CHAPTER 1

INTRODUCTION TO PERSONAL AND COMMUNITY HYGIENE

History of Hygiene

The word hygiene comes from Hygeia, the Greek goddess of health, who was the daughter of
Aesculapius, the god of medicine. Since the arrival of the Industrial Revolution (c.1750-1850) and the
discovery of the germ theory of disease in the second half of the nineteenth century, hygiene and
sanitation have been at the forefront of the struggle against illness and disease.

For many of us, hygiene is a natural and almost trivial part of everyday life. At the same time, it is
enormously important to health in modern societies. Access to running water, clean toilets and soap is
as much a part of our everyday lives as the high standard of hygiene in hospitals thanks to highly
effective disinfectants, sterile instruments, and surgical gowns.

Concept of Hygiene

Approaches to hygiene have changed greatly over the course of humanity. For centuries, very
different forms of cleanliness were practiced, depending on religion, nation, and culture. Progressive
discoveries were always met with resistance; there were intrigues and important knowledge was lost
again. The use of disinfectants is also relatively new, with a history of only about 150 years.

Hygiene: is the practice through which people maintain or promote good health. Making themselves and
their surroundings clean, cleaning and - when needed - disinfecting surfaces, hands, units, surroundings
and items of personal use in order to break the chain of infection, all contribute to hygiene.

Cleaning: is the mechanical or chemical removal of dirt and soil from the human body, an object or an
area. Normally, cleaning with soap or detergent followed by rinsing with water is adequate to remove
visible dirt and allergens. By removing dirt, the number of germs will be considerably reduced. Hence,
cleaning is a major step towards hygiene.

Disinfection: in situations where there is high risk of transmission of germs (e.g., when there is someone
who is infected or is vulnerable to infection), the targeted use of a disinfectant helps prevent infections.
Disinfectants are products that contain or generate biocidal active substances with antimicrobial
properties and that communicate this function to end users. These products prevent the spread of
infection by deactivating/killing harmful organisms.

Classification of Hygiene

What is personal hygiene?

Good personal hygiene is one of the best ways to protect yourself from getting gastro or infectious
diseases such as COVID-19, colds and flu. Washing your hands with soap removes germs that can make
you ill. Maintaining good personal hygiene will also help prevent you from spreading diseases to other
people.
Why is personal hygiene important?

• Good hygiene is vital because it helps prevent you and your children from getting or
spreading germs and infectious diseases. The germs that cause many diseases can be
passed on through touching other people, getting faces (poo) on your hands, handling
contaminated food, or coming into contact with dirty surfaces or objects.

Conditions that you can develop if you have poor personal hygiene include:

• COVID-19 and other infectious diseases

• diarrhea, especially gastroenteritis - infection and inflammation of digestive system
• respiratory infections, including colds and flu
• staph infections - caused by staphylococcus bacteria
• worm-related conditions, such as threadworms
• scabies - it is an itchy skin rash
• trachoma, an eye infection which can lead to blindness
• tinea or athlete’s foot
• tooth decay
• Washing your body

Try to bathe or shower each day. Wash well, especially under your armpits and around your genitals and
anus. Keeping clean will prevent skin irritations and remove bacteria that cause body odor.

Wash yourself with soap, shower gel or a hypoallergenic body wash. Soap removes more germs, but you
may need to wash sensitive body parts with plain water or salt water. If there is no tap water or it is
scarce, clean yourself with a clean wet cloth or sponge.

• Washing your hands

To avoid getting sick, wash your hands properly for at least 20 seconds.

• Wet your hands with water.

• Apply enough soap to cover all surfaces of your hands.
• Rub your palms together.
• Clean between the fingers and the back of your hands.
• Clean dirty nails with a scrubbing brush, if one is available.
• Rinse both sides of your hands, preferably under clean running water.
• Dry off your hands with a clean towel.
• Use the towel to turn off the tap.
You can also use hand sanitizer. Make sure you use enough of the product to cover all surfaces of your
hands. Make sure you rub the palms, backs of the hands and in between your fingers.

