it can contribute to, and through, the exchange
of ideas and experiences among universities in this
regard and through the activities of training,
re
search regional seminars, studies, etc.,
which the
IEEP envisages.
Courtesy :
Conne June 1984
143
Road Transport Most Exposed to Occupational Risk
D OAD transport is one of the most crucial occupalions in almost all countries because of its key
role in economic life, but it is also one of the most
exposed to occupational risk because of the frequency
and severity of road accidents.
Of every 1,000 persons killed in traffic accidents,
between 15 and 20 are occupants of commercial
vehicles, a report of the International Labour Officer
estimates.
In the United States alone, over 6,500 drivers and
passengers of commercial vehicles were killed in road
accidents in 1982 and nearly 400,000 were injured.
144
According to an American survey, trucking has the
worst record for both frequency and severity of accident
rates, well over the all-industry average.
The proportion of fatal traffic accidents for which
commercial vehicles are responsible varies from 25 per
cent in Denmark, to 9 per cent in Belgium, according
to ILO statistics.
—UN WEEKLY NEWS LETTER
February, 1985
SWASTH HIND
Unprecedented threat
posed by drug abuse
VI1 HE social and economic fabric of most countries is being threatened by illegal drugs to an
unprecedented extent, according to the Annual Report
of the International Narcotics Control Board (INCB).
The dimensions of drug abuse are so enormous
that governments around the world have launched
unparalleled counter-offensives against trafficking. But
at the same time some countries’ toleration of socalled “soft” drugs in efforts to contain “hard” ones
has led to an increase in abuse of both.
Stemming from the Board's review of the global
drug situation during its thirty-sixth session last
autumn, the Report for 1984 paints a picture of drug
abuse spreading rapidly on an international basis.
Health hazards are being aggravated by multiple use
of opiates, cocaine, cannabis and a variety of psycho
tropic substances (man-made drugs), as well as by the
“increasingly perilio.us means” they are taken.
Illegal drug production and trafficking financed by
organized crime is so pervasive that the economies
of entire countries “are disrupted, legal institutions
menaced and the very security of some states threat
ened”.
“Whenever illicit cultivation, production and
trafficking occur”, the Report observes, “abuse among
local populations nearly always ensues. This ac
counts for the spread of drug abuse geographically
beyond the few countries which were once the main
centres of such abuse. The fact is that very few
countries now remain unaffected.”
In Western Europe the number of addicts, even
among the very young, is rising dramatically toge
ther with the number of drug related deaths, expected
to exceed at least 1,500 in 1983. Heroin seizures of
1.6 tons for the year were up by 40 per cent over
1982, while cannabis seizures increased a third to an
all-time high of 112 tons in 1983. Underlining the
growing abuse of cocaine in the region, more than a
ton was confiscated in 1983 compared with less than
a kilo 15 years ago.
Statistics for the first seven months of 1984 showed
some 70 per cent of the heroin seized in Western
Europe and more than half of that in North America
came from the near and Middle East. In addition,
local demand by the more than one million opium
and heroin addicts in Tran and Pakistan alone is
june 1985
estimated to total 500-800 tons of opium annually.
Size and frequency of seizures from the region con
tinue to increase, with interceptions now being made
in transit countries previously unaffected.
Despite this trend, INCB points out the incongruity
that, with the exception of Pakistan, no other coun
try in the region has reported any significant illegal
opium-poppy farming. While three and a half tons
of heroin, more than a ton of morphine and 35 tons of
opium were seized in its eastern border provinces,
Iranian authorities, for example, state that no opium
cultivation exists in the country. The Board has
therefore urged countries concerned to “accord high
priority to assessing realistically the situation con
cerning illegal supply.”
India is also identified as fast becoming a major
transit country for opiates and cannabis destined for
other parts of the world, with New Delhi and Bom
bay the most important exit points.
