The role of individual in solving the major health problems of Nepal

There is an important role of every individual of family and of society to solve the health problems of his own society. Every individual is the member of the society, and he has to be aware and devoted himself and encouraging to others to keep the clean environment, management of pollution, precaution towards diseases etc. If it happens, most of the health problems can be solved.

The role of individual to solve major health problems are:

• The individual who is the member of a community must have a good habit of personal hygiene.
• The individual must be aware of the existing health problem.
• The individual must be aware of the environmental sanitation and should motivate others to keep the environment health.
• The individual may protect himself/ herself against risks to which he/ she is exposed.
• The individual may set minimum standards of education, hygiene, medical treatment and so on in the interest of the community.
• The individual may motivate and guide the family members and others to set hygienic behavior.

Health problems can be solved through health education

In Nepal, many people die due to communicable diseases, such as dysentery, cholera, typhoid and so on. The people especially in rural areas are not aware on sanitation. they are not provided proper medical care if they suffer from such diseases too. Due to the lack of knowledge in preventive as well as curative measures they fall in  sick and get deaths too. Some religious taboos and beliefs on which doctor also cause the death. Due to unawareness of parents many children get death. In this situation, if we provide health education, they may not die due to such diseases.

Health education brings awareness about sanitation, it teaches healthy habits and importance of proper care and treatment if they fall in sick. People can save themselves from many diseases if they have healthy habit which the health education teaches them.

Similarly, they become aware about the diseases and care properly if they fall in sick. Health education also helps people in this respect. Thus, many of the health problems can be solved through health education.

Infant mortality and maternal mortality affect the community health of Nepal

Infant mortality rate is generally regarded as the most sensitive indicator of health and the level of living of people. The infant mortality rate of Nepal is comparatively higher than the other Asian countries. According to the Central Bureau of Statistics, 1999 the number of death of infants below one year of age is 79 to 100. The major causes of infant mortality are lack of health services and facilities, poverty, early marriage, family size illiteracy, ignorance of child care, poor environmental sanitation etc. Thus, it has been recognized as one of the major health problems of Nepal. The high maternal mortality rate has also been accepted as a major health problem in Nepal. The maternal mortality rate was 75 per thousand up to the beginning of 8th five year plan, and now the figure is changed and it is 43.9 per thousand. However, the rate is still high in comparison to the developed country and some of the south Asian countries. The reasons behind this problem are illiteracy, poverty, lack of health awareness etc.

Methods of solving child and maternal mortality rate problems are:

• Educate illiterate and uneducated women and girls to the highest possible number and extent.
• Provide rural women with skill and trainings so that they will become, able to earn on their own.
• Conduct awareness generating programmers for the illiterate and backward women on maternal health, child spacing and superstition and orthodox practices.
• Provide medical care and treatment by efficient health personal.
• Manage allowance, supplementary food, shelter and clothes to the mothers.
• Pre-natal and post natal care to the newly born children.

High infant mortality rate is one of the major health problems of Nepal

High infant mortality rate is one of the major health problems in Nepal. When it is not sure whether the children born die or live, parents tend to give more births than they want. It causes population growth in one hand and on the other hand both the mother and children may not get proper care, which affects adversely in the health status on both mother and children. They will not be able to provide health services and facilities, nutritious food, quality education in such family. In 1994 the infant mortality rate was 90 per thousand. This rate is dropped to 64 in 2006. This rate is very high as compared to the rate of developed countries. Thus, infant mortality is considered as one major health problem of Nepal.

Prevalence of communicable diseases a major health problem of Nepal

Due to lack of sanitation, safe drinking water, healthy and nutritious food, Nepal is facing a problem of communicable and infectious diseases like diarrhea, dysentery, cholera, typhoid etc. About 45,000 children are dying per year due to diarrhea in Nepal.

Few decades ago, more deaths used to occur due to the famines, smallpox and malaria. Nowadays, these diseases have been eradicated. But the diseases like hepatitis 'B', HIV/ AIDS have appeared now as great problems.

The diseases like leprosy, tuberculosis may be cured easily, but people do not show such diseases even they are infected assuming that they would be hated by the society.

Thus, Nepal has been facing many great health problems of infectious diseases due to ignorance, poor sanitation, illiteracy and social customs.