• When to wash your hands

It is especially important to wash your hands after going to the toilet because faces, which you might
come into contact with, contains billions of germs. Also, wash your hands:

• before and after eating or preparing food

• after changing babies’ nappies
 • before and after touching a sick person or cleaning up vomit or body fluids
• after blowing your nose
• before and after treating cuts or wounds
• after touching rubbish, dirty surfaces or objects
• after handling pets or farm animals

➢ Preventing body odor

After washing, apply deodorant to your armpits. Put on clean, dry clothing. Wash sweaty or dirty
garments well and, if possible, hang them outdoors to dry. If you have a problem with excessive
sweating, make an appointment to see your doctor.

➢ Handling food safely

Wash your hands before and after preparing food. This will stop you contaminating food and will also
protect you from getting ill or passing on bacteria from foodstuffs, such as raw meat. Find out more here
about food safety.

➢ Preventing bad breath

Bad breath can be caused by poor oral hygiene. Brush and floss your teeth twice a day since this reduces
gum disease and the chances of future tooth decay. Use these dental care tips and make an appointment
with a dentist for a check-up if you have further symptoms.

Community hygiene

Community hygiene is the cooperative effort to bring greater health and prevention of disease to a
group of people living near one another.

In many countries, children learn valuable hygiene and sanitation knowledge at a young age. But, in large
parts of the world, knowledge on how to prevent illness and maintain hygiene is not widely known or
taught.

-Community hygiene is foundational to social progress.

Core Community Hygiene and Sanitation Practices Include:

Washing hands with soap and water

Keeping dishes and utensils clean and off the ground
Using a toilet to keep feces separate from people
Sweeping the home and keeping rubbish off the floor to prevent environmental contamination
Keeping livestock separate from the home
Washing bodies regularly to maintain physical cleanliness

What are the Benefits of Community Hygiene?

Community hygiene helps prevent infectious diseases from spreading throughout a neighborhood,
school, compound, office space, and more. Hygiene practiced regularly creates healthier communities.

On a more global scale, community hygiene helps save lives of the world’s youngest children.
Right now, diarrhea is the second leading cause of death for children worldwide. According to UNICEF,
480,000 children under the age of five die each year; that’s 1,300 of the world’s youngest children lost to
diarrhea in a day. The primary cause of diarrhea is unsafe water and a lack of basic sanitation and
hygiene. It’s entirely preventable.

Food hygiene

Food hygiene meaning refers to the practice a food manufacturing business applies to safeguard public
health from any risks of foodborne illnesses that can be caused by bacterial contamination. Particularly,
food hygiene deals with the biological aspect of keeping food safe.

Food hygiene is a collection of practices and guidelines to keep your operations clean and under healthy
conditions.

This term is concerned with food handling, transport, proper storage of food, and the actual processing
of your materials. Specifically, the objectives of food hygiene include the following:

• To prevent food from spoiling due to contamination as a result of unclean environmental

conditions, poor food hygiene practices, and lack of orientation on food safety.
• To orient and educate people involved in the processing of your product on how to
practice safe food handling and sanitary practices.
• To extend the shelf-life of your product through clean processing.
• To prevent releasing unsafe food to the market that can result in foodborne illnesses.

• Achieving and maintaining food hygiene is an essential task for every food business, wherever
the business is in the world. Combine the power of technology with food hygiene practices by
using Food Docs Food Safety Management System. Our smart software covers monitoring tasks
for maintaining strict food hygiene standards. Use our software tools, such as a smart
notification system to remind food handlers of important, everyday hygiene task.

Domestic Hygiene

• Domestic hygiene: domestic hygiene (sanitary preparation of food, cleanliness, and ventilation)
means cleanliness in your home whereas personal hygiene (proper living habits, cleanliness of
body and clothing, healthful diet, a balanced regimen of rest and exercise) means cleanliness of
your body.

• Domestic hygiene activities include all the work which is done to keep the house and people's
clothes and bedding clean. These jobs include sweeping and washing floors, cleaning the toilet,
washing clothes and bedding, and washing dishes and cooking utensils after meals. It is
important that the house be kept clean so that it is a healthy place. If the house and everything
in it are not cleaned often, moisture and dirt gather and it becomes an ideal place for germs,
parasites and vectors (disease-carrying animals) to breed and multiply. These germs can cause
the people living in the house to get sick.
 CHAPTER 2
PRINCIPLES OF HEALTHFUL LIVING
The importance of diet for health, and prevention of diseases

“The foods you choose make difference”

-You are what you eat
History of healthy diet

The first diet book came out in 1558, and it is still in print today. Italian Luigi Cornaro wrote The Art of
Living Long. It advised readers to limit themselves to 12 oz of food a day and 14 oz of wine. In 1614, The
Fruits, Herbs, and Vegetables of Italy heavily criticized the sugary and meaty diet of the British.