Drug experts call for prompt action
Combating the health problems arising from spi
ralling cocaine abuse must receive the “highest pri
ority”, according to drug experts who met at the
World Health Organization (WHO) on 8 February,
1985.
Cocaine abuse has reached “epidemic levels” in
North and South America and is rapidly spreading
in parts of Europe and South-East Asia, the experts
noted. The smoking of coca paste by urban youth
in coca-producing countries of Latin America has
also emerged as a serious and widespread pheno
menon.
Calling cocaine “the most dependence-producing
drug available”, the members of the drug consulta
tion agreed that its abuse now constitutes a major
public health concern. The consultation group urged
WHO to develop a strategy and action plan to treat
the health problems arising from cocaine abuse, and
to prevent further abuse of the drug around the world.
The
increasing abuse of volatile solvents—the
sniffing or inhaling of paints and glues—particularly
by children between the ages of 8 and 14, was also
highlighted by the drug experts as a priority area for
action. WHO will convene an advisory group to
discuss the adverse health consequences of abuse
of volatile solvents this year.
—W.H.O.
145
Asthma
asthma sufferer can tell you the symptoms:
difficulty in breathing, a tight, uncomfortable feel
ing in the chest, shortness of breath, cough and wheez
ing. (Wheezing describes the highpitched . whistling
sound sometimes heard during breathing).
A
ny
It is often obvious that a person has asthma, how
ever, as symptoms of asthma occur with other diseases
of the lung or heart, you need to be examined by a
doctor. Simple breathing tests are also often done to
make a definite diagnosis of asthma.
If you have asthma, your bronchial tubes (or airways)
are different from normal. They are “twitchy” and
sensitive. They over-react to many things: exercise,
viral infections and temperature changes. The way
What is it?
they over-react is by narrowing and this is what produ
ces the symptoms of asthma.
In asthma, three things can narrow the bronchial
tubes:
•
Bronchial muscle tightening (or bronchospasm).
•
Swelling of the tissue which line the inside of the
bronchial tubes.
•
Mucus (or phlegm) sitting in the airways, block
ing them. Probably the most important cause of
bronchial tube narrowing is bronchial muscle
spasm. Bronchospasm can come on quickly and be
relieved quickly with medication. On the other
hand, tissue swelling and mucus develop more
slowly and once present, they slow down the reco
very from an attack.
Courtesy : HEALTH
Spring l984New Zealand
How do we breathe?
As we breathe in, air passes
through the mouth and nose, down
the windpipe and into the bronchial
tubes. The windpipe and bronchial
tubes (sometimes called the
airways) look a bit like the trunk
and branches of a tree. At the end
of the smallest branches lung
tissue is made up of millions of
tiny air sacs which look like a
sponge. It is through the sponge
like air sacs that oxygen enters the
bloodstream.
146
SWASTH HIND
Your Ear and Noise Pollution
F course, people don’t always
realise when they need hearing
projection. But if the noise is so
loud that you have to shout to be
understood by someone standing
less than a metre away, then you’re
in trouble.
O
The ear is a very delicate and
complex organ. Loud noises can
physically
damage
the sensitive
cells in the ear which enable you
to hear; repeated loud noise will
destroy these cells for ever.
When this happens, you can no
longer hear certain sounds, inclu
ding some of the common speech
sounds such as t,s,p,f.
You find
that speech becomes indistinct and
hard to understand,
thus making
conversation
very difficult and
causing endless
problems in the
family, at work and when you go
out.
Hearing damage
Damage to hearing can happen
very quickly, although of course,
it depends on how loud the noise
is and how much exposure you
have to it.
Regular exposure to
higher level of noise
for longer
time can cause damage unless you
wear hearing protection.
Its worth your while to bother
about hearing conservation:
•
To continue to communicate
with your friends and family
•
To feel less tired and less
irritable at the end of the day
To appreciate
the sounds of
the birds—your
stereo—your
TV—Your children’s voices.
