Epistemology and Knowledge Essay Example for Free

Epistemology and Knowledge Essay Epistemology, or the study of knowledge, requires the scholar analyze the what, how, and why’s of their own knowledge. Asking these questions of themselves is essentially applying that which they have learned. There are different origins of knowledge as conceptualized by philosophers, educators, and scientists. Early philosophers defined knowledge as â€Å"justified true belief† (Cooper, pg. 23). In order for an individual to know something it must be true, he or she must believe it, and the belief in it must be justified or rationally reasonable. Later, early modern philosophers required knowledge to be proven and absolute. The scientific method was employed to provide proof for ideas and beliefs. The means by which knowledge is acquired varies. Feldman cites sources of knowledge as perception, expert testimony, memory, reasoning, and introspection (Feldman, 2003). As an educator, instructing primary age students on a daily basis, I must not only have great insight into what I believe, but I also must have insight into my student’s knowledge as well. Instructors need to know a number of things about their students, such as: Do the students have adequate prior knowledge to understand the new material being presented? Are the students sufficiently motivated to engage in the cognitive tasks required of them? Does the information fit an existing scheme of knowledge or will it require some alteration of current understanding? Understanding what my student know and at what depth they are able to apply that knowledge guides my instruction. My natural curiosity, a natural inclination for question, and a need for answers motivate the search for explanations. Knowledge and wisdom give an understanding of our position, role, and function in the world. Achterbergh and Vriens (2002) stated, â€Å"The role of knowledge in generating appropriate actions is that it serves as a background for articulating possible courses of action (articulation), for judging whether courses of action will yielded the intended result and for using this judgment in selecting among them (selection), for deciding how actions should be implemented and for actually implementing action (implementation)† (pg. 223). Knowledge enables interpretation of experiences, predictions of consequences, and provides the ability to make informed decisions. My own personal epistemology is a product of each of these views. Personal experiences have a major influence on beliefs and should be an acceptable source of knowledge but not the only consideration when acquiring knowledge. There is also a place for the scientific method which offers proven data to base knowledge. For me, knowledge is a product of reasoning (Feldman, 2003). I derive knowledge from information imported through different modes and from various sources, such as personal experiences, advice from experts, and data. These inputs of information are cognitively processed and filtered with the reference to past experience and prior knowledge to become new â€Å"justified true beliefs† (Cooper, ). Thus, knowledge acquisition is a process involving the collection of raw data or information, reasoning, and judgment making. For example, after my students have taken a test, I look at the data, think about the patterns in the data, or the lack of a pattern using prior knowledge and experiences as a filter. Finally, I decide what my next step or strategy will be. Do I need to reteach the subject because the pattern suggests that most of my students did not fully understand the skill or concept? Or do I move on to another more complex skill or concept because my students have proven themselves knowledgeable? It is in this way that I acquire knowledge and apply that knowledge to planning lessons for my students. Many of my colleagues rely solely on the scientific method to make decisions in regards to student learning. They are satisfied with looking at a spreadsheet full of data and believe that it tells the complete story in regards to students. They are also under the assumption that scores derived from a series of multiple choice tests given on a set of skills will reveal if a student has acquired the desired knowledge. Basing grades on these tests is also appropriate. I do not believe that this tells the full story of my student’s knowledge. These tests may demonstrate the ability to regurgitate this knowledge within a certain context, but out of this context this may not be true. I do, however, use this data to help inform many of my decisions, however, I do not make decisions based exclusively on this data. There must be a balance  of reasoning, using my 16 years of experiences and training, as well as raw data tells a more complete story of my student’s knowledge and abilities. I have worked for Porterville Unified School District (PUSD), in Porterville, California, my entire career. PUSD’s vision and mission statements read as follows: â€Å"PUSD students will have the skills and knowledge to be prepared for college and career and to make a positive impact in a dynamic global society. The mission of PUSD is to provide students a dynamic, engaging and effective educational experience that prepares them with the skills to be productive citizens in a global society. † As a result, it is perceived that all students will develop and demonstrate â€Å"critical thinking and problem solving skills; cultural awareness and the ability of collaborate with diverse groups; effective communication skills of listening, speaking and writing; creativity and innovation; leadership, self-management and organizational skills obtained through real world applications and community involvement; (and) the ability to navigate the global world of work and further their education (Porterville, 2012). † Porterville Unified (PUSD) has given explicit expectations for what students should know at the end of their educational career with the district, how students get to these end goals is a little less clear and left to the judgment of the teachers. There are some expectations of teachers and lessons presented to students given by the district. Many professional development hours have been spent on instructing teachers about the specific things that administrators will look for as they do brief observations of classroom instruction. The expectations include teaching explicitly to the essential standards; posting of the essential standard being taught; 80% student engagement during the lesson; display of exemplary work; higher order questioning and thinking skills. Administrators collect this data and share it with grade levels and school wide to help teachers focus on areas that are lacking. Administrator walk-throughs give a quick snap shot of the type of teaching and learning taking place during a lesson and they help to build a holistic picture of the teaching methods and resources being used (Hetzner, 2011). PUSD has placed an emphasis on the strategies needed for effective lessons and, in turn, effective student learning. As a 4th grade teacher for Porterville Unified School District, my task is to create daily lesson plans that serve to guide me as I teach my students. My first step in creating these lessons is to determine my student’s level of prior knowledge. I can accomplish this by looking at formal and informal assessments and data. Observation of this data gives me a better understanding of what my next steps with my student should be. In some cases, I need to go back and reteach skills, while in other cases I can teach my students a new skill. I have to make an informed decision as to what cognitive level I need to teach to next. Awareness of how my students are performing as well as where I need to be as far as pacing and staying on track to get through all the skills needed to be taught within the year are vital to my daily task as a 4th grade teacher. As I compare my personal epistemology with that of my district, I realize that I spend more time assessing data after the lesson has been taught while the district places more emphasis on data collected during a lesson. Both of these approaches are valuable and, in fact, the district does place value on the end result (i. e. State test scores), however, there is little action that can take place after the end of the year data is collected. PUSD has placed and emphasis on good instruction because they see it as the road to a good education, as well as, the skills and goals they have set in the mission and vision statements. Our epistemologies align in that we both rely on the research of experts. I trust, as does PUSD, that the data given by experts is valuable to our own knowledge and it should guide how I teach my students. The district also views its teachers as experts in the field and has given many freedoms in the presentation and uses of resources when teaching students. As I reflect on my school districts focus as compared to me I realize that even though our epistemologies are not exactly aligned we are aligned in our focus of the students. Students come first. That means I will use whichever strategies I need to in order to create effective student learning. Reviewing test scores and planning lessons are vital to student learning, however, I have been so centered on what I am teaching that my students have not been engaged as well as they could be and thus have not learned the subject matters to their full potential. Also, although pacing is important, it should not be of top priority. Top priority should be assessing my students during the lesson and changing strategies, or even the skills being taught, if my students are not engaged. There is no point in plowing through a lesson if the majority of my students are not listening to what is being taught. This new insight will definitely help to drive my instruction and will help make me a more effective teacher. References: Achterbergh,J. , Vriens, D. (May-June 2002). Managing viable knowledge. â€Å"Systems Research and Behavioral Science. † V19i3p223 (19). Cooper, D. E. (Ed. ). (1999). Epistemology: The classic readings. Malden, MA: Blackwell. Feldman R. (2003). Epistemology. Upper Saddle River, NJ: Prentice Hall. Hetzner, Amy, 2011. Walk-throughs give school administrators firsthand view of staff in action. JSOnline: Milwaukee, Wisconsin Journal Sentinel. May 14, 2011. Retrieved on November 20, 2012 from: http://www. jsonline. com/news/education/121843078. html Porterville Unified School District, 2012 . PUSD: Vision and mission statements. Retrieved on November 20, 2012 from: http://dnn. portervilleschools. org/dotnetnuke/District/VisionMission. aspx.

