BASIC SAFETY HEALTH AND FIRST AID

TOPIC ONE: THE HEALTHY INDIVIDUAL

INTRODUCTION

This topic presents the essentials of good health detailing healthy living, living in a healthy
environment and the procedures for identifying common infections, symptoms, causes and treatment.

By the end of this topic, you should be able to:

• Identify and describe the characteristics of persons who are physically, mentally, socially and
emotionally healthy.

• Identify the common infections, symptoms, causes and treatment

OBJECTIVES

Sections in the topic

This topic consists of three sections namely:
Essentials of good health
• Physical health
• Mental health
• Social and emotional health
Health and environment
• Environment and good health
• Food storage
• Refuse disposal
• Insects pests and health
Common infections, symptoms, causes and treatment

Section 1: Essentials of good health

Introduction: This section discusses aspects of health including physical, mental, social and emotional health. The essentials
of how to care for the environment are also presented along with the symptoms of common infections, causes and treatment.

Good health is very essential to every individual human being.

Good health entails a state of being well in the physical, mental, social and emotional being.
World Health Organization (WHO) defines ‘health’ as a state of complete physical, mental and social well being and not
merely the absence of disease or infirmity. This means that for one to be considered healthy, he or she must be physically,
mentally, and socially well.

Physical Health is when the body systems are functioning well. These include; the digestiv e system, respiratory, nervous,
skeletal, lymphatic and excretory systems.
It should be noted that a healthy body is free from simple diseases such as cough, flu, headache, among others and other
defects.

Physically healthy individuals eat a balanced diet which must contain proteins, carbohydrates, fats and fruits.

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It is important to note that for one to be physically healthy;

✓ He or she avoid junk food and fast food

✓ Avoid impulsive eating
✓ Have a regular routine exercise
✓ Have enough rest especially through sleep because sleep cools the tired nerves and aching muscles. One should sleep
at least 8 hours for grownups.
✓ Avoid smoking
✓ Drink alcohol either sparingly, or not at all.

If the above facts are not observed by an individual, then one is likely to develop physical disease.

Physical diseases may be caused in three ways:

i) Structurally as a consequence of physical damage. For example an individual may have broken limbs and other body
areas like the spinal vertebrae, skull among others.
ii) Disease causing organisms such virus, bacteria and parasites
Note: (details of viruses, bacteria and parasites will presented later in this module).
iii) Genetic complications such as sickle cell anemia.

To improve on physical health, there are four different steps to be taken depending on the type of ailment. These are: curative
measures, preventive measures, palliative care and rehabilitative action.
Let us try to list each of the measures.
a) Curative measures – these are measures taken to cure a disease. In case of sickness the patient is required to establish
the cause of the disease by carrying out an investigation, to know the cause of disease then take measures to treat to
cure.
b) Prevention measures- these are measures taken to prevent a disease before it is caused or spreads. Prevention is
usually carried out through immunization.
c) Palliative care - This is care given to improve health of people with terminal ailments such as cancer.

d) Rehabilitative action- rehabilitative action involves restoring persons with injuries such as broken limbs and
alcoholics and drug addicts.
Mental health is when a person is capable of coping with the normal responsibilities expected of him. It is when a person is not
mentally stressed, depressed or anxious and all his or her senses are in working order. Such a person is well adjusted and
interacts with smoothly with others in the society without problems.

Mentally healthy persons:

➢ Are able to make rational decisions,

➢ Work to solve problems and have realistic solutions
➢ Are able to manage stress by employing relevant self help skills and strategies such as exercise, listening to music
among others.
➢ Read life enriching books
➢ Are able to realize and admit to their mistakes or failures and do not ignore problems that may have been their fault.
➢ Do not allow their emotions to get out of control- even when the situation calls for it.

Mental diseases are caused by different factors, some of which are as follows:
- Diseases such as measles, polio, meningitis, may damage the brain.
- Injury to the brain either during child birth or afterwards may cause mental health.
- Stress due to various pressures in life can cause mental health
- Brain fatigue
- Drug abuse
- Hereditary factors
- Malnutrition in early childhood.
- Unrealistic demands by parents or guardians.

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There are various preventive measures that one can take to avoid mental diseases. These include:
Seeking assistance from counselor, if this does not work out then the counselor can refer one to a psychiatrist for medical
attention.
One should take part in physical exercises such as jogging, running, swimming, among others.
- Be helped by relatives
- Keep good physical health
- Eat balanced diet (Malnutrition in childhood can also interfere with maximum brain development).
We hope you have studied the previous section without any problem. You are now welcome to the next subsection entitled
social and emotional health.

Social and emotional health is very much related to physical and mental health.
Social health refers to how people interact with others in areas around them. This affects their physical, mental, emotional and
spiritual health. To be socially healthy, one makes friends easily and is able to work with people happily and friendly in a
group.

Emotional health is closely tied to social development. It refers to the expression of one’s feelings about the self, others, and
the situations he or she will face in the world around him/her as well as gaining control of his or her bodily functions, learning
to focus, and pay attention.

There are many factors that may affect the way children express their social skills or emotional competencie s or the rate at
which children acquire social skills or emotional competencies.

Factors that influence social and emotional development include; environmental risk factors, family risk factors and within -
child risk factors.
Environmental risk factors such as
• Living in an unsafe community
• Receiving care within a low-quality child care setting
• Lack of resources in the community or lack of policies supporting children and families
Family risk factors such as
➢ Maternal depression or mental illness in the family
➢ Parental substance abuse
➢ Family violence
➢ Poverty at family level among others

Within-child risk factors include

➢ Being temperamental,

➢ Delay in development especially caused by serious health conditions.

➢ All of these factors need to be taken into careful consideration when gathering information to fully understand and
support children's social and emotional health through a comprehensive, ecological approach.
It is important to note that being socially unhealthy depends very much on

the following factors:

- Ones upbringing , that is the way one is brought up and socialized at family level
- The environment one has been exposed to (at home, school, community among others)
- The level of education that is the level at which one has attained his education.
- Virtues instilled in a person, that is the positive attributes one has acquired such as honesty, integrity, respect
for others among others
- Poverty level
- Change in social trends.
To prevent social disease it is important to
- Expose the growing child to the right environment.
- Every individual child must receive education and subjects that encourage good manners, honesty and good
morals.

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 - Religious education should be highlighted in all schools.
- The society should to take care of the poor.
- Laws should be enacted to govern peoples’ social behaviour.

Section 2: Health and environment

Introduction
This section presents information on how to care for the environment both at home and the school

Yes! That is part of your environment!

The environment refers to our surrounding. Surrounding includes air, plants, trees, houses, furniture, vehicles, people, clothes,
mountains, rivers etc. What is around us can contribute to either good health or bad health.

Yes! The environment can affect your health adversely!

For example:
- If your house is not kept clean
- When houses your house is not safely built and maintained.
- When the food you eat is not well stored in a clean place.
- When the compound and surrounding you live in is not kept clean.
- When refuse is not disposed of f in the right manner.
- When human wastes is not well disposed.

A house where people live should be kept clean and tidy by sweeping the floor and dusting. Furniture should be dusted;
utensils cleaned so as not to habour bacteria which may cause diseases such as diarrheal to the children and adults. It is also
important to eat clean food by ensuring safety in food storage.

Proper food storage is important because it helps to avoid food wastage, and insects and vermin do not have a chance to it.

Storage of vegetables and fruits

Vegetables and fruits should be stored open to air to prevent rotting but protected by netting wire where possible.
Storage of grain and its products
Grain and its products should be stored in containers with well fitting lids.
Food utensils

Food utensils should be kept either in closed cupboards or covered to protect them from dust.

The environment around the house should be kept clean by sweeping, picking rubbish and proper refuse disposal.
Proper refuse disposal
Refuse must be disposed of properly to get rid of:
- Bad smells which can be offensive.
- Rodents such as rats which can spread diseases
- flies and other insects

This is because rodents and insects are responsible for various health problems. For example flies cause eye diseases like
conjunctivitis and trachoma diarrheal diseases such as dysentery, typhoid and cholera. Rats cause plague fleas which cause the
disease called plague.

To dispose refuse in a home or school environment one can:

➢ Deposit it in a composite pit
➢ Burn
➢ Burry the refuse.
➢ In urban centers, garbage collection services are provided.
Human waste includes faeces and urine. It contains diseases causing organisms and it is one of the ways through which
communicable diseases such as diarrhea, cholera, typhoid dysentery, amoebiasis, bilhazia among others are spread. Flies act as
vehicles in transporting germs from a sick person to a healthy person.

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Places for disposing human waste include pit latrines/ water closed toilets.

In rural areas, each household should have its own pit latrine for human waste disposal. Public health officers instructions are
that, pit latrines be built 30 meters away from any source of water for human or animal consumption.
- A pit should not be built uphill from a source of water to avoid seepage.
- The pit should be 5-7 meters deep
- Cemented floors are recommended to enable users keep it clean. If it is not possible to cement then wood should
be used.
- The latrine should be always clean.
- The deeper the latrine the better to avoid flies to breed inside.
- The hole should be small so as not to allow children to fall into the pit.
- A little house for shelter and privacy while using the pit latrine should be built.
- Also, water closed toilets in towns, they should be kept clean.

Section 3: Common Infections- Symptoms, Causes and Treatment

In this section you will learn about the common infections, their symptoms, causes and treatment.

Common infections are caused by viruses, bacteria, parasites and f ungi.

A virus is a microorganism smaller than a bacterium, which cannot grow or reproduce. A virus invades living cells and uses
their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with mutations.
The ability of a virus to mutate is responsible for the ability of some viruses to change slightly in each infected person, making
treatment more difficult. Viruses cause many common human infections, and are also responsible for rare diseases.

In this section we will not discuss all the viruses but instead we will identify a few which cause the common
infections.Examples of viral illnesses include common cold, which is usually caused by one of the rhinoviruses. Other viruses
include Mononucleosis, Herpes Zoster Ophthalmicus Bronchiolitis, Cytomegalovirus, West Nile Virus among others.

Ophthalmicus (HZO)
Herpes zoster ophthalmicus (HZO) is caused by the chickenpox virus. Herpes zoster is also often referred to as shingles . It
involves the skin around the eye and sometimes the eye itself. It is not the same virus that causes herpes simplex.

HZO can cause a rash with small blisters to break out on the forehead and around the eye on one side of your face. Sometimes
one will have pain in the same area of the face a few days before the outbreak.

If one has HZO, he or she will probably have a rash that looks like chickenpox, but only on one side of the face. Besides
examining you, the doctor will not need to do any additional tests to see if you have HZO. Sometimes herpes simplex
infections can resemble HZO. However, the patterns of the rashes are different and the doctor will be able to tell them apart.

If one has HZO, he or she should see a doctor right away. Early treatment with antiviral medicines can reduce pain and the
duration of symptoms. Your doctor can give you advice about treatment, but rest is also important. Cool compresses can ease
the pain and rash. Pain relieving medicine such as aspirin or acetaminophen may help.

Can one infect others with HZO?

If one has HZO, he or she can infect the virus that causes chickenpox to other people. Therefore, one should avoid people who
have not had chickenpox (especially pregnant women) and very sick patients (such as patie nts with cancer or AIDS). If one
lives with children who have not had chickenpox, you should tell your doctor.
Another viral disease is common cold or flu. Let us learn more about flu.

Common cold/flu

The symptoms are:

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 ➢ Running nose,
➢ Headache
➢ Tiredness
Note: It takes 7 days with treatment and 7days without treatment for flu to clear.

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
The virus is transmitted through contact with the blood or other body fluids of an infected person - not through casual contact.

The symptoms of Hepatitis B are: fever, loss of appetite, general malaise and loss of consciousness.
Prolonged suffering from Hepatitis B may lead to it turning cancerous and may lead to death.
HIV and AIDS- Though viral it is transmitted mostly through sexual intercourse. You will learn more about HIV and AIDS in
topic 7 in this module. Now let us study about measles.
Measles
Measles is an infection of the respiratory system caused by a virus, paramyxovirus of the genus Morbillivirus. Morbilliviruses,
like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses.
Measles is mainly a childhood disease though it can affect grownups who were not immunized against it.
Measles is a highly communicable disease.

Symptoms of measles include:

• Fever, cough, runny nose, red watery eyes, hoarseness of voice.
• After 3 days, typical measles rash at the back of ears, at the junction of the fore head and hair then spreads to
the whole body.
• The rush stays for 3 days then deepens the color, fades and gradually disappears.

Measles it is transmitted through the air ways

• Measles has no treatment
• Once a patient gets measles has to go through the full course.
• Measles can develop complications and can cause death.
Complications in Measles
• Diarrhea and vomiting
• pneumonia
• eye infections which may lead to blindness
• inner ear infections which may lead to death
• Brain damages as a result of brain infections and convulsions.
• Malnutrition due to lack of appetite.
Mumps is a disease caused by a virus that usually spreads through saliva. It infects many parts of the body, especially the
parotid salivary glands.

• high fever
• Swelling and tenderness of one or more salivary glands.

Mumps is dangerous if it affects adolescents as it affects other glandular organs such as the testicles for men and ovaries in
women and as such it may cause infertility Mumps can also affect the pancreas.
Mumps is controlled by isolation because it spreads by droplet and direct contact with saliva of the patient.

b) Bacterial infections

Some of the bacterial infections include: whooping cough, strep throat, urinary tract infections in children, bacterial
vaginosis , cat-scratch disease, otitis externa, tuberculosis ,tick-borne diseases, lyme disease among others.

Pneumonia

Pneumonia is caused by bacteria called streptococcus. It is common in children. The main symptoms of pneumonia include;
fever, sweating, pain in the chest, hard cough.

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Pneumonia is treated through the advice of a qualified medical doctor with the right dosage of anti-biotic.

Tuberculosis

Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects
the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory
disease.

• The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness,
weight loss, fever and night sweats.
• Tuberculosis is treatable with a six-month course of antibiotics.

Another bacterial infection is typhoid fever.

• Typhoid fever is a bacterial disease, caused by Salmonella typhi. It is transmitted through the ingestion of food
or drink contaminated by the faeces or urine of infected people.
• Symptoms usually develop 1–3 weeks after exposure, and may be mild or severe. They include high fever,
malaise, headache, constipation or diarrhoea, rose-coloured spots on the chest, and enlarged spleen and liver.
Healthy carrier state may follow acute illness.
• Typhoid fever can be treated with antibiotics. However, resistance to common antimicrobials is widespread.
Healthy carriers should be excluded from handling food.

• Fever, headache, stomachache, vomiting, Body weakness,

• malaise, constipation or diarrhoea, rose-coloured spots on the chest, and enlarged spleen and liver
• Typhoid fever can be treated with antibiotics
Cholera
• Cholera is an infection of the small intestine caused by the bacterium Vibrio cholerae.
• It is a highly fatal disease contracted though contaminated food, water etc
• Flies can act as carriers of the disease.
• Profuse diarrhea and vomiting
• If not treated immediately one dies of dehydration.
Let us learn more about Sexually Transmitted Diseases (STDs)
Sexually Transmitted Diseases (STDs)

These are diseases which infect the sexual organs and the urinary tract.
• They are contagious diseases.
• Common ones include: Gonorrhea, syphilis among others.
Some major complications from STDs include:
• Primary and secondary infertility, painful conditions eg Pelvic Inflammatory Diseases (PID).
• Urinary infections.
• Syphilis may affect liver, the heart and cause death.
• Foetal malformation and abortions
Parasitic infections

Parasitic infection is a disease spread by a parasite such as protozoa.