The importance of community health

The study of community health helps to keep the healthy environment:

1. The prevalence of most communicable diseases are due to the poor sanitation. Most of the people throw their waste product in the open street which will create the problem of poor sanitation. If we study the community health, we analyze the community health problem as methods of controlling them.
2. Healthy manpower can be produced through improvement of community health:
3. If an individual keeps himself healthy, he could contribute to his country otherwise his birth might be useless. Therefore, such types of spirit can be developed through the study of community health.
4. Study the community health encourages people for social services:
5. If communities organize health camps, cleanliness campaign and many different activities. When they are benefited from those activities they are praised community health through their joint effort they will involve in such activities. Establishment of Nepal Red Cross Society, Nepal Paropakar Association, Local Health Clinics and clubs are some of the examples of such effort.
6. The importance of community health
7. The study of community health helps to keep the healthy environment:
8. The prevalence of most communicable diseases are due to the poor sanitation. Most of the people throw their waste product in the open street which will create the problem of poor sanitation. If we study the community health, we analyze the community health problem as methods of controlling them.
9. Healthy manpower can be produced through improvement of community health:
10. If an individual keeps himself healthy, he could contribute to his country otherwise his birth might be useless. Therefore, such types of spirit can be developed through the study of community health.
11. Study the community health encourages people for social services:
12. If communities organize health camps, cleanliness campaign and many different activities. When they are benefited from those activities they are praised community health through their joint effort they will involve in such activities. Establishment of Nepal Red Cross Society, Nepal Paropakar Association, Local Health Clinics and clubs are some of the examples of such effort.

Fundamental and derived units

The units of fundamental quantities can't be expressed in terms of other units i.e. they do not depend upon other units. Hence, they are basic unit or fundamental units. For example kilogram (kg), second (s), meter (m) etc. The units used to measure the derived quantities involve the combination of two or more than two fundamental units. For example, unit of velocity depends upon the unit of distance and time i.e. the unit of velocity (m/s) can be expressed in terms of two fundamental units m and s. So, it is a derived unit. Thus, derived units are those units which can be expressed in terms of two or more than two fundamental units and are used for measuring derived quantities.

Systems Likewise, the unit of force, newton, involves three fundamental units kg, m and s, the unit of pressure, pascal, also involves kg, m and s. of units. Different people use different systems of units to measure different physical quantities. There are only a few system of units which are more scientific and are accepted as the standard system of units. Following are the most popular system of units for scientific purposes, derived on the basis of units used for measuring fundamental quantities.

FPS system
This system is also known as British system of units. In this system, length, mass and time are measured in foot, pound and second respectively.

CGS System
This is a French system of units. In this system, length, mass and time are measured in centimeter, gram and second respectively.

MKS System
This system is also known as metric system of units. In this system, length, mass and time are measured in meter, kilogram and second respectively.

SI System FPS, CGS and MKS systems involve only three quantities (length, mass and time) as fundamental quantities. These three quantities are insufficient to measure some physical quantities in thermodynamics, current electricity and optics. To solve this problem, in 1960 A.D., the 11th general conference of weight and measure was organized which introduced a logical and rationalized system of units called SI system (System International 'd' units). This system is an extended form of MKS system and involves the several fundamental quantities.

Unit

The process of measurement involves a numerical value associated with a standard reference terms. For example, measurement of mass involves kilogram associated with numerical value i.e. 1kg, 5kg, 10kg etc. So, kilogram is the unit of mass. Likewise meter is the unit of length, second is the unit of time, newton is the unit of force, watt is the unit of power etc. Thus, unit is a standard reference quantity of a substance in terms of which a physical quantity can be measured. The unit of a physical quantity is the most convenient amount of that quantity. Different physical quantities have different units for their measurement.

Fundamental Quantities and Derived Quantities

There are certain physical quantities which are independent of other physical quantities. Length, mass, time, temperature, electric current, luminous intensity and amount of substances are the physical quantities which are independent upon other quantities and are the examples of fundamental quantities. All other quantities are dependent upon two or more than two fundamental quantities. For example, velocity is physical quantity which depends upto two fundamental quantities length and time. Similarly, force depends upon mass and acceleration and the acceleration inturn depends upon length and time. Thus, velocity, force, acceleration, work, area, volume, pressure etc are derived quantities.