Factors Influencing Sanitation Conditions

Factors Influencing Sanitation Conditions ABSTRACT This thesis examines the socio-cultural and demographic factors influencing sanitation conditions, identifies the presence of Escherichia coli in household drinking water samples and investigates prevalence of diarrhoea among infants. It is based on questionnaire interviews of 120 household heads and 77 caretakers of young children below the age of 5years, direct observation of clues of household sanitation practice as well as analyses of household water samples in six surrounding communities in Bogoso. Data collected was analysed using SPSS and the Pearson Product Moment Correlation Value(R) technique. The findings revealed that the sanitation condition of households improved with high educational attainment and ageing household heads. On the contrary, sanitation deteriorated with overcrowding in the household. Furthermore, in houses where the religion of the head of household was Traditional, sanitation was superior to those of a Christian head and this household also had better sa nitary conditions than that with a Moslem head of household. Water quality analysis, indicated that 27 samples out of the 30 representing 90% tested negative for E. Coli bacteria whilst 17(56.7%) samples had acceptable levels of total Escherichia coli. Finally, it was found out that diarrhoea among infants were highly prevalent since 47 (61.04%) out of the 77 child minders admitted their wards had a bout with infant diarrhoea. Massive infrastructural development, supported by behavioural change education focussing on proper usage of sanitary facilities is urgently needed in these communities to reduce the incidence of public health diseases. Intensive health education could also prove vital and such programs must target young heads of household, households with large family size and households whose heads are Christians and Moslems. CHAPTER ONE INTRODUCTION BACKGROUND TO THE STUDY Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality by two thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water- linked diseases which kill thousands of children every day (United Nations, 2006). According to the World Health Organization (2004), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got poorly from diseases caused by unhygienic water. Each year 1.8 million people pass away from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004). Ghana Water and Sewerage Corporation (GWSC) had traditionally been the major stakeholder in the provision of safe water and sanitation facilities. Since the 1960s the GWSC has focussed chiefly on urban areas at the peril of rural areas and thus, rural communities in the Wassa West District are no exception. According to the Ghana 2003 Core Welfare Indicators Questionnaire (CWIQ II) Survey Report (GSS, 2005), roughly 78% of all households in the Tamale Metropolis, 97 percent in Accra, 86% in Kumasi and 94% in Sekondi-Takoradi own pipe-borne water. Once more, the report show that a few households do not own any toilet facilities and depend on the bush for their toilet needs, that is 2.1%, 7.3%, and 5% for Accra, Kumasi, and Sekondi-Takoradi correspondingly. Access to safe sanitation, improved water and improved waste disposal systems is more of an urban than rural occurrence. In the rural poor households, only 9.2% have safe sanitation, 21.1% use improved waste disposal method and 63.0 % have access to improved water. The major diseases prevalent in Ghana are malaria, yellow fever, schistosomiasis (bilharzias), typhoid and diarrhea. Diarrhea is of precise concern since it has been recognized as the second most universal disease treated at clinics and one of the major contributors to infant mortality (UNICEF, 2004). The infant mortality rate currently stands at about 55 deaths per 1,000 live births (CIA, 2006). The Wassa West District of Ghana has seen an improvement in water and sanitation facilities during the last decade. Most of the development projects in the district are sponsored by the mining companies, individuals and some non-governmental organisations (NGOs). Between 2002 and 2008, Goldfields Tarkwa Mine constructed 118 new hand dug wells (77 of which were fitted with hand pumps) and refurbished 48 wells in poor condition. Also, a total of 44 modern style public water closets, were constructed in their catchment areas. The company also donated 19 large refuse collection containers to the District Assembly and built 6 new nurses quarters. The Tarkwa Mine has so far spent 10.5million US dollars of which 26% went into health, water and sanitation projects, 24% into agricultural development, 31% into formal education and the remaining went into other projects like roads and community centre construction ( GGL, 2008). Golden Star Resources (consist of Bogoso/Prestea Mine and Wassa Min e at Damang) also established the community development department in 2005 and has since invested 800 thousand US dollars. Their projects include 22 Acqua-Privy toilets, 10 hand dug wells (all fitted with hand pumps) and supplied potable water to villages with their tanker trucks (BGL, 2007). Other development partners complimenting the efforts of the central government include NGOs WACAM, Care International and Friends of the Nation (FON). WACAM is an environmentally based NGO which monitors water pollution by large scale mining companies. They have sponsored about 10 hand dug wells for villages in the district. Care International sponsors hygiene and reproductive health programmes in schools and on radio. They have also donated a couple of motor bicycles to public health workers in the district who travel to villages. The aims of all these projects were to improve hygiene and sanitation so as to reduce disease transmission. Despite efforts by the development partners, water supply and sanitation related diseases are highly prevalent in the district. Data obtained from the Public and Environmental Health Department of the Ministry of Health (M.O.H., 2008) showed that the top ten most prevalent diseases in the district include malaria, acute respiratory infections, skin diseases and diarrhoea. The others are acute eye infection, rheumatism, dental carries, hypertension, pregnancy related complications and home/occupational accidents. A lot more illnesses occur but on a lower scale and these include intestinal worms, coughs and typhoid fever. A complete data on the top ten diseases prevalent in the district is attached as Appendix D but below is a selection of the illnesses that directly result from bad water and sanitation practices. The number of malaria cases decreased from 350 in 2006 to 300 cases per 1000 population in 2008. Despite the decrease, the values involved are still quite high. The incidence of diarrhoea among infants and acute respiratory infection remained 30 and 60 cases per 1,000 populations respectively. This can be attributed to several reasons, including population boom, lack of uninterrupted services and inadequate functioning facilities. In fact, according to the World Health Organization (WHO, 2004), an estimated 90% of all incidence of diarrhoea among infants can be blamed on inadequate sanitation and unclean water. For example, in a study of 11 countries in Sub-Saharan Africa, only between 35-80% of water systems were operational in the rural areas (Sutton, 2004). Another survey in South Africa recognized that over 70% of the boreholes in the Eastern Cape were not working (Mackintosh and Colvin, 2003). Further examples of sanitation systems in bad condition have also been acknowledged in rural Ghana, where nearly 40% of latrines put up due to the support of a sanitation program were uncompleted or not used (Rodgers et al., 2007). The author had a personal communication with the District Environmental Officer and he estimated that, approximately there are 224 public toilets, 560 hand dug wells, 1,255 public standpipes and 3 well managed waste disposal sites in the district. According to the 2006 projection, the population of the district is expected to reach 295,753 by the end of the year 2009 (WWDA, 2006). Development partners in the past have concentrated their efforts on facilities provision only. They have not looked well at the possible causes of the persistence of disease transmission despite the effort they are making. Relationships between households socio cultural demographic factors and peoples behaviour with respect to the practice of hygiene could prove an essential lead to the solution of the problem. The fact is, merely providing a water closet does not guarantee that it could be adopted by the people and used well to reduce disease transmission. Epidemiological investigations have revealed that even in dearth supply of latrines, diarrhoeal morbidity can be reduced with the implementation of improved hygiene behaviours (IRC, 2001: Morgan, 1990). Access to waste disposal systems, their regular, consistent and hygienic use and adoption of other hygienic behavioural practices that block the transmission of diseases are the most important factors. In quite a lot of studies fro m different countries, the advancement of personal and domestic hygiene accounted for a decline in diarrhoeal morbidity (Henry and Rahim, 1990). The World Bank, (2003) identifies the demographic characteristics of the household including education of members, occupation, size and composition as influencing the willingness of the household to use an improved water supply and sanitation system. Education, especially for females results in well spaced child birth, greater ability of