Who started the first diet?

-William Banting

So started William Banting's “Letter on Corpulence,” likely the first diet book ever published. Banting, an
overweight undertaker, published the book in 1864 to espouse his success after replacing an excessive
intake of bread, sugar and potatoes with mostly meat, fish and vegetables.

Why is diet history important?

The medical history should routinely include a diet history that may be relevant to the patient's primary
problem but is also used to identify nutritional deficiencies or excesses. The information obtained in the
diet history should be used in counseling the patient and helping them improve their dietary habits.

In fact, having a balanced diet will make it easier for you to lose weight with the bonus of being
healthier. The following is a list of delicious foods that you can consume while on a diet.

What are the 5 Main Groups?

• Fruit and vegetables

• Bread, rice, pasta, potatoes, and other starchy carbohydrates
• Meat, fish, eggs, beans, and other proteins
• Milk, dairy products, and alternatives
• Oils and spreads

WHY IS A HEALTHY DIET IMPORTANT?

A healthy diet is essential for good health and nutrition. It protects you against many chronic
noncommunicable diseases, such as heart disease, diabetes and cancer. Eating a variety of foods and
consuming less salt, sugars and saturated and industrially-produced trans-fats, are essential for healthy
diet.
People often think that carbohydrates and large meals affect their weight. In fact, it all depends on how
much of the food you consume.

What is the definition of healthy eating?

Eating healthy means following a healthy eating pattern that includes a variety of nutritious foods and
drinks. It also means getting the number of calories that's right for you (not eating too much or too
little).

A healthy balanced diet also includes:

• Water and other drinks

• Foods high in fat, salt, and sugar
Importance of healthy food

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with
essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate
fiber and food energy.

Advantages of healthy food

Healthy food helps in maintaining or improving health. A healthy food full fills all the nutrients required
by the body, i.e., micronutrients such as fibers, vitamins, and adequate food energy.

Healthy food may include sweetened beverages, vegetables, whole grains, and no processed food.
Demand for healthy food can be met from plant-based and animal-based sources. Several Institutes,
Government organizations, and Private Medical organizations publish material regarding healthy food
habits.

Advantages of Healthy Food

1. Maintenance and Weight Loss

Controlling high-calorie food is very important for maintaining and achieving a healthy weight. Intake of
lean protein, whole grain, fruit, and vegetables to replace high-calorie food. Fiber-contained foods like
vegetables, fruits, and whole grains will keep you longer than foods with high sugar content.

2. Blood Sugar Control

Foods such as ice cream, soda, fruit, white bread, and juice may increase your sugar level. Your body is fit
to handle minimal influxes in glucose, but the repetition will cause insulin problems and could turn into
type 2 diabetes. Carbohydrates such as brown rice, grain bread, and oat would help slow the sugar
release into the blood and regulate the blood sugar.

3. Reduces Risk of Cancer

Fruits and Vegetables contain antioxidants. These antioxidants help eliminate potentially damaging cells,
referred to as free radicals. These free radicals are loaded with an uneven quantity of electrons, which
makes them highly unstable. They tend to steal electrons from healthy cells, making them suffer a lot.
Antioxidants help eliminate free radicals by giving one of their electrons, which changes one free radical
into a stable molecule.
4. Lowering Heart Diseases

Frequent consumption of high-fat-containing food items can increase your triglyceride and cholesterol
levels and which can lead to causing plaque buildup in arteries. It could also do stroke and heart disease.
Intake a moderate amount of fats in seeds, fish, nuts, olive oil, and avocadoes shields your heart.

5. Good for Mental Health

Healthy food is as good for your body as for the brain. Several neurological foods are directly connected
with unhealthy food consumption patterns. Some deficiencies in the food nutrient increase the chances
of depression in your mind. The nutrients that are involved in the brain cell are potassium.

6. Improves Your Mood and Boosts Your Energy Levels

Healthy foods keep your mood light even in the depression situation and tension. It keeps your energy
level high. Higher energy levels help you in doing the work more efficiently and effectively. Lighter moods
help you maintain a work-life balance.

