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INTRODUCTION TO COMMUNITY HEALTH AND ENVIRONMENTAL SANITATION WORKSHEET AND STUDY GUIDE

FOR THE EXCLUSIVE USE OF UNIVERSITY OF ST. LA SALLE STUDENTS

Compiled by BIEN ELI NILLOS, MD

NATURAL SCIENCES DEPARTMENT COLLEGE OF ARTS AND SCIENCES


Academic Year 2011-2012

FOREWORD

This Worksheet is designed to supplement the lectures for Community Health and Environmental Sanitation, an elective class for USLS College students, particularly those taking Bachelor of Science Major in Biology. It shall also serve as one of the major references for the course. To better appreciate and learn the principles in Community Health and Environmental Sanitation, classroom instruction must be complemented with a large amount of community exposure. Therefore, during field work and community exposure, this worksheet will come in handy for the student in reviewing the basic principles of Community Health and Environmental Sanitation. Public Health, or sometimes referred to as Community Health, is defined as the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health.(Winslow, 1920). Its major elements therefore include: Prevention and Control of Community Infections, (through) Sanitation, Education, Health Care Service Delivery and Social Structures. Throughout the course, the students will be expected to learn and apply these elements of Community health and Environmental Sanitation.

Worksheet No. 1 INTRODUCTION TO HEALTH The World Health Organization defines Health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. How would you define Health? Make your own definition of Health. HEALTH is _________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ STUDY GUIDE According to Buddha, Every human being is the author of his own health or disease. What does this imply? Research on the LaLonde Report. What do you think was the significant contribution of Marc LaLondes report for his community/country? Read up on the functions of WHO.

If you are having a hard time trying to make your own definition of health, read some of the definitions of health according to various individuals and/or groups: Health is a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. (Ottawa Charter for Health Promotion, 1986) Health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society (LaLonde Report, 1974)

By this time, you must already have some understanding about Health. The WHO definition mentions the term Disease. It can be said that Disease is exactly the opposite of Health. DISEASE is _________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

What is the difference between DISEASE and ILLNESS? DISEASE ILLNESS

Throughout the history of mankind, there have been many interpretations as to what would cause a disease or illness. In the early days, disease is due to an evil spirit, a curse or a spell. It was only logical therefore for early people to refer to their priests and shamans for treatments since the cause of their diseases was perceived to be due to something spiritual. Treatments of diseases were incorporated into religious ceremonies such as the offering of an animal to appease the spirits. From your own observations and experiences, what can be the many general causes of a DISEASE? Write down as many as you can think of: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ According to historians, Public Health began when human beings started living together (communal living). From small tribes, human beings began to build towns and cities; thus the development of rural to urban living. In order support urban living, people started building infrastructures that would make life easier and more comfortable. For example, to make clean

water more accessible, aqueducts were built. To dispose human waste and dirty water, sewage systems were built. The motivation therefore of doing environmental engineering was not because of some health concerns but due to the demands of urban living. After all, when it came to health and disease, they were all due to spiritual causes. STUDY GUIDE Research on Hippocrates De are, aquis et locis. Read about Hippocrates. What were his biggest contributions to the field of Medicine? How did the Romans accept the concepts proposed by Hippocrates? It was not until Hippocrates came and noted the effect of food, of occupation, and especially of climate in causing disease. Hippocrates was said to be the Father of Medicine and because of his revolutionary concept of health and causes of diseases, the idea of environmental factor as a cause of health or illness came to establish the field of Public Health. Following the Hippocratic Thinking of the causes of diseases, fill up the table below by listing specific illnesses or diseases and their corresponding environmental causes according to ENVIRONMENTAL FACTORS drinking dirty or infected water

your observation or experience. DISEASE/ILLNESS e.g. Diarrhea/Dysentery

Since then, other concepts regarding the causes of diseases or illnesses came to focus such as the concept of bodily fluids not in equilibrium (Humors) and the existence of

microorganisms that cause specific diseases. The idea therefore of supernatural causes of illnesses has been replaced by scientifically-based concepts on health and disease.