parents to give better health care which in turn contribute to reduced mortality rates among children under 5years (Grant, 1995). In a study into water resource scarcity in coastal Ghana, Hunter (2004) identified a valid association between household size, the presence of young children and the gender of the household head. It was noted that, female heads were less likely to collect water in larger households. Furthermore, increasing number of young children present increased the odds of female head/spouse being the household water collector. Cultural issues play active part in hygiene and sanitation behaviour especially among members of rural communities. For example, women are hardly seen urinating in public due to a perceived shame in the act but men can be left alone if found doing it. Also, the act of defecation publicly is generally unacceptable except when infants and young children are involved. The reason is that the faeces from young people are allegedly free from pathogens and less offensive (Drangert, 2004). Ismails (1999) work on nutritional assessment in Africa, detected that peoples demographic features, socioeconomic and access to basic social services such as food, water and electricity correlate significantly to their health and nutrition status. Specifically, factors such as age, gender, township status and ethnicity, which are basic to demography, can play a role in the quality of life especially of the elderly. This research assessed peoples practice of personal hygiene in Bogoso and surrounding villages. It also identified the common bacteria present in household stored water sources. Furthermore, the research identified the relationships between some socio-cultural demographic factors of households and the sanitation practice of its members. THE PROBLEM STATEMENT The Wassa West District in the Western Region is home to six large scale mining companies and hundreds of small scale and illegal mining units. Towns and villages in the district have been affected by mining, forestry and agricultural activities for over 120 years (BGL EIS, 2005). Because of this development, the local environment has been subjected to varying degrees of degradation. For example, water quality analysis carried out in 1989 by the former Canadian Bogoso Resources (CBR) showed that water samples had Total coliform bacteria in excess of 16 colonies per 100ml (BGL EIS,2005). Most of the water and sanitation programs executed in the district exerted little positive impact and thus, diarrhoeal diseases are still very high in the towns and villages (See Appendix D on page 80). However, in order to solve any problem it is important to appreciate the issues that contribute to it; after all, identifying the problem in itself is said to be a solution in disguise. Numerous health impact research have evidently recognized that the upgrading of water supply and sanitation alone is generally required but not adequate to attain broad health effects if personal and domestic hygiene are not given equivalent prominence (Scherlenlieb, 2003). The troubles of scarce water and safe sanitation provisions in developing countries have previously been dealt with by researchers for quite some time. However, until recent times they were mostly considered as technical and/or economic problems. Even rural water and sanitation issues are repeatedly dealt with from an entirely engineering point of view, with only a simple reference to social or demographic aspects. Therefore, relatively not much is proven how the socio-cultural demographic influences impinge on hygiene behaviour which in turn influences the transmission of diseases. The relationship between household socio cultural factors and the sanitation conditions of households in the Wassa West District especially the Bogoso Rural Council area has not been systematically documented or there is inadequate research that investigates such relationship. THE RESEARCH QUESTIONS The following research questions were posed to help address the objectives; Why are the several sanitation intervention projects failing to achieve desired results? Why is the prevalence of malaria and diarrhea diseases so high in the district? What types of common bacteria are prevalent in the stored drinking water of households? OBJECTIVES The main aim of this research was to investigate peoples awareness and practice of personal hygiene, access to quality water and sanitation and the possible causes of diarrhoeal diseases and suggest ways to reduce the incidence of diseases in the community. The specific objectives were; To assess the quality of stored household drinking water To establish the extent to which sanitation behaviour is affected by household socio-cultural demographic factors like age and education level of the head. To investigate the occurrence of diarrhoea among young children (0-59 months old) in the households. To identify and recommend good intervention methods to eliminate or reduce the outbreak of diseases and improve sanitation. HYPOTHESIS In addition to the above objectives, the following hypotheses were tested; Occurrence of infant diarrhoea in the household is independent on the educational attainment of child caretakers. There is no relationship between households background factors and the sanitation conditions of the household. CHAPTER TWO LITERATURE REVIEW In this chapter, various literature related to the subject matter of study are reviewed. Areas covered are sanitation, hygiene, water quality and diarrhoeal diseases. Theories and models the study contributed to include USAIDs Sanitation Improvement Framework, the F diagram by Wagner and Lanois and the theory of Social learning. SANITATION Until recently, policies of many countries have focused on access to latrines by households as a principal indicator of sanitation coverage, although of late there has been a change and an expansion in understanding the term sanitation. Sanitation can best be defined as the way of collecting and disposing of excreta and community liquid waste in a germ-free way so as not to risk the health of persons or the community as a whole (WEDC, 1998). Ideally, sanitation should end in the seclusion or destruction of pathogenic material and, hence, a breach in the transmission pathway. The transmission pathways are well known and are potted and simplified in the F diagram (Wagner and Lanois 1958) shown below by figure 3.1. The more paths that can be blocked, the more useful a health and sanitation intervention program will be. It may be mentioned that the health impact indicators of sanitation programmes are not easy to define and measure, particularly in the short run. Therefore, it seems more reasonable to look at sanitation as a package of services and actions which taken together can have some bearing on the health of a person and health status in a community. According to IRC (2001:0), issues that need to be addressed when assessing sanitation would include: How complete the sanitation programme is in addressing major risks for transmitting sanitation-related diseases; Whether the sanitation programme adopted a demand driven approach, through greater peoples participation, or supply driven approach, through heavy subsidy; Whether it allows adjustment to peoples varying needs and payment; If the programme leads to measurably improved practices by the majority of men and women, boys and girls; If it is environmentally friendly. That is; if it does not increase or create new environmental hazards (IRC, 2001) Sanitation is a key determinant of both fairness in society and societys ability to maintain itself. If the sanitation challenges described above cannot be met, we will not be able to provide for the needs of the present generation without hindering that of future generations. Thus, sanitation approaches must be resource minded, not waste minded. HYGIENE Hygiene is the discipline of health and its safeguarding (Dorland, 1997). Health is the capacity to function efficiently within ones surroundings. Our health as individuals depends on the healthfulness of our environment. A healthful environment, devoid of risky substances allows the individual to attain complete physical, emotional and social potential. Hygiene is articulated in the efforts of an individual to safeguard, sustain and enhance health status (Anderson and Langton, 1961). Measures of hygiene are vital in the fight against diarrhoeal diseases, the major fatal disease of the young in developing countries (Hamburg, 1987). The most successful interventions against diarrhoeal diseases are those that break off the transmission of contagious agents at home. Personal and domestic hygiene can be enhanced with such trouble-free actions like ordinary use of water in adequate quantity for hand washing, bathing, laundering and cleaning of cooking and eating utensils; regular washing and change of clothes; eating healthy and clean foods and appropriate disposal of solid and liquid waste. Diarrheal Dise ases Diarrhoea can be defined in absolute or relative terms based on either the rate of recurrence of bowel movements or the constancy (or looseness) of stools (Kendall, 1996). Absolute diarrhoea is having more bowel movements than normal. Relative diarrhoea is defined based on the consistency of stool. Thus, an individual who develops looser stools than usual has diarrhoea even though the stools may be within the range of normal with respect to consistency. According to the United States Centre for Disease Control and Prevention (CDC, 2006), with diarrhoea, stools typically are looser whether or not the frequency of bowel