Disadvantages of Healthy Food

We’ve not considered it an ugly product. We believe in seasonal, organic, and natural produce

1. Change is Very Tough

Changes brought by Healthy food are very tough to incorporate into our lifestyle. A person has to adjust
to their daily routine. It becomes very difficult for beginners to avoid their normal eating and switch to
the latest healthy diet plan.

2. Need to Read Food Labels

In this era, when all food materials contain some amount of chemical in it. It becomes necessary for the
consumer to check, verify and look for the food label. People must read all the guidelines and relevant
information available to verify whether the product is healthy or not. Organic food and chemically free
foods are not readily available in the market.

3. Expensive

Organic foods are scarcely available in the market, and they are expensive in the market. They require
special maintenance and equipment to store them. Special transportation measures must be arranged
because these organic products are grown in far-flung areas. This special transportation adds more cost
to the product.

4. Special Knowledge

In this modernized world, it has become common for people to have some basic knowledge of what is
healthy and unhealthy. This adds more strain on the consumer.

5. Boredom

Healthy foods do not often suit our tastebuds, and people get bored after some time. They start shifting
to the old unhealthy food diet. Healthy foods do not arouse any serious interest in people, and they have
come to eat healthy food by force. So, it's natural for them to get bored after some time.
 3 BEST NUTRITION

three nutrients that greatly influence the success of a diet are: Fiber, calcium, and protein.

An unhealthy food plan is a major cause of numerous chronic diseases and includes

Cardiovascular diseases
Overweight/obesity
High Cholesterol
Abnormal Blood Lipids
High Blood Pressure

Chapter 3
Community Health and Hygiene
In an ever-changing world with a growing population and increasing industrialization, the
significance of maintaining a clean and healthy environment has never been more critical.
Environmental hygiene is the cornerstone of safeguarding our planet’s well-being and preserving the
health of its inhabitants. From the air we breathe to the water we drink and the spaces we inhabit,
environmental hygiene plays a pivotal role in creating a sustainable and thriving ecosystem.

But what exactly is environmental hygiene?

We will delve into the definition of environmental hygiene, exploring its core principles and
impact on our daily lives. Moreover, we will uncover the best practices that individuals, communities,
and governments can adopt to ensure a cleaner, greener, and healthier future for future generations.

What’s Environmental Hygiene?

Environmental hygiene refers to maintaining and promoting cleanliness and health in the
surroundings where people live and work. It involves various measures and actions to prevent the
spread of diseases, minimize health risks, and create a safe and healthy environment. Environmental
hygiene is essential for the well-being of individuals and communities, as it helps reduce exposure to
harmful agents and ensures a clean and safe living and working environment.

Some key aspects of environmental hygiene include:

• Sanitation: Proper waste management, sewage disposal, and garbage collection are crucial
for preventing the spread of diseases and maintaining a clean environment.
• Water quality: Ensuring access to clean and safe drinking water prevents waterborne
diseases and maintains public health.
• Air quality: Controlling air pollution and indoor air quality is essential to reduce respiratory
problems and other health issues related to air pollutants.
• Pest control: Managing pests like insects and rodents helps prevent the spread of diseases
they may carry.
• Food safety: Proper food handling, storage, and preparation practices help prevent
foodborne illnesses.
• Personal hygiene: Encouraging good personal hygiene practices among individuals, such as
handwashing, is an essential aspect of environmental hygiene.
 • Infection control: In healthcare settings, maintaining a clean and sterile environment helps
prevent the transmission of infections.

Environmental hygiene is essential in everyday life and settings like hospitals, schools, workplaces, and
public places. Following proper hygiene practices can reduce the risk of illnesses, promote better health
outcomes, and create a more sustainable and healthier environment for everyone.

INTRODUCTION TO ENVIRONMENTAL HYGIENE

Environmental hygiene encompasses effective cleaning of surfaces using appropriate products,
decontamination of medical equipment and devices used in patient-care procedures, safe and
appropriate handling of sharps, blood and body fluid spills, waste and linen.
Environmental hygiene is maintaining a clean environment by cleaning equipment between use,
disinfecting surfaces, and sterilizing medical equipment according to best practice to remove and destroy
potential infectious microorganisms. Healthcare environments can harbor infectious microorganisms
that have the potential to spread throughout the healthcare setting and infect susceptible individuals.
Keeping the healthcare environment clean, including the client’s room, common areas, and workstations
will break the chain of transmission and help decrease the risk of infection.