Physical quantities

Physical phenomenon of the nature can be explained either qualitatively or quantitatively. But only the qualitative explanation is not sufficient and today's advancement of science would not have possible only with qualitative study of natural phenomenon. A quantity is an observation of natural phenomenon that can be expressed quantitatively. "A physical quantity is that which can be measured directly or indirectly." Length, mass, time, speed, force, work, pressure, volume etc are some example of physical quantities. Physical quantities are the physical properties of matter.

The health programmes of as targeted by three years interim plan

To attain the vision, a three-year programme has been formed to enact different objectives. The objectives are enlisted below.

1. To upgrade the level of sub-health posts in accordance with the density and geographical remoteness to health post. To upgrade health institutions to primary health centers wherever there isn't one in an election area.
2. To give priority to all those who are socially, financially downcast; women, indigenous peoples, dalits, Muslim community, senior citizens and physically challenged in providing basic health service free of cost.
3. To make previsions such that the free health services provided by governmental and private hospitals be made available to neighboring districts as well. In addition, the private and teaching institutions to provide free of services to the people of a particular area.
4. To make health services available to citizens in far-western region, Mid-western region and marginalized area by developing the infrastructure and increasing health services manpower.
5. To give continuity to primary health principle and provide immunity, primary, promotional and curative health services. To be emphasize on surgery, sage motherhood, (reproduction, reproductive health, uterine prolapsed etc) and communicable diseases.
6. To make child inoculation and nutrition more effective.
7. To increase the number of gynecologists in the district hospitals.
8. To bring into action health programme in citizen and enact service for citizen health programmes.
9. To make alternative health services like ayurvedic medicine available to the citizens according to their choice. The concerned, districts and health institutions to bring into action national programmes in which all other institutions and the manpower involved to take active participation.
10. To contribute the services to the eye run by non-governmental organizations and add more such programmes for expansion.

Tenth five year plan regarding health programme

The health programmes of Nepal as targeted by tenth five year plan are as follows:

1. To expand accessibility of basic health services.
2. To provide the local authority with a responsibility of running health centers.
3. To expand vaccination program
4. To improve women health through high priority of reproductive health.
5. To control population growth through effective implementation of family planning programme.
6. To develop traditional alternative health service.
7. To coordinate for producing qualities health manpower.
8. To make health institution capable to manage epidemics.
9. To manage safe blood transfusion service.
10. To promote the concept of national health system, national health insurance, health tax etc.

Promotive Health Service

Promotive health services are those measures which intend to bring the improvement in the present health of the people. As an example, maternal-child health care, communicable disease control programme etc.

People of rural areas of Nepal do not have a good access to curative services and preventive services. The promotional health services are the only one way to make people healthy and avoid illness. If promotional method of health service becomes available to people suffering from malnutrition, unsafe motherhood and similar other situation, their life becomes better and healthy and their quality of life also improve. Since preventive and curative health service along are not sufficient for upgrading of public health, public promotional method should be followed.

Communicable disease is major problem in Nepal

Health profit of Nepal is very poor in comparison to other countries of the SAARC. Low life expectancy, infant mortality, child mortality, maternal mortality etc. are some of the indicators of poor health situation of Nepal. All of the above problems have a major reason which is communicable disease. Tuberculosis, diarrhea, dysentery, cholera, worms, acute respiratory diseases and sexually transmitted diseases are some of great health problems in Nepal. Hence, communicable diseases are regarded as major problems in Nepal.

Following are the list of measures to be taken for prevention of communicable diseases:
a) Health education should be provided to increase awareness of diseases.
b) Children should be immunized against all fatal disease like tuberculosis, polio, measles etc.
c) Cleanliness in and outside home and management of latrines, drainage system etc. should be properly done.
d) Children should be breast fed for two years.
e) Reproductive health care, child care and maternal care should be promoted.
f) Nutritious food should be taken by all.
g) Regular health checkup should be done to detect early symptoms of diseases.
h) Personal hygiene, control of insects, cleanliness in drinking water and food should be promoted.