movements is increased. This looseness of stool which can vary all the way from slightly soft to watery is caused by increased water in the stool. Increased amounts of water in stool can occur if the stomach and/or small intestine produce too much fluid, the distal small intestine and colon do not soak up enough water, or the undigested, liquid food passes too quickly through the small intestine and colon for them to take out enough water. Of course, more than one of these anomalous processes may occur at the same time. For example, some viruses, bacteria and parasites cause increased discharge of fluid, either by invading and inflaming the lining of the small intestine (inflammation stimulates the lining to secrete fluid) or by producing toxins (chemicals) that also fire up the lining to secrete fluid but without caus ing inflammation. Swelling of the small intestine and/or colon from bacteria or from ileitis/colitis can increase the haste with which food passes through the intestines, reducing the time that is available for absorbing water. Conditions of the colon such as collagenous colitis can also impede the capacity of the colon to soak up water. Escherichia coli O157:H7 is probably the most dreaded bacteria today among parents of young children. The name of the bacteria refers to the chemical compounds found on the bacteriums surface. Cattle are the main sources of E. coli O157:H7, but these bacteria also can be found in other domestic and wild mammals. E. coli O157:H7 became a household word in 1993 when it was recognized as the cause of four deaths and more than 600 cases of bloody diarrhoea among children under 5years in North-western United States (US EPA, 1996). The Northwest epidemic was traced to undercooked hamburgers served in a fast food restaurant. Other sources of outbreaks have included raw milk, unpasteurized apple juice, raw sprouts, raw spinach, and contaminated water. Most strains of E. coli bacteria are not dangerous however, this particular strain attaches itself to the intestinal wall and then releases a toxin that causes severe abdominal cramps, bloody diarrhoea and vomiting that lasts a week or longer. In small children and the elderly, the disease can advance to kidney failure. The good news is that E. coli O157:H7 is easily destroyed by cooking to 160F throughout. Reducing diarrhoea morbidity with USAIDs Framework To attain noteworthy improvement in reducing the number of deaths attributed to diarrhoea, its fundamental causes must be addressed. It is approximated that 90% of all cases of diarrhoea can be attributed to three major causes: insufficient sanitation, inadequate hygiene, and contaminated water (WHO 1997). According to USAID, for further progress to be made in the fight against diarrhoea, the concentration will need to include prevention, especially in child health programs. The first method, case management of diarrhoea, has been tremendously successful in recent years in reducing child mortality. The primary process of achieving effect has been through the initiation and operation of oral rehydration therapy; i.e. the dispensation of oral rehydration solution and sustained feeding (both solid and fluid, including breast milk). In addition, health experts have emphasized the need for caretakers to become aware of the danger signs early in children under their care and to obtain suitable, appropriate care to avoid severe dehydration and death. The second approach, increasing host resistance to diarrhoea, has also had some victory with the enhancement of a childs nutritional status and vaccination against measles, a familiar cause of diarrhoea. The third element is prevention through hygiene improvement. Although the health care system has dealt comprehensively with the symptoms of diarrhoea, it has done insufficiently to bring down the overall incidence of the disease. Despite a drop in deaths owing to diarrhoea, morbidity or the health burden due to diarrhoea has not decreased, because health experts are treating the symptoms but not addressing the causes. Thus, diarrhoeas drain on the health system, its effects on household finances and education, and its additional burden on mothers has not been mitigated . Programs in several countries have confirmed that interventions can and do reduce diarrhoea morbidity. A critical constituent of successful prevention efforts is an effective monitoring and appraisal strategy. In order to reduce transmission of faecal-oral diseases at the household level, for example, an expert group of epidemiologist and water supply and sanitation specialist concluded that three interventions would be crucial. These are: Safer disposal of human excreta, particularly of babies and people with diarrhoea. Hand washing after defecation and handling babies faeces and before feeding, eating and preparing food, and; Maintaining drinking water free from faecal contamination in the home and at the source (WHO, 1993). Studies on hand washing, as reported in Boot and Cairncross (1993), confirm that it is not only the act of hand washing, but also how well hands are washed that make a difference. To prevent diarrhoea, its causes must first be fully tacit. According to the USAIDs hygiene improvement framework, a thorough approach to diarrhoea at the national level must tackle the three key elements of any triumphant program to fight disease. These are; contact with the necessary hardware or technologies, encouragement of healthy behaviours, and assistance for long-term sustainability. The concept is explained by figure 3.3 below; The first part, water supply systems, addresses mutually the issue of water quality and water quantity, which reduces the risk of contamination of food and drink. Similarly, ensuring access to water supply systems can greatly ease the time women spend collecting water, allowing more time to care for young children and more time for income generating activities. The third element, household technologies and materials, refers to the increased accessibility to such hygiene supplies as soap (or local substitutes), chlorine, filters, water storage containers that have restricted necks and are covered, and potties for small children. The second element of the hardware component, toilet facilities, involves providing facilities to dispose off human excreta in ways that safeguard the environment and public health, characteristically in the form of numerous kinds of latrines, septic tanks, and water-borne toilets. Sanitation reporting is important because faecal contamination can spread from one household to another, especially in closely populated areas. WATER QUALITY STANDARDS AND GUIDELINES Water quality is defined in terms of the chemical, physical, and biological constituents in water. The word standards is used to refer to legally enforceable threshold values for the water parameters analyzed, while guidelines refer to threshold values that are recommended and do not have any regulatory status. This study employs the world health organization (WHO) and the Ghana standards board (GSB) standards and guidelines in determining the quality of water. Water Quality Requirements for Drinking Water – Ghana Standards The Ghana Standards for drinking water (GS 175-Part 1:1998) indicate the required physical, chemical, microbial and radiological properties of drinking water. The standards are adapted from the World Health Organizations Guidelines for Drinking Water Quality, Second Edition, Volume 1, 1993, but also incorporate national standards that are specific to the countrys environment. Physical Requirements The Ghana Standards set the maximum turbidity of drinking water at 5 NTU. Other physical requirements pertain to temperature, odour, taste and colour. Temperature, odour and taste are generally not to be objectionable, while the maximum threshold values for colour are given quantitatively as True Colour Units (TCU) or Hazen units. The Ghana Standards specify 5 TCU or 5 Hazen units for colour after filtration. The requirements for pH values set by the Ghana Standards for drinking water is 6.5 to 8.5 (GS 175-Part1:1998). Microbial Requirements The Ghana Standards specify that E.coli or thermotolerant bacteria and total coliform bacteria should not be detected in a 100ml sample of drinking water (0 CFU/100ml). The Ghana Standards also specify that drinking water should be free of human enteroviruses. WHO Drinking Water Guidelines Physical Requirements Although no health-based guideline is given by WHO (2006) for turbidity in drinking water, it is recommended that the median turbidity should ideally be below 0.1 NTU for effective disinfection. Microbial Requirements Like the Ghana Standards, no E.coli or thermotolerant bacteria should be detected in a 100 ml sample of drinking water. Water Related Diseases Every year, water-related diseases claim the lives of 3.4 million people, the greater part of whom are children (Dufour et. al, 2003). Water-related diseases can be grouped into four categories ( Bradley, 1977) based on the path of transmission: waterborne diseases, water-washed diseases, water-based diseases, insect vector-related diseases. Waterborne diseases are caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses. These include cholera, typhoid, amoebic and bacillary dysentery and other diarrhoeal diseases. Water washed diseases are caused by poor personal hygiene and skin or eye contact with contaminated water. These include scabies, trachoma and flea, lice and tick-borne diseases. Water-based diseases are caused by parasites found in intermediate organisms living in contaminated water. These include