•
Courtesy : HEALTH
Spring 1984, New Zealand
JUNE 1985
147
What everybody should know......
Meningococcal Meningitis is Curable
A Teningitis is an inflammation of membranes of
the brain and spinal cord. Epidemics of disease
are commonly due to “meningococcal meningitis”.
The disease occurs throughout the year but increases
during the period from December to April every year.
It usually affects the children and young adults more
though all age groups are liable to get it.
ther with other supportive medicine as per doctor’s
advice. The patient should not take the treatment by
himself but consult doctor in the nearest hospital/heal
th clinic without any delay because after onset of the
disease, it affects the brain quickly. Any delay may
be fatal.
Prevention and control measures
Causation
The disease is caused by tiny germs. It is known as
“meningococcus”. It is the primary cause of the men
ingitis prevalent during the epidemics.
Mode of spread
Human-being is the only source and reservoir of in
fection. The disease normally spreads from a patient
or carrier by direct contact or by droplet from dis
charges of nose and throat. It is transmitted more
often by a person who carries the germs, than by a
patient.
Incubation period
The incubation period of the disease is very short.
It varies from 3 to 4 days. In some cases it ranges
from 2 to 7 days.
Signs and symptoms
The onset of the disease is marked by sudden high
fever, intense headache, nausea, often vomiting and
stiffness of the neck. Sometimes tiny pink rash also
appears on the body. If not treated in time, the patient
may show signs of fall of blood pressure, shock and
often coma, which may result in death.
Treatment
The disease is fully curable, if promptly treated.
Antibiotics including penicillin are administerd toge
148
•
Over-crowding leads to the spread of the disease
and it should be avoided.
•
Proper ventilation of the living and sleeping rooms
should be maintained.
• The patient should be isolated and contact
with the discharges from nose and throat of the
patient should be avoided by covering the mouth
and nose either by the attendant or of the patient.
•
If there is any suspected case of meaningitis, local
health authorities should be immediately informed
and proper treatment taken.
•
Contacts of case can be protected by prophy
lactic administration of sulphadazine.
•
Seek the advice of medical officer.
Remember
if treated prompt
•
Meningitis is totally curable,
ly.
®
Consult nearest hospital/health centre in case of
high fever with headache.
•
Delay in treatment may turn fatal and must be
avoided in such cases.
•
Your health is in your hand. Follow these instruc
tions and take proper treatment immediately as
per doctor’s advice.
A
SWASTH HIND
Steps against Meningitis in Delhi
There are no specific or ascertainable reasons for
the spread of the disease during the year. The inci
dence pattern over the years has been irregular with
out following any particular mode.
The following measures have been undertaken to
check the spread of the disease.
(i) Constant surveillance is being maintained, es
pecially in the affected and congested localities.
(ii) Early diagnosis and treatment, even on the
basis of presumptive clinical diagnosis, is being
undertaken.
for early diagnosis and treatment the services
of AIR and Doordarshan, and also of the Press,
are utilised.
(v) The Indian Medical Association have initiated
action to issue instructions to their members
regarding proper management of cases.
(vi) The WHO, at our behest, has airlifted Sera for
proper typing of the causative organisms.
(vii) The Indian Council of Medical Research has
initiated studies on carriers and their manage
ment in order to provide information on the
epidemiology of the disease for better control.
(viii) It has been decided to vaccinate the identified
high-risk groups.
(iii) Arrangements for adequate supply of drugs re
quired to combat the disease have been made.
All the hospitals and dispensaries have stocked
sufficient quantities of the required antibiotics
and supportive drugs.
No forecast regarding the spread of the disease to
adjoining states has been madd. However, as a precau
tionary measure the State Health Directorates have
been alerted and the situation is being monitored.
(iv) In order to create a general awareness amongst
the public and to impress upon them the need
(Information, given by Smt. Mohsina Kidwai’
Minister for Health and Family Welfare in
Lok Sabha on 13 March, 1985.)