• Some of the parasitic infections Include: Malaria, amoebiasis, yellow fever, bilharzias, dysentery, asearis,
hook warm, tape warm.
Malaria

Malaria is a parasitic disease caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes.
In the human body, the parasites multiply in the liver, and then infect red blood cells.
The symptoms of malaria include:

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 • High fever
• Chills
• Shaking
• Extreme sweating
• Fatigue
• Discomfort (called malaise) and body aches
• Headache
• Nausea
• Vomiting
Malaria is a health problem in many tropical countries. It can also be a problem for people visiting these countries.

One should do whatever is possible to avoid mosquito bites.

- Use a mosquito net over your bed.
- Spray the net with permethrin (one brand name: Elimite). (Permethrin is a spray that repels mosquitoes.)
- Avoid going outdoors without protection in the evening, when mosquitoes are typically more active.
- Medicine is also available to help prevent malaria.
Fungus
Fungal infections include: Tenea group: tenea capitis: affecting the head, tinea carporis affecting the body, tinea cruris-
athlete foot, candiadisis- sexual organs
Other infections
• Eye infections – conjunctivitis, trachoma (can lead to blindness).
• Ears otitis media- infection inside the ear.
• throat- upper respiratory tract infections.(URT I)
SUMMARY

Good health entails a state of being well in the physical, mental, social and emotional being. To be
physically healthy, there is need to eat a balanced diet, exercise regularly and take enough rest.
Mental health is a state which one is free from stress, anxiety, depression and apprehension. Social
health refers to how people interact with others while emotional health refers to the expression of
one’s feelings about the self, others, and the situations around them. The environment also
contributes to the health of individuals. It is therefore imperative to keep the house, the compound
and the grounds clean by disposing waste. It is important to store food in a clean manner to avoid
contamination. Common infections, symptoms and methods to treat them have been discussed.

ACTIVITIES

Please note that ‘health is wealth’ and for one to be healthy, it is important to observe physical,
mental, social and emotional health. Keeping the environment clean and handling common infections
clinically when you notice the slightest of the symptoms .

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 1. List the immunizable diseases and the ages at which the immunization should be given

2. Visit a school counseling office or a social worker and identify the common social and
mental problems they handle.

3. Visit the nearest school and observe how refuse is disposed and areas the school can
improve on in refuse disposal .

TOPIC
TWO:

HANDLING LEARNING AND PHYSICAL DISABILITIES

INTRODUCTION

TOPIC
OBJECTIVES
Welcome to the second topic in this module. In the last topic you covered the essentials of
good health, environment and health and how to identify common infections, their symptoms
and treatment. In this topic you will cover disability and how to handle persons with
disability.

This topic consists

of two sections as
By the end of this topic you should be able to: follows:
• Define terms used to identify disability Definition of
• Explain manifestations of different types of disabilities terms and causes
• Handle persons with different types of disabilities of disability
The Full spectrum
of impairment and
adaptive mechanisms: Visual impairment, Hearing impairment, Speech impairment, Physical disability, mental disability, deaf,
blindness

Definition of terms: impairment, disability and handicap

Introduction
In this section you will learn the definition of terms impairment, disability and handicap and the full spectrum of the different
types of impairment and different mechanisms how persons with disability can adopt to the environment

Well! Let us discover together the difference

According to World Health Organization (WHO) impairment, disability and handicap have been systematically identified in
relation to health condition to provide a unified and standard language and framework for the description of hu man functioning
and disability as an important component of health.

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The definition covers any disturbances in terms of “functional states” associated with health conditions at body (impairment) ,
individual (disability) and society level (handicapped).

At the body level, emphasis is laid on functions of the body system and the body structure, while at the individual level;
performance of activities is underscored (impairment).

At the individual level focus is on activities that cover a complete range of activities performed by an individual (disability).

At the societal level, participation of the individual in the society is emphasised, that is, classification is made on areas of life
in which an individual is involved, has access to and has social opportunities or barriers.
However, this classification does not cover the functional states that are not health related e.g. those brought about by socio -
economic factors independent of health conditions. A case in point is the restriction in participation bec ause of race, gender,
religion among others.
Definition of disability
According to the disability act 2003, disability is the; physical, sensory, mental, or other impairment, including a visual,
hearing or physical disability, which has a substantial long term adverse effect on a person’s ability to carry out usual day to
day activities.

From the above definition, disability is, viewed as a physical, mental, or psychological condition or impairment that
substantially affects a person’s daily activities or limits a person’s ability to perform one or more major life activities (referred
to herein as Activities of Daily Life- ADL).

Look at the following statistics and discuss what they inform you about disability in Kenya

1. According to WHO 10% of any populations has some kind of disability.

In Kenya according to 2009 National census the population stands at 38, 610, 097 persons. What is the population of persons
with disability?

2. 95% of people with disability come from poor families (those who live with less a dollar per day.

3. 80% of the whole disabled people live in the developing countries

Did you list some of the following?

• Wrong medication or Management
• Lack of immunization,
• Diseases
• Domestic violence and fighting
• Environmental pollutants,
• Burns (domestic or industrial)
• Lack of breast feeding and poor nutrition.
• Accidents
• Use of drugs and alcohol during pregnancy among others
The Full spectrum of impairment and adaptive mechanisms

This section presents the full spectrum of impairment and the coping mechanisms of persons with disability in a school
environment.

The full spectrum of impairment covers different types of disabilities which include the following: (to include graphics of
persons with those conditions)

• Visual impairment

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 • Hearing impairment

• Speech impairment

• Physical disability

• Mental disability

• Deaf blindness

• Autism (mental condition characterized by great difficulty in communicating with others and in using language and
abstract concepts)

• Albinism

• Epilepsy

• Cerebral palsy: a condition marked by impaired muscle coordination and spastic paralysis caused by damage of the
brain before or after birth

• Behaviour & emotional problems

• Learning difficulties

• Multiple disabilities

Let us explain the main ones especially the ones which have not been explained above.

Visual impairment describes the various degrees of vision loss. The vision loss ranges from low vision to total blindness.

• The definitions of what constitutes “low vision” vary, but generally low vision is defined as inability to see objects that
are small or distant objects.

• “Total blindness” is the complete absence of vision and light perception.

• A person is considered to have an eyesight or visual disability if he / she doesn’t have normal vision even if he/she
wears eyeglasses or contact lenses.

• Visual impairments are caused by injury, disease, through accident, nerve degeneration or cataracts or are congenital.

• By giving a thorough orientation and mobility training so that the learner can be able to move and travel
independently.

• By providing adaptive equipment, which include; Braille computers, collapsible cane, magnifying glasses, and
stenography, among others to aid the learners to adapt the curricular in meeting their individual unique needs.

Hearing impairment refers to people who are completely deaf (the deaf) or has partial hearing (the Hard of Hearing) in one or
both ears.

Hearing impairment can be caused by;

• Injury or disease.
• In some cases extremely high frequency sound waves
• Genetic factors.

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 - Learners with hearing impairment need to access learning, the language of instruction as well as that of social
interaction when involved in analytical conversations.

- Therefore, the students with hearing impairment or hard of hearing require the use of sign language or a total
communication system to enable them obtain information that others gain by listening.

- They may need technological aids such as amplifiers or hearing aids.

When formulating special programmes for these learners, areas of focus should be:

- First, exploit the learners´ capabilities so as to enable them to develop socially and compensate for the loss of hearing.

- Secondly, achieve the personal development of the learner with an overriding aim of his or her future life situations i.e.
these learners should be prepared to evaluate their disability positively so as to achieve self -esteem.

- The school staff need to learn sign language, for easy communication

Speech and language difficulties refer to problems in communication or difficulties in using spoke n language.
There are two main types of speech and language difficulties.
These are:
• Speech difficulties: Voice difficulties; fluency difficulties (stammering; articulation difficulties)
• Language difficulties: receptive language difficulties (comprehension; expressive language
difficulties)
The difficulties might be characterized by an interruption in the flow or rhythm of speech, such as stuttering.
• These delays and disorders range from simple sound substitutions to the inability to understand or use langu age or use
the oral-motor mechanism for functional speech.
• Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, drug abuse,
physical impairments such as cleft lip or palate, and vocal abuse or misuse.
• Persons with speech disabilities are often not able to communicate effectively with others, therefore when dealing with
them it is important to give them time, support and encourage them to communicate.

Physical disability

Physically handicapped children can be classified into three major groups namely: Orthopaedic, Neurological and Health
Disabilities.

Let us explain each one of them

a) Orthopaedic: Orthopaedic disabilities include those children with poliomyelitis (an infectious viral disease that affects
the central nervous system and can cause temporary or permanent paralysis ), amputations, clubfoot, congenital
dislocation of the hips, Leprosy, leg-Calves, curvature of the spine, among others
b) Neurological: Neurological disabilities include cerebral palsy, spinal cord injury, childhood muscular atrophy among
others.
c) Health Disabilities. Health disabilities include epilepsy, juvenile diabetes, Haemophilia (a medical condition in which
the ability of the blood to clot is severely reduced, causing severe bleeding from even a slight injury) Asthma, Heart
diseases, Tuberculosis among others.

- Schools where the physically challenged children are integrated should be barrier free.

- Physical facilities within these schools need to be extensively adapted to the ne eds of the physically handicapped
learners.

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 Most schools which are not adopted to accommodate persons with disabilities are found in rural areas where learners
not only cover long distances but lack proper transport to sch ools. At the same time, these roads and paths are
impassable during the rainy season.

- To minimize the unfriendly nature of the built environment, professionals in construction such as designers,
architectures, engineers concerned should co-operate in putting up a barrier-free physical environment to guarantee the
health of the learners.
- Areas of emphasis should include classes, social rooms, sanitary facilities which should, if possible, are accessed
independently.

- What are the main causes of physical impairment?

• Diseases such as polio
• Injuries,
• Muscular degeneration
• Muscular weakness,
• Muscular paralysis,
• Joint stiffness,
• Substance & drug abuse

Mental disability affects peoples’ cognitive functioning and developmen t (mental development)

• It also affects the ability to perform activities like other people of similar age group / age groups (e.g. activities of daily
living – dressing, eating, and toileting).

• Persons with mental disability may have difficulty of remembering things, reasoning, decision making, concentrating
or coordinating body movements and functions.

Mental impairment also includes difficulties in executing many different functions like:

• ability to pay attention,

• learn and retain information,

• solve problems,

• use language to express thoughts

• Executing simple tasks.

What are the main causes of mental disability?

• Brain damage or genetic disorders.

• Drugs, lack of oxygen to the brain during delivery,

• Brain Developmental delay due to unknown factors.

Self care

• Self care difficulties refer to difficulties carrying out personal daily activities like in: dressing, bathing, eating,
grooming and hygiene, toileting, getting around inside the home.

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 • These difficulties may have arisen as a result of other disabilities such as physical or mental disability.

• This type of difficulty may present in most disabilities. It may be more pronounced in mental disability, severe
physical disabilities and multiple disabilities.

These refer to any other disabilities not mentioned or covered above. They could be any of the following:
• albinism
• epilepsy
• autism
• Cerebral palsy

It is important to:
• Know that whatever shortcoming we find in any human being is a challenge to alleviate them or remedy them to the
best of our ability.
• Teachers should try to identify the specific needs of each special person in order to provide them adequately.
• the most important requirement of special needs person include:
- being loved and understood
- being appreciated as persons
- Being appreciated in what they do.
- attention given should be in a climate of true human affection
1.1 SUMMARY

In this topic you have learnt about impairment, disability and handicap where the three terms were
differentiated. You have also learnt the whole spectrum of impairment where a detail of how each one
manifests itself and the coping mechanisms for persons suffering from differnent impairments.

ACTIVITIES

Visit a school where persons with impairments are integrated in a normal school and identify
the challenges those persons face.
In a class debate with your colleagues on the motion: “It is better to teach children with
disabilities in integrated schools than to teach them in special schools”

Disability is not inability persons with disability do not require sympathy but an enabling environment to cope.

1.7 FURTHER READING

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SELF-TEST QUESTIONS

Score
board

1. State five causes of mental impairment. (5 marks)

2. Identify coping mechanisms of persons with:

i. Visual impairment
ii. Hearing impairment
iii. Physical impairment in a school set up (15 marks)

TOPIC THREE: FIRST AID AND HANDLING COMMON ACCIDENTS

Introduction
Welcome to the third topic in this module. In the second topic you le arnt about disability, the full
spectrum of disability and how to help persons with disability to cope. In this topic you will learn about
the essentials of First Aid, the techniques and equipment in First Aid and the life saving procedures.

Objectives

By the end of the topic you should be able to:

• Define First Aid
• Explain its importance to a practicing teacher
• Define accident
• Identify some of the causes of accidents at home and school.
• Identify the common accidents at home and in school
• Explain the First Aid measures to be taken in cases of different accidents

This topic consists of two main sections:

• First aid essentials
• First AID Techniques procedures.

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Let us discuss each one of them in details. (There are many illustrations in this topic some will be given while others are
being sought for)

First Aid is the usage of certain principles of treatment at an accident or when there is sudden illness by making use of facilities
and materials available at the time. It is a technique of managing causality until one is taken to a doctor or to hospital if
considered necessary.

- An accident may be defined as an unfortunate event resulting from carelessness, unawareness, ignorance or a
combination of causes which usually result in injury or injuries. The injuries could be:
• Fractures
• Wounds
• Burns
• Bites from animals, insects, snakes etc
- Accidents can lead to death if First Aid is not administered immediately.
- Accidents have many causes, with emphasis put on home accidents and in particular those that happen to childr en.

What are some of the causes of home/school accidents?Children left alone to care for themselves.
- Children left in the care of inexperienced or very young caretakers.
- Keeping dangerous drugs, insecticides and cleaning materials within reach of children .
- Keeping dangerous implements and tools within reach of children e.g. knives, nails, matches among others.
- Putting poisonous substances in beverage bottles so that children mistake the contents and drink the kerosene .
- Large unplanned families who make it difficult for a mother or caretaker to pay attention to each individual child.
- Mothers being too busy and unable to take care of all children particularly those in crawling age.
- Having open fires or leaving hot pots or kettle where small children can pull over.
- Being untidy in the home and leaving things lying around that people can trip over.
- Careless in electrical wiring.
- Careless keeping of lab equipment and chemicals in schools.

You can list other causes of accidents!

- Children are naturally very curious.

- They like to find things out for themselves.
- This unfortunately means they are exposed to danger e.g.
a) From fire
b) From chemicals
c) From medicine or other things kept at home
- When an accident has occurred, simple First Aid can be given while help is being sought for.
- What are the First Aid Priorities?
- Assess the situation quickly and calmly. (illustrate)
- Protect yourself and the casualty or casualties.
- Comfort and reassure the casualties.
- Deal with any life threatening condition.
- Obtain medical aid if necessary.
- If you suspect a serious illness or injury call an ambulance.

3.2 Some Common Accidents and the First Aid Measures

Welcome to the second section of this topic. In this section common accidents will be presented and the First Aid measures to
handle them.