Research on the development of Public Health and cite 3 examples of successful milestones in the history of Public Health. A classic example would be the eradication of smallpox through vaccination. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ STUDY GUIDE Research about the Salerno Medical School. What was this historical schools innovation and contribution to the history of Health and Medicine What was the Regimen Sanitatis Salernitanum? Why was it called the first health guide of the masses? Who was Girolamo Fracastoro? What was the central theme of his On Contagions and the Cure of Contagious Diseases? During the Age of Expansion, when Europeans traveled to the New World in search of new lands, they brought with them not only their culture but also their diseases. Read up on examples of Diseases brought to the New World and vice versa. Read up on the concept of Global Health.

WORKSHEET NO. 2 INTRODUCTION TO PRIMARY HEALTH CARE Below is a true-to-life story of Rosario1. The village of Tanyong lies beside the river of Malabon in Metro Manila. The village has a land area of 5 hectares and a population of 12,400 or 1,850 families. To reach the houses of Tanyong, one has to cross unsteady makeshift wooden bridges, and it is not uncommon to hear of children falling into the murky black waters of the river. The river serves as the sewer and main garbage disposal system of the village. A survey done in the village revealed that only STUDY GUIDE Highlight the pertinent details that 10% of the households had toilets, while 90% used the river to dispose of human wastes. Only describe the living conditions of 10% availed of water piped into their houses; Rosarios family. Highlight the pertinent details that 90% had to buy water from entrepreneurs who fetched water from 2 deep wells in the village. 5 describe Jaimes family as a unit. gallons of water cost between P15-30, Considering their living depending on the distance of the house from the conditions and their situation as a well. None of the families living in the village family, do you think Rosarios owned the house nor the land they lived on. family can cope up when an illness beset them? A small room rented out for P500-P1000 per month; while a bigger room rented out for P1500-2000 a month. Jaime and his family lived in the village of Tanyong. Jaime was 24 years old, while his wife Lucy was 27. They had four children: Jocelyn, 5 years old; Marites, 4 years old; Antonio, 2 years old; and Rosario, 1 year and 4 months old. Jaime was among the 70% of the population who migrated to Metro Manila from the provinces looking for a better life. Jaime, like his father, was a poor peasant, but the land did not produce enough to support Jaimes family and so they migrated to Manila. In Manila, Jaime worked as a laborer in a construction site. He earned P165 a day, and this was hardly enough to support his family. He and Lucy were chronically in debt. Lucy usually strove to fit 3 meals a day within a budget of P50, and often skipped meals in order to feed her children. In these times, Lucy found her strength in her faith, and repeated in her mind what she had heard the Bishop say in a sermon: Blessed are they who suffer, for they shall inherit the kingdom of God. Lucy grew up in a rural community and graduated from high school, unlike Jaime who completed only 3 years of elementary education. She did not learn the proper ways of caring for children. When her oldest child was still a baby, she was told by a physician that she should not breastfeed because she had a heart ailment. She was told instead to buy an infant formula from a nearby pharmacy that was owned by the same physician. Lucy, however, had no heart ailment according to another physician who had examined her a few years later.
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Story presented by Christian Gomez, MD of the UP College of Medicine during the 2010 Global health Course at the University of Tampere, Finland.