I
Keep a gap of three years
between two children
'I
?!
149
june 1985
CONFERENCE ON STRENGTHENING OF
STATE HEALTH EDUCATION BUREAUX
Union Health and Family Welfare Minister,
Shrimati Mohsina Kidwai inaugurated a two-day
Conference on “Strengthening of State Health Educa
tion Bureaux” organised by the Central Health Educa
tion Bureau on 4 March 1985, in New Delhi.
he
T
Shrimati Kidwai highlighted the importance of tak
ing the health education activities to the people at
the grassroot level in every nook and corner of the
country so that the community itself was able to look
after its health needs. She added that the life style of
the people and their health status could be achieved
only when health and media agencies at various le
vels are mobilized for health education purposes. In this
connection she also expressed the need for suitable
strengthening of State Health Education Bureaux.
Shrimati Kidwai also stressed the importance of
developing health education models designed appro
priately to real life situation. She stressed that research
in health behaviour should be conducted with a view
to developing effective communication media to secure
people's participation in health programmes.
Shrimati Serla Grewal, Health Secretary, speak
ing on the occasion gave comprehensive details about
various health programmes being undertaken by the
Ministry. . She emphasized the importance of the role
of Health Guides for health education purposes. She
requested the State Governments to have health educa
tion teams at Block/Taiuka levels for providing the
necessary health education/family welfare information
to the people or the community as a whole.
Shrimati Grewal also mentioned about the impor
tance of health education and said that 50 per cent of
the diseases could not be there if masses had become
health-conscious. Secretary, Health and Family Welfare,
stressed on clean environmental conditions and said
many of the diseases like malaria, filaria, etc.,
can be prevented if the standing water around the
150
villages can be filled-up with community efforts. She
added, more information and education to public help
ed in controlling meningitis in the city of .Delhi where
an unusually large number of cases had been reported
this year. Smt. Grewal also mentioned of the important
role that the SHEBs could play in providing informa
tion and education to masses.
Earlier welcoming the Chief Guest and the partici
pants, Dr M. D. Saigal, Additional Director-General
(PH) said that the success of all health programmes in
cluding family welfare, MCH or communicable diseas
es ultimately rested on health education. Clarifying the
point further he added that these objectives could be ac
hieved if we strengthen health education component at
all levels. Explaining about the need and scope of the
Conference, he said that it would provide an opportunity
to identify the strengths and weaknesses of the Bureaux
in respect of health education services, school health
education, production and utilization of media and
training programmes, etc. He added that the Con
ference would suggest ways and means to strengthen
the above activities in the context of available resour
ces and also the strategy for monitoring SHEBs pro
grammes in the country and to improve liaison bet
ween the Central Health Education Bureau and the
Slate Health Education Bureaux.
While extending thanks to the Union Minister and
the Secretary of Health and Family Welfare Dr H. C.
Agarwal, Director CHEB assured that their views and
suggestions will make the basis for deliberations of the
Conference and it would bring out practical re
commendations to strengthen State Health Educa
tion Bureaux for effective health education to masses
through the use of existing media and available resour
ces. Dr Agarwal also thanked other Senior Officers of
the Ministry and the Dte. General of Health Services,
representatives of WHO, UNICEF, Media Wing of the
Ministry of Information & Broadcasting, Planning
Commission, participants from States/U.Ts. and other
distinguished invitees and officers of CHEB.
•
SWASTH HIND
ON FAMILY PLANNING
Making Small Family a Way of Life
a success story
S.C. Jain
eventy year old Javitri Devi of Nangla Ganga. a
S
village in Panchayat Samittee Kumher of District
Bharatpur in Rajasthan was not favourably disposed to
the concept of small family. She used to shower abu
ses on the medical teams visiting her village for fa
mily planning. Now this has become a thing of the
past. Javitri Devi has turned out to be a strong
supporter of small family norm. She has not only
got her two daughters-in-law protected against con
ception, she also feels pleasure in educating eligible
couples in and around her village about the advan
tages of small family. She radiates visible joy when
a couple adopts one or the other family planning me
thod.
