ENVIRONMENTAL_HEALTH_AND_SANITATION-2022.pptx

Environmental have for missing students for those who wants to come up with distinction should you use this PowerPoint presentation by kamuzu University of health science

1. ENVIRONMENTAL HEALTH AND SANITATION April,2022. E . THOMBOZI

2. This presentation focuses on environmental health issues that influence the health of individuals, families and communities. Emphasis will be on sewage and sewage disposal, refuse and refuse disposal, water and water supply, housing, pests and pest control, food hygiene and personal hygiene. INTRODUCTION

3.   At the time that nursing began to emerge as a profession, the interaction of the environment and health was difficult to ignore. Nurses worked predominately in the community, overseeing the care given to the sick in homes, work sites, and schools, where environmental threats to health were often extreme and highly visible (DeWitt, 1990 in Pope et al 1995). In those early days, nursing care included responsibility for "the construction, sanitation, and hygiene of all places where people pass their working hours or sleep" (Davis, 1990 in Pope et al 1995).

4. INTRODUCTION The environment is one of the primary determinants of individual and community health. And, whether it is justifiable or not, there is growing public concern and apprehension about the potential adverse health effects associated with exposure to substances in the home, the workplace, and in the other community settings.

5. INTRODUCTION A comprehensive approach to nursing practice requires the awareness, recognition, and treatment of critical factors that affect individual and community health, even if these factors are not obvious at first to patients or providers. A child who has a behavior problem in school because of lead poisoning; a young adult who has respiratory problems due to the inhalation of solvents while working in the garage at home;

6. INTRODUCTION a worker who is exhibiting neurological symptoms related to handling chemicals on the job; and a retired person whose rash is caused by a garden pesticide are all examples of people who have been affected by environmental health hazards in ways that could easily be misinterpreted in the absence of information about the origin of the problem.

7. Nurses role in environmental health Nurses are well positioned to address environmental health hazards, both on an individual and community level, for a number of reasons: They are the largest group of health care providers and generally speaking, they have more opportunities than other health care providers to talk in-depth with patients. They are often the only health care providers who visit patients in their homes, workplaces, and local communities, thus gaining firsthand knowledge of the potential environmental health hazards present in these settings

8. Nurses role in environmental health The close interaction of nurses with patients and the "on-site" aspects of nursing care provide tremendous opportunities for nurses to detect previously unrecognized health problems, including those related to environmental exposures, and to initiate appropriate interventions. Finally, there is a good fit between environmental health concerns, the historical development of the nursing profession, and core nursing values.

9. Nurses role in environmental health The CHN should understand the scientific principles of the relationship between individuals, or populations and the environment, including the basic mechanisms and pathways of exposure to environmental health hazards, basic prevention and control strategies and interdisciplinary nature of effective interventions and the role of research. The nurse should be able to conduct an environmental health history (assessment) and refer

10. Describe environment Describe components of the environment that influence health Explain various types of sewage disposal Explain types of refuse disposal Explain types of water supply LEARNING OUTCOMES

11. Discuss importance of pest control Describe a good house and its importance to health Explain food hygiene Explain personal hygiene Learning outcomes cont...

12. Environment is the collective term used to describe all the living and non-living things that make up our surroundings. These include the biological, technological, physical, cultural, social, economic and political aspects. ENVIRONMENT

13. The physical environment consists of air water soil climate and other physical conditions. Physical environment

14. Biological environment includes living things like the Plants Animals microorganisms. These also influence the health of the people. Biological environment

15. The social, technological and political environments are man made e.g. The family, village, culture, beliefs, industries, politics and the government. Social, technological and political environments

16. Environmental health encompasses all elements of the environment that influence people’s health and well being. It is concerned with assessing, controlling and improving the impact people make on their environment and the impact of the environment on people. Description of environmental health

17. The health, and even the survival of man depends on his ability to adjust or adapt to the environment, and vice versa. Cont …

18. The management of those factors in the physical environment that may cause disease is known as environmental sanitation or environmental hygiene . It is one of the most important aspects of primary prevention. Therefore it is the responsibility of all health workers to help improve the environment. Cont...

19. Sewage is waste water comprised of faecal matter, urine, sullage from personal washing, laundry, food preparation, the cleaning of kitchen utensils, industrial and agricultural wastes. Excreta includes faeces, urine, vomitus and sputum from the human body. Sewage and sewage disposal

20. Human beings need to get rid of excreta everyday and hygienic disposal of excreta is important. There are diseases that are spread by feaces either directly or indirectly through the 4 F connections Sewage disposal cont....