Burns and Scalds

- A burn is an injury that results from fire or a chemical agent.

- Injuries from hot liquids and steam are called scalds.
- Burns and scalds vary in depth, size and severity.

16
 - They may damage the skin and the body under the skin.

Burns can be caused by;

1. Carelessness with matches
2. Badly constructed fireplace
3. Hot liquids
4. Defective cooking
5. Electrical equipment
6. Chemical e.g. caustic soda, strong acids and strong detergents.

Besides surface burns, other hazards of fire in a building include the fo llowing;

- Inhalation (breathing) of poisonous gases including carbon monoxide.

- Suffocation (asphyxia) from insufficient oxygen in the air.
- Harmful smoke (e.g. from burning plastics) as a result of fire.
- Falls and injuries from collapsing walls in burning buildings.

First Aid in Burns

• To limit the depth and severity of the burn.

• To relieve pain.
• To prevent infection.
• To treat for shock.
• How can you recognize Burns?Reddened skin.
• Pain in the area of the burn.
• Swelling and blistering of the skin.

Precautions!

• Do not apply lotion, ointment or fat to a burn.

• Do not touch the burn or burst any blisters.
• Do not remove anything sticking to the burn.
• Keep cooling with water until help arrives.
• If the burn is caused by chemicals, cool for at least 20 minutes.
• Burns on sensitive parts of the body e.g. the face or the genital area, serious
• burns of hands or feet and extensive or deep burns should be treated in hospital.

What action should be taken after burns?

• As quickly as possible, apply or pour cold water to the bu rnt part or submerge it in ice cold water for at least 10
minutes.
• Carefully remove any clothing or jewellery from the area before it starts to swell. However, do not remove any
clothing that is sticking to the burn.
• How do you prevent infection in a burn?
• In order to prevent infection, keep the burn as clean as possible using a dry sterile gauze or clean cloth or non fluffy as
protective dressing.
• Do not try to break blisters or remove shreds of skin.
• Do not use any antiseptic preparation, ointment or spray on a severe burn.
• Chemical burns are caused by acids and alkalis or other corrosive chemicals.
• When irritating chemicals come in contact with the skin, injuries begin instantly.
• In such circumstances, first aid is required quickly.
- What are the essentials of First Aid in Chemical Burns?
- In chemical burns wash away the chemical as quickly as possible with large quantity of water.

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 - Chemical burns should be cooled by water for at least 20 minutes. Put the injured part or face under a tap to get a good
flow of water to wash off the chemical.
- If chemical gets into the eye, it should be washed out as quickly as possible with plenty water.

Fractures

A fracture is a break or a crack in a bone.

Mostly fractures are caused by:

• Motor vehicle accidents

• Falls
• Accidents related to sports and fighting.

Classifications of Fractures

There are two classifications of fractures namely: closed or simple and open or compound fractures

What are closed or simple fractures? (Illustrate)

These are fractures where a bone is broken but there is no wound or break in the skin over or near the fracture site.

What are open or compound fractures? (illustrate)

These are fractures with open wounds through which broken bone protrudes.

- Difference in the shape and length of the corresponding limb or other part on the two sides of the victim’s body.
- Obvious deformities such as a bend or the bone showing under the skin.
- Crookedness, shortening or rotation of a limb.
- An open wound over the bone.
- Swelling and bruising over the fracture.
- Pain and tenderness on gentle pressure at the site of the suspected fracture.
- What are the First Aid essentials in Fractures?
- Stop bleeding if any by simple pressure over the injured part using a clean pad of cloth.
- Do not wash the wound.
- Do not probe it.
- Do not insert your fingers into it.
- If a fragment of bone is protruding, cover the entire wound with a clean cloth or towel.
- Apply a splint to the injured part to prevent movement (splint- a piece of rigid materials applied along to the sides of
the limb to prevent two broken ends of the bone from moving.)
- Purpose is to reduce injury to the soft tissues and to keep the bone more or less aligned and reduce pain.
- Raise the injured part slightly to reduce bleeding and swelling.

Wounds and Bleeding

- A wound is a break or a tear in the tissue of the body.

- It may be internal where the body tear is not visible or external where the body tear is visible.
- Wounds are classified as either open or closed.
- An open wound is where there is a break in the skin while a closed wound involves underlying parts without a break in
the skin.
- Open wounds allow blood and other fluids to be lost from the body and enable germs to enter.
- In a closed wound, bleeding is confirmed within the body tissues.

Types of Wounds

- There are different types of wounds depending on the object that produced the wound such as a knife, bullet among
others.
- Each type of wound carries specific risks associated with the surrounding tissue damage and infection as f ollows:

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 Laceration is caused by crushing or ripping force which results into tears or lacerations.
• These wounds bleed less profusely but may have more tissue damage.
• Lacerations are often contaminated with germs hence the risk of infection much higher.

Abrasion is a superficial wound where:

- The topmost layers of the skin are scrapped off leaving a raw tender area
- It is caused by a sliding fall or a friction burn
- Abrasions may contain embedded foreign particles that may result in infection.

What are incised wounds?

- These may be caused by a clean cut from a sharp-edge object such as a razor.
- Blood vessels are cut straight across, hence bleeding may be profuse.
- Structures such as tendons, nerves, or arteries may be damaged.

What is Contusion (Bruise)?

- Is a wound brought about by a blunt blow or punches and can rupture capillaries beneath the skin causing blood to leak
into the tissues.
- The skin occasionally splits
- Severe contusion may indicate deeper damage such as a fracture or an internal injury.

A puncture wound is brought about by an injury such as stepping on a nail or being pricked by a needle or sharp objects.
- It has a small entry side but a deep track of internal damage.

- This is because germs and dirt can be carried far into the body, hence the infection risk is high.

What is Stab wound?

- This is a wound caused by along or bladed instrument usually a knife penetrating the body.
- Stub wound to the trunk must always be treated seriously because of the dangers of injury to vital organs or life
threatening internal bleeding.

- What is a Gunshot wound?

A bullet or other missile may drive into or through the body causing serious internal injury, and sucking in clothing and
contaminants from the air.
- The entry wound may be small and neat and the exit wound may be large and rugged.

- What are the Causes of Wounds?

From the types of wounds you realize that, wounds are as a result of physical force.

The most common causes of wounds therefore are:

1. Motor-vehicle accidents
2. Falls
3. Mishandling of sharp objects e.g. nails, needles, razor blades
4. Mishandling of tools such as jembes, knives
5. Machinery
6. Weapons such as guns

Wounds may cause the following damages

1. Destruction of tissues
2. Loss of blood
3. Nerve injury
4. Contamination with foreign material
5. Inability to use the part or inability for the part to function normally.
6. Death

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First Aid in Wounds

The main objective of first aid in wounds is to:

i. Asses the casualties condition

ii. Control bleeding by applying pressure on elevating the injured part
iii. Keep the wound clean
iv. Comfort and reassure the casualty
v. Minimize shock
vi. Obtain medical help, if necessary
vii. Call an ambulance if you suspect a serious illness or injury

When there is a wound and the bleeding is severe it can be dramatic and distressing. Shock is likely to develop and the casualty
may lose consciousness. If bleeding is not controlled, the casualty’s heart could stop.

- Bleeding at the face or neck may impede the flow of air to the lungs
- When treating severe bleeding check first to ensure there is no object embedded in the wound. Take ca re not to press
the object
How can you control bleeding?
1. Put on disposable gloves if available
2. Remove or cut clothing as necessary to expose the wound.

3. Apply direct pressure over the wound with your fingers and palm preferably over a sterile dressing on no n fluffy, clean
pad
4. Raise and support the injured limb above the level of the casualty’s heart to reduce blood loss.
5. Help the casualty to lie down on a blanket if available to protect him/her from cold
6. If you suspect shock may set in, raise and support the legs so that they are above the level of his/her heart.
7. Secure the dressing with a bandage that is tight enough to maintain pressure but not so tight that it impairs blood
circulation
8. If further bleeding occurs apply a second dressing on top of the first
9. If blood seeps through the dressing remove both dressing and apply a fresh one.

What are Bites?

Bites are wounds or injuries caused by tearing or piercing by teeth or fangs or sucking organ of an insect

Human bites

All human bites that break the skin may become seriously infected because human mouths have a variety of harmful bacteria.

Animal bites

A bite of any animal whether it is a wild animal or a pet may result in a dangerous wound.
Dogs, cats and other pets may have rabies.
Tetanus is an added danger in animal bites.
Any animal bite carries a great risk of infection. It is therefore important to ensure that the wound from the bite is
treated by cleaning with water to wash away the poison, bandage and seek for med ical help.
What is rabies?

Rabies is an infectious disease caused by a virus

It is transmitted through the infected saliva of a rabid animal to another animal or human being
Rabies is usually transmitted to human beings by dogs
However the disease is also carried by cats, jackals, mongoose and other wild animals.
The infection is spread when an animal with rabies bite even if it makes a scratch or licks an existing open wound.

What are the First aid tips in rabies?

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Clean the bite with soap and lots of water and take the victim to hospital immediately so that he/she can be given a series of
anti-rabies injections.

If it is not clear whether the animal such as a dog was rabid or not, it should be tied up and watered.

A dog with rabies usually dies from the disease within ten days.

A rabid animal to must be killed and where possible the head of the animal be taken to public health authorities for
examination.

What should you do to prevent and Control rabies?

Kill any animal suspected of having rabies,

Cooperate with local authorities to vaccinate dogs every year

Keep children away from animals that seem sick or act strange.

After any animal bite go to the clinic for treatment and advice.

Snake bite

What are the First aid measures in snake bites?

Keep the victim as calm as possible preferably in a lying position.

Do not move the part that has been bitten because the more it is moved the more rapidly the poison will spread through the
body.

A person who has been bitten on the foot should not walk but should be carried on a stretcher is possible. Where possible tie
the upper part of the leg to prevent the poison from spreading to the other parts of the body quickly.

A bite from a poisonous snake is dangerous.

Transport the victim to hospital as soon as possible taking the dead snake with you if possible.

What are the First Aid measures in insect bites?

For minor stings and bites wash in cold water and apply a soothing cream or jelly like Vaseline.

For a bee sting, scrap the sting off quickly

No not try to pull the sting out because then you compress it and force more venom into the victim

If a person has been stung by many bees he or she should be taken to hospital.

Other venomous insects are spiders, scorpions, wasps, ants among others.

What is Nose bleeding?

Nose bleeding occurs when a small blood vessel in the inside of the nose is injured and starts to bleed.

At times there may be no reason but nose bleeding can also result from injury, disease such as high blood pressure or after a
cold or strenuous exercise.

What are the First aid measures in nose bleeding?

Keep the victim calm
Put him/her in a sitting position leaning forward whenever possible.
Press the bleeding nostril towards the midline for five minutes
Obtain medical assistance if bleeding continues.

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Poisoning
A poison is any substance – solid, liquid or gas that can impair health or cause death when introduced into the body or on the
skin.
What Causes poisoning?
Poisoning occurs in various ways such as:

Swallowing or inhaling a harmful substance.

Sometimes poisoning results from taking an overdose of drugs whether deliberately or accidentally.

What are the First aid measures in poisoning?

The objective of first Aid in poisoning is to:

• Get rid of the poison as quickly as possible

• Maintain breathing
• Treat for shock
• Give medical assistance without delay

To get rid of the poisons give the victim water to dilute the poison.

Try to get the victim to vomit unless the poison is kerosene, acid, alkali or any other chemical which burns the skin

Note: acids and alkalis which burn the skin change the colour of the lips and tongue.

It is important to identify the poison taken by saving the container label of the suspected poison to show th e doctor.

Maintain breathing

If the victim is unconscious keep the air ways open by laying him/her on on e side and holding the jaw forward.

What is Suffocation?

Suffocation occurs when normal breathing is prevented or stops or breathing is reduced such that oxygen intake is insufficient
to support life.

What are the Causes of suffocation?

Suffocation is caused by blockage of the air passage by an object stuck in the airways

When breathing air is too little or there is a lot of smoke from fire

Air containing carbon monoxide

Poisonous gas

Drowning

Strangulation

Food chocking

What are the First aid measures in suffocation?

Food Chocking

Food chocking occurs when food gets stuck in the throat and stops the victim from breathing. .

When food gets stuck in the throat and stops a person from breathing do the following:

• Stand behind the victim and put your arms around the chest

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 • Clasp your hands together against the persons stomach above the navel

• Press inwards with a sudden strong upward jerk

• Repeat several times

• If it is a baby, then hold the baby with legs upside down for a while. This allows the chocking substance to come out of
the nose or mouth.

SELF-TEST QUESTIONS

Score
1. What are the essentials of First Aid? (5 marks) board
2. Why is it important to leave children with careful care givers? (5marks) =
3. Explain the First Aid tips in snake bite, wounds, fractures burns, (20 marks)
LO =

TOPIC FOUR: HEALTH AND SAFETY IN THE SCHOOL

INTRODUCTION

This topic presents the role of public health services in society and the healthy and safety standards
detailing how to ensure safety in the school environment. In the topic the standards measures to be met in
the construction of different structures in a school are discussed and the disaster risk reduction measures
in a school.

Objectives

By the end of this topic, you should be able to:

• Explain the role of public health in society

• Identify the healthy and safety standards for a school

• Apply disaster risk reduction procedures in a school to ensure safety

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 This topic is divided into two sections as follows:
• Public health
• School safety

Public Health

• Public health is the art and science of prevention of disease to prolong life while promoting health. This is done
through organized effort of people or society, or communities by informed choices.

• Public health is important because when people are informed, they are aware of problems/diseases which can be in the
environment.

What is the Purpose of public health?

Public health in Kenya was established under an act of parliament Cap 242 to empower people to take care of their own health.

What does public health deal with?

Public health deals with the prevention, promotion, rehabilitation, contamination, sanitation and housing.

• Public health deal with notifications to alert the public about disease outbreak. Some of the outbreaks are malaria,
cholera among others.

• Public health officers give health education messages e.g. the use of mosquito nets, how to control spread of HIV and
AIDS etc

• Quarantine – when there is a plague.

• Immunization of common diseases.
• Vaccination to prevent spread of certain diseases.

School safety
School safety are measures undertaken by the learners, staff, parents and other stakeholders to either minimize or eliminate
risky conditions or threats that may cause accidents, bodily injury, emotional and psychological distress. There are many things
that a person can experience that can be categorized as emotional distress. These include fear, shock, and indignity.
Psychological distress refers aspects of sadness, frustration, anxiety, and a number of other negative mood states.

The objectives of school safety are to:

• Provide opportunities for the learner to exploit and maximize potential for learning, growth and development.
• Provide opportunity for the learner to participate in enhancing school safety.
• Promote, maintain and contribute to the understanding of child and staff safety.
• Provide a benchmark for monitoring and appraising the safety status of schools.
• Empower members of the school community to handle disasters and thus minimize risks.
• Provide first line emergency services to learners and staff who become victims of injury or are taken ill.
• Counsel, guide and advice learners and staff on issues relating to school safety.
• Empower the school to liaise with parents, members of the community and other partners in order to increase
awareness about issues related to school safety.
• Forge alliances and networks that enhance school and child safety.