But since she was forbidden to breastfeed, she raised all her children on condensed milk because this was more affordable than formula milk. She did not know the importance of sterilizing her childrens feeding bottles and rubber nipples, nor could she afford to do it regularly. She was also not aware of what food was nutritious for her children. As a result, all her children were malnourished. They were prone to respiratory tract infections, and frequently had fever and diarrhea. Their abdomens were large and protruding. They frequently passed out worms (parasites) in their feces, which Lucy believed to be good. She believed that intestinal parasites aided in the proper digestion of food. The 2 youngest children, Antonio and Rosario, were not vaccinated because Lucy was frightened when Jocelyn and Marites developed fever after receiving their vaccinations. Jaime scolded her when this happened. Besides, the village health center did not have enough vaccines for all the children in the village. Rosario, the youngest, was the most sickly among Lucy and Jaimes children. She was very thin, STUDY GUIDE pale and invariably suffered from diarrhea. Read about breastfeeding. Was the doctor correct on his advice One day, Rosario contracted measles. Lucy on Rosario and her breastfeeding? brought her to the nearest public health center, Read about immunization. Was it where medical consultation was free. The nurse a correct decision on Jaimes part in the center, however, informed Lucy that the not to immunize Antonio and center had run out of medicines, and that the Rosario? Why? budget for medicines for the year had been used What is measles? How can one up. The request for additional budget for get measles? What are the signs medicines was turned down by the City Council and symptoms of measles? because they suspected the City Health Officer and the Mayor of misappropriating funds intended for medicines. Lucy decided to buy the medicines prescribed for Rosario: Carbocisteine for the cough (P109), a preparation for the diarrhea (P243), and an antibiotic (P150). Though Rosario was still sick after a bottle of each of these meds were consumed, Lucy could not buy additional medicines because she did not have money left. Rosario continued to have diarrhea and was soon dehydrated. Lucy then brought Rosario back to the village health center, but the nurse in the health center advised Lucy to bring Rosario to a larger facility, a private hospital nearby. In the hospital, Lucy was required to give a deposit of PhP1200 before Rosario could be admitted. It was a good thing that Jaime was able to borrow PhP1500 from the village leader at usurious rates. Because Rosario was so anemic, Jaime needed to donate blood that was transfused to Rosario. After only one night in the hospital, Lucy and Jaimes bill piled up to Php 4,125 and was increasing fast. Every item used in the treatment of Rosario like cotton balls, alcohol, gauze and tape, was charged and added to their bill. Jaime and Lucy finally decided that it was best to take Rosario home against the doctors advice. They had to sign a document absolving the hospital and the doctors of any legal liability, should Rosarios condition deteriorate. Jaime and Lucy were told to bring Rosario back to the hospital when they had enough money to pay for the hospital services or to bring Rosario to a government (public) hospital.

After one week of continuous fever and diarrhea, Rosario further weakened and eventually died. Question: Why did Rosario die? Discuss with classmates and be ready to participate during the open forum in class. In the story of Rosario, one can observe that inadequate health care was given to Rosario and may have contributed to her demise. There was therefore some form of inaccessibility to the different levels of health care. Define the three levels of care and give an example for each: PRIMARY CARE SECONDARY CARE TERTIARY CARE

Community Health is largely dependent on a strong Primary health care system. The World Health Organization, through the Alma Ata Declaration of 1978, defined Primary Health Care as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and selfdetermination. Get a copy and read the Alma Ata Declaration of 1978. Be ready to share your insights in the class during the open forum. From the Alma Ata Declaration, pick out a statement

that struck you the most and comment. Write your essay in not more than 15 sentences to be submitted in class. One can analyze the cause of death of Rosario using what we call a Problem Tree. Below is an example of a Problem Tree. Base on your own analysis, make your own Problem tree for Rosarios case focusing only on three direct causes of Rosarios death. DEATH OF ROSARIO

DEHYDRATION/DIARRHEA

NO MEDICINES

DIRTY WATER

LIVING IN SLUM AREA

HEALTH CLINIC WITH NO DRUGS

LIVING IN POVERTY

Submit your Problem Tree Analysis on the case of Rosario. Be ready to discuss your problem tree in front of the class.

WORKSHEET NO. 3 COMMUNICABLE DISEASES Fill up the table below citing as many causative agents/diseases as you can. Diseases may not necessarily be endemic in the Philippines .
CAUSATIVE AGRNT DISEASE TYPE OF ORGANISM MODE OF TRANSMISSION DISTRIBUTION

CAUSATIVE AGRNT

DISEASE

TYPE OF ORGANISM

MODE OF TRANSMISSION

DISTRIBUTION

Cite the Differences between a Bacterium, Virus and a Parasite. Consider its cellular structure, size and behavior when comparing. BACTERIA VIRUS PARASITE

Define the Germ Theory ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________

STUDY GUIDE Read up on the following persons and know their contributions to the development of Medicine and Public Health: o Louis Pasteur o Robert Koch

Write the Kochs Postulates: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

WORKSHEET NO. 4 IMMUNIZATION The body is constantly exposed to pathogens such as bacteria, viruses, parasites and even fungi. However, our body is equipped with a mechanism that would protect itself against these harmful and disease-causing pathogens. Define LEUKOCYTES: ________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Draw and describe the functions of the six types of Leukocytes in the human body.