dracunculiasis, schistosomiasis and other helminths. Water related diseases are caused by insect vectors, especially mosquitoes that breed in water. They include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever. The Theory of Social Learning Learning is any relatively permanent change in behaviour that can be attributed to experience (Coon, 1989). According to the social learning theory, behavioural processes are directly acquired by the continually dynamic interplay between the individual and its social environment (Mc Connell, 1982). For example, children learn what to do at home by observing what happens when their siblings talk back to their parents or throw rubbish into the household compound. The learning process occurs through reinforcement and punishment. Reinforcement refers to any event that increases chances that a response will occur again (Coon, 1989). Reinforcement and punishment can be learned through education where the person can read about what happens to people as a result of actions they make. The elementary unit of society is the household and this can be defined as a residential group of persons who live under the same roof and eat out of the same pot (Friedman, 1992). Social learning is necessary for the household in acquiring the skills pertinent to the maintenance of health promoting behaviour. Most of our daily activities are learned in the household. Individuals begin to learn behaviour patterns from childhood by observing especially the parents and later on their siblings. The environment is understood as comprising the whole set of natural or biophysical and man-made or socio-cultural systems, in which man and other organisms live, work or interact (Ocran, 1999). The environment is human lifes supporting system from which food, air and shelter are derived to sustain human life. Humans interact with the physical and man-made environment and this interaction creates a complex, finely balanced set of structures and processes, which evolve over the history of a people. These structures and processes determine the culture of the society, their social behaviour, beliefs and superstition about health and diseases. Social relationships seem to protect individuals against behavioural disorders and they facilitate health promoting behaviour (Barlow and Durand, 1995; Ho Factors Influencing Sanitation Conditions Factors Influencing Sanitation Conditions ABSTRACT This thesis examines the socio-cultural and demographic factors influencing sanitation conditions, identifies the presence of Escherichia coli in household drinking water samples and investigates prevalence of diarrhoea among infants. It is based on questionnaire interviews of 120 household heads and 77 caretakers of young children below the age of 5years, direct observation of clues of household sanitation practice as well as analyses of household water samples in six surrounding communities in Bogoso. Data collected was analysed using SPSS and the Pearson Product Moment Correlation Value(R) technique. The findings revealed that the sanitation condition of households improved with high educational attainment and ageing household heads. On the contrary, sanitation deteriorated with overcrowding in the household. Furthermore, in houses where the religion of the head of household was Traditional, sanitation was superior to those of a Christian head and this household also had better sa nitary conditions than that with a Moslem head of household. Water quality analysis, indicated that 27 samples out of the 30 representing 90% tested negative for E. Coli bacteria whilst 17(56.7%) samples had acceptable levels of total Escherichia coli. Finally, it was found out that diarrhoea among infants were highly prevalent since 47 (61.04%) out of the 77 child minders admitted their wards had a bout with infant diarrhoea. Massive infrastructural development, supported by behavioural change education focussing on proper usage of sanitary facilities is urgently needed in these communities to reduce the incidence of public health diseases. Intensive health education could also prove vital and such programs must target young heads of household, households with large family size and households whose heads are Christians and Moslems. CHAPTER ONE INTRODUCTION BACKGROUND TO THE STUDY Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality by two thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water- linked diseases which kill thousands of children every day (United Nations, 2006). According to the World Health Organization (2004), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got poorly from diseases caused by unhygienic water. Each year 1.8 million people pass away from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004). Ghana Water and Sewerage Corporation (GWSC) had traditionally been the major stakeholder in the provision of safe water and sanitation facilities. Since the 1960s the GWSC has focussed chiefly on urban areas at the peril of rural areas and thus, rural communities in the Wassa West District are no exception. According to the Ghana 2003 Core Welfare Indicators Questionnaire (CWIQ II) Survey Report (GSS, 2005), roughly 78% of all households in the Tamale Metropolis, 97 percent in Accra, 86% in Kumasi and 94% in Sekondi-Takoradi own pipe-borne water. Once more, the report show that a few households do not own any toilet facilities and depend on the bush for their toilet needs, that is 2.1%, 7.3%, and 5% for Accra, Kumasi, and Sekondi-Takoradi correspondingly. Access to safe sanitation, improved water and improved waste disposal systems is more of an urban than rural occurrence. In the rural poor households, only 9.2% have safe sanitation, 21.1% use improved waste disposal method and 63.0 % have access to improved water. The major diseases prevalent in Ghana are malaria, yellow fever, schistosomiasis (bilharzias), typhoid and diarrhea. Diarrhea is of precise concern since it has been recognized as the second most universal disease treated at clinics and one of the major contributors to infant mortality (UNICEF, 2004). The infant mortality rate currently stands at about 55 deaths per 1,000 live births (CIA, 2006). The Wassa West District of Ghana has seen an improvement in water and sanitation facilities during the last decade. Most of the development projects in the district are sponsored by the mining companies, individuals and some non-governmental organisations (NGOs). Between 2002 and 2008, Goldfields Tarkwa Mine constructed 118 new hand dug wells (77 of which were fitted with hand pumps) and refurbished 48 wells in poor condition. Also, a total of 44 modern style public water closets, were constructed in their catchment areas. The company also donated 19 large refuse collection containers to the District Assembly and built 6 new nurses quarters. The Tarkwa Mine has so far spent 10.5million US dollars of which 26% went into health, water and sanitation projects, 24% into agricultural development, 31% into formal education and the remaining went into other projects like roads and community centre construction ( GGL, 2008). Golden Star Resources (consist of Bogoso/Prestea Mine and Wassa Min e at Damang) also established the community development department in 2005 and has since invested 800 thousand US dollars. Their projects include 22 Acqua-Privy toilets, 10 hand dug wells (all fitted with hand pumps) and supplied potable water to villages with their tanker trucks (BGL, 2007). Other development partners complimenting the efforts of the central government include NGOs WACAM, Care International and Friends of the Nation (FON). WACAM is an environmentally based NGO which monitors water pollution by large scale mining companies. They have sponsored about 10 hand dug wells for villages in the district. Care International sponsors hygiene and reproductive health programmes in schools and on radio. They have also donated a couple of motor bicycles to public health workers in the district who travel to villages. The aims of all these projects were to improve hygiene and sanitation so as to reduce disease transmission. Despite efforts by the development partners, water supply and sanitation related diseases are highly prevalent in the district. Data obtained from the Public and Environmental Health Department of the Ministry of Health (M.O.H., 2008) showed that the top ten most prevalent diseases in the district include malaria, acute respiratory infections, skin diseases and diarrhoea. The others are acute eye infection, rheumatism, dental carries, hypertension, pregnancy related complications and home/occupational accidents. A lot more illnesses occur but on a lower scale and these include intestinal worms, coughs and typhoid fever. A complete data on the top ten diseases prevalent in the district is attached as Appendix D but below is a selection of the illnesses that directly result from bad water and sanitation practices. The number of malaria cases decreased from 350 in 2006 to 300 cases per 1000 population in 2008. Despite the decrease, the values involved are still quite high. The incidence of diarrhoea among infants and acute respiratory infection remained 30 and 60 cases per 1,000 populations respectively. This can be attributed to several reasons, including population boom, lack of uninterrupted services and inadequate functioning facilities. In fact, according to the World Health Organization (WHO, 2004), an estimated 90% of all incidence of diarrhoea among infants can be blamed on inadequate sanitation and unclean water. For example, in a study of 11 countries in Sub-Saharan