21. The diseases are : Cholera, typhoid fever, bacillary dysentery, poliomyelitis, infective hepatitis A, food poisoning, schistomiasis and all intestinal worms. Cont...

22. Picture 1 The 4 F connections FLIES FOOD FAECES FINGERS

23. The hygienic disposal of excreta is important because infective organisms for many diseases leave the body through faeces and urine. To provide sanitation, it is necessary to provide simple sanitary facilities which are affordable and easily made by any family. I mportance of sewage disposal

24. Types of sewage disposal

25. A common method of excreta disposal in rural areas is the pit latrine. A pit latrine consists of a hole in the ground, a squatting plate (on which to squat) when defecating or urinating. 1. Latrines

26. A pit latrine should be situated 15 meters away from the water source if on the same level or below the source , or more than 30 meters if the latrine is above the source Latrines…

27. Preferably the pit latrine should be 3.5 - 5.0 metres deep. Pit latrine should be on dry ground where water drains away, and with a surrounding storm-water drain. Cont...

28. Other types of latrines are; Bucket latrine and composting latrine Cont ...

29. This is the most hygienic method of sewage disposal when properly used. Their construction is more complicated and expensive, and can only be done by trained workers. 2. Flush toilet/ water closet

30. Flush toilets also need a permanent, continuous and adequate piped-water supply. Any failure of the water supply makes them unhygienic to use. Flush toilet/ water closet…

31. QUESTIONS???

32. SEWAGE TREATMENT

33. Sewage treatment is the process of removing contaminants from municipal wastewater, containing mainly household sewage plus some industrial wastewater. Physical, chemical, and biological processes are used to remove contaminants and produce treated wastewater that is safe enough for release into the environment SEWAGE TREATMENT

34. Water-borne sewage needs treatment before disposal. The principle of treatment is holding the sewage in an open or closed space for a few days to allow fluids and solids to separate and biological (bacterial) action to turn it into a safe and usable form. Water- borne sewage treatment

35. There are two types Small scale systems- the septic tank- this is ideal for a house, health centre or small school. Sewage drains in a special concrete underground tank where solid matter settles to the floor and anaerobic bacteria digest it. Water- borne sewage cont....

36. Larger systems- where sewage ponds or lagoons are used and are cited some distance away from buildings in the open air, also biological action takes place. Mostly used in urban centres. Water- borne sewage cont ...

37. Clemenstone , S., McGuire, S. And Eigisti , D.G. (2002). Comprehensive community health nursing: aggregate and community practice. (6 th edition). London: Mosby Wood et al (2008). Community health. (3 rd edition). Kenya: AMREF References

38. QUESTIONS???

39. REFUSE DISPOSAL April, 2022 Thombozi

40. Description of refuse Refuse or solid waste is considered as something which is no longer wanted in a given place and time . The type and amount of refuse produced varies from one community or house hold to another.

41. Types of refuse Domestic - left over foods, waste paper, plastic bags Street - wrecks of cars, plastics and papers Commercial – glass, metal, tins, pieces of cloth Institutional - left over foods, waste paper, plastic bags Industrial - glass, metal, tins, pieces of cloth, chemicals Agricultural – chemicals, pieces of plants, wood

42. Refuse disposal Solid waste is constantly produced where one lives or works There are various means of refuse disposal; depends on type of refuse, affordability, accessibility

43. Effects of improper refuse disposal on health It can result in health hazards such as contamination of ground water, surface water, air pollution, causing diseases like cholera. Produces offensive smell Attracts insects, pests and vermin e.g. rodents Favours vectors e.g. flies breeding. Refuse disposed of indiscriminately is aesthetically unaccepted. Can cause fires, spread diseases and pollution of air .

44. Methods of refuse disposal 1. Controlled tipping This means depositing refuse into depressions or large holes in the ground situated at least half a kilometre from the settlement preferably out of sight and down wind. After each day’s refuse has been deposited, it should be covered with a thin layer of earth.

45. Methods of refuse disposal 2 . Incineration/burning Simply refers to burning of refuse Burning may be done in a simple drain or mud brick; cheaper May also be done in a bin incinerator made out of a drum with fire bars across it and air holes underneath is an effective and affordable way of disposal. Disadvantage; rubbish awaiting to be burnt harbours vermin and blows out.