Name:

Name:

Name:

Name:

Name:

Name:

STUDY GUIDE Know the Definition of the following: o Diapedesis o Chemotaxis o Phagocytosis What are Macrophages? What is Active versus Passive Immunity?

Differentiate Innate Immunity from Acquired Immunity: ____________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ ____________________________________. Write down the recommended schedule of

Immunization according to the WHOs Expanded Program of Immunization as implemented in The Philippines: Name of Vaccine Type of Vaccine Number of Doses Time Interval Minimum age in months

BCG

Hepatitis B

DPT(diphtheria, Pertussis, tetanus)

Oral Polio Virus

Measles

There are other vaccines available that are not actually included in the Expanded Program of Immunization (EPI) implemented in the Philippines. Examples of which are Pneumococcal

Vaccine, Hemophilus Influenza B Vaccine or MMR (Measles, Mumps, Rubella) Vaccine. Read up on the other vaccines. If you are to add another vaccine in the EPI Program, what would this vaccine be and why? Read up on facts about the disease addressed by this vaccine. Cite data that would justify your choice. Be ready to submit your paper and discuss it during the open forum with the class. What is a Fully Immunized Child as defined under WHOs EPI? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Given the list below, mark the children who are considered as FIC. 1. Andres 10 months old Received HepB x 3 doses, OPV x 3 doses, DPT x 3 doses 2. Bogart 7.5 months old Received HepB x 2 doses, OPV x 2 doses, DPT x 2 doses 3. Charo 11 months old Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3 doses, Measles x 1 dose 4. Denise 9 months old Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3 doses, Measles x 1 dose 5. Edgar 12 months old Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3 doses, MMR x 1 dose 6. Ferdinand 15 months old Received HepB x 2 doses, OPV x 3 doses, DPT x 3 doses, Measles x 1 dose 7. Gary 3 months old Received HepB x 1 dose, OPV x 1 dose, DPT x 1 dose. 8. Holly 6 months old Received BCG, HepB x 1 dose, OPV x 2 doses, DPT x 2 doses. 9. Irene 15 months old Received HepB x 1 dose, OPV x 2 doses, DPT x 2 doses 10. Jackie 8 months old Received OPV x 3 doses, DPT x 3 doses, Measles x 1 dose

What are the possible side effects of a vaccine and what are the contraindications? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

WORKSHEET NO. 5 VECTOR-BORNE DISEASES

Malaria is taken from the words mal aria which means bad air since it was previously believed that Malaria was inhaled from polluted air. Malaria, which is endemic in some parts of the Philippines, is an example of a vector-borne disease. The vector is an Anopheles Mosquito which carries the parasite. There are three types of Anopheles mosquito. Describe and compare the three types of Anopheles.

A. flavirostris

A. litoralis

A. maculates

As of November 2007, 22 of the 57 provinces endemic for malaria have been cleared, the more recent ones being Marinduque, Sorsogon, Albay in Luzon; Eastern and Western Samar in the Visayas; and Surigao del Norte.

STUDY GUIDE What is endemic? What is epidemic? What is pandemic? What is a vector? What are the signs and symptoms of a patient who has Malaria?