Shri Maharaj Singh. Sarpanch of village Dhansoti
under Kumher Panchayat Samittee got himself vasectomised along with four of his brothers and set an
example which prompted other residents of the vill
age to accept sterilization or other family planning
measures.
Shri Surendra Singh, another Sarpanch of village
Panchayat Borabai under the same Panchayat Samittee
gives his own incentives in addition to the usual incen
tives being offered by the government. He gives a shawl
and three stainless steel utensils to every couple who
undergoes sterilization.
Smt. Tanko Bai of village Semlifatak, a village in
the tribal region of District Kota, considers steriliza
tion operation for the labour class people most ess
ential. According to her. frequent pregnancies keep
the woman away from work resulting in severe strain
on her health and financial resources of the family.
She is fully convinced that two or three children born
at sufficiently long intervals make it easier for the
woman to give them proper care and also avoid cur
tailment in family income.
JUNE 1985
These are some of the examples from Districts of
Bharatpur and Kota of Rajasthan which reveal that
persuasion and systematic health education coupled
with prompt service delivery can go a long way in
making family planning a way of life with the ordi
nary people.
Bharatpur and Kota districts are among the four
districts of Rajasthan where an intensive programme
of Family Welfare is being carried out under an area
project assisted by UNFFA. Other two districts are
Dholpur and Sawai Madhopur where also similar
programmes are being implemented.
The imaginative and innovative strategy of commu
nity participation has led to the achievement of cent
per cent coverage of eligible couples under Family
Planning in 89 villages of District Bharatpur and Kota
with total 7929 eligible couples in a total population
of 47,835. It is reported that similar coverage has been
achieved in 50 villages of Distt. Sawai Madhopur
where the help of adult literacy centres has been taken
for the propagation of this programme.
Intensive training of communication staff through
job-related field-based courses, orientation for pro
gramme managers in the techniques of communica
tion planning and management, replacement of out
dated equipments and provision of appropriate addi
tional equipments and materials, production of need
based communication soft-ware as per local require
ments, preparation of local action plans through local
activities with the help of local opinion leaders, increas
ing the frequency and improving the quality of inter
personal communication, formation of Family Wel
fare groups among local communities and establishing
their linkages with other development activities and
agencies in the area, organisation of special orienta
tion training camps, active involvement of village
15]
health committees and Mahila Mandate in the pro
gramme, and arrangements for prompt family planning
and follow-up care are the key features of this suc
cessful approach.
One of the significant factors responsible for the suc
cess of the programme has been the formation of Mahila Mandate and village Health Committees which
have been set up in most of the villages. A Mahila
Mandal consists of 10 lady members of the village
with some influential lady of the area as chairperson.
Mahila Mandal meets at least once a month and mem
bers review the achievements and monitor the action
plans. Members keep meeting friends, relatives and
other women in the village and actively participate in
disseminating the message of small family and educat
ing fellow women of the village about the need and
importance of adopting any family planning device
suiting their circumstances. Members of Mahila Man
dal also function as Depot-holders for the distribution
of contraceptives to the women folk of the village.
They are also assigned the responsibilities to ensure
that children in each household are provided immuni
zation services. The awakening of women-folk in these
areas is evident from the fact that meetings of Mahila
Mandate are as a rule well-attended and the partici
pants freely discuss use of contraceptives along with
subjects like female health, child care, advantages of
family limitation, etc. Quite a few members of Mahila
Mandate have composed folk songs on the theme of
small family. These songs are freely sung not only in
meetings but also on the occasions of family and com
munity functions like marriage, birth of the child, Holi
Mela, Rakhi and Teej. etc.