Threats to school safety include:

1. Accidents- the main causes of accidents in schools are human related that is accidents caused through
carelessness, inattentiveness, ignorance, irresponsibility, or negligence.
2. School violence and harassment- violence in schools takes the form of teacher-on- learner violence and
learner on learner violence among others.
3. Lack of adequate healthcare and nutrition.

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 4. Lack of sensitivity to sexual maturation challenges for both boys and girls.
5. Armed conflicts and insecurity.
6. Hostile school environments eg a school environment that does not accommodate the welfare of its
learners or neglects the needs of its learners.
The components of school safety standards are:
• Safety on school grounds.
• Safety of physical infrastructure.
• Health and hygiene safety.
• Safety in school environment.
• Food safety.
• Safety against drug and substance abuse.
• Safe teaching and learning environment.
• Socio-cultural environment of the school.
• Safety of children with special needs.
• Safety against child abuse.
• Transportation safety.

Safety on school ground

School grounds refer to the entire enclosure designated for use by the school for any of its activities such as learning, playing,
games or sports. Such grounds should be large enough to house the required physical infrastructure, including classrooms,
offices and latrines, playing grounds and assembly walkways and many more.

The indicators of a safe school ground include:

➢ A title deed well kept in a temper-proof facility and away from any risk or clearly demarcated school compound
pending documentation and issuance of title deeds.
➢ Registration documents such are registration certificate properly kept.
➢ Properly fitted and lockable gate or gates with a security office.
➢ Good security arrangements with provision for both night and day security personnel.
➢ Well maintained and clean learning rooms.
➢ Well maintained and clean desks and chairs in classrooms, offices and other relevant places.
➢ Properly maintained playgrounds for various sporting activities and a free area for general play.
➢ Properly arranged and maintained walkways, motorways and parking.
➢ Properly reinforced fence with appropriate mechanisms for repair and maintenance.

Safety of physical infrastructure

Physical infrastructure includes:

• Structures such as classrooms, offices, toilets, dormitories, libraries, laboratories, kitchen, water tanks, playground
equipment and many more.

• The structures should be appropriate, adequate and properly located, devoid of any risks to users or to those around
them.

• They should also comply with the provisions of the Education Act (Cap 211), Public Health Act (Cap 242), and
Ministry of Public Works building regulations/standards.

Class rooms should observe the following:

▪ They should be of the right size that is; length and width should be as specified in the ministry of education building
specifications i.e. 7.5m x 5.85m. They should be able to accommodate 30 learners on one seater desk and 40 in double
seater desk.
▪ Doorways should be adequate for emergency, open outwards.
▪ For storey buildings stairways should be wide enough and located on both ends of the building. Should be clear of any
obstructions; provide needs for learners with disabilities, hand rails in the stairs should be strong and firmly fixed.

25
 ▪ Corridors and classrooms should be well ventilated and lit.
▪ Windows should not have grills.
▪ Floors should be level and kept clean always.
▪ Each block should be fitted with serviceable fire extinguishers.
▪ Classrooms should be furnished with appropriate desks comfortable for both boys and girls.
▪ Desks should be arranged in a way which allows for easy movement.
▪ Sockets should be placed beyond reach of young learners to avoid tempering.

Dormitories should:
▪ Be kept clean and well ventilated.
▪ Have space between beds should be at least 1.2 m and path ways not less than 2m.

Have doorways that are wide enough at least 5 feet wide and open outwards.
▪ Have doors at both end and an emergency door at the middle.
▪ Be locked when students are away.
▪ Have windows be without grills.
▪ Be fitted with functional fire extinguishers.
▪ Have beds that are firm and fitted with side-grills to protect young learners against falling.

Pit latrines should be:

▪ Built at least 10m away from tuition and boarding facilities and on the downwind side.
▪ Where ablution block is attached to the dormitory, a high degree of cleanliness must be maintained.
▪ Pit latrines should be at least 15m away from a borehole or well or water supply point.
▪ Pit latrines should not be less than 6m deep and be regularly disinfected.
▪ In mixed schools sanitation points be separated and for girls sanitation areas offer complete privacy.
▪ Each school to ensure safe and effective disposal of sanitary wear.
▪ Ratios: for the first 30 learners 4 closets are recommended. - The next 270 learners: one extra closet for every 30
learners. – For every additional learner over 270 learners: one closet per 50 learners. 1/3 closets for boys be
urinals.
▪ All closets should be kept clean, well ventilated and properly maintained.
▪ For staff at least one closet for 12 persons and with separate provision for ladies and gentlemen.
▪ Care should be taken to accommodate learners with special needs and very young learners.

Libraries should have:

▪ Adequate ventilation
▪ Wide alleys of passageways to facilitate evacuation.
▪ Specious room for easy movement.
▪ A programme of dusting books regularly preferably after 3 days.
▪ Properly reinforced and well spaced bookshelves.

How about the administration block?

The following should be observed in constructing a school’s administration structure.

• Offices for key school personnel in the school.

• It should be centrally located and not far from classrooms.

The administration block is an important block in the school. It is the first station of call for all visitors to
the school. It is the store house for all important school records and equipment. An ideal administration
block should put into consideration the prevailing security situation of the school environment and the
needs of the school. 26
 • Door and windows should be burglar proof.
• Should have fire extinguishers.
• Provisions should be made to acquire fire-proof cabinets for storage of essential office materials and
documents.
• There should be provision for easy access to legal and administrative documents.
• An ideal administration block should put into consideration the prevailing security situation of the school
environment and the needs of the school.
How should health and hygiene safety be maintained in a school?
To promote good health and hygiene among learners the school should:
• Impart knowledge, skills, practices and attitudes to learners in relation to health.
• Promote and maintain good health practices among the learners.
• Monitor and appraise the health status of the learners through health screening and examinations.
• Provide first line emergency services to learners and teachers injured or take ill.
• Collaborate with health agencies, parents and communities on issues relating to learners’ health.
• Counsel and give guidance to learners and parents on matters relating to health.

What is environmental safety?

Environmental safety refers to the proper and sustainable management of the physical surroundings of the school. Proper
management of the school environment entails appropriate mechanisms of waste management, orderly use and replenishment
of plants and animals within the school compound and enhancing a sustainable balance of biodiversity.

A school environment should be safe to promote learners’ concentration on learning and to facilitate the development of their
social skills without compromising, in anyway, sustainable biodiversity.

How should safety in the school environment be ensured?

The school should strive for indoor and outdoor air quality by ensuring the following:

• Regular inspection and replacement of ventilation equipment/air ducts.

• Exterior and interior lighting is appropriate so as to make it difficult for intruders to go un detected.
• Classrooms and occupied rooms are well lit to ensure that learners do not strain while undertaking learning activities.
• Solid waste is properly disposed to avoid the spread of communicable diseases, discourage the presence of pests and
other vector and prevent human contact with hazardous materials.
• Regular inspection of school facilities.
• Good sanitation practices and proper maintenance of structures and grounds to seal structural cracks through which
pests and rodents can enter.
• Adequate tuition and boarding facilities.

• Waste materials from the kitchen, laboratories, classrooms dormitories, construction sites among others is done
appropriately by: Dumping in isolated areas away from the learning facilities, Different wastes are disposed
differently, dump sites are fenced off and access denied to unauthorized persons, provision of waste buckets in rooms
etc.

What is Food safety?

Food safety refers to access and consumption of wholesome food that promotes health and optimal body functioning. Learners
in schools should have access to safe and wholesome food for their prope r physical and intellectual development.

What should schools do to ensure food safety?

To ensure food safety schools should:

• Have adequate and safe storage facilities.

• Ensure illegal hawking food in school is denied.
• Food purchased for children in school is in good condition, fresh and safe for human consumption.
• Food is protected from rodents, insects and bacterial contamination.

27
 • Places where food is prepared are clean.

Students and staff are encouraged to observe hygiene. For instance utensils should be kept clean, hands should be washed with
clean water before and after eating among others.
What should schools do to ensure safety against drug and substance abuse?

• Schools must endeavour to create a safe and caring environment where learners and staff know the dangers of drug
abuse, and strive to make the school a drug free environment by:

Mainstreaming drug abuse tips in their teaching subjects, advertisements, brainstorming, displaying drug related information in
bulletin boards, displaying posters and articles among others.
What should schools do to ensure safe teaching and learninenvironment?
Schools should provide and sustain a safe caring environment that promotes q uality teaching and learning by:

• Ensuring comfortable conditions that facilitate quality learning

• Encouraging instructional strategies that actively engage learners in the learning process
• Supporting efforts to promote child-centered approaches to teaching
Identifying and attending to learners with special needs among others.

• What is the Socio cultural environment of the school?

This refers to ensuring good working relationships and amicable interactions of all stakeholders.

How should the Socio cultural environment of the school be?

All interpersonal relationships between various stakeholders in and outside the school need to be:

• Cordial
• Cooperative
• Respectful and focused on promoting a conducive environment for teaching and learning.
Safety against child abuse

Child abuse is defined as subjecting children to suffering through physical, sexual, emotional or neglectful behaviour. Child
abuse may take place in schools, homes and in the community. Child abuse may be physical, emotional, and sexual and child
neglect.

What is Physical abuse?Physical abuse involves non accidental injuries resulting from hitting/beating, shaking, throwing,
pinching, poisoning, burning or scalding, drowning or suffocating the child.

The symptoms of physical child abuse may include the following:

• Unexplained injury or injuries.
• A repeated pattern of injuries.
• Scalds and burns with clear outlines.
• Bite marks.
• Untreated internal injuries or broken bones.
• Bruising on the face, buttocks and torso.
• Fingertip bruising, hand marks, grasp marks and marks of implements.
• Reluctance to discuss injuries.

What is emotional abuse

Emotional abuse occurs when the child is denied basic needs like love, security, positive regard, warmth, and praise among
others.

The symptoms of emotional abuse include:

• Chronic absence of self-esteem and low self confidence.
• Immature emotional responses, regression and neurotic behaviour.

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 • Demanding behaviour, attention seeking, in appropriate behaviour towards non -parental adults.
• Withdrawal behaviour.
• Fear of new tasks
• Developmental and learning delays.
• Outbursts of anger or distress.
• Indifferent or negative relationships with parents.
• Over-compliant behaviour, excessive desire to please.

What is Sexual abuse?

Sexual abuse takes the form of forcing or enticing a child into sexual activities.

What are the symptoms of sexual abuse?

• Bruise or bite marks around the genitals

• Unusual bleeding or discharge from the genitals.
• Inappropriate sexual behaviour towards adults or other children.
• Sexual knowledge inappropriate for the child’s age.
• Self harming.
• Eating and sleeping disturbances.
• Depression and low self-esteem.
• Poor achievement in a given task.
• Withdrawal symptoms in relation to a given activity.
What is Child neglect
Child neglect involves failure to provide a child with basic needs like food, good levels of hygiene and health,
clothing, shelter and medical treatment when the child falls ill.
The symptoms of child neglect include:
• Poor growth and development,
• Learning delays, poor academic performance in school.
• Poor hygiene, inadequate clothing.
• Untreated medical conditions.
• Poor self-esteem.
• Chronic tiredness and hunger, falling asleep in class, voracious eating.
• Sores, poor health condition.
• Lateness to school, frequent non-attendance.
• Poor social relations.
• High levels of accident

Disaster Risk ReductionA disaster is an emergency event that occurs with little or no warning, causing extensive destruction
of property, lives and disruption of normal operations. Disasters can be divided in to two main categories; natural and
manmade disasters.

Natural disaster may include: earthquakes, floods, drought, landslides, winds, volcanic eruptions among others.

Manmade disasters are calamities caused by actions of human being either directly or indirectly. eg fires, oil spillage, industrial
accident, pollutions, bomb blasts etc.

Disaster Risk Reduction refers to actions designed to minimize destruction of life, property and disruption of normal
operations. The risk reduction strategy calls for the establishment of a disaster Crisis Respon se Team with the mandate to
prevent, mitigate and effectively prepare against potential disaster hazards. It also includes organizing and carrying out rescue
and rehabilitation operations during and after a disaster has struck.

Early warning refers to careful monitoring and early warning actions to avert potentially dangerous events or circumstances
that can lead to emergency or disaster.

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The purpose of monitoring and early warning is to enable remedial measures to be initiated and to provide more timely and
effective relief through disaster and emergency preparedness actions.

Early warning mechanisms will provide the school community and other stakeholders with relevant information to enable them
make informed decisions for evacuation or relocation.

The following should be observed to manage disasters in schools:

Schools should:
• Post evacuation maps at every entrance and exit to buildings.
• Schedule practice drill sessions for fire, earthquake, lockdowns etc
• Develop a telephone tree list of all employees.
• Maintain school emergency kit with items like; first aid kit, whistle, fire blankets, flash torches, fire extinguishers,
blueprint of school buildings.
• Observe safety measure during various types of disasters.

Measures to be observed during various types of disasters

What measures should be taken during floods?

• Parents should keep in touch with the local authorities to determine whether it is safe for their children to go to a flood
prone area.
• Student should avoid flood prone routes to school.
• After floods sockets and electric appliances should be checked before use.
• Drinking water should be treated before use.
• All buildings should be checked by experts before use after floods.
What should be done to ensure Safety during landslides?
• During heavy rains schools in land slide-prone areas should be on the lookout for unusual land movement.
• On detecting unusual land movement alternative learning facilities should be identified.

Rapid evacuation should be done when land slide takes place.

What should be done to ensure safety during thunderstorms and lightening?
• Learners should remain in school and stay indoors.
• Learners be discouraged to take shelter in verandahs or open places.
• Learners be advised not to take shelter under trees or walk in rain.
• In areas prone to thunderstorms and lightening, schools should install lightning arresters. What should be done to
ensure safety during earthquakes?
Though earthquakes are almost not experienced in Kenya, but, in case of such occurrences it is necessary to do the following:
• Learners are in class t should be advised to take cover under tables and desks.
• They should not panic or attempt to rush outside or go near the window.

If outside learners should not move near buildings.

What Safety measures should be taken during strong winds?

• If learners are in a classroom windows should be closed and also stay away from windows.
• Be advised to take shelter under tables of desks.
• In open grounds learners should be advised to lie flat on the ground.
What measures should be taken to ensure safety during fire?

Fire prevention

The following measures should be observed to prevent disasters related to fire outbursts.

• All kinds of trash should be discarded as they tend to catch fire easily.
• Inflammable substances should be stored tightly in closed cans or containers.
• All wiring should be checked regularly.

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 • Learners should not carry or play with matches.
• Use of hurricane lamps in the dormitories should be properly regulated.
• Learners and staff should undertake periodic fire drills at least twice a term.
• Fire extinguishers should be located in strategic places in the school.

In case of fire outbreaks:

• Learners should leave the room immediately without creating panic rush.
• When going through a smoky area learners be advised to crawl.
• Doors that feel hot should not be opened as fire from the side could be blazing fiercely or one co uld get killed by the
burst of heat and smoke when the door is opened.
• One should not run on clothes that are on fire.
• Learners should not return to the classrooms or any other buildings.

Safety during chemical emissions and severe pollutions

• In case of chemical and gas emissions that are a threat to staff and learners inform school authorities immediately.
• Once informed the authorities should inform gas or chemical experts immediately.
• Evacuation plans be quickly implemented in the schools.
• For affected individuals, school authorities should seek immediate emergency treatment that is giving First Aid and
refer the victims to a doctor.