COMMON HEALTH PROBLEMS IN THE COMMUNITY

Public health challenges are those that affect the general health of our global population. Contrary to
health care, public health is concerned with the health of entire populations rather than individual
individuals.

Even before COVID-19 struck, marginalized and rural communities were already struggling with health
problems, like:

1. Nutrition and Degenerative Diseases

Research shows that physical inactivity increases the chances of acquiring diseases like heart
disease, diabetes, and tuberculosis. Cardiovascular diseases, such as heart failure or heart attacks, as
well as cancer, are the two leading causes of death in the Philippines. 17% of all deaths of Filipinos die
every year due to some cardiovascular-related death.

Obesity is also a growing global public health problem. Several countries throughout the world
have seen a two- or threefold rise in the number of obesity cases over the previous three decades; most
likely because of urbanization, unhealthy lifestyles, and increased intake of high-calorie processed foods.
The worrisome rise in childhood obesity signals a major burden of chronic disease prevention in future
public health care systems worldwide. Physical activity is also linked to depression and mood swings.

2. Mental Health

People’s relationships with their children, spouses, relatives, acquaintances, and coworkers are
all affected by poor mental health. This leads to problems such as social issues involving communication
and interactions with others. This can be risky for children and teenagers, whose development depends
on establishing and strengthening ties with family members and peers. Social isolation in adulthood can
lead to family collapse, divorce, or even child neglect.

3. Substance Abuse

Over a quarter of a billion people worldwide “take drugs,” and over 35 million “suffer” from
drug use disorders. In the Philippines alone, 1.7 million Filipinos are reportedly using drugs. As with
other countries, the Philippine drug problem is connected with a wide range of factors, including
poverty, inequality, limited access to health care, and systemic governance problems.

4. Tobacco Abuse

According to a Philippine Statistics Authority (PSA) poll, most Filipinos smoke cigarettes, both
manufactured and hand-rolled. 47 percent of men and 9 percent of women smoke cigarettes. Male daily
smokers use 11 cigarettes per day on average, while female daily smokers consume 7 cigarettes per day.

5. HIV/AIDS

HIV/AIDS infection in the Philippines is low, but continues to spread. The country has one of the
lowest infection rates in the world, but it also has one of the fastest-growing numbers of cases. There
were 1,054 confirmed HIV-positive individuals reported to the HIV/AIDS & ART Registry of the
Philippines (HARP) in February 2022, accounting for 96,266 documented cases since January 1984.

EFFECTS OF COMMUNITY HEALTH PROBLEMS

Political, social, and economic inequities are the core causes of poor health for millions around
the world. Poverty is both a cause and a result of bad health, thereby raising the likelihood of bad
health. Poor health, in turn, traps communities in poverty. Every year, infectious and neglected tropical
diseases kill and weaken millions of the poorest and most vulnerable individuals.

Since these health problems are very evident in most communities and the Philippines, poor
Filipinos still lack access to basic healthcare. Poverty has prevented millions of Filipinos from receiving
necessary healthcare services, many of whom can’t afford to go to the hospital and receive therapy.

The advent of the COVID-19 pandemic has also highlighted the need to invest in global health
systems. However, many other public health concerns remain, and it is critical to have a clear
understanding of which public health threats should be tracked and targeted by the government. The
pandemic’s influence on mental health is projected to be more prominent in the coming years. Fear,
anxiety, and despair are on the rise, according to global health authorities. It is critical to promote and
build a better healthcare system.

Child hope Philippines in Action to Solve Community Health Problems

The pandemic has resulted in the economic and health disaster that we are experiencing today.
Thankfully, charitable organizations and individuals are ready to help those in need. The majority of
these organizations includes non-profit organizations (NGOs). Several NGOs in the Philippines that
advocate for health frequently have their own clinics, hospitals, and health care centers. Others
collaborate with the government on health service planning and training.
 Child hope is one of the prominent NGOs in the Philippines that focus on the needs of children.
We advocate for the welfare of children, particularly those who do not have a safe place to live. We
know the importance of protecting their individual rights. This is why we run several health initiatives to
help them enhance their quality of life.