The objectives of Nepal Paropakar Santha

In Kathmandu, thousands of people killed by choleara in 1994 B.S. During that period, Mr. Dayabir Singh Kansakar provides free health services to the infected people with the help of some volunteers. A group of Paropakar volunteers started their work since 2003 B.S. (1946). But the Nepal Paropakar Sanstha was finally established on 10th Aswin 2004 B.S. The central office of this Sanstha has been providing the following objectives or services:
a) This association has established a charitable programme for helping poor or suffering people.
b) It distributes free medicines and provides free health services to poor and orphans through the establishment of primary health depots in different parts of the country.
c) It is also providing ambulance services.

Psychological factors of Birth

1. Parenthood as the feeling of completeness: People consider parenthood as attaining wholeness. After giving birth, couples think their social responsibility is fulfilled. Unless they give a birth even after some years of marriage, family society, neighbor, relatives, etc. look them in suspicious eyes that they might be infertile. Therefore, couples hurriedly give birth thinking the fulfillment of their role and responsibility.
2. Virility: Many people think giving birth as successful manhood or womanhood. Childless couples are hated in our society. They do not have social prestige. Therefore, married couples realize virility and increase of so-called prestige, the faster and the more births take place. It also lures the couples towards more births.
3. Continuity of family name: Existence of family is questionable if the family does not have male (son) heir of family property. At that situation, the family is meaningless without son. People have strong belief that male birth is necessary for the existence and continuity of family name. The family size becomes large due to too many female births with the hope of bearing male child.
4. Feeling of competition: Most of the people live in rural areas and majority of them are illiterate and they do not have the knowledge of quality of life. As a result, they foolishly compete to bear the child with the people in society including their parents. It shows the competition of people to give more births than others.

Biological Factors of Birth

1. Heredity: It is said that heredity affects fecundity and fertility (the daughter many give birth to twins if her mother had given birth to twins) but there is no significant basis of empirical study on it. However, infirmity in reproductive system and STIs adversely affect the fertility.
2. Age: Human being attain fecundity only after specific age. Women cannot conceive and give birth before maturity and after reproductive span. Generally, women attain fecundity after menarche in 14-15 years and they are fecundable till about 49 years. The women in 20-24 and 25-29 years are highly fecundable. The reproductive period is 34 years from 15 to 49 years. The later the marriage takes place, the shorter will be the reproductive span and vice versa. As a result of early marriage, the span remains longer for child-bearing. Thus, the fertility remains high. Male's fecundity remains longer than female.
3. Health: Health is wealth of person. The healthy people have higher fecundity as their proper physical development including reproductive system. Morbid people have less fecundity comparatively healthy ones.
4. Ovulation: There are two ovaries either side of uterus in women. After onset of menstruation, an ovum is released alternatively from both ovaries every month. At the mid-point (14th day) of menstruation cycle (MC), ovulation (releasing a matured ovum from ovary) takes place. The ovum comes to fallopian tube and stays there. If the sexual intercourse takes place during that time, the conception takes place with the penetration of the ovum of female by a sperm of male. Otherwise, the conception does not take place in other time.
5. Lactation: The breast feeding (lactating) mother conceives later because her ovulation is delayed and menstruation takes place later. Lactation also causes the contraction of uterus. It reduces the possibility of conception. The period from child birth to at least 6 months is called lactational amenorrhea period. Therefore, lactation has direct relationship with human fertility.
6. Miscarriage: we cannot say that every fecund woman can give live birth. For this, they should give the birth alive. Due to various causes, some of the pregnancies are terminated prior to the expected date of delivery without viability of life. This is called miscarriage or spontaneous abortion.

Relation between Health and Environment

Earth is our common home. It provides different resources such as air, water, food, soil, minerals, wood etc. Because of the growth of population, these resources are being used faster and faster haphazardly. Destruction of green forests causes landslides, erosion, flood, drought, etc. Urbanization and industrialization  cause air pollution.  Human being are responsible for deforestation and different types of pollution such as air, water, soil, noise etc.

Human beings and environment are closely related. Human beings depends upon environment for their survival because the environment fulfills their basic needs. We get food, air, water, etc. from the environment which are the basic necessities for our life. Fresh, healthy and proper environment has positive effects on our health and increases the longevity whereas the polluted environment has negative effect on our health and we suffer from different diseases. Thus, it is very essential to conserve our environment to promote our health.

Cold Waves

Cold waves occur generally in cold regions. People who live in Himalayan regions are found affected more because they have to walk over snow and the climate  is very cold. Cold  waves may cause shivering and even unconsciousness.