ACTIVITIES
Assume that you have been appointed to head a newly established school. Draw a sketch map of the new school showing
how you will site different buildings in the school.

TOPIC 5: THE YOUTH AND FAMILY LIFE

INTRODUCTION

Welcome to the fifth topic in this module. In this chapter we will discuss youth and family issues where the concept of youth
will be presented, dating and courtship, marriage and family life detailing the different types of families and the challenges of
modern family life.

The Concept of Youth as a lifecycle stage

Definition of youth
• Youth refers to a separate stage in the lifecycle between childhood and adulthood.
• It is a period of transition which involves complex interplay of personal, institutional and macroeconomic changes that
most young people have to negotiate.
In terms of age bracket, there are varied definitions of youth.
• In Africa for instance, some countries have adopted the United Nations (UN) definition of youth (15 to 24 years) while
others use the Commonwealth definition (15 to 29 years).
For policy purposes, the age range can be even wider.
• For instance in some African countries, such as Ghana, Kenya and Tanzania, the definition of youth used for policy
purposes ranges from 15 years to 35 years.
• In Nigeria however, it ranges from 12 to 30 years.
• South Africa’s National Youth Policy defines youth as any person between the ages of 14 and 3 5 years
Be that as it may, the legal status of a young person for different purposes can also vary widely. As such, legal minimum ages
often vary not only by gender but also accordingly to the purpose of the age limit - marriage, voting rights, criminal
responsibility, military service, access to alcoholic beverage, consent to medical treatment, consent to sexual intercourse,
among others.
All in all, the changes that young people have to negotiate revolve around moving from dependence to independence; which
involve at least four distinct aspects.
The four aspects are:
▪ Leaving the parental home and setting up new living arrangements
▪ finishing full-time education;

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 ▪ Settling into a more or less stable source of livelihood through employment and/or career choice .
▪ Forming close stable personal relationships outside their family of origin, often resulting into courtship and marriage.
Dating and Courtship
Dating is the process of meeting people socially for possible mate selection.

It also implies a couple setting a specific date, time, and place to meet.

Dating is part of the marriage market, in which prospective spouses compare the assets and liabilities of eligible partners and
choose the best available mate

People date for various functions. These are as follows:

1. Manifest functions
▪ Maturation - adolescent has reached puberty
▪ Recreation- about self-gratification where people date to satisfy their own needs.
▪ Companionship
▪ Love and affection
▪ Mate selection
2. Latent functions
▪ Socialization - learning about gender roles, family structures
▪ Gaining social status - dating can enhance prestige
▪ Fulfilling ego needs by being asked out or accepted
▪ Opportunities for sexual experimentation and intimacy
▪ Big business - economic market for products and services

The dating spectrum includes the traditional and the contemporary patterns and dating in later life.
Traditional Dating
In the traditional dating males and females follow culturally defined and clear gender role scripts.

Contemporary dating
Contemporary dating patterns tend to be either casual or serious.
▪ Casual dating behaviors include : hanging out, getting together, pack dating and hooking up

Dating in later life

▪ can provide companionship to those who are widowed or divorced it can be daunting because of nervousness,
worry, or bitterness
How do people meet dating partners
Many people meet dating partners through friends and family.
Other avenues include:
▪ Personal classified advertisements—twice as many men place ads as do women.
▪ Mail-order brides—American men often seek wives from Asian or Russian countries.
▪ Professional matchmakers—people pay for “advice.”
▪ Speed dating—allows people to meet face to face in a short period of time, to decide mutual interest.
▪ Cyber dating—the Internet allows people to interact before meeting, although it has disadvantages as well.
When do harmful dating relationships occur?
Dating abuse isn’t an occasional argument or a bad mood; it is a pattern of controlling behavior that someone uses against a
girlfriend or a boyfriend.

The following are warning signs of this type of dysfunctional and harmful relationship:

• Giving up activities or hobbies that they previously enjoyed

• Withdrawing from family or friends
• Spending excessive time with only the person they are dating
• Signs of jealousy and possessiveness
• Constant contact by phone calls, texting or sending instant messages
• Signs of threats, insults, or inappropriate control of temper from the person they are dating

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Courtship
Courtship is the period in a couple's relationship which precedes their engagement and marriage, or establishment of an
agreed relationship of a more enduring kind.

In courtship, a couple gets to know each other and decide if there will be an engagement or other such agreement.

A courtship may be an informal and private matter between two people or may be a public affair, or a formal arrangement with
family approval.

Traditionally, in the case of a formal engagement, it has been perceived that it is the role of a male to actively "court" or "woo"
a female, thus encouraging her to understand him and her receptiveness to a proposal of marriage. Within many modern
societies, these distinct gender roles have lost some of their importance and rigidity.

How many Phases are there in Courtship?

Courtship has five phases which include:

▪ Attention phase
▪ Recognition phase
▪ Conversation phase
▪ Touching phase
▪ Love-making phase

As noted earlier, courtship precedes engagement and marriage. However, some relationships end up in break ups before
marriage.

Breaking Up
What are the reasons for breaking up?
People in courtship breakup because of:

a) Individual reasons may include: communication problems, different interests, emotional and physical abuse, obsessive
“love” and controlling behavior, mismatched love and sexual needs, Self disclosure that reveals repulsive attitudes,
Disillusionment, Lowered affectionate behavior, Infidelity, “Freeloading” without commitme nt.
b) Structural reasons such as: moving away, economic recessions that trigger unemployment and arguments about
finances, societal reactions that disapprove of relationships such as those between younger and older people, those
from different racial or ethnic and religious backgrounds, or same sex couples.

▪ Ending relationships may be painful, but it can provide opportunity to find a better mate

Is breaking up healthy?
▪ Breakups are usually painful
▪ Men seem to get over breakups more quickly than women do
▪ An important function of dating and courtship is to filter out unsuitable prospective mates, thus breaking up is a normal
process.
▪ It can be a great relief to end a bad relationship.
▪ Breakups should occur more often to provide opportunities to find a mate who may be more suitable
Marriage

Marriage is a social institution under which a man and a woman establish their decision to live together as husband and wife by
legal commitments, religious or traditional ceremonies.
A similar institution involving partners of same gender: gay marriage.
Many cultures limit marriage to two persons of the opposite sex, but some recognize same-sex marriage.

In Kenya, the following types of marriages are given due recognition by law:

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 i. Statutory Marriages – marriage provided for under statute such as under the Marriage Act, f or instance, Civil
Marriage, African Christian Marriage, Hindu Marriage, Mohammedan Marriage
ii. Customary Marriages-marriage under traditional customs
iii. Presumed Marriages – long cohabitation recognized as presumed marriage

Selecting a marriage partner

Choosing well is the foundation for a good marriage. Yet choosing is one of the most neglected pieces of the process of
meeting, bonding, marrying, living life together and possibly having children. Choose well: the good and the bad outcomes of
your choise will shape your marriage, whether a first or a second, a common law marriage, a mixed race marriage or same sex
marriage.

- One is more likely to have a successful marriage if he/she selects a marriage partner with whom he/she is compatible and
can grow close to over the years.
- To be compatible means to be able to get along together well.
-
What factors increase the likelihood of a compatible marriage?
▪ Similar values
▪ Clearly defined goals
▪ Similar intelligence and educational experience
▪ Families that have similar philosophies
▪ Ability to communicate with each other
▪ Physical attraction to one another
▪ Healthful attitudes about marriage and sex
▪ Equal sense of commitment to the importance of marriage
▪ Similar views about having and rearing children
▪ Compatible personality traits
▪ Adequate financial resources
▪ Similar age
▪ Compatible hobbies and interests
▪ Independence from parents
▪ Pre-marriage counseling and/or pre-marriage classes.

FAMILY LIFE

A family is a collective body of persons who live in one house, and under one head or manager; a household, including
parents, children, and servants.
It also refers to a group comprising a husband and wife and their dependent children, constituting a fundamental unit in the
organization of society.
What are the functions of a family?
(1) Stable Satisfaction of Sex need:

This is the Primary and essential function of family. Sex instinct is the natural urge of h uman being. The satisfaction of this
need requires that both male and female should live together as life partners. It is the family where the husband and wife can
satisfy their sex instincts easily and comfortably. Without family the satisfaction of sex n eed is almost socially quite
impossible. A family not only satisfies but also provides the appropriate mechanism through marriage to regulate sexual
behaviour of husband and wife.

(2) Reproduction or procreation:

Reproduction or procreation is another essential function of family. The family along with regulating the sexual behaviour in
relation to the satisfaction of sexual needs secures a legitimate basis for procreation.

(3) Protection and care of the young:

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Protection and care of the children is another essential function of family. It is regarded as an institution par excellence for the
production and rearing of children.

(4) Socializing Functions:

Family is one of the primary agents of socialization. Family members teach the child the norms, value mora ls, beliefs and
ideals of society.

(5) Provision of a home

Family makes a provision of a home or a common habitation for its members.

Types and Forms of Family

On the basis of marriage: Family has been classified into three major types:
▪ Polygamous family- arrangement where one man (husband) is married to many wives
▪ Polyandrous family- arrangement where there is one woman married to many men
▪ Monogamous family- arrangement where one man is married to one woman

On the basis of the nature of residence family can be classified into three main forms.

▪ Family of matrilocal residence- where family lives in the woman’s (wife’s ) maternal residence
▪ Family of patrilocal residence- where family lives in the man’s (husband’s) paternal residence
▪ Family of changing residence- where family chooses where to live depending on the situation

On the basis of ancestry or descent family can be classified into two main types

▪ Matrilineal family- the name of the family follows your mother’s family tree e.g in Scotland
▪ Patrilineal family- the name of the family follows your father’s family tree

On the basis of size or structure and the depth of generations family can be classified into two main types.

▪ Nuclear – family group consisting of father, mother (husband and wife) and their children
▪ Joint family- extended family arrangement prevalent among Hindus of the Indian subcontinent where parents, their
children, and their children’s spouses and offspring stay in one dwelling unit.

On the basis of the nature of relations among the family members the family can be classified into two main types.

▪ The conjugal family which consists of adult members among there exists sex relationship.
▪ Consanguine family which consists of members among whom there exists blood relationship - brother and sister, father
and son etc.

Parenthood

Parenthood is the most important profession yet there is no formal training for one to be a responsible, successful and satisfied
parent. People learn about parenting by observing and imitating their parents.

What are the Priorities of responsible parenthood?

Responsible parents:

▪ Set aside a quantity and quality time to spend with their children.
▪ Learn about the way children develop at different ages.
▪ Teach their children rules for health and safety.

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 ▪ Give their children love and affection.
▪ Teach their children with a positive attitude, avoiding condemnation and criticism.
▪ Teach their children values.
▪ Teach their children self-discipline and self-control by example and by using effective disciplinary techniques rather
than child abuse.
▪ Provide economic security for their children.
▪ Recognize that their children have rights and respect those rights.
▪ Rear their children in a stable, secure family that is free from substance abuse (alcohol marijuana, among ot hers)

What are the emerging challenges to the family institution?

Teenage parenthood
It is challenging because teenagers are changing emotionally, and physically. Also one is gaining skills he or she would need to
become an autonomous adult.

Teenage mothers may also be stressed by:

Dropping out of school hence, their potential income is only half of those women who finish high school before having a baby.
Equally teenage fathers have similar stressors

Teenagers with children are more likely to separate and divorce than married teenagers without children.

Family violence

Family violence harms the health of many family members through; physical injuries, murders, and child abuse.

Battered spouses

A battered spouse is a person who is physically and emotionally abused by a marriage partner.

Although some abusers are women, the most common abusers are men. Reasons:

▪ The man has poor self-esteem

▪ A high level of frustration
▪ Needs to control others
▪ May have been physically abused as a child
The most common victim is a woman who has low self -esteem and feels that leaving her husband would pose financial
difficulties. She may also feel that she wants to maintain the marital relationship for the benefit of the children.

Interventions can be made through the legal processes and counseling of cou ples.

Child abuse

This is maltreatment of children. Research has shown that 85-90% of child abuse is by family members.
Teenage parents are most likely abusers. Perhaps they had not planned to have a baby or they have financial pressures or are
poorly trained in parenting skills.
Parents who were abused as children are also much more likely to abuse their own children.
Parents who are involved in substance abuse are less stable and more likely to abuse children.

Separation and Divorce

What is the difference between legal separation and divorce?

On one hand, a legal separation is a court decree recognizing that a married coup is living apart and regulating the couple’s
multual rights and liabilities. The most important factors are that the couple is still married, can still hold their real property as
tenants by the entity (if one dies, the property automatically belongs to the survivor), may each have right to make medical or
funeral decisions for the other, and each will be the surviving spouse of the other for purposes of inheritance.

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Divorce on the other hand changes a couple’s legal status in relationship to one another. Their marriage is legally dissolved.
Once the decree has been entered each other relinquishes any future claims against the other or their estate except for matters
related to child support. If the couple owns property, the tenancy is reduced to a tenancy in common. That is, if one dies their
half interest passes to their heirs at law. A former spouse has no right of inheritance.

Separation and divorce create stress within a family. Each family member is affected in some way. Research has shown that
some family breakages affect adolescent children more than young children. This is because the adolescents stop getting
parental love, support and guidance when parents go their separate ways.

What are the effects of family breakages among children?

▪ Depression and withdrawal

▪ Demonstrate angry and hostile behavior.
▪ Poor performance in school

ACTIVITIES
In a school of your choice, find out the numbers of children from single parenthood and establish some of the reasons
for single parenthood.
In your class discuss the challenges facing children from single parent families.

1. Discuss the functions of a family in society (15 marks)

2. Discuss the challenges facing the family institution in modern times (15 Marks).

TOPIC SIX: DRUG AND SUBSTANCE ABUSE

This topic is divided into three sections namely;

• Definition of terms
• Commonly abused drugs and their effects
• Drug tolerance

DRUGS

A drug is any chemical substance which when taken in to the body modifies or alters the way the mind and body function from
their normal state.

Drugs can be orally administered, injected, chewed, sniffed, smoked or applied.

Drugs can also be classified as legal and illegal depending on the country.

Drug abuse is the non-medical use of drugs, for example: the use of alcohol, cigarettes and other chemical substances that
destroy health and productive life of an individual.

Drug abuse can also be defined as the intentional use of psychoactive substances for purposes of altering one’s psychological
state without medical supervision.

Drug abuse often leads to pathological drug dependence, a condition in which the abuser is no longer able to stop using the
drug even when the habit is causing serious damages to him or to others.

Drugs that are abused in Kenya

There are two types of drugs commonly abused in Kenya that is positive and negative drugs.