List down the ways one can prevent the spread of Malaria: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ What are other vector-borne diseases? List down the disease, the causative agent and the vector

WORKSHEET NO. 6 DENGUE Dengue Fever/Dengue Hemorrhagic Fever is another example of a vector-borne disease. It is endemic in the Philippine and other Asian and African countries. The mosquito that carries the Dengue Virus is the Aedes aegypti. Read up on the Aedes mosquito and describe the behavioral characteristics of the Aedes aegypti. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

STUDY GUIDE Be ready to know the definitions of the following words: Incubation Period Asymptomatic versus Symptomatic Carrier Subclinical Prodromal Latency

Dengue Fever, if left untreated, can lead to a hemorrhagic phase. The virus affects platelet production in the body. The platelet ensures clotting of blood, thus, if the platelets are low in number, a person affected with the Dengue Virus can bleed spontaneously. Sites of bleeding can be in the gums, underneath the skin (purpuric rash) or even internally such as Gastrointestinal bleed (hematochezia or hematemesis), or bleeding along the urinary tract (hematuria).

Read up on the 4S Program of the Philippine Department of Health regarding Dengue Outbreak Prevention. Give examples on how you can implement the 4S program in the school or in the community. Be ready to discuss it with the class.

WORKSHEET NO. 7 DIARRHEAL DISEASES Review the list of causative agents in Worksheet No. 3 and identify how many of those organisms can cause diarrheal diseases in humans. Write them down in this table and identify how they can be transmitted (water-borne, food borne, etc). Causative Agent Type of Organism Mode of Transmission

Define Diarrhea: ____________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________

STUDY GUIDE Prevalence of Diarrheal Diseases correlates with the standard of living conditions in a population. Poor housing for example can contribute to the development of diarrheal diseases. What are other social factors that can lead to the high prevalence of diarrheal diseases in a community?

Review the story of Rosario. From the story of Rosario in Worksheet No. 2 you can identify some measures that can prevent the occurrence of diarrheal disease. Based on the information and your readings regarding causative agents of Diarrhea, write down five major disease prevention strategies for diarrhea.

STRATEGY NO. 1

STRATEGY NO. 2

STRATEGY NO. 3

STRATEGY NO. 4

STRATEGY NO. 5

Review the attached Integrated Management of Childhood Illnesses Guidelines for managing cases of diarrhea in children.

WORKSHEET NO. 8 ANIMAL BITES Diseases can be transmitted to humans by animals. In your Worksheet No. 3, you may have listed down some causative agents that are transmitted by animals such as rodents, cats and any other animal. Fill in the table below with diseases transmitted by animals and their corresponding causative agents. They dont have to be endemic in the Philippines: Causative Agent Animal Carrier Name of Disease Type of Organism

One common disease a person can get from an animal is rabies. Rabies is caused by a rhabdiriform virus and is a deadly disease. Once a person has shown signs and symptoms of rabies, it is always 100% fatal. Read up on Rabies and list down the signs and symptoms of this disease: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ _______________________________________________________________________ In Public Health, Rabies is one of the notifiable diseases, which means, if a person in your community has been diagnosed with Rabies, you have to report it to the health authorities. In the Philippines, the most common source of animal bites that lead to deaths due to Rabies is the canine animal (dogs). Other animals include cats and bats. There are three categories of Animal Bites/Contact that would guide the health worker in managing and preventing Rabies. Fill up the table below and differentiate the categories based on level of exposure to animal and the appropriate treatment. CATEGORY ONE CATEGORY TWO CATEGORY THREE

WORKSHEET NO. 9 SEXUALLY TRANSMITTED DISEASES Sexually Transmitted Disease is a disease that is transmitted through sexual contact. STDs are highly contagious and sexually active individuals are prone to developing these illnesses, especially when engaged in unprotected sex. Read on the various types of STDs and based on your readings, complete the table below:

Type of STD

Causative Agent

Type of Organism

Some STDs are easily detected because they would show obvious signs and symptoms. In some cases, STDs are very hard to detect because they would not usually show obvious signs and symptoms. People who have these kinds of STDs and would continue to be sexually

active are known to be carriers of the disease and would help spread the disease. A classic example would be the Human Immunodeficiency Virus (HIV). HIV is transmitted not only through sexual intercourse but through other means as well. List down the other ways a person can get infected with HIV: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ __________________________________________________________________________

Read up on HIV, especially on how the virus would sabotage the immune system of the human body. Draw a diagram depicting the step by step process of how an HIV can do this.