In  order to prevent ourselves  from cold waves, we should wear warm clothes during winter, live indoors when the cold wave is on, keep the room warm with available heater o r fire and take hot drinks during cold season.

First Aid for Cold Waves

• Put the casualty in bed well-covered with warm clothes.
• Apply any means such as fire, heater, etc, to warm up the body.
• If the casualty is conscious, give him/ her hot drinks.
• If necessary, apply resuscitation.
• In extreme cases, take the casualty to the hospital for medical help.

Snake Bite

The effect of snake bite depends upon how poisonous the snake is. Some snakes are non-poisonous, some less poisonous and some are highly poisonous. When a poisonous snake bites, it is very fatal if proper care and treatment is not provided immediately. In order to prevent ourselves from snake bites, we should keep the surroundings of the house clean, clear the grass, bushes etc. from our residential surroundings. We should never walk bare-footed and always carry a torch or light while walking at night.

First Aid for Snake Bite

• Apply tight bandage a little above and if possible a little below the bitten spot.
• Keep the patient calm.
• Clean the bitten part with soap and water.
• Cut open the bitten spot with a sharp knife or razor and allow blood to flow out or suck  blood from that part using a suction cup. Never suck the venom using your mouth.
• Apply resuscitation if needed.
• Watch closely the pulse rate and breathing of the casualty and if he/she is in danger, rush him/her to the hospital at once.

Drowning

Drowning is a common accident where there are rivers, ponds or lakes. We should be very careful while going into the water. We should never go swimming alone. We should not swim when we are  tired. We should always be careful about our children if river or pond is nearby.

First Aid for Drowning

• Pull out anything, if stuck, in the mouth or nose.
• Lie the casualty on his/her chest. Apply pressure from his/her back and make the casualty vomit out water.
• If breathing is difficult, apply resuscitation.
• Cover the victim to conserve the body heat.
• If the victim is unconscious for a longer duration, take him to the hospital as soon as possible.

Electric Shock

Electric shock causes unconsciousness, respiratory paralysis, cardiac disorders, etc. It occurs when we touch the exposed parts in the electric circuit. Therefore, we should be very careful while handling electrical appliances or live electrical wires in our homes. We should never touch the switches, plugs, or any other electrical appliances with wet hands.

First Aid for Electric Shock

• Switch off the electric current at once and then  only remove the victim from the electric contact.
• When the victim is free, check his breath. He may need artificial respiration.
• Cool the affected areas and place a sterile dressing over it.
• Keep the victim warm and comfortable. Hot drinks, fresh air and cheerful atmosphere are very necessary.
• Take the victim to the hospital for medical help.

Sprain

 A sprain is the injury that affects the ligaments which hold the bones together at the joints. This is caused when the ligaments are over stretched or torn. To avoid sprains, we should be careful while playing, running, jumping, walking, etc. We should warm up our body before any strenuous physical exercise.

First Aid for Strain

• Let the casualty rest and support the injured part in the most comfortable position.
• Apply ice pack to reduce the swelling.
• Wrap a crepe or a firm bandage to counteract swelling.
• Check the bleeding.
• Wrist injury may be supported by an arm-sling.
• Elevate the injured limb.
• Take the casualty to the hospital and seek for x-ray diagnosis.

Safety and First Aid

Accidents and injuries occur anywhere at any time. It occurs due to our carelessness, indifference and lack of knowledge. Sometimes the injuries are severe and the victim may die if he is not treated properly in time. Thus, it is very necessary to know what to do in a emergency. Doing the right thing promptly, we may be able to save one's life.

First aid is the treatment given to the casualty for any injury or sudden  illness before  receiving medical help. It is very necessary because it prevents the person from serious injuries and possible loss of life.

Despite all efforts, many accidents happen now and then. In such situation, the knowledge of first aid saves the life of the casualty. The major objectives of the first aider is to save the life of the casualty by adopting artificial respiration, stopping bleeding, rushing him to the nearby hospital or by some other means.

Quality of life differs according to family, place and time

Quality of life is the state of complete satisfaction which can be measured by the accessibility of the basic needs of the family and individuals. But the needs of family differ in different place and time. It shows the standard of living and life style of people.

Quality of life differs according to different families because the needs of different families differ to each other. For example, the needs of a poor family and the needs of a rich family are quite different as the resources to attain the needs are different which is determined by the income level and life style of people.