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Positive drugs: these are drugs that are useful to our health.
These are drugs bought over the counter in the chemists, in clinics and on the streets.
They are abused in the following ways:
• Overdosing
• Under-dosing
• Doctoring one self
• Wrong drugs
• Drugs for pleasure
• Taking drugs from non-drug experts
Negative drugs: are drugs which are risky to our health.
They include:
• Tobacco
• Alcohol
• Bhang
• Miraa/Khat
• Inhalants e.g. Petrol, glue, nails polish, oil paint, turpentine, thinner, gum. These are petrol oriented materials, have
very strong smell which is very addictive.
• Kuber
• Hard drugs e.g. heroin, cocaine, madrax,

DRUGS COMMONLY ABUSED IN KENYA

Tobacco
• Is a broad leafed plant (Nicotiana taba cum) that has been known to man from far back as 3500BC.
• It was cultivated by the Indian tribes of south and Central America who perceived it as an herbal remedy against
toothache, snake and insect bites.
• The plant is now grown primarily in third world countries including Kenya.
• In the farm, the plant is poisonous and can harm the person handling it through the skin hence it is used as a pesticide.
• In the raw form it is known to be used by farmers as a pesticide and weed killer.
• The leave is harvested, dried, and processed into cigarette, snu ff, cigar tuber etc.
• When it is burnt, the smoke releases over 4000 substances, majority of which are poisonous
• When it is chewed, these poisons cause cancer of the mouth and throat
• At least 40 of the chemicals contained in tobacco cause over twenty five types of cancer.
• Tobacco contains nicotine, a substance that causes addiction.
• The four thousand plus chemicals which tobacco smokers pump into the body include poisons like.
1. Hydrogen cyanide (used in gas chambers)
2. Arsenic (rat poison).
3. DDT (insecticide) which is harmful
4. Cadmium (highly poisonous metal used in batteries)
5. Carbon Monoxide (lethal gas)
6. Methanol (Rocket fuel)
7. Ammonia (found in toilet cleaner)
8. Acetone (paint stripper)
9. Tar (clogs lungs stains nails, teeth)
10. Formaldehyde (used to preserve dead bodies)
11. Other many cancer causing agents.

How harmful is tobacco?

According to World Health Organization (WHO) and World Bank studies, Tobacco killed 4.9 million people around the world
in the year 2002.

By 2030 this will rise to over 10 million people dying every year all over the world.

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 • This figure will be more than the combined death from Malaria, road accidents, childhood diseases , HIV and AIDS
and Tuberculosis put together.
• Seven out of ten of the deaths will occur in the developing countries, Africa and Kenya included.
• For every stick of cigarette smoked, the smoker looses 6 minutes of his or her life.
• Passive smokers suffer even greater because they inhale unfiltered cigarette smoke.
• They loose 6 minutes of their lives for every stick of cigarette smoked by neighbours.
• Increased distance from smokers decreases the risk
• Panting processing and handling tobacco also causes harm

Over 60% of patients in health centers in tobacco growing areas of Kenya suffer from the effects of nicotine that has been
absorbed through the skin.

What is nicotine?
• Is a colourless poisonous chemical present in tobacco
• It is highly addictive
• It is readily absorbed through the skin and mucous membrane
• It is a central nervous system stimulant
• If taken in large amounts it can cause fatal seizures.
• The addictive power of nicotine can be measured by the number of smokers who have difficulties in stopping
the use of drugs.
• The uptake of nicotine in the blood stream is instantaneous and the drug takes a mere 7 seconds to reach the
brain cells
• One needs to smoke the first five sticks of cigarette to get hooked forever.
• Nicotine is extremely toxic and addictive.
• It also causes the blood vessels to constrict leading to high blood pressure.
• Long time use of nicotine especially in diabetics causes heart attack.
Large amount of nicotine can kill by paralyzing the muscles of the lungs.
What are the health problems linked to tobacco chewing and sniffing?
• Mouth cancer
• gum diseases
• throat cancer
• heart disease
• stroke

Thus, tobacco use is risky to one’s health

Smoking during pregnancy is also dangerous as follows;

• It can lead to increased risk of neonatal mortality or Sudden Inf ant Death Syndrome (S.I.D.S)
• Babies of mothers who smoke during pregnancy are often smaller than normal
• It may lead to still birth, miscarriage and premature deliveries than women who do not smoke
• Babies of smoking mothers have a high rate of pneumonia, asthma and bronchitis in their first year
• The babies of mothers who smoke may experience impaired physical growth and low academic attainment compared
to children of non smoking mothers
Can smoking be stopped?

Yes smoking can be stopped, however;

• Due to high nicotine level the body is used to, it is difficult but it is very possible to stop
• stopping should be gradual
• reduce levels if one cannot stop at once
• smoking is learnt behaviour that can be unlearnt
Tips to help one stop smoking!

• A strong will to give up the habit, an inner power that causes you to overcome. This can be cultivated by the correct
understanding of the dangers of smoking and desire to live a long healthy life.

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 • Learn about the dangers of smoking
• Be conscious of every cigarette smoked, the place one is likely to smoke and time. Keep a record of these so as to
identify the circumstances that trigger the craving and monitor your progress.
• Write down the benefits of not smoking and reasons why you began smoking no matter how obnoxious they may
sound.
• If one is already dependent on cigarette, should reduce the intake gradually to avoid the unpleasant effects of
withdrawal.
• Where possible avoid places, events or people who trigger you to smoke. Avoid smokers and occupy non smoking
sections only.
• Eat fruits and drink plenty of water and fruit juice to flush out nicotine.
• Do exercises as this helps to stimulate the body, causes relaxation and helps relieve stress.
• When craving arises, chew on low calorie nibbles like carrot or gum.
• Ask a non-smoking friend for moral support.
• Avoid having a lot of unstructured time.
• Medication is also valuable, consult a doctor.
• Use of Nicotine patches.
Alcohol
Alcohol is a chemical compound produced by fermentation of sugar using yeast.

Such sugars are derived from grains, coconut, fruit juice, sugar cane, potatoes, bananas, honey. The chemicals interact with
yeast to provide the active ingredient called ethanol amongst other chemicals. For instance, beer and whisky is made from hops
and malts; wine and brandy from fermenting grapes; Changaa is made from various grains including millet and maize and
Mnazi from taping coconut juice.
Generally, ethanol content in various alcoholic drinks is as follows though it varies from one brand to another.
▪ beers 5%v/v
▪ wines 12%v/v
▪ spirits 40% v/v
▪ changaa 90% v/v

Sometimes the fermentation process is incomplete and other substances find their way into alcoholic drinks e.g. methanol- a
product of wood alcohol or isopropyl- alcohol which is used for cleaning wounds.

Factors that affect alcohol absorption

❖ Alcohol is absorbed unaltered from both the stomach and the small intestines.
❖ Mixes in all quantities with water hence can reach all parts of the body systems
❖ It is absorbed and distributed faster in people with small body mass.

The factors which affect distribution include

❖ Concentration of alcohol in the alcoholic drink

❖ The quantity taken
❖ The rate at which it is taken

Drinking too fast does not allow the liver and body to metabolize the alcohol fast enough.

The liver can only break down once 28.35g of alcohol per hour and therefore only passage of time will allow for complete
elimination of alcohol from the body.

The presence of food especially fatty foods in the stomach slows down absorption of alcohol

Intake of carbonated drinks and poor nutritional status of a person may accelerate the absorption of alcohol.

What are the dangers of taking alcohol?

❖ Alcohol contains ethanol which is a very poisonous chemical that adversely affects body organs immediately or gradually
over the years.
❖ Organs such as the brain, liver, stomach, pancreas, kidney, skin and bones among others are affected.

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❖ Alcohol causes diabetes, heart failure, stomach ulcers, kidney failure, and brittle bones that fracture easily.
❖ Alcohol can cause vomiting through its direct irritation of the sensitive stomach lining and stimulation of the vomiting
centre in the brain to some people.

Some brewers add some adulterants added to presumably make them more potent. These include bhang, heroine, sisal juice,
formaldehyde, battery acid, human urine, and other toxic substances.

These factors added, greatly to the unpredictability of the effects and damage from consumption of these drinks.

The consumer can rarely be sure how strong or poisonous the adulterated drink is.

What are the effects of alcohol

Most effects of alcohol when taken take place in an incremental way and are not noticed immediately.

• Continued use of alcohol may lead to a false sense of security in matters regarding health risks.
• When taken drinkers feel happy and are talkative
• Later they become drunk
• Makes all muscles numb
• Sharpness of sight is lost
• Personality changes are experienced-person becomes impatient and aggressive.
Mouth
• An increasing thickening of the tissues that line the mouth
• Gradual loss of taste
• Changes to the tissues may predispose to cancers of the mouth
Heart
• Inflames and damages heart-muscle
• Hardening of arteries
• Fatty degeneration
Pancreas
• Irritates the cells leading to swelling and bleeding causing diabetes
• Blocks flow of digestive enzymes
Stomach and intestines
Alcoholic gastritis
Causes stomach and duodenal ulcers
Interferes with nutrition vitamin B1, B2 folic acid, fat and some amino acids.
Stomach lining shrinks.
Circulatory system
Blood vessels dilate causing the individual to feel warm while actually experiencing heat loss.
Slows down circulation and action of the white blood cells thus delaying the process of resistance to infection.
Causes red blood cells clump together. This increases the risk of blood clotting and it inhibits oxyge n transportation to the
tissues.
Liver
– Results to jaundice
– Cirrhosis of the liver
– Nutritional deficiencies are experienced
Sex glands
• Swelling of prostate gland this interferes with sexual performance
• Can lead to spontaneous abortion in women
Kidney and bladder
Alcohol increase fluid loss and extra water is expelled
The bladder is inflamed making it difficult to stretch and accommodate the extra fluid.
Brain and spinal cord
• Causes gradual destruction of the cell of the cortex of the brain.

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 • Loss of control and reflex action
Kuber
It is a substance made from leftovers from cigarette manufacturing in India. It is swept from the factory floor and packed in
colorful sachets for export to Kenya and other African countries. It contains 41% nicotine which is highly addictive. It also
contains other unknown substances as it is unregulated. By comparison, cigarette contains 14-21% nicotine. It is meant to hook
young users.

Kuber is banned in India its country of origin an indication that it is unfit for human consumption.

Bhang

• Bhang is the leaves, flowering shoots, seeds and other parts of a plant called Cannabis Stiva.
• Positively used it has been prescribed to relieve cancer patients chemotherapy side effects
• It has other 69 names of which are Ganja, Weed, Stone, Marijuana, Pot, Grass,Kizusha Bongo, Holy Herb, Ngwai,
Kaya, Maryjay, Joint, Spliff, Hashish, Dagga, Hemp etc.
• It is used by smoking and contains cannabinoids which are min d altering substances.
• It also contains delta a tetrahydrocannabinol (THC).
• The chemical can remain in the body for long time (36days or more) even when one has stopped using bhang.
• It is against the law to grow, possess use or trade in Bhang in Kenya .
• Bhang has over 400 chemical substances most of which are harmful to the body
• Bhang smoke contains 50% more tar cancer causing substance than smoke from cigarettes.
• The residual effects can last a lifetime and often leads to mental problems for some users .
• it is used by both male and female in schools
What are the short term effects of taking Bhang?

❖ Relaxation
❖ Delayed fatigue
❖ Distortions of time and space
❖ False bravery
❖ False confidence
❖ Delusion
❖ Unreasonable fear
❖ Weird dreams
❖ Restlessness
❖ Irritability
❖ Aggression
❖ Sleeplessness
❖ Nausea and cramps
❖ Narrow-mindedness
❖ Loss of coordination
❖ Sudden panic
❖ Lack of interest
❖ Poor judgment
❖ Detachment from reality.
❖ What are the long term effects of Bhang?

Bhang consumed in high doses and for a long time can lead to:
• Impaired motor coordination.
• loss of steadiness in the hands and body movements
• Increased reaction time so that response to stimulus is slowed.
• Diminished short term memory
• Distorted sense of time.
• Impaired ability to conduct a logical conversation.
• Can lead to a motivational syndrome- this is a pattern of personality changes characterized by apathy, lack of concern
for future, loss of ambition and decline in school and work performance.
• May harm lungs.

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 • Causes cancer
• Increases blood pressure
• Can lead to reduced testosterone level in men
• Reduced sperm count
• Abnormal menstrual periods and failure to ovulate
• poor immunity
• brain shrinkage
• red blood shot eyes
• urge to use other strong drugs
• can lead to insanity
• can lead to death

Bhang and crime

❖ Bhang has been referred to as a ‘focusing drug’

❖ One of its major effects is narrow mindedness i.e. thinking or conc entrating on a single place or thing. Such narrow
mindedness enables bhang abusers to focus on any particular subject with vigor, determination, and recklessness that
borders on insanity. This at times may be misinterpreted to mean confidence and success.
❖ Bhang also interferes with attention, concentration, memory and logical thinking so that an individual’s ability to perform
complex actions or to make sound judgment becomes altered.
❖ Such a person becomes violent and runs into serious problems.
Miraa

Miraa is a plant whose fresh leaves and soft twigs are chewed to release a juice containing cathinone and cathine, the active
chemicals that alter the mood of the abuser. Cathinone is a stimulant, which is said to cause excitement, loss of appetite and
euphoria. In 1980, the World Health Organization (WHO) classified it as a drug of abuse that can produce mild to moderate
psychological dependence.
Consumers also refer to miraa using less familiar names such as Khat, Veve, Muguka, Goks, Gomba, Mbachu, Mairungi, Alele,
Giza or Halwa. (NACADA, 2010).
• What Are the Effects of Chewing Miraa?
• Causes one to feel exited
• One feels healthy
• Lack of sleep
• Loss of memory of major events
• Poor concentration
• Instant poisoning
Long Term Effects of miraa?
• Irritability
• Difficult to please
• Impotence
• Natural ejaculation after 72hours (spermatorrhoea).
• Bad smell- mouth
• Mouth disease
• Constipation
• Infertility
• Irregular periods
Depresses bone marrow

Hard Drugs and soft drugs

From the above discussions of some of the drugs abused, we can deduce that some drugs are acceptable to use but with
reservations. These may be referred to as soft drugs as opposed to hard drugs which are addictive and perceived to be
damaging.
Hard and Soft drugs are terms to distinguish between psychoactive drugs that are addictive and perceived as especially
damaging and drugs that are believed to be non-addictive (or minimally addictive) and with fewer dangers associated with their

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use. The term "soft drug" is considered controversial by its critics because it implies that the drug causes no or insignificant
harm.
What are the classifications of the hard drugs?
• Opiets (E.g.- morphine, Codeine, heroine, methadone)
• They are psychoactive drugs derived from the opium poppy plant or made synthetically.
• They induce sleep and reduce pain;
• Non medical use of opiets is illegal and dangerous.
• They are highly addictive
• A person dependent on opiets may have withdrawal symptoms.
• If a certain level of the drug is not maintained in the blood one develops flu like symptoms.
• Further drop may result to weakness, nausea, vomiting, stomach pain, muscle pain.