HIV is a huge burden especially among many African countries. If untreated, HIV can cause AIDS which is Acquired Immunodeficiency Syndrome. What is happening in the body of a person that has Discuss among your friends how a full-blown AIDS? _____________________ person can avoid getting an STD. ____________________________________ ____________________________________ Debate: Are Filipino students ____________________________________ ready for Sex Education Today? ____________________________________ ____________________________________ ____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ MINI-SURVEY. With a group of four friends/classmates, randomly ask fellow students in campus the following questions: 1. Are you aware about HIV or AIDS? Count how many said Yes and No. 2. What do the letters H-I-V or A-I-D-S stand for? Count how many answered correctly 3. How do you get infected with HIV? Record their answers and tally. 4. Can HIV kill a person? Count how many said Yes and No and I dont know. Bring the results to class and be ready to share your insights during the open forum. This minisurvey can also be done in your own adopted community.

STUDY GUIDE What are other STDs that can manifest without signs and symptoms?

WORKSHEET NO. 10 INTRODUCTION TO EPIDEMIOLOGY Define Epidemiology __________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ __________________________________________________________________________ Cite 3 importance of Epidemiology in relation to Community health 1. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________________ 2. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ____________________________________________________________________ 3. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ In epidemiology, it is important to know how data are gathered and most of all interpreted so that conclusions that are derived from the interpretation can lead to sound recommendations that would influence people in authority to regulate laws and policies and strategies that would benefit the over-all health of the population. Below are some data an epidemiologist must need to gather and interpret. Read up on their definitions and write the formula on how to calculate for these important indicators. 1. Prevalence

2. Incidence

3. Crude Birth Rate

4. Crude Death Rate

5. Cumulative Incidence

6. Attack Rate

7. Fertility rate

8. Mortality rate (versus mortality ratio) -

9.

Population Density

10. Literacy Rate

11. Maternal Mortality Ratio

12. Infant Mortality Rate

The Epidemiological Triad is the traditional model for infectious disease causation. Draw the epidemiological triad and identify its three components:

There is another form or version of the epidemiological triad as shown below. Label properly the three components of the triad based on this new version.

WORKSHEET NO. 11 LIFESTYLE-RELATED DISEASES

Lifestyle Disease is a disease associated with the way a person or a group of person lives. According to latest data, Lifestyle Diseases are increasing. Unlike infectious diseases, lifestyle or non-communicable diseases are not contagious however genetics to some extent can come into play. Read up on examples of these Lifestyle Diseases and based on your readings, fill up the table below: LIFESTYLE DISEASES POSSIBLE CAUSE/HUMAN ACTIVITY

Life communicable diseases, Lifestyle-Related diseases are also preventable. Go back to your list of Lifestyle-related diseases and list the ways you can prevent the occurrence of these diseases or prevent the progression of these diseases to their irreversible complications. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ One lifestyle or human activity that has a direct link with a particular lifestyle disease is smoking. Smoking can cause lung cancer and other forms of diseases. Read up on data and studies regarding smoking and its effects on both the individual and the entire population as a whole. If you are to propose an anti-smoking program in your school or in your adopted community, how will you implement it? Write your proposal or plan of activities in the following format: Name Activity of Description People responsible Budget/Resources Outcomes

Suggested strategies before you lay-out your proposal or plan of activities: a. Visit your Pulmonologist and interview him/her regarding the effects of smoking b. Visit your Health Officers (City, Provincial, etc) and ask about data regarding the effects of smoking c. Make a rapid survey in your community or school and measure how many are active smokers vs. non-smokers d. Interview random smokers and ask about their smoking habits (how young they started, how many sticks a day, willingness to quit, etc.)

STUDY GUIDE In the Philippines, the number of women who smoke are on the rise. According to estimates, 250 Filipinos die every day due to smoking-related illnesses. According to the WHO, in every 8 seconds, a person dies due to smoking-related illnesses.

WORKSHEET NO. 12 WASTE DISPOSAL Waste management is the collection, transport, processing, recycling or disposal, and monitoring of waste materials. The term usually relates to materials produced by human activity, and is generally undertaken to reduce their effect on health, the environment or aesthetics. Waste management is also carried out to recover resources from it. Waste management can involve solid, liquid, gaseous or radioactive substances, with different methods and fields of expertise for each. Describe each method of solid waste disposal and focus on the advantages and disadvantages of each method.

