Growth charts

 It is a visible display of the child's physical growth and development

 It is useful for longitudinal follow-up of a child
 For children below 5 years which compares weight for age
 There are separate charts for boys and girls
 Pink border growth charts are for girls and blue border charts are for boys
 Has two axes - horizontal - x axis is for recording the age of the child
vertical - y axis is for recording the weight of the child in kilograms
Interpretation:
 On each growth chart there are 3 printed growth curves
 When the plotted point is
 above the second curve the child’s growth is normal
 between the second and third curve the child is moderately underweight
 below the third curve the child is severely underweight

 The direction of curves is important

 Upward growth curve: Good - Indicates adequate weight gain for the age of the
child and the child is growing well and is healthy

 Flat growth curve: Dangerous - Indicates that the child has nor gained weight and
is not growing adequately. It signals growth failure - an early symptom of PEM
and the child needs to be investigated

 Downward growth curve: Very dangerous - Indicates loss of weight and he child
requires immediate referral and health care
 ENVIRONMENT
1. Sanitary well
• Properly located
• Well-constructed
• Protected against contamination
• Safe water supply

1. LOCATION:
 The well should be located not less than 15 m (50 feet) from likely sources of contamination
 At a higher elevation with respect to a possible source of contamination
 Well should be so located that no user will have to carry water for more than 100 m
2. LINING:
 The lining of the well should be built of bricks or stones set in cement up to a depth of at least 6
m (20 feet) so that water enters from the bottom and not from the sides of the well.
 The lining should be carried 60- 90 cm (2-3 feet) above the ground level
3. PARAPET WALL:
 There should be a parapet wall up to a height of at least 70-75 cms above the ground
4. PLATFORM:
 There should be a cement-concrete platform round the well extending at least 1 m (3 feet) in all
directions
5. DRAIN:
 There should be a pucca drain to carry off spilled water to a public drain or a soakage pit
constructed beyond the "cone of filtration" (area of drainage) of the well.
6. COVERING:
 The top of the well should be closed by a cement concrete cover
7. HAND-PUMP:
 The well should be equipped with a hand-pump for lifting the water in a sanitary manner
8. CONSUMER RESPONSIBILITY:
 Strict cleanliness should be enforced in the vicinity of the well.
 Personal ablutions, washing of clothes and animals, and the dumping of refuse and wastes
should be prohibited
 Ropes and buckets from individual homes should not be used for drawing water from the well
9. QUALITY:
 The physical, chemical and bacteriological quality of water should conform to the acceptable
standards
2. Household purification of water

Boiling –
 Rolling boil 10-20 minutes
 Kills bacteria, spores, ova, cysts
 Demerits – Taste of water is altered which is harmless
No Residual protection

Chemical disinfection –
1. CHLORINE –
 Chlorine solution
 Prepared by using bleaching powder
 4kg of bleaching powder available with 25% chlorine is mixed with 20 litres of
water to give 5 % chlorine solution
 To be stored in dark, cool & dry place in a closed container
 Chlorine/halogen tablets
 They are quite good for disinfecting small quantities of water
 Single tablet of 0.5g is sufficient to disinfect 20 litres of water
2. IODINE
 2 drops of 2% ethanol solution of Iodine (Lugol’s Iodine) will suffice for 1 litre
of water
 Contact period required – 20 – 30 minutes.
Demerits
 Iodine is physiologically active & interferes with thyroid activity
 It does not react with ammonia or organic contents to greater extent
 High cost

3. POTASSIUM PERMANGANTE
 Powerful oxidising agent
 Kills Cholera vibrio, but ineffective against other organisms
Demerits
 Alters colour, smell & taste of water
 Hence, not recommended for disinfection of water
Filtration –

CHAMBERLAND BREKEFELD

 TYPES OF FILTERS: CHAMBERLAND, KATADAYN, BREKEFELD

 The essential part of a filter is the "candle" which is made of porcelain in the Chamberland type, and
of kieselgurh or infusorial earth in the Berkefeld filter
 Filter candles of the fine type usually remove bacteriae found in drinking water, but not the filter-
passing viruses.
 Filter candles are liable to be logged with impurities and bacteriae.
 They should be cleaned by scrubbing with a hard brush under running water and boiled at least once
a week

Ultraviolet radiation –

 It is effective against most micro organisms – bacteria, yeast, viruses, fungi, algae, protozoa.
 Exposure of film of water about 120mm thick, quartz mercury vapour arc lamps emitting, UV
radiation at a wavelength of 254nm.
 Exposure is for short period. No change in taste & odour.
 No residual effect. Expensive.
Reverse osmosis –

 Multistage reverse osmosis purification process is used to make water both chemically and
microbiologically potable by reducing the total dissolved solids, hardness, heavy metals and disease
causing bacteria, virus, protozoa and cysts.