Depressants
Drugs that slow the down the functions of the central nervous system
• Depressants that produce a calming effect, relax muscles or relieve tension are called sedatives.
• Large doses of sedatives induce drowsiness leading to sleep.
• Drugs that have sleep inducing effects are called hypnotics.
• The combination term of sedative hypnotic describes the drugs in this section.
• Sedatic-hypnotic drugs produce a variety of effects when misused or abused.
• They can cause nausea, headaches, dizziness an drowsiness, withdrawal symptoms and if not treated the symptoms can
cause death.
Stimulants E.g.: amphetamines and cocaine
• Drugs that increase the functions of those organs controlled by the central nervous system.
• Amphetamines are a group of synthetic chemicals that affect the areas of the brain that control blood pressure, the
heart, breathing rate, and metabolism.
Short term use can cause nervousness, elevated blood pressure and headaches.
• Long term use can result in sleeplessness, irritability, confusion, dizziness, elevated blood pressure which can lead to
burst of blood vessels, tolerance and psychological dependence etc.
Cocaine
• Obtained from the leaves of the coca shrub
• Coca shrub grows in the Andes Mountains IN South America.
• Cocaine in most cases is illegally used.
• Cocaine enters the blood stream when sniffed. It can also be injected.
• One use of cocaine that is dangerous is freebasing.
• Freebasing is a chemical process in which cocaine powder is changed into a smokable solution.
• Cocaine can cause restlessness, irritability, depression,. Elevated blood pressure, heart damage, damage of the mucous
membrane and the nose, disruption of eating and sleeping habits and weight loss and cocaine psychosis.

What are the stages of the effects of drugs?

Stage I: causes euphoria where one feel exited. This is also called the trapping stage.
Stage II: Normal between abnormal.
In this stage the drug abusers get tolerance and dependency.
If one does not get the drug they get withdrawal syndrome.
(Can get phobia, can become violent, or is angered very fast).
Stage III: This is a visionary stage.
❖ One gets hallucinations, illusions, Derichams, nightmares, (can see angels and ghosts)
❖ can feel they are God
❖ can dream wildly and yell
Why do young people take drugs and get trapped?

• Family: copying from parents-this creates a subconscious desire for imitation.

• Poor family cohesiveness – especially when there is family break up or family members especially parents who are
busy to give attention to children.
• Friends – that is influence from friends in school or in the neighborhood
• Peer pressure – where one takes drugs so as to feel accepted by peers
• Ignorance – some take drugs out of lack of information especially when cheated by friends.

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 • Curiosity- to taste what it feels
• Hero worship e.g. Rasta faris, Black- black people, Green- Green Bangi, Yellow- Jah lovers, Red- oath of solidarity.
• Belief in three things: sex, freedom, smoking bhang or drug taking.
• Belief in fighting three people: parents, church, and authority.

Physiological and psychological effects of drug and substance abuse

What are the physiological and psychological effects of drug and

substance abuse

Drug dependence is a state of being enslaved by drugs. We have physiological and psychological dependence. Physiological
dependence means that if you remove the drugs the body cannot function. If it functions, it will have great discomfort or
feeling of sickness e.g.
• One cannot fall asleep without drugs.
• One can have diarrhea.
• One can have irregular heartbeat
• Pain
• Shaking of hands.
When you take the drug, the symptoms disappear temporarily until the levels fall once more.
Psychological dependence – is when the drug is taken for stimulation or pleasure.

Drug addiction is a state when drug dependency has developed to such an extent that, it has serious detrimental effects on the
user and often on their family as well.

- Addiction is characterized by loss of control over the use of the drug, one cannot do without it.

- An addicted person is compelled to use drugs everyday to remain intoxicated and has great difficulty in stopping.

- Drugs take over their life. The cells of the body become adapted to the presence of that substance and without it
they cannot function.

What is Drug Tolerance?

This is a condition in which the body requires increasingly large amounts of the drug to achieve the same effect due to frequent
and continuous use. For example, a person who has taken more alcohol or to get high for long may require more to reach the
desired effect. Tolerance is one indicator of progression to addiction.

What are signs of drug abuse among the youth?

There many signs one can observe as signals of drug abuse among youth. They include the following:

a) Possession of drug released paraphernalia

- Rolling paper called rizzla – small rectangular or mostly bright while paper in packs of 50.
- T-shirts shakers caps with a picture of bhang leaf or Bob Marley in red yellow and green colours.
- Necklaces bearing signs of bhang leaf.
- Small bottles of nose and eye drops.
- Small Beltane to rules, lighters burnt spoon and candles.
- Syringes and needles.

The other category of signs includes:

b) Possession of drugs or evidence of drugs for instance:

- Having Peculiar plants, bulbs, seeds leaves in ash tray or clothing pockets.
- Availability of Banana leaves and miraa-twigs.
- Traces of powder and round nostrils
- Empty bottles under their beds.
- Wearing sun glasses even in the house.
- Medicines to relieve constipation (laxatives).

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 - Odour of drugs.
- Cover up scents e.g. air and mouth fresheners, incense and aerosol sprays.
- Brushing teeth many times in a day.
- Constantly sucking oink and chewing gums.
- Wearing long sleeved shirts to cover needle marks.
- Blood short eyes, dilated pin pointed pupils drooping eyelids due to over sensitivity to sunlight necessitating
sunglasses, a running nose for no medical reason.
Others signs are related to:
c) Identification with drug culture such as
- Drug related magazines, slogans on clothing.
- Conversation and jokes that are pre occupied with drugs.
- Hostility in discussing drugs.
- Keeping company of known drug abusers and peddlers.

d) Other categories of signs are related to physical deterioration such as:

- Memory lapses, short attention span difficulty in concentration.
- Sexual problems which include lack of appeal, function and promiscuity.
- Disturbed sleep patterns including over-sleeping, marked drowsiness, moodiness, fatigued look, restlessness.
- Poor physical co-ordination, slurred or incoherent speech.
- Chronic cough that does not respond to treatment.
- Unhealthy appearance.
- Indifference to hygiene and grooming.
- Burnt or stained thumb nails, burn holes on clothing.
- Track marks as evidence of using needles.
- Unpleasant skin rash
- Excessive sweating
- Complaints of headaches especially if they are associated with memory loss.
- Drop in appetite or sudden heightened appetite for food.

e) Other signs are dramatic changes in school performance categorized in form of:
- Drastic downward trend in students’ grades.
- Increased withdrawal behaviour e.g. keeping to themselves.
- Generally being anti-social
- Work and assignments not completed.
- Increased absenteeism.
- Lacking in energy.
- Inattentiveness, lack of concentration losing touch with reality, low motivation with a blank facial expression.
- Poor workmanship.
f) Lastly are signs to do with changes in behavior such as:
- Quarrelsomeness, outbursts of violence or unexplained anti-social behaviour.
- Chronic dishonesty, lying cheating stealing and trouble with police.
- Household items disappearing (sold to buy drugs).
- Changes in friends, evasiveness in talking about them and referring to them by their first names e.g. Vic, Bob.
- Nervous mannerism – frequent lip liking, jittering, foot trapping.
- Demand for large amounts of money.
- Reduced motivation, energy, self discipline and self esteem.
- Diminished interest in extra-curricular activities and hobbies.
- Leaving home early and coming back late.
- Irregular class attendance, frequent requests to go out of schools that are made to sound as a matter of life and
death.
- Sudden laughter, outbursts for reasons not really worth it.
- Disorientation in time and space.

ACTIVITIES

. What is drug and substance abuse? (2marks)

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2. Discuss the effects of drug and substance abuse among the youth (10 marks)

3. Discuss the common physical symptoms of youth under the influence of drugs? (18 marks

TOPIC SEVEN: HIV AND AIDS COUNSELLING

Definition of terms
HIV stands for Human Immunodeficiency Virus (HIV)
AIDS is: Acquired Immunodeficiency Syndrome (AIDS)
• Acquired –means it is not hereditary
• Immune –refers to the body’s defence system
• Deficiency – means impairment of the immune system
• Syndrome – combination of signs and symptoms

MEANING: HIV and AIDS is a disease caused by deficiency in the body’s immune system. It is a syndrome because
there are a range of different symptoms which are not always found in each case. It is acquired because AIDS is an
infectious disease which is spread from person to person, through various means.
How are HIV and AIDS spread?

HIV and AIDS are transmitted through: Sexual intercourse, blood transfusion and from mother to child especially during
birth.

a) Sexual transmission
• Requires direct contact between two people, in which the virus is transmitted from an infected person to a
susceptible person.
• Through heterosexual activity and homosexuality.

b) Transmission through blood

• Transfusion of blood
• Hemophiliacs and factor 8 – have a genetic deficiency that prevents blood from clotting in cases of cuts and
injuries.
• Infected drug users.
• Skin piercing

c) Mother to child transmission

Other factors which contribute to the spread of HIV and AIDS include:
i) Socio-cultural factors
• Absentee husbands
• Polygamy
• Wife sharing
• Wife inheritance
• Traditional initiation rites
ii) Economic factors
• Kenya’s economic performance has not been good for some years.

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 • 51% of the population the majority of whom are women, and ¾ of whom are in the rural areas, where access to
treatment is a challenge.
What are the models of prevention of spread of HIV and AIDS?

ABC Model of Prevention

A is for Abstinence - not engaging in sexual intercourse or delaying sexual debut. Whether abstinence occurs by delaying
sexual debut or by adopting a period of abstinence at a later stage, access to information and education about alternative safer
sexual practices is critical to avoid HIV infection when sexual activity begins or is resumed.

B is for Being faithful (sometimes Be safer) - being faithful to one's sexual partner or reducing the number of sexual partners.
Having fewer sexual partners reduces the risk of HIV exposure. However, strategies to promote faithfulness among couples
only lead to lower incidence of HIV when neither partner has HIV infection nor both are consistently faithful.

C is for Correct and Consistent Condom use - condoms reduce the risk of HIV transmission for sexually active people,
couples in which one person is HIV-positive, sex workers, and their clients. Research has found that if people do not have
access to condoms, other prevention strategies lose much of their potential effectiveness.

A, B and C interventions can be adapted and combined in a balanced approach that will vary according to the cultural context,
the population being addressed, and the phase of the epidemic.

Source: 2004 Report on the global AIDS epidemic, UNAIDS

What is the SAVE model of Prevention

S refers to safer practices - covering all the different modes of HIV transmission. For example: safe blood for blood
transfusion; barrier methods for penetrative sexual intercourse; sterile needles and syringes for injecting; safer methods for
scarification; and adoption of universal medical precautions.

A refers to available medications. - Antiretroviral (ARV) therapy is by no means the only medical intervention needed by
people living with HIV. Long before it may be necessary, or desirable, for a person to commence ARV therapy, some HIV
associated infections will have to be treated. Treating these infections results in better quality of life, better health, and longer
term survival. Every person needs good nutrition and clean water, and this is especially true for people living with HIV and
AIDS.

V refers to voluntary counseling and testing. - Individuals who know their HIV status are in a better position to protect
themselves from infection; and if they are HIV-positive, from infecting another. Someone who is HIV-positive can be provided
with information and support to enable them to live positively. People who are ignorant of their HIV status, or who are not
cared for, can be sources of new HIV infections.

E refers to empowerment through education. - It is not possible to make informed decisions about any aspect of HIV or
personal behavior without access to all the relevant facts. Inaccurate information and ignorance are two of the greatest factors
driving HIV and AIDS related stigma and discrimination. Correct, non-judgmental information needs to be disseminated to all,
both inside and outside the church. This will assist people to live positively - whatever their HIV status - and to break down
barriers which HIV has created between people and within communities. Education also includes information on good
nutrition, stress management, and the need for physical exercise.

What is HIV and AIDS counseling?

HIV and AIDS counseling is the provision of support and strength to individuals, couples, families or groups by, competent
persons, to help them cope with the knowledge that they are infected or affected by HIV. It is an ongoing process that allows
the individuals to develop a sense of responsibility in meeting challenges posed by their infection. Counselling should also be
given to HIV negative individuals to promote behaviour change and condom use.
One of the facets of HIV and AIDS counseling is information giving. A thorough up to date knowledge of facts related to
HIV/AIDS is required by the counselor to enable clients to make informed decisions and cope with HIV infection.

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Various studies have proved that good counselling has:assisted people to make informed decisions—such as whetherto have
an HIV test; helped many other people living with HIVor AIDS to cope better with their condition and lead morepositive lives;
and helped prevent HIV transmission.

How is HIV counselling carried out?

HIV counselling is a confidential dialogue between a client and a counsellor aimed at enabling the client to cope with stress
and take personal decisions related to HIV/AIDS.
It concentrates specifically on emotional and social issues related to possible or actual infection w ith HIV and to AIDS.
With the consent of the client, counselling can be extended to spouses, sex partners and relatives (family -level counselling,
based on the concept of shared confidentiality). HIV counseling has as its objectives both prevention and car e.
A counselor is a person trained in the skills of the job: listening to the client, asking supportive questions, discussing options,
encouraging the client to make his or her own informed decisions, giving practical information and suggesting follow -up.

Counselling should be a process involving a series of sessions as well as follow-up. It can be done in any location that offers
peace of mind and confidentiality for the client. Two types of counselling, according to site, are practiced.
• Clinic-based counselling is counseling provided in a formal session— in a hospital, health centre or clinic—by
a trained professional, such as a doctor, social worker, nurse or psychologist.
• Community-based counseling is given in a non-formal environment, in a village or urban neighbourhood—by
one community member trained in counselling to another community or family member.
What is pre - test counseling
Pre-test counseling is
• HIV counselling is often given in connection with a voluntary HIV test. Such counselling helps to prepare the client
for the HIV test, explain the implications of knowing that one is or is not infected with HIV, and facilitates discussion
about ways to cope with knowing one’s HIV status.
• It also involves a discussion of sexuality, relationships, possible sex- and drug-related risk behaviours, and how to
prevent infection.
• It helps correct myths and misinformation around the subject of AIDS. Whenever resources permit, pre -test
counselling should be made available to those who desire it. People who do not want or do not have access to pre-test
counselling should not be prevented from taking a voluntary HIV test, however. In contrast, informed consent is
always required before an HIV test where the individual’s name will be linked to the result.
• To allay anxieties while awaiting the test result, some individuals may seek support not only from their own families or
a knowledgeable community worker.
What is post- test counseling
• Post-test counselling helps the client understand and cope with the HIV test result.
• The two usually discuss ways to reduce the risk of infection or transmission. HIV test results should always be given
with counselling. The form of post-test counseling will depend on what the test result is.
• Where it is positive, the counsellor needs to tell the client clearly, and as gently and humanly as possible, providing
emotional support and discussing with the client on how best to cope, including information on relevant referral
services. Ongoing counseling will help clients accept their HIV status, and take a

•But counselling is also important after a negative result. While the client is likely to feel relief, the counsellor must
emphasize several points. First, because of the “window period”, a negative result may not mean absence of infection,
and the client might wish to consider returning for a repeat test after 3-6 months. Second, counsellors need to discuss
HIV prevention, providing support to help the client adopt and sustain any new safer p ractices.
STAGES OF COUNSELLING

There are three stages in the counseling process these are: the beginning stage, middle stage and terminal stage.
What does the beginning or relationship building stage involve?
This is the stage that influences the course of the counseling process.
• It is the first time the client and counseller are meeting
• The counseller should take the opportunity to assure the client of confidentiality and trust
• Also includes history taking and exploration of the client problem and how the client feels about it.
What is in the Middle or information gathering stage?
iii) When the client is sure that the counselor can be trusted, and will provide information, guidance and support,
the counseling enters the middle stage.