46. Methods of refuse disposal 3. Composting Wet and dry refuse is heaped onto alternate layers onto a plot about 1.5 metres then covered with grass or earth. Fermentation decomposes the refuse, which should be turned after 30 days and again at 60 days. After 90 days, the refuse is ripe as manure and may be used for growing crops.

47. QUESTIONS???

48. Water and water supply April, 2022 Thombozi

49. Introduction Water is essential for life. It is part of every cell in our body and is most necessary for basic functions like digestion. Lack of water may result in the increased transmission of diseases called water-washed diseases. It can also carry microorganisms of certain diseases called water-borne diseases. Lack of safe water causes water- borne diseases.

50. Sources of water Surface water- water from rivers, streams, dams, ponds, sea and lakes. Rain water- is water falling as natural precipitation which may be collected on surfaces. -It is presumed safe for drinking if it falls directly into the container.

51. Water sources cont.... Underground water - shallow wells Deep wells

52. Water purification methods Preventing water from getting dirty is easier than cleaning it afterwards. There are various methods of making water pure and safe for drinking

53. 1. Storage The simplest and easiest way of storing water is to store it in a covered container. If the water is stored for at least 48 hours, any shistosome cercarie (causes schistosomiasis) in it will become non infective

54. Storage cont... This should be done using a 3 pot system! Storage allows harmful organisms to die because they can not survive in the water for a long time. A lot of suspended matter settles at the bottom of storage container.

55. 2. Filtration Filtration is a process of separating a suspended solid, such as a precipitate, from the liquid in which it is already suspended by straining Filtration for house hold can be done using these methods:

56. Filtration cont... Clean cloth filtration- the cloth should be clean and not used for other purposes. Sand filtration – can be set up in individual homes by use of large containers. The maximum depth of the filter sand should not be less than 60cm. The filter medium needs a continuous flow of water and the rate of filtration should be controlled to not >than 2 litres per minute.

57. 3. Boiling Water should be brought to boiling point and kept boiling for 20 minutes. This destroys all forms of microorganisms, including the resistant spores or cysts.

58. 4. Chlorination Chlorine is the disinfectant most readily available and suitable for use in most circumstances. It oxides organic matter and kills microorganisms. Add 10 mls of chlorine to a standard pail of 20 litres (1 tablespoon of stock solution)

59. Cont... One gram of powder chlorine is put in 1 litre of water to make stork solution. Wait for 30 minutes to allow the chlorine react with microorganisms and substances. If the water is dirty (turbid) filter the water before chlorination.

60. 5. Iodination Iodine and its compounds can be used effectively for water disinfection, and it is believed to be a better disinfectant than chlorine. Tincture of iodine applied at the rate of 2 drops per litre of water usually gives satisfactory results. Iodine is relatively expensive and also causes the water to have a medicinal iodine odour.

61. References Clemenstone , S., McGuire, S. And Eigisti , D.G. (2002). Comprehensive community health nursing: aggregate and community practice. (6 th edition). London: Mosby Wood et al (2008). Community health. (3 rd edition). Kenya: AMREF

62. QUESTIONS???

63. FOOD HYGIENE AND SAFETY E. THOMBOZI April, 2022

64. Introduction Food is one of the basic human needs. Food is essential for growth, development and provision of energy. However it can also be responsible for the spread of diseases.

65. Cont... The aim of food hygiene is therefore to prevent food from going bad or becoming contaminated at any stage of production, collection, storage, sale, preparation or consumption. No food remains fresh for long as it starts to decompose due to bacterial action- it becomes soft, smells and becomes unfit to eat.

66. Cont.. Therefore food hygiene is concerned with all measures necessary to ensure safety of food at all stages of production, preparation, marketing and distribution. Contamination occurs most commonly from excreta on people’s fingers or flies.

67. Cont.. Food borne illnesses are caused by ingestion of food which contains pathogenic microorganisms. Because of the importance of safe food, laws have been passed to protect the public. The laws vary from country to country. Health officers and veterinary staff are also involved in inspection and enforcing these food laws.

68. Regulations for food 1. SURVEY Survey the types of food and premises that exist in a catchment area. Plan programmes for inspection, sampling and analysis of food. Inspect food selling points for sanitation; the case of LL KFC, 2019

69. Regulations for food… 2. INSPECTION Meat and milk are the foods that go bad most often and health officers e.g. Environmental health officers, community health nurses are required to inspect slaughter houses, dairies and shops where meet and milk are sold. Inspect food premises for compliance with sanitary requirements and hygienic practices. Issue licences in respect of premises which comply with regulations.