Besides Mahila Mandate, there arc health and family
welfare special committees in every village. These
committees consist of. 10-15 members with the sarpanch or some other influential person of the area, as
chairman. The Health and Family Welfare Committee
is responsible for identifying eligible couples, distribu
tion of contraceptives, preparing village action-plans, re
questing authorities for arranging of service facilities
like MCH, ’immunization and family planning, and
maintaining case cards and registers for programme
planning and monitoring.
Mother and Child Health Care has been found to be
a very effective starting point in group meetings and
individual contacts by family welfare workers. Pre
152
gnant women and children are first covered under
immunization services and the nursing mothers are
told about various measures to protect their babies
from malnutrition and infections. They are educated
about the importance of growth monitoring, timely
immunization, breast-feeding, oral rehydration therapy
and food supplements. This practical concern about
the health of mother and children make women
quite receptive about family planning devices and
facilities.
Last but not the least, commitment and dedication
of field workers to the programme has played a very
potent role in making this innovative approach a suc
cess. Now there is a need to arrange proper follow-up
services in the area. This can be done by arranging
periodic visits of specialists. Such visits are of great
value. Apart from removing the post-sterilization
complications which may arise in a very few cases, the
visits will reassure the acceptors that they are properly
cared for. They also help in curbing the tendency
to link any subsequent health problem with steriliza
tion by giving proper advice and treatment to the pa
tients. There is also need to try this approach in
bigger villages and to make it more systematic Cor
wider replication in other parts of the country. A
GREEN CARD SCHEME FOR
ACCEPTORS OF FAMILY PLANNING
SHRI YOGENDRA MAKWANA, MINISTER OF
STATE FOR HEALTH AND FAMILY WELFARE,
informed the Rajya Sabha on 13 March, 1985, that, “the
scheme relating to issue of green cards envisages that
such cards may be given to the acceptors of terminal
methods of family planning after two children as a mark
of recognition and priority attention in areas where pre
ferential treatment is feasible. The Central Government
had requested all the States to start this scheme. The
scheme is reported to have been introduced in Dadra
& Nagar Haveli. Himachal Pradesh, Chandigarh, Tamil
Nadu, Punjab. Jammu & Kashmir. Delhi, Arunachal
Pradesh, Orissa, Andaman and Nicobar Islands, Guja
rat and Karnataka”.
SWASTH HIND
MEDICAL OFFICERS’ COURSE ON
AUTHORS OF THE MONTH
HEALTH EDUCATION
Hugh O’ Haire
C/o People News/Fcaturcs
18-20 Lower Regent Street
London SWIY 4 PW
England
—Participants view
K. R. Swadeshi
K-ll, Fateh Nagar,
New Delhi-110018
On 20th of December 1984 we reached CHEB, won
dering what we will be taught about health education,
which, frankly admitting, to most of us appeared to be
something to be practised by the paramedical staff. The
doctors, being very busy in their clinical work, would
not find time to impart health education. As the course
proceeded it gradually dawned upon us that to be more
effective as a doctor, one has to impart health education
to the patient, his family and the community.
S. C. Jain
Editor (Hindi)
Ministry of Health and Family Welfare,
5, Kotla Marg,
New Delhi-110002
Hence the course has enabled us to realize the im
portance of imparting health education while provid
ing health care. The didactic sessions, group discus
sions and project work have enabled us to plan and
execute a health education programme in hospital,
clinic and community situations. Health education ac
tivity, which is at present neglected by most of the
physicians, can play a tremendous role in improving
the health of the people.
In our country it will be even more rewarding, where
a large section of the community believes in supersti
tions based prejudices; ignorant of principles of hygi
ene, sanitation and health care. If these can be taken
care of and simple measures like washing bands before
eating, using sanitary latrines, taking a balanced diet
especially by the young children and expecting and nur
sing mothers, etc., prevalence of many diseases can be
brought down significantly.