Africa, only between 35-80% of water systems were operational in the rural areas (Sutton, 2004). Another survey in South Africa recognized that over 70% of the boreholes in the Eastern Cape were not working (Mackintosh and Colvin, 2003). Further examples of sanitation systems in bad condition have also been acknowledged in rural Ghana, where nearly 40% of latrines put up due to the support of a sanitation program were uncompleted or not used (Rodgers et al., 2007). The author had a personal communication with the District Environmental Officer and he estimated that, approximately there are 224 public toilets, 560 hand dug wells, 1,255 public standpipes and 3 well managed waste disposal sites in the district. According to the 2006 projection, the population of the district is expected to reach 295,753 by the end of the year 2009 (WWDA, 2006). Development partners in the past have concentrated their efforts on facilities provision only. They have not looked well at the possible causes of the persistence of disease transmission despite the effort they are making. Relationships between households socio cultural demographic factors and peoples behaviour with respect to the practice of hygiene could prove an essential lead to the solution of the problem. The fact is, merely providing a water closet does not guarantee that it could be adopted by the people and used well to reduce disease transmission. Epidemiological investigations have revealed that even in dearth supply of latrines, diarrhoeal morbidity can be reduced with the implementation of improved hygiene behaviours (IRC, 2001: Morgan, 1990). Access to waste disposal systems, their regular, consistent and hygienic use and adoption of other hygienic behavioural practices that block the transmission of diseases are the most important factors. In quite a lot of studies fro m different countries, the advancement of personal and domestic hygiene accounted for a decline in diarrhoeal morbidity (Henry and Rahim, 1990). The World Bank, (2003) identifies the demographic characteristics of the household including education of members, occupation, size and composition as influencing the willingness of the household to use an improved water supply and sanitation system. Education, especially for females results in well spaced child birth, greater ability of parents to give better health care which in turn contribute to reduced mortality rates among children under 5years (Grant, 1995). In a study into water resource scarcity in coastal Ghana, Hunter (2004) identified a valid association between household size, the presence of young children and the gender of the household head. It was noted that, female heads were less likely to collect water in larger households. Furthermore, increasing number of young children present increased the odds of female head/spouse being the household water collector. Cultural issues play active part in hygiene and sanitation behaviour especially among members of rural communities. For example, women are hardly seen urinating in public due to a perceived shame in the act but men can be left alone if found doing it. Also, the act of defecation publicly is generally unacceptable except when infants and young children are involved. The reason is that the faeces from young people are allegedly free from pathogens and less offensive (Drangert, 2004). Ismails (1999) work on nutritional assessment in Africa, detected that peoples demographic features, socioeconomic and access to basic social services such as food, water and electricity correlate significantly to their health and nutrition status. Specifically, factors such as age, gender, township status and ethnicity, which are basic to demography, can play a role in the quality of life especially of the elderly. This research assessed peoples practice of personal hygiene in Bogoso and surrounding villages. It also identified the common bacteria present in household stored water sources. Furthermore, the research identified the relationships between some socio-cultural demographic factors of households and the sanitation practice of its members. THE PROBLEM STATEMENT The Wassa West District in the Western Region is home to six large scale mining companies and hundreds of small scale and illegal mining units. Towns and villages in the district have been affected by mining, forestry and agricultural activities for over 120 years (BGL EIS, 2005). Because of this development, the local environment has been subjected to varying degrees of degradation. For example, water quality analysis carried out in 1989 by the former Canadian Bogoso Resources (CBR) showed that water samples had Total coliform bacteria in excess of 16 colonies per 100ml (BGL EIS,2005). Most of the water and sanitation programs executed in the district exerted little positive impact and thus, diarrhoeal diseases are still very high in the towns and villages (See Appendix D on page 80). However, in order to solve any problem it is important to appreciate the issues that contribute to it; after all, identifying the problem in itself is said to be a solution in disguise. Numerous health impact research have evidently recognized that the upgrading of water supply and sanitation alone is generally required but not adequate to attain broad health effects if personal and domestic hygiene are not given equivalent prominence (Scherlenlieb, 2003). The troubles of scarce water and safe sanitation provisions in developing countries have previously been dealt with by researchers for quite some time. However, until recent times they were mostly considered as technical and/or economic problems. Even rural water and sanitation issues are repeatedly dealt with from an entirely engineering point of view, with only a simple reference to social or demographic aspects. Therefore, relatively not much is proven how the socio-cultural demographic influences impinge on hygiene behaviour which in turn influences the transmission of diseases. The relationship between household socio cultural factors and the sanitation conditions of households in the Wassa West District especially the Bogoso Rural Council area has not been systematically documented or there is inadequate research that investigates such relationship. THE RESEARCH QUESTIONS The following research questions were posed to help address the objectives; Why are the several sanitation intervention projects failing to achieve desired results? Why is the prevalence of malaria and diarrhea diseases so high in the district? What types of common bacteria are prevalent in the stored drinking water of households? OBJECTIVES The main aim of this research was to investigate peoples awareness and practice of personal hygiene, access to quality water and sanitation and the possible causes of diarrhoeal diseases and suggest ways to reduce the incidence of diseases in the community. The specific objectives were; To assess the quality of stored household drinking water To establish the extent to which sanitation behaviour is affected by household socio-cultural demographic factors like age and education level of the head. To investigate the occurrence of diarrhoea among young children (0-59 months old) in the households. To identify and recommend good intervention methods to eliminate or reduce the outbreak of diseases and improve sanitation. HYPOTHESIS In addition to the above objectives, the following hypotheses were tested; Occurrence of infant diarrhoea in the household is independent on the educational attainment of child caretakers. There is no relationship between households background factors and the sanitation conditions of the household. CHAPTER TWO LITERATURE REVIEW In this chapter, various literature related to the subject matter of study are reviewed. Areas covered are sanitation, hygiene, water quality and diarrhoeal diseases. Theories and models the study contributed to include USAIDs Sanitation Improvement Framework, the F diagram by Wagner and Lanois and the theory of Social learning. SANITATION Until recently, policies of many countries have focused on access to latrines by households as a principal indicator of sanitation coverage, although of late there has been a change and an expansion in understanding the term sanitation. Sanitation can best be defined as the way of collecting and disposing of excreta and community liquid waste in a germ-free way so as not to risk the health of persons or the community as a whole (WEDC, 1998). Ideally, sanitation should end in the seclusion or destruction of pathogenic material and, hence, a breach in the transmission pathway. The transmission pathways are well known and are potted and simplified in the F diagram (Wagner and Lanois 1958) shown below by figure 3.1. The more paths that can be blocked, the more useful a health and sanitation intervention program will be. It may be mentioned that the health impact indicators of sanitation programmes are not easy to define and measure, particularly in the short run. Therefore, it seems more reasonable to look at sanitation as a package of services and actions which taken together can have some bearing on the health of a person and health status in a community. According to IRC (2001:0), issues that need to be addressed when assessing sanitation would include: How complete the sanitation programme is in addressing major risks for transmitting sanitation-related diseases; Whether the sanitation programme adopted a demand driven approach, through greater peoples participation, or supply driven approach, through heavy subsidy; Whether it allows adjustment to peoples varying needs and