70. Cont... Inspect food handlers i.e in restaurants, hotels and food shops Inspect food sold in shops and supermarkets e.g. By the Malawi Bureau of Standards (MBS) for expiry dates and hygiene All food laws should be enforced and implemented However, the law itself can not protect all food, and health education is extremely important for all who handle food at any stage, from production to cooking.

71. Individual Assignment Identify laws and regulations on food safety and hygiene in Malawi. Identify bodies and organisations that enforce food safety and hygiene laws in Malawi

72. FOOD PRESERVATION Food preservation prevents the growth of microorganisms, or other microorganisms, as well as slowing the oxidation of fats that cause rancidity. Food preservation include processes that inhibit visual deterioration, such as the enzymatic browning reaction in apples after they are cut

73. FOOD PRESERVATION METHODS DRYING/SMOKING This is done by fire or smoke Bacteria require moisture, therefore they will not survive in dried or smoked foods such as in dry fish and meat. The heat dries the food, and the smoke coats

74. FOOD PRESERVATION METHODS… SATURATION Saturation of food with salts or sugar, makes it inhabitable for bacteria. e .g jam and fish. REFRIDGERATION Although refrigeration does not kill bacteria, it prevents dangerous multiplication of bacteria.

75. Cont... Deep freezing keeps food safe and fresh for weeks or months while the ordinary domestic refrigerator will keep it for a day or two

76. FOOD PRESERVATION METHODS SEALING/CANNING/BOTTLING In this process, food is first heated to a temperature that will kill all bacteria: then while still very hot, it is sealed in bacteria-proof containers (tins) where it can remain safe for years at room temperature.

77. QUESTIONS???

78. HOUSING E. THOMBOZI FEBRUARY, 2022

79. Introduction Housing provides security to the occupants from adverse weather conditions and other threats such as wild animals. A combination of dampness, poor light and poor ventilation together with overcrowding contribute to the spread of airborne droplet infections.

80. Cont..... Earth floors and walls and unscreened windows permit the entry and breeding of flies, bedbugs and mosquitoes. Thus it is important to improve the quality of housing. Official standards for housing may be unrealistic, but a great deal can be done by making simple improvements.

81. Types of housing Permanent housing A permanent house is made of durable materials- walls, roof and floor.

82. Cont... Semi permanent house A semi permanent house is made of a combination of permanent materials and non permanent Temporary House A temporary house is made of non permanent materials

83. Characteristics of an ideal home Location- it should be built on a good site i.e ground not subject to flooding. There should be separate accommodation for humans and animals It should be dry It should have adequate light and ventilation There should be separate rooms for food storage and food preparation

84. Cont.... It should have a hard floor and walls preferably concrete and plaster with no cracks or holes, to protect against vermin and insects. There should be a good pit latrine Should have a strong roof, that does not leak. There should be an adequate method of refuse disposal- burial, burning or compositing site There should be a reliable and clean water supply.

85. Cont..... In many places, mud bricks are an appropriate method for improving houses, stores, latrines or incinerators. They require less cement or lime and are consequently cheaper than other building material.

86. PESTS AND PEST CONTROL Insects and other pests spread some of the common diseases. It is useful to consider what can be done to control pests to protect water sources, food and housing. The control of insect pests and vermin should take into consideration the life cycle and the general conditions favourable to their growth.

87. Cont... This enables health personnel to identify possible methods for intervention and control.

88. Common pests House flies Mosquitoes Bilharzia snails Rodents Fleas Bed bugs Ticks Tsetse flies Ticks Mites Human lice

89. How to control pets Disposing of all refuse, any decaying matter, faeces properly- that is burying, burning or composting for fertiliser. Keeping all surroundings clean all the time Keeping all food vessels and utensils clean Keep food in covered containers Draining or filling up water holes and ditches. Clearing bush and grass along the banks of rivers and ponds. Spraying insecticides in the environment.

90. Personal Hygiene Personal hygiene can be described as the principle of attaining and maintaining cleanliness and grooming of the external body Personal hygiene refers to a person’s ability to care for himself or herself by performing the primary care functions of bathing, dressing and basic toileting. Proper care of skin, teeth, hair and nails promote good health by helping to protect the body from infection and disease.

91. Individual assignment Describe the care of; Hair Scalp Teeth Skin Nails Armpits Feet Eyes

92. QUESTIONS???