SANJIV KUMAR
Centre for Community Medicine,
All India Institute of Medical Sciences,
New Delhi-110029
YOUTH POPULATION 922 MILLION
IN 1984
Unless a physician himself realizes the importance of
these simple measures he will not be an effective agent
in bringing about the desired change in the health beha
viour of an individual, family or a community.
A report prepared in connection with this year's - obser
vance of International Youth year States that the major
problems facing the youth of the world have a universal
dimension. In the 1980, those problems concern develop
ment the family, work and culture.
A physician must realize his role as the most effec
tive health educator in the health team and must take
every opportunity to educate his patients and attendants
who come to him for curative care. World over the
health care is becoming more and more community ori
ented with increasing emphasis on prevention. A physi
cian taking a lot of pain and using all available know
ledge and skill to treat a hospitalized severely malnou
rished child, but not educating 'the mother about feeding
the child at home—surely the child will come again and
again with the same problem. He will be saving his
time and precious resources if he teaches the mother
how to feed the child during the process of treatment.
ISSUED BY THE CENTRAL HEALTH EDUCATION BUREAU,
NEW
DELHI-110 002
AND
PRINTED
BY
THE
The report, called for by the Economic and Social Coun
cil, estimates the World Youth population to be 922 mil
lion in 1984, an increase of 79 per cent from 515 million
in I960. It defines a youth as being between 15 and 24
years of age.
The report also states that International- Youth
Year
provides an opportunity for integrating policies and pro
grammes pertaining to youth and for strengthening link
ages among the national, regional and international levels
at which those policies and programmes operate.
It re
commends that governments continue efforts
to develop
integrated Youth policies, and calls for a regional and
global exchange of views and experience that are germane
to young people everywhere.
—UN WEEKLY NEWSLETTER
15 Feb. 1985
(DIRECTORATE GENERAL OF HEALTH SERVICES), KOTLA MARG,
MANAGER,
GOVERNMENT OF INDIA
PRESS,
COIMBATORE-641019.
Regd. No. D(C) 359
Regd. No. R. N. 4504/57
More Shelters for Homeless
in the Seventh Plan
T HE SCHEMES for shelter and
dwelling units for the
homeless in the Seventh Plan
will receive greater attention in view of the action plans for the United Nations International
Year of Shelter for the Homeless (1987). As the task involved is colossal, institutional financing
will have to be strengthened and also new technology adopted for low cost construction.
India may have to seek greater involvement of the international organisations and bilateral
aids for the purpose.
India stands committed to the goal of providing a shelter to all the homeless by the year
A.D. 2000. India is determined to achieve the maximum within its limited resources during the
1987—United Nations International Year of Shelter for the Homeless.
The provision of shelter was a burning problem for the millions of shelterless people living
in the developing countries. The shortage of dwelling units in both urban and rural areas
is colossal. The situation is worsening by unplanned and unregulated urban growth. India’s
present housing shortage was that of 24.7 million housing units—18.8 million in rural areas and
5.9 million in urban areas. The removal of this shortage needs attention of Government agencies,
the public sector and the individual efforts.
A National Focal Point has been identified and a national Apex Body has started func
tioning to devise* and implement shelter programmes for the IYSH action plans. The State Focal
points have also been designated and the process of identification of target groups has started.
The schemes for increasing the provision of shelter and improving the neighbourhoods are being
implemented. These will be extended and outlays increased during the Seventh Five Year Plan.
Some of the programmes already under implementation include providing house sites to
the landless rural families, giving construction assistance, sites and services schemes, improvement
in the environment of slums and squatter settlements and construction of more houses for the
economically weaker sections.
At least 17 million additional houses would be needed during the Seventh Five Year Plan
for the increasing population. Along with that will be needed the growth of infrastructure
for providing basic facilities of electricity, water supply, roads, sewerage and garbage collection.
IYSH-1987 was meant for generating consciousness for the need for taking up a massive
programme for providing shelter to the homeless. A lot of important work has got to be done
before and after the year 1987. A
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