payment; If the programme leads to measurably improved practices by the majority of men and women, boys and girls; If it is environmentally friendly. That is; if it does not increase or create new environmental hazards (IRC, 2001) Sanitation is a key determinant of both fairness in society and societys ability to maintain itself. If the sanitation challenges described above cannot be met, we will not be able to provide for the needs of the present generation without hindering that of future generations. Thus, sanitation approaches must be resource minded, not waste minded. HYGIENE Hygiene is the discipline of health and its safeguarding (Dorland, 1997). Health is the capacity to function efficiently within ones surroundings. Our health as individuals depends on the healthfulness of our environment. A healthful environment, devoid of risky substances allows the individual to attain complete physical, emotional and social potential. Hygiene is articulated in the efforts of an individual to safeguard, sustain and enhance health status (Anderson and Langton, 1961). Measures of hygiene are vital in the fight against diarrhoeal diseases, the major fatal disease of the young in developing countries (Hamburg, 1987). The most successful interventions against diarrhoeal diseases are those that break off the transmission of contagious agents at home. Personal and domestic hygiene can be enhanced with such trouble-free actions like ordinary use of water in adequate quantity for hand washing, bathing, laundering and cleaning of cooking and eating utensils; regular washing and change of clothes; eating healthy and clean foods and appropriate disposal of solid and liquid waste. Diarrheal Dise ases Diarrhoea can be defined in absolute or relative terms based on either the rate of recurrence of bowel movements or the constancy (or looseness) of stools (Kendall, 1996). Absolute diarrhoea is having more bowel movements than normal. Relative diarrhoea is defined based on the consistency of stool. Thus, an individual who develops looser stools than usual has diarrhoea even though the stools may be within the range of normal with respect to consistency. According to the United States Centre for Disease Control and Prevention (CDC, 2006), with diarrhoea, stools typically are looser whether or not the frequency of bowel movements is increased. This looseness of stool which can vary all the way from slightly soft to watery is caused by increased water in the stool. Increased amounts of water in stool can occur if the stomach and/or small intestine produce too much fluid, the distal small intestine and colon do not soak up enough water, or the undigested, liquid food passes too quickly through the small intestine and colon for them to take out enough water. Of course, more than one of these anomalous processes may occur at the same time. For example, some viruses, bacteria and parasites cause increased discharge of fluid, either by invading and inflaming the lining of the small intestine (inflammation stimulates the lining to secrete fluid) or by producing toxins (chemicals) that also fire up the lining to secrete fluid but without caus ing inflammation. Swelling of the small intestine and/or colon from bacteria or from ileitis/colitis can increase the haste with which food passes through the intestines, reducing the time that is available for absorbing water. Conditions of the colon such as collagenous colitis can also impede the capacity of the colon to soak up water. Escherichia coli O157:H7 is probably the most dreaded bacteria today among parents of young children. The name of the bacteria refers to the chemical compounds found on the bacteriums surface. Cattle are the main sources of E. coli O157:H7, but these bacteria also can be found in other domestic and wild mammals. E. coli O157:H7 became a household word in 1993 when it was recognized as the cause of four deaths and more than 600 cases of bloody diarrhoea among children under 5years in North-western United States (US EPA, 1996). The Northwest epidemic was traced to undercooked hamburgers served in a fast food restaurant. Other sources of outbreaks have included raw milk, unpasteurized apple juice, raw sprouts, raw spinach, and contaminated water. Most strains of E. coli bacteria are not dangerous however, this particular strain attaches itself to the intestinal wall and then releases a toxin that causes severe abdominal cramps, bloody diarrhoea and vomiting that lasts a week or longer. In small children and the elderly, the disease can advance to kidney failure. The good news is that E. coli O157:H7 is easily destroyed by cooking to 160F throughout. Reducing diarrhoea morbidity with USAIDs Framework To attain noteworthy improvement in reducing the number of deaths attributed to diarrhoea, its fundamental causes must be addressed. It is approximated that 90% of all cases of diarrhoea can be attributed to three major causes: insufficient sanitation, inadequate hygiene, and contaminated water (WHO 1997). According to USAID, for further progress to be made in the fight against diarrhoea, the concentration will need to include prevention, especially in child health programs. The first method, case management of diarrhoea, has been tremendously successful in recent years in reducing child mortality. The primary process of achieving effect has been through the initiation and operation of oral rehydration therapy; i.e. the dispensation of oral rehydration solution and sustained feeding (both solid and fluid, including breast milk). In addition, health experts have emphasized the need for caretakers to become aware of the danger signs early in children under their care and to obtain suitable, appropriate care to avoid severe dehydration and death. The second approach, increasing host resistance to diarrhoea, has also had some victory with the enhancement of a childs nutritional status and vaccination against measles, a familiar cause of diarrhoea. The third element is prevention through hygiene improvement. Although the health care system has dealt comprehensively with the symptoms of diarrhoea, it has done insufficiently to bring down the overall incidence of the disease. Despite a drop in deaths owing to diarrhoea, morbidity or the health burden due to diarrhoea has not decreased, because health experts are treating the symptoms but not addressing the causes. Thus, diarrhoeas drain on the health system, its effects on household finances and education, and its additional burden on mothers has not been mitigated . Programs in several countries have confirmed that interventions can and do reduce diarrhoea morbidity. A critical constituent of successful prevention efforts is an effective monitoring and appraisal strategy. In order to reduce transmission of faecal-oral diseases at the household level, for example, an expert group of epidemiologist and water supply and sanitation specialist concluded that three interventions would be crucial. These are: Safer disposal of human excreta, particularly of babies and people with diarrhoea. Hand washing after defecation and handling babies faeces and before feeding, eating and preparing food, and; Maintaining drinking water free from faecal contamination in the home and at the source (WHO, 1993). Studies on hand washing, as reported in Boot and Cairncross (1993), confirm that it is not only the act of hand washing, but also how well hands are washed that make a difference. To prevent diarrhoea, its causes must first be fully tacit. According to the USAIDs hygiene improvement framework, a thorough approach to diarrhoea at the national level must tackle the three key elements of any triumphant program to fight disease. These are; contact with the necessary hardware or technologies, encouragement of healthy behaviours, and assistance for long-term sustainability. The concept is explained by figure 3.3 below; The first part, water supply systems, addresses mutually the issue of water quality and water quantity, which reduces the risk of contamination of food and drink. Similarly, ensuring access to water supply systems can greatly ease the time women spend collecting water, allowing more time to care for young children and more time for income generating activities. The third element, household technologies and materials, refers to the increased accessibility to such hygiene supplies as soap (or local substitutes), chlorine, filters, water storage containers that have restricted necks and are covered, and potties for small children. The second element of the hardware component, toilet facilities, involves providing facilities to dispose off human excreta in ways that safeguard the environment and public health, characteristically in the form of numerous kinds of latrines, septic tanks, and water-borne toilets. Sanitation reporting is important because faecal contamination can spread from one household to another, especially in closely populated areas. WATER QUALITY STANDARDS AND GUIDELINES Water quality is defined in terms of the chemical, physical, and biological constituents in water. The word standards is used to refer to legally enforceable threshold values for the water parameters analyzed, while guidelines refer to threshold values that are recommended and do not have any regulatory status. This study employs the world health organization (WHO) and the Ghana standards board (GSB) standards and guidelines in determining the quality of water. Water Quality Requirements for Drinking Water – Ghana Standards The Ghana Standards for drinking water (GS 175-Part 1:1998) indicate the required physical, chemical, microbial