 Stage 1: 5μ sediment filter

 Stage 2: GAC filter
 Stage 3: Activated carbon block filter
 Stage 4: Reverse osmosis membrane
 Stage 5: Bacteriostatic silver impregnated activated carbon
3. Rapid Sand Filtration

1. Aeration:
 Water is run through fountains
 Oxygen mixes with water and partially removes taste and odour producing compounds
and oxidizes iron and manganese

2. Coagulation:
 Raw water is treated with Alum in a dose of 5-40 mg/L

3. Rapid mixing:
 Water is then subjected to violent agitation in a mixing chamber

4. Flocculation:
 Here slow and gentle stirring of water is done for 30 minutes at 2 to 4 rpm
 Results in the formation of a thick, copious, white flocculant precipitate of aluminium
hydroxide

5. Sedimentation:
 Then the water is detained in sedimentation chamber for 2-6 hours
 Flocculent together with impurities and bacteria settle down
 Tanks should be cleaned regularly from time to time

6. Filter beds
 Then the water goes to the filter bed where sand is the filtering medium
 Surface area is 80-90 sq.m.
 Effective size of sand: 0.4-0.7mm
 Rate of filtration: 5-15 m3/m2/hr
 Alum-floc not removed by sedimentation is held back on sand bed and forms a slimy
layer.
 It adsorbs bacteria from the water, oxidation of ammonia also takes place during the
passage of water through the filters
 The filter is cleaned by backwashing which is nothing but the reversal of flow of water
through the sand bed.

7. Disinfection:
  Filtered water which is collected from the sand filter is then disinfected through chlorine
gas
4. What is hardness and how to remove hardness of water?
 Hardness is the soap destroying power of water
 It is due to four dissolved compounds in water –
 Calcium bicarbonate
 Magnesium bicarbonate
 Calcium sulphate, and
 Magnesium sulphate
Chlorides and nitrates of calcium, magnesium, iron, manganese and aluminium compounds can also
cause hardness but they occur generally in small amounts
 Drinking water should be moderately hard

Hardness

Temporary hardness Permanent hardness

calcium and magnesium calcium and magnesium

bicarbonates sulphates, chlorides and nitrates

 REMOVAL OF HARDNESS
 Temporary hardness
 Boiling - removes the temporary hardness by expelling carbon dioxide, and precipitating the
insoluble calcium carbonate
Ca(HC03)2 CaC03 + H2O + CO

 Addition of lime - Lime absorbs the carbon dioxide, and precipitates the insoluble calcium
carbonate
Ca(OH)2 + Ca(HC03)2 2CaC03 + 2H20

 Addition of sodium carbonate -

Na2 C03 + Ca(HC03)2 2NaHC03 + CaC03
CaS04 + Na2 C03 CaC03 + Na2 S04

 Permutit Process / Base exchange process -

o Sodium permutit is a complex compound of sodium, aluminium and silica (Na2 Al2
Si2O H2O)
o When hard water is passed through the permutit the calcium and magnesium ions are
entirely removed by base exchange and the sodium permutit is finally converted into
calcium and magnesium permutit.
o By this process, water can be softened to zero hardness
o Since water of zero hardness is corrosive, a part of the raw water is mixed with the
softened water to secure the desired hardness
 Permanent hardness
 Addition of sodium carbonate
 Base exchange process
5. Senthils Chloroscope

 0.1 ml of the reagent to 1 ml of water

 Reading within 10 seconds - free chlorine in water
 After 15-20 minutes - both free and combined chlorine

6. Halazone tablets

 They are quite good for disinfecting small quantities of water

 Single tablet of 0.5g is sufficient to disinfect 20 litres of water
 Halazone's disinfecting activity is mainly due to the hypochlorous acid (HClO) released

5. Bore hole latrine

 The latrine consists of a circular hole in, dug vertically into the ground
 Diameter - 30 to 40 cm
 Depth - 4 to 8 m
 For a family of 5 or 6 people, a bore hole serves well for over a year
 When the contents of the borehole reach within 50 cm of the ground level, the squatting plate is
removed and the hole is closed
 The nightsoil undergoes purification by anaerobic digestion
4. Dug well latrine

 The latrine consists of a circular hole in, dug vertically into the ground
 Diameter - 75 cm
 Depth - 3 to 3.5 m
 For a family of 5 or 6 people, a bore hole serves well for over a year
 A concrete squatting plate is placed on the top of the pit
 The nightsoil undergoes purification by anaerobic digestion

5. P-trap

 The trap is a bent pipe which is connected with the pan of RCA type of water seal latrine
 Diameter of pipe is 7.5 cm
 It holds water and provides the necessary water seal
 The water seal is the distance between the level of water in the trap and the lowest point in the
concave upper surface of the trap.
 The depth of the water seal (AB) in the RCA latrine is 2 cm (3/4 in.)
 The water seal prevents the access by flies and suppresses the nuisance from smell