CURRENT GLOBAL HEALTH ISSUES/CONCERNS

1. Climate crisis

The world's climate crisis has major health implications, according to WHO, with air pollution
alone killing an estimated seven million people annually. In addition, more than 25% of deaths from
chronic respiratory disease, heart attack, lung cancer, and stroke are attributed to the same emissions
responsible for global warming, WHO said. Climate change also worsens malnutrition and promotes the
spread of infectious diseases, according to WHO.

To address the issue, WHO said it is working toward creating "a set of policy options for
governments" that aim to lower the health risks associated with air pollution. The organization said,
"Leaders in both the public and private sectors must work together to clean up our air and mitigate the
health impacts of climate change."

2. Health care delivery in areas of conflict and crisis

WHO said it recorded a total of 978 attacks against health care workers or facilities in 11
countries last year, which resulted in 193 deaths. The conflicts also forced a record number of people to
leave their homes, resulting in limited health care access for tens of millions of people, WHO said. WHO
noted that it is "working with countries and partners to strengthen health systems, improve
preparedness, and expand the availability of long-term contingency financing for complex health
emergencies." However, the group said "political solutions" are need "to resolve protracted conflicts,
stop neglecting the weakest health systems, and protect health care workers and facilities from attacks."

3. Health care equity

There are major discrepancies in the quality of people's health across socio-economic groups,
WHO said. For example, WHO noted that there is an 18-year difference between the life expectancy of
people in low- and high-income countries, as well as significant differences in life expectancies among
people living within the same countries and cities. In addition, low- and middle-income countries face a
disproportionately large burden of cancer, diabetes, and other noncommunicable diseases, which can
quickly put a strain on the resources of low-income households.

4. Access to treatments

According to WHO, about one-third of people across the world lack access to essential health
products such as diagnostic tools, medicines, and vaccines. Limited access to these products fuel drug
resistance and threaten people's lives and health, according to WHO. To address the issue, WHO said it
will "sharpen its focus" on efforts to combat "substandard and falsified medical products; enhance[e]
the capacity of low-income countries to assure the quality of medical products throughout the supply
chain; and improve access to diagnosis and treatment for noncommunicable diseases."
5. Infectious disease prevention

HIV, sexually transmitted infections, viral hepatitis and other infectious diseases will kill an
estimated four million people this year, accord to WHO. Vaccine-preventable diseases also are expected
to kill thousands of people over the next decade.

Part of the reason why infectious diseases continue to spread is because of weak health systems
in endemic countries and insufficient levels of financing, WHO said. As such, WHO said there is "an
urgent need for greater political will and increased funding for essential health services; strengthening
routine immunization; improving the quality and availability of data to inform planning, and more
efforts to mitigate the effects of drug resistance."

6. Epidemic preparedness

An airborne and highly infectious virus pandemic "is inevitable," WHO said, but countries around
the world continue to spend more on responding to these emergencies than preparing for them. This
leaves countries unprepared for when another pandemic strikes and potentially threatens the lives of
millions of people, according to WHO.

WHO said countries should invest in evidence-based practices to strengthen their health
systems and protect populations from disease outbreaks, natural disasters, and other health
emergencies.

7. Unsafe products

Nearly one-third of today's global disease burden is attributed to a lack of food, unsafe food,
and unhealthy diets, according to WHO. WHO said while food insecurity and hunger continue to be an
issue, there also is a growing number of people who have diets that are high in fat or sugar, leading to a
rise in weight- and diet-related diseases. Further, there's been an increase in tobacco and e-cigarette
use in most countries, raising additional health concerns.

WHO said it is looking to combat health risks related to unsafe foods and other products by
"working with countries to develop evidence-based public policies, investments, and private sector
reforms to reshape food systems and provide healthy and sustainable diets," and "to build political
commitment and capacity to strengthen implementation of evidence-based tobacco control policies."

8. Underinvestment in health workers

There is a shortage of health workers around the world because of low pay and chronic
underinvestment in health workers' education and employment, WHO said. According to WHO, the
shortages negatively affect health systems' sustainability and jeopardize health and social care services.
An additional 18 million health workers, including nine million nurses and midwives, will be needed
across the world by 2030, according to WHO.

WHO said the World Health Assembly has designated 2020 as the "Year of the Nurse and the
Midwife" in an effort to spur "action and encourage investment in education, skills, and jobs" for health
care workers. In addition, WHO said it is working with countries to generate new investments to ensure
health care workers are trained and paid "decent salaries."