Types of Disposal LANDFILL

Solid

Waste Advantages

Disadvantages

Landfill Trench method

Landfill - Area method

Sanitary Landfill

Incinerator

Recycling Plants

Composting

Another form of Solid waste is Human Excreta. Management of human excreta is essential in public health because human waste carries germs that can cause diseases and can spread and contaminate clean water and food source. There are many ways of disposing human excreta. On the paper provided, draw the set-up for the following forms of Human excreta disposal: a. b. c. d. e. f. g. Simple pit latrine Ventilated Improved Pit (VIP) Pour flush latrines Composting latrines Aquaprivies Septic Tanks Sewerage and sewage sanitation

For each method of waste sanitation there can be many variants. Be aware of these variants and read up on them. Research on how many Filipino homes are practicing such methods of human waste sanitation.

WORKSHEET NO. 13 WATER SANITATION

Water is essential for life and for quality health. It is important therefore to ensure a potable water supply for human consumption in order to preserve quality public health. There are many ways to use water. Water can be utilized for direct human consumption (drinking, bathing, washing of laundry, etc). Water can also be utilized for agricultural purposes such as irrigation or as water source for cattle. It can also be utilized for industry such as production of processed food or beverages. Water can also be used for recreational activities. There are two general types of water: salt and fresh water. Draw a diagram or picture of the many sources of fresh water. Label.

There are three levels of water systems in the Philippines. According to data, only 63% of the total population have access to potable water supply in 20002. World Bank (December 2005). Philippines: Meeting Infrastructure Challenges. Retrieved 2008-04-09., p. 107
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Describe the three levels of water systems in the Philippines and illustrate. Levels of Water Supply Definition Examples

Illustration:

Review of the water Cycle:

Identify human activities that would create water stress or affect the water supplies in our communities. Be ready to share insights during the open forum. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ _________________________________________________________________________

Bacteriological Water testing is a method of analysing the presence of pathogenic bacteria in water, measuring their count and if possible sorting their types. It is a microbiological analytical procedure which uses samples of water and from these samples determines the concentration of bacteria. It is then possible to draw inferences about the suitability of the water for use from these concentrations. This process is used, for example, to routinely confirm that water is safe for human consumption or that bathing and recreational waters are safe to use. There are many methodologies of Bacteriological water analysis. Read on them and describe one method: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ The presence of Microorganisms is just one of the factors you must consider in analysing water sources. There are four other major factors you must also consider: 1. 2. 3. 4. ____________________________________ ____________________________________ ____________________________________ ____________________________________

Presence of elements and minerals are relevant in the analysis of a water source. Outline at least 4 of these elements and minerals and describe how the presence or absence of these minerals and elements affect the suitability of a water source. Elements/Minerals Relevance

Water Analysis may be performed by the class. A different set of instructions will be given by your teacher.

WORKSHEET NO. 14 THE GREEN IDEA Incorporating every concept and principle learned, think of one Innovative and Creative Idea that can propose a solution to a particular environmental or public health problem of a local community, school or even the entire City. It must be grounded on facts (data gathering) and must answer the question, Why? Why focus on that particular problem? Why the urgency and attention? The Green Idea can be a modification of an original concept already being applied elsewhere and customized to fit the proposed recipients or beneficiaries. Original ideas however are highly encouraged. Experts will be invited to comment on the Green Idea based on the following criteria: Innovation, Applicability (feasibility), Ability to Address Problem, Knowledge of Principles in Environmental Sanitation and Community Health, Knowledge About the problem. An exhibit of Green Ideas will be done by the end of the course. The exhibits will be judged as well. Suggested Areas to focus are: 1. Prevention of Dengue and other Mosquito-borne diseases 2. Solid waste management 3. Water sanitation 4. Reduction of air pollution 5. Reduction of Animal Bites 6. Efficient Waste Collection 7. Zero-Waste Strategies