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 iv) During this stage of information gathering the counselor should:
1. Support the continuing expression and discussion of feeling
2. Promote the continuation of changes in behaviour
3. Help the person to move towards acceptance and control
What is in the terminal/ end stage?
At some point counseling has to end. Therefore this is the final stage in counseling.
v) It’s often difficult for clients who have built a close relationship with their counselors
vi) The thought of ending the counseling relationship may be painful for buth client and counselor
vii) The counselor should assure the client of continued help with handling future problems

Psychological ReactionsAs the HIV infection is fatal, being diagnosed HIV positive can create varying psychological
reactions in the individual. The following are some of the possible reactions:

• Shock – usually characterized by: silence, numbness, disbelief, despair and withdrawal
• Anxiety – physical symptoms, for example, elevated blood pressure, upset stomach, and change in appetite, tension,
headache etc or behavioural symtoms such as decreased productivity, increased use of alchohol, drug and smoking,
loss of interest in usual activities, among others.
• Denial - clients diagnosed with HIV infection may say “this cannot happen to me” as a sign of denial
• Anger – experienced after the initial shock and can be directed at a sexual partner or oneself. Leads to: deliberate
effort to spread the virus to others, abuse of achohol/drugs.
• Guilt – the fact that HIV is related to lifestyle, it causes self – examination of past lifestyle or seen as a punishment
from God.
• Depression – leading to: fatigue, loss of memory, weight loss, decreased social interactions, feeling of worthlessness.
Decreased libido.
• Hypochondria – an exaggerated concern over one’s health.
• Bargaining – Prayer and appealing for magical power, seeking any form of h ealing ( traditional or faith healing),
performing cultural rituals to appease the
• Acceptance – the realization that: one’s condition is inevitable, there is no cure, the infection is permanent and the
individual has to live with it.

Counseling Challenges

The challenges include but not limited to:

1. Poor selection of trainees for counselling
People are sometimes put on training courses simply because they are “due” for another course, or to fill up the course, and not
because they will be taking up positions as counsellors. This is one reason why those trained in counseling often do not
continue to practise it.
2. Lack of supervised practice and follow-up after training
Because counselling is a skill dependent on the personal qualities of warmth and understanding, it is often mistakenly assumed
to require little in the way of preparation and practical training. For this reason, a 2-3-day workshop, without any supervised
practice, is sometimes felt to be enough to produce a trained counsellor.

3. Inadequate resources, facilities and organization

• Counselling is not considered an essential social service, and there are therefore no clear policies on funding.
• Sometimes there is a lack of confidentiality.
• Counsellors often have an established job—such as nursing—which is regarded as taking priority over counselling. Without
priority or proper resources being given to counselling, many counselors have to carry out home visits in their spare time, a s a
voluntary activity. The consequent frustration can result in burnout.
4. Burnout
Burnout is a state of emotional exhaustion, which results when the counsellor has reached his or her limit to deal with HIV and
the emotional stress it causes. This may lead to a state of irritability and anger, often directed at sup ervisors, colleagues and
even clients.
E WHAT Challenge
Suggested ways to overcome the challenges

Establishing the role of HIV counselling

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One way counselling can be accorded its proper respect is by conducting studies on its delivery, quality and impact. Research
findings on counselling can help convince decision-makers and service managers to endorse and provide resources in support
of counselling services.
Proper selection of trainees for counselling
Candidates for a counseling training course should satisfy a number of conditions. They must be given a job description that
specifies that they can provide counselling. They must have the necessary agreed professional background—this may be as a
social worker, health worker, teacher, community worker, or a volunteer from a group of people living with HIV/AIDS.
Training workshop, followed by supervised practice
Most of the current effort in training takes the form of a single workshop, with no follow up supervision. Instead, after the
initial workshop the trained person should be placed in counselling work, with support and good supervision, and should
participate in a second training workshop later.
Retention of trained counselors
In Tanzania, a study showed that of those who had received counseling training, less than a quarter were reported to be
practicing counseling. Counsellors often leave their jobs, most probably because of bu rnout and lack of proper support.
SELF-TEST QUESTIONS
1. Explain the main stages in HIV counseling (9 marks)

2. Discuss the modes of handling the challenges faced by HIV and AIDS counselors (12 marks)

3. Discuss why HIV and AIDS is wide spread in the developing countries (9 marks).

TOPIC EIGHT: MODERN TECHNOLOGY AND HEALTH

• The use of modern technological equipment

• Health hazards associated with use of modern technological equipment

All societies want to grow and prosper. For a society to prosper and advance, it requires; security to defend itself against both
internal and external threats to it individuals and to the entire society. It also requires the economy to produce goods for
consumption, provide services, and improve the overall quality of life for its citizens and education to prepare its citizens so
they can benefit from what is already known and even add to the world’s b ody of knowledge. The above mentioned are
achieved through telecommunications where for example computers, the manufacture of space technologies of satellites, space
craft, and space station among others are critical. Medicine and health care, agriculture, environmental management,
entertainment, and architecture.

To actualize the prosperity, utilization of technology is important. However, the use of the same technology has positive and
negative impacts to the people utilizing it.

Technology has contributed to:

Longer Life

With new agricultural methods and equipment, the world is able to produce more food with less work at a cheaper price. With
better medicines and more effective treatments, people can survive diseases that would have once easily killed the m.

More Information

Improvement in communications technology, beginning with the invention of the printing press in the 15th century and
continuing up through the proliferation of the internet in the 1990s, has allowed more people access to an amount of
information that would have once been impossible. It helps them to become better educated and more informed.

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Form groups and discuss other positive aspects of using modern technology in society today

Modern technology has also brought in adverse effects on society. Some of the negative effects of modern technology include:

Mechanized Destruction

Use of modern weapons provides humans with the means of bringing themselves to a rapid extinction. For example use of
modern weapons in conflict and war is very destructive.

Isolation

Computers have significantly reduced the amount of face-to-face interaction people once enjoyed. In place of the richness of
human contact, many now settle for the comparatively pale pleasures of computer social networking.

Access to the internet has exposed the youth to unintended information such as phonographic information which influences the
youth to indulge in sex at early stages in life which is a recipe for the spread of HIV and AIDS.

Unintended Consequences

New technology brings with it a number of unpredictable side effects, some of which are good and some of which are bad. For
example, when asbestos was introduced, it was touted an important technological development in fire safety. Decades after it
was introduced, however, people learned that exposure to certain types of the substance could cause chronic health problems in
that such substances cause cancer.

Use of modern technological equipment at home

Modern technological equipment is used at home basically for cooking and entertainment. The use the microwaves and other
cooking devises are common in many modern kitchens. Whereas use of modern equipment allows use of clean energy, some of
the equipment like microwaves has adverse effects on human health. It is being pointed out that food heated by micro wave
may cause cancer.

What are the effects of eating micro waved food and exposure to
micro waves?

The following is a list of some physical problems that can be caused by eating micro waved foods and from being frequently
exposed to microwaves.

• Changes in the blood

• Cancer
• Leukocytosis
• Breakdown in systems of digestion and elimination
• Deterioration of the life-energy field (aura)
• Degeneration of the nervous-system
• Brain damage
• Immune system deficiencies
• Loss of hormonal balance
• Brainwave and psychological disturbances, including
• Loss of memory and ability to concentrate
• Decreased intellect
• Emotional instability
• Sleep disturbances
• Passivity

The cell phone

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The cell phone has revolutionarised modern communication. However, despite the ease of communication brought by use of
the cell phone, its use has brought with it many negative ef fects.
Think about it! Supposing children were allowed to carry mobile phones in school; what will teaching and learning be like?

The following are the physical problems caused by exposure to digital signals and emissions from cell phones and cell phone
towers:

• Increased cancer risk in many forms, especially breast cancer

• Unhealthy changes in blood levels of serotonin and melatonin, causing
• Defects in brain messaging
• Alterations of mood
• Sleep irregularities
• Immune system problems
• Headaches
• Poor memory
• Mental excitation
• Confusion
• Anxiety
• Depression
• Appetite disturbance

What are the positive and negative effects of use of ICT among students in Kenya today

Discuss negative effects of watching different programmes of the Television?

Discuss the effects of use of mobile phone in society today.

What are the effects of use of the television set?

ANSWERS TO SELF-TEST

1.1. Contributors to poor physical health

- Failure to feed on balanced diet

- Physical damage eg broken limbs, spinal vertebrae, skull etc.
- Infections from disease causing organisms eg virus, bacteria and parasites.
- Genetic complications eg Sickle cell anemia.
-
1.2. Characteristics of persons who are mentally ill
They are unable to:
- make rational decisions,
- Work to solve problems and have realistic solutions
- To manage stress Read good books
- To realize and admit their mistakes or failures and do not ignore problems that may have been their fault.
- Lie, cheat or steal.
- Allow their emotions to get out of control- even if they are alone

2.1. State five causes of mental impairment. (5 marks)

• Brain damage

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 • Genetic disorders.

• Use of drugs and substances of abuse.

• lack of oxygen to the brain during delivery

• Brain Developmental delay due to other factors (unknown)

2.2. Identify coping mechanisms of persons with:

i. Visual impairment
• a thorough orientation and mobility training
• By providing adaptive equipment, which include; Braille computers, collapsible cane,
magnifying glasses, and stenography
ii. Hearing impairment
• Use of sign language
• Uses of total communication systems to enable them obtain information that others gain by
listening.
• They may need technology such as amplifiers or hearing aids.

iii. Physical impairment in a school set up

• Schools where the physically challenged children are integrated should be barrier free.
• Physical facilities within these schools need to be extensively adapted to the needs of th e physically
handicapped learners.
• The built environment, should be barrier-free physical environment to guarantee the health of the
learners

3.1. What are the essentials of First Aid? (5 marks)

• Assess the situation quickly and calmly.
• Protect yourself and the casualty or casualties.
• Comfort and reassure the casualties.
• Deal with any life threatening condition.
• Obtain medical aid if necessary.
• If you suspect a serious illness or injury call an ambulance

3.2. Why is it important to leave children with careful care givers? (5marks)
• To be able to keep the baby neat
• To be able to feed the baby with the right food
• To be able to detect cases of accidents and administer First Aid.
• To be able to keep environment clean

3.3. Explain the First Aid tips in snake bite, wounds, fractures burns, (20 marks)

Wounds
• Assess the casualties condition
• Control bleeding by applying pressure on elevating the injured part
• Keep the wound clean
• Comfort and reassure the casualty
• Minimize shock
• Obtain medical help, if necessary
• Call an ambulance if you suspect a serious illness or injury

Fractures
• Stop bleeding if any by simple pressure over the injured part using a clean pad of cloth.
• Do not wash the wound.

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 • Do not probe the wound.
• Do not insert your fingers into the wound .
• If a fragment of bone is protruding, cover the entire wound with a clean cloth or towel.
• Apply a splint to the injured part to prevent movement (splint- a piece of rigid materials applied along to the
sides of the limb to prevent two broken ends of the bone from moving.)
• Burns
• Do not apply lotion, ointment or fat to a burn.
• Do not touch the burn or burst any blisters.
• Do not remove anything sticking to the burn.
• If the burn is to face do not cover it.
• Keep cooling with water until help arrives.
• If the burn is caused by chemicals, cool for at least 20 minutes.
Burns on sensitive parts of the body e.g. the face or the genital area, serious
• As quickly as possible, apply or pour cold water to the burnt part or submerge it in ice cold water for at least
10 minutes.

Snake Bites

• Keep the victim as calm as possible preferably in a lying position.

• Do not move the part that has been bitten because the more it is moved the more rapidly the poison will spread
through the body.
• A person who has been bitten on the foot should not walk but should be carried on a stretcher is
possible.(illustrate)
• A bite from a poisonous snake is dangerous.
• Transport the victim to hospital as soon as possible taking the dead snake with you if possible.

4.1. What is the role of public health services in society? (5marks)

Public health deals with:

• Prevention
• Promotion
• Rehabilitation
• Contamination,
• Sanitation
• Housing.

4.2. Discuss the essentials of health and safety in a school (15 marks)

• Safety on school grounds.

• Safety of physical infrastructure.
• Health and hygiene safety.
• Safety in school environment.
• Food safety.
• Safety against drug and substance abuse.
• Safe teaching and learning environment.
• Socio-cultural environment of the school.
• Safety of children with special needs.
• Safety against child abuse.
• Transportation safety.

4.3. What is Disaster Risk Reduction and how can it be realized in a school? (10marks)

• Actions designed to minimize destruction of life, property and disruption of normal operations. It calls for the
establishment of a disaster Crisis Response Team with the mandate to prevent, mitigate and effectively prepare against

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 potential disaster hazards. It also includes organizing and carrying out rescue and rehabilitation operations during and
after a disaster has struck.
• Establish early warning systems
• Post evacuation maps at every entrance and exit to buildin gs.
• Schedule practice drill sessions for fire, earthquake, lockdowns etc
• Develop a telephone tree list of all employees.
• Maintain school emergency kit with items like; first aid kit, whistle, fire blankets, flash torches, fire extinguishers,
blueprint of school buildings.
• Observe safety measure during various types of disasters.
5.1 Discuss the functions of a family in society (15 marks)
• Stable Satisfaction of Sex need
• Procreation
• Protection and care of the young
• Socializing Functions
• Provision of a home
• Spiritual support
5.2 Discuss the challenges facing the family institution in modern times (15 Marks).
• Teenage parenthood
• Violence
• Battered spouses
• Child abuse
• Divorce, separation and dissolution
• Single parenthood
6.1. What is drug and substance abuse? (2marks)

• Drug abuse is the non-medical use of drugs, for example: the use of alcohol, cigarettes and other chemical substances
that destroy health and productive life of an individual.

6.2. Discuss the effects of drug and substance abuse among the youth (10 marks)

• Ill health due to poisoning

• Poor socialization
• Can lead to self damage
• Can lead to social vices like crime and theft
• consumption of drugs can cause diseases
• Death etc

6.3. Common physical symptoms of youth under the influence of drugs?

(18marks)
- Memory lapses, short attention span difficulty in concentration.
- Sexual problems which include lack of appeal, function and promiscuity.
- Disturbed sleep patterns including over-sleeping, marked drowsiness, moodiness, fatigued look, restlessness.
- Poor physical co-ordination, slurred or incoherent speech.
- Chronic cough that does not respond to treatment.
- Unhealthy appearance.
- Indifference to hygiene and grooming.
- Burnt or stained thumb nails, burn holes on clothing.
- Track marks as evidence of using needles.
- Unpleasant skin rash
- Excessive sweating
- Complaints of headaches especially if they are associated with memory loss.
Drop in appetite or sudden heightened appetite for food

7.1 Explain the main stages in HIV counseling (9 marks)

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 • the beginning stage,
• middle stage
• Terminal stage.

N B: Candidates give details

7. 2. Discuss the modes of handling the challenges faced by HIV and AIDS counselo rs (12 marks)

• Establishing the role of HIV counseling

• Proper selection of trainees for counselling
• Training workshop, followed by supervised practice
• Retention of trained counselors
• 7.3 Discuss why HIV and AIDS is wide spread in the developing countries (9 marks
• Poverty
• Ignorance
• Family separation due to economic activities
• Shortage of drugs
• Cultural factors, among others.
What are the positive and negative effects of use of ICT among students in Kenya today (20 Marks)
• Ease of communication
• Free flow/access to information
• Effect in research
• Ease in curriculum implementation strategies (variety)
• Increase in learner independence
• Promotes collaborative learning
• Tailoring learning to learners

Negative
Effects on health:
• Obesity, sight, among others.
• Access to unwanted sites (phonographic materials)
• Time wasting on social sites, among others.

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