9. Adolescent safety

Each year, more than one million adolescents ages 10 to 19 die, with road injuries, HIV, suicide,
lower respiratory infections, and interpersonal violence leading as causes of death among teens.
According to WHO, a number of factors—including harmful alcohol use, unprotected sex, and lack of
physical activity—increase the risks of these types of death.

WHO said it will aim to promote mental health and curb harmful behaviors among adolescents
in 2020 by issuing new guidance and working to bolster emergency trauma care.

10. Improving public trust of health care workers

The spread of misinformation, coupled with weakening trust of public institutions, is playing an
increasing role in the health decisions patients make, according to WHO. But when patients trust health
care systems, they are more likely to follow a health care workers' advice on how to stay healthy and are
more likely to rely on health services, WHO said.

In order to bolster public trust in health care workers and systems, WHO said it is working to
help countries "strengthen primary care" and to combat misinformation on social media platforms.
Further, WHO added that "scientists and the public health community need to do a better job of
listening to the communities they serve," and there is a need for investments "in better public health
data information systems."

11. Capitalizing on technological advancements

Breakthroughs in technology have revolutionized disease diagnosis, prevention, and treatment,

WHO said, and genome editing, digital health technologies, and synthetic biology have the potential to
solve a number of health problems.

However, WHO also noted that these technologies raise a number of questions regarding how
they should be regulated and monitored. WHO cautioned that without the appropriate guardrails, these
technological advancements have the potential to create new organisms and harm people, and said it is
setting up new advisory committees to review evidence and provide guidance on the technologies.

12. Threat of anti-microbial resistance and other medicines

Anti-microbial resistance (AMR) has the potential to undo decades of medical advancements
and has increased due to a number of factors, including limited access to quality and low-cost
medications, the unregulated prescription and use of antibiotics, poor infection control, and more, WHO
said.

The organization said it is working to combat AMR "by addressing its root causes, while
advocating for research and development into new antibiotics."
13. Health care sanitation

Billions of people across the world live in communities without adequate sanitation services or
potable water, which are major causes of disease. And about one-fourth of health care facilities across
the world lack basic water services, which are critical to health systems, WHO said. A lack of water and
other basic resources results in poor-quality care and increases the likelihood of infections, according to
WHO.

To address the issue, WHO and its partners are working with low- and middle-income countries
to improve hygiene, sanitation, and water conditions at the countries' health care facilities. WHO also is
calling on all countries to ensure all health care facilities have basic hygiene, sanitation, and water
services by 2030.

CURRENT LOCAL HEALTH ISSUES/CONCERNS

Physical Activity and Nutrition

Research indicates that staying physically active can help prevent or delay certain diseases,
including some cancers, heart disease and diabetes, and also relieve depression and improve mood.
Inactivity often accompanies advancing age, but it doesn't have to. Check with your local churches or
synagogues, senior centers, and shopping malls for exercise and walking programs. Like exercise, your
eating habits are often not good if you live and eat alone. It's important for successful aging to eat foods
rich in nutrients and avoid the empty calories in candy and sweets.

Overweight and Obesity

Being overweight or obese increases your chances of dying from hypertension, type 2 diabetes,
coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems,
dyslipidemia and endometrial, breast, prostate, and colon cancers. In-depth guides and practical advice
about obesity are available from the National Heart Lung and Blood Institute of the National Institutes of
Health.

Tobacco

Tobacco is the single greatest preventable cause of illness and premature death in the U.S.
Tobacco use is now called "Tobacco dependence disease." The Centers for Disease Control and
Prevention (CDC) says that smokers who try to quit are more successful when they have the support of
their physician.

Substance Abuse

Substance abuse usually means drugs and alcohol. These are two areas we don't often associate
with seniors, but seniors, like young people, may self-medicate using legal and illegal drugs and alcohol,
which can lead to serious health consequences. In addition, seniors may deliberately or unknowingly mix
medications and use alcohol. Because of our stereotypes about senior citizens, many medical people fail
to ask seniors about possible substance abuse.
HIV/AIDS

Between 11 and 15% of U.S. AIDS cases occur in seniors over age 50. Between 1991 and 1996,
AIDS in adults over 50 rose more than twice as fast as in younger adults. Seniors are unlikely to use
condoms, have immune systems that naturally weaken with age, and HIV symptoms (fatigue, weight
loss, dementia, skin rashes, swollen lymph nodes) are similar to symptoms that can accompany old age.
Again, stereotypes about aging in terms of sexual activity and drug use keep this problem largely
unrecognized. That's why seniors are not well represented in research, clinical drug trials, prevention
programs and efforts at intervention.