Similarly, quality of life differs according to different places where people have been living by consuming the available modern facilities and other development. For example, the quality of life of the urban people and the rural people is different because their needs are different and also the resources to fulfill the needs are different which affected by the development of infrastructures. The basic needs of developed zones or countries can be luxurious needs of developing and utility of such resources is also different. Furthermore, quality of life differs according to time or situation, as the need sof people furng different period are different. The ancient people were living a nomadic life and hunting gathering life, their needs were just to get food substance but the modern people do not satisfy only on food substance instead. They desire different modern tools and technologies and other modes of living.  So, the living standard has become different.

Hence we can say that the quality of life differ according to family, place and time period how they are living where they are living and when they are living.

The definition of quality of life is different to country, situation and time

The definition of quality of life is different according to country, situation and time due to following reasons;

• Quality of life is a quite microcosmic phenomenon. There is various interpretation of quality of life.
• Some define the quality of life according to social economic and cultural viewpoint.
• Some define it on the basis of individual priority and philosophy of life.
• The standard of living, of course is very important to one's quality of life. Some basic elements have affected the standard of living. As quality life depends on these elements and the way of receiving satisfaction quality life differs in country to country. Because of these elements are not the same in all situations.

Education enhance the living standard of an individual and family

Along with the development of the modern age, different human needs have been changed. The development of human resource needs for modern facilities health services, quality education, different tools and technologies etc. are the basic requirements of the day. For the accessibility of all the development activities, education plays the prominent role which has made human beings as a being from the other animals.

Education is a key variable among the components of quality of life as an educated person only can grab the different life chances, employment opportunities, different modern facilities etc. similarly, an educated person can manage the family resources properly, planning of family wisely, understand the importance of appropriate age at marriage and conception, adaptation of the means of family planning etc. which are very much helpful to promote ones life style and the quality of life. If any members of a family are educated, the other members of the family are always encouraged to get education and other different life chances. So all the members of the family become of quality of life.

In the same way, the educated and skilled manpower can contribute of the development activities of the society and the nation as well. As a result, all the citizens of the nation can have access to the different development activities and the components of quality of life.

Health helps the individual and family to improve their standard of living

Health is the valuable property of man. Therefore, health is regarded as the important indicator among major elements essential for quality of life. If family members are not physically and mentally healthy, they will not be able to read and write and involve in income generating activity. Health is not merely related with the condition of the body remaining away from diseases; it covers quite a large in term of quality of life. From the point of view health, the following aspects are taken into consideration in order to maintain quality of life

a) Consumption of nutritious and balanced diet.

b) Adequate facility of clean drinking water.

c) Personal and community sanitation and hygiene.

d) Neat, clean and green environment of the surrounding area.

e) Regular health check up and timely treatment.

f) Marriage at appropriate age and first conception and birth spacing.

g) Knowledge of normal exercises and its facility.

h) Acquiring the knowledge on first aid and the provision to enjoy them.

Role of quality of life in the development of social aspect

Every couple should be active to provide their children with an opportunity of quality education by realizing the demand of time so that their future could be bright. Such an investment will have a good result in future which will make children get employment with high salary and make their lives happy and prosperous. In future, they will be able to perform their responsibility to make their family prosperous.

In this way, we have to bring a revolution in social sector for maintaining happy and prosperous life in a family and society as well. Such a change in our society is possible only when we can bring a change in thinking, attitude and behavior of the whole people. Quality of life is specifically related with our social structure. Therefore, it plays a very important role in bringing changes in social development.

The importance of quality of life from the socio-cultural aspect

Quality of life is important from the socio-cultural aspect. The traditions, culture and performance of the people depend upon the education gained by the family members. Involvement of the women in the social affairs and economic activities are also determined by quality of life. If a family has gained the quality of life various superstitions, impractical customs, wrong concepts and values from the society and slowly eradicated. Pre-planning about the proper possible from the parents enjoying quality of life. Then only their children are able to refund the investment of their parents. The children become highly skilled manpower useful for the development of their society. Responsible citizens of future can be prepared by the education and skill gained.

The development of the society and culture is possible by the changes in the thinking of people, attitude and behaviors. Therefore, quality of life is related with components of society and culture. To bring the positive changes in the socio-cultural aspects, quality of life is important.