Mental Health

Dementia is not part of aging. Dementia can be caused by disease, reactions to medications,
vision and hearing problems, infections, nutritional imbalances, diabetes, and renal failure. There are
many forms of dementia (including Alzheimer's Disease) and some can be temporary. With accurate
diagnosis comes management and help. The most common late-in-life mental health condition is
depression. If left untreated, depression in the elderly can lead to suicide. Here's a surprising fact: The
rate of suicide is higher for elderly white men than for any other age group, including adolescents.

Injury and Violence

Among seniors, falls are the leading cause of injuries, hospital admissions for trauma, and
deaths due to injury. One in every three seniors (age 65 and older) will fall each year. Strategies to
reduce injury include exercises to improve balance and strength and medication review. Home
modifications can help reduce injury. Home security is needed to prevent intrusion. Home-based fire
prevention devices should be in place and easy to use. People aged 65 and older are twice as likely to
die in a home fire as the general population.

Environmental Quality

Even though pollution affects all of us, government studies have indicated that low-income,
racial and ethnic minorities are more likely to live in areas where they face environmental risks.
Compared to the general population, a higher proportion of elderly are living just over the poverty
threshold.

Immunization

Influenza and pneumonia and are among the top 10 causes of death for older adults. Emphasis
on Influenza vaccination for seniors has helped. Pneumonia remains one of the most serious infections,
especially among women and the very old.

Access to Health Care

Seniors frequently don't monitor their health as seriously as they should. While a shortage of
geriatricians has been noted nationwide, URMC has one of the largest groups of geriatricians and
geriatric specialists of any medical community in the country. Your access to health care is as close as
URMC, offering a menu of services at several hospital settings, including the VA Hospital in Canandaigua,
in senior housing, and in your community.

DIFFERENT ENVIRONMENTAL HEALTH PROGRAMS IN THE PHILIPPINES

In the Philippines, Doctors of the World has initiated a health and environment project in San
Andres, in the city of Manila. Most residents there live in informal housing and shacks crowded into low-
lying land that used to be swamps and which today remain regularly flooded during the rainy season.
DotW has been working with these inhabitants since 2018 and supports them in identifying and
mitigating the risks associated with their precarious living environment.

The intervention initially started in Barangay 775, a district in Manila, and was extended in 2021
to Zone 84, an area where nearly 40,000 people live. Activities and community mobilization have been
supported with the help of volunteers from the “AYOS” project (“Let’s go!” in Tagalog).

DotW supported the creation of the local organization by integrating the project’s historical
volunteers. Together and with our support, the inhabitants of Area 84 and volunteers of the
organization have worked on making their neighborhoods “clean, green, and safe”.

EMERGENCY RESPONSE TO ENVIRONMENTAL DISASTERS: In early 2021, DotW continued its

intervention in Catanduanes in partnership with the NGO Handicap International (HI, Humanity &
Inclusion), after Typhoon Goni hit the Philippines in November 2020.

DotW set up a 3-month emergency response, supporting local health structures with equipment
and medicines, and distributing hygiene kits to the 700 most affected families: this response has
enabled continuity of care for nearly 12,000 people in the region.

As the Philippines is a country particularly vulnerable to disasters, we have also decided to

formalize the collaboration with Handicap International (HI) in order to be able to rapidly deploy an
emergency response together.

Finally, in the same month, Super Typhoon Rai caused a wave of destruction in the center of the
country, affecting nearly 10 million people, destroying or damaging 1.7 million homes and 300 health
structures. In coordination with the United Nations and other NGOs, DotW launched an emergency
intervention in the Province of Palawan, with the distribution of medical equipment, medicines and
hygiene kits.

In 2021, as part of our humanitarian mission in the Philippines:

• 4,000 families have been made aware of COVID-19 and disaster preparedness
• 3 local health units have been set up in 3 Barangays of Zone 84
• 26 health staff and volunteers from these units were trained in first aid and the care of people
with chronic illnesses