and radiological properties of drinking water. The standards are adapted from the World Health Organizations Guidelines for Drinking Water Quality, Second Edition, Volume 1, 1993, but also incorporate national standards that are specific to the countrys environment. Physical Requirements The Ghana Standards set the maximum turbidity of drinking water at 5 NTU. Other physical requirements pertain to temperature, odour, taste and colour. Temperature, odour and taste are generally not to be objectionable, while the maximum threshold values for colour are given quantitatively as True Colour Units (TCU) or Hazen units. The Ghana Standards specify 5 TCU or 5 Hazen units for colour after filtration. The requirements for pH values set by the Ghana Standards for drinking water is 6.5 to 8.5 (GS 175-Part1:1998). Microbial Requirements The Ghana Standards specify that E.coli or thermotolerant bacteria and total coliform bacteria should not be detected in a 100ml sample of drinking water (0 CFU/100ml). The Ghana Standards also specify that drinking water should be free of human enteroviruses. WHO Drinking Water Guidelines Physical Requirements Although no health-based guideline is given by WHO (2006) for turbidity in drinking water, it is recommended that the median turbidity should ideally be below 0.1 NTU for effective disinfection. Microbial Requirements Like the Ghana Standards, no E.coli or thermotolerant bacteria should be detected in a 100 ml sample of drinking water. Water Related Diseases Every year, water-related diseases claim the lives of 3.4 million people, the greater part of whom are children (Dufour et. al, 2003). Water-related diseases can be grouped into four categories ( Bradley, 1977) based on the path of transmission: waterborne diseases, water-washed diseases, water-based diseases, insect vector-related diseases. Waterborne diseases are caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses. These include cholera, typhoid, amoebic and bacillary dysentery and other diarrhoeal diseases. Water washed diseases are caused by poor personal hygiene and skin or eye contact with contaminated water. These include scabies, trachoma and flea, lice and tick-borne diseases. Water-based diseases are caused by parasites found in intermediate organisms living in contaminated water. These include dracunculiasis, schistosomiasis and other helminths. Water related diseases are caused by insect vectors, especially mosquitoes that breed in water. They include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever. The Theory of Social Learning Learning is any relatively permanent change in behaviour that can be attributed to experience (Coon, 1989). According to the social learning theory, behavioural processes are directly acquired by the continually dynamic interplay between the individual and its social environment (Mc Connell, 1982). For example, children learn what to do at home by observing what happens when their siblings talk back to their parents or throw rubbish into the household compound. The learning process occurs through reinforcement and punishment. Reinforcement refers to any event that increases chances that a response will occur again (Coon, 1989). Reinforcement and punishment can be learned through education where the person can read about what happens to people as a result of actions they make. The elementary unit of society is the household and this can be defined as a residential group of persons who live under the same roof and eat out of the same pot (Friedman, 1992). Social learning is necessary for the household in acquiring the skills pertinent to the maintenance of health promoting behaviour. Most of our daily activities are learned in the household. Individuals begin to learn behaviour patterns from childhood by observing especially the parents and later on their siblings. The environment is understood as comprising the whole set of natural or biophysical and man-made or socio-cultural systems, in which man and other organisms live, work or interact (Ocran, 1999). The environment is human lifes supporting system from which food, air and shelter are derived to sustain human life. Humans interact with the physical and man-made environment and this interaction creates a complex, finely balanced set of structures and processes, which evolve over the history of a people. These structures and processes determine the culture of the society, their social behaviour, beliefs and superstition about health and diseases. Social relationships seem to protect individuals against behavioural disorders and they facilitate health promoting behaviour (Barlow and Durand, 1995; Ho

The Truth Will Set You Free Essay -- Literary Analysis

Many writers apply experiences and thoughts into their work and express them in such a way the reader can relate. Critics would agree Edgar Allan Poe left a unique mark as a short story writer. Author Ray Bradbury was quoted saying, â€Å"It doesn't matter what you do, so long as you change something from the way it was before you touched it into something that's like you after you take your hands away†¦Ã¢â‚¬  (Bradbury). Fiction writing was simple until Poe begins to put his twist around the world. During the terrible times that Edgar Allan Poe experienced as a young man would ultimately alter the history of short stories, he was unique and an extraordinary writer therefore exemplifying the mark that he leave upon society in his short stories Hop-frog. In Poe’s early life, he goes through a devastating and tragic event as his mother dies and his biological father abandons him at the age of two leaving him as an orphan. Writer W.D. Johnson says, â€Å"Increased susceptibility to depression and anxiety is another result of the heightened stress levels associated with being an orphan. Typically, the younger the age of a child when orphaned and the longer he remains without a home, the more drastic the impact that his experiences as an orphan will have on his development† (Johnson). Poe’s adolescence seemed to be on a path destined for self-destruction following the Allan’s informal adoption of him at the age of two. Francis and John Allan, his foster parents, forced him to move away from his siblings in Boston to their home in Richmond, Virginia. From a young age, Poe lacked the stability of a fruitful environment for a boy to grow and mature into a man acceptable to society’s standards. Poe and his foster family moved to England in pursuit of... ... Mark. "Edgar Allan Poe." Edgar Allan Poe. Web. 07 May 2012. . "Edgar Allan Poe." Goodreads. Web. 07 May 2012. . Farlex. "Tuberculosis." The Free Dictionary. Farlex. Web. 07 May 2012. . "Poe's Life." Edgar Allan Poe Museum : Poe's Life, Legacy, and Works : Richmond, Virginia. Poe Museum, 1922. Web. 07 May 2012. . Soon, Willie and Steven Yaskell. "Year Without a Summer." Year Without a Summer. World Scientific Publishing Company, July 2001. Web. 07 May 2012. ."Year Without a Summer." Wikipedia. Wikimedia Foundation, 05 June 2012. Web. 07 May 2012. .

Comparison of Genetic Information In Eukaryotes And Prokaryotes Essay

Comparison of Genetic Information In Eukaryotes And Prokaryotes As for organisms in the world from humans to the smallest microbe, they directly reflect upon biodiversity, in respect to the appearance, size and expression. The reason behind this is caused by the genetic material found in each and every cell that composes each organism. Given that there are two types of cell organizations found in life, comparison of both ‘eukaryote’ and ‘prokaryote’ genomes will provide a better understanding for such diversity. ‘karyote’ refers to the nucleus, and also ‘pro’ means ‘absence’ and ‘eu’ means ‘presence’. Therefore the words prokaryote and eukaryote reflect upon the individual cell organization. In contrast, the both organizations show discrepancies as well as similarities which ultimately make them unique to one and other. The aim of this essay is to compare and contrast the genomes in eukaryotes and prokaryotes according to the perspective of Cell biology (The science that studies about cells). This comparison is conducted on genetic material, in respect to their location, size, expression, structure, architecture as well as number. Genome Location The location of genomes in both prokaryotes and eukaryotes show major discrepancies because they have different levels of cell organization. Due to the simplicity of the prokaryotes, they lack membrane bound organelles such the nucleus. Therefore, genomes of the prokaryotes reside as irregular Protein and deoxyribos nucleic acid (DNA) complex in cytosol (liquid portion of cytoplasm). This area of the cytoplasm is defined as the ‘nucleoid’ (Bauman.R 2004). Unlike Eukaryotes, it does not possess a nuclear envelope. On the... ... In conclusion, the above comparison draws out few facts that should be taken into account for a better understanding of the genomes of the two organizations. Above all, the fact that the eukaryotes show similarities to prokaryotes could mean that they derived from prokaryotes initially, and then became more complex as they advanced. This fact also supports the Endosymbiosis theory. And the eukaryotic genomes are larger and more repetitive, which makes them less productive than the prokaryotic genes. But considering by the quantity of the genes, eukaryotes are effective. In the perspective of expression, the complex eukaryotes have to go through physical borders and take more time and energy to express its genes. Due to the simplicity of the prokaryotes, their genomes highly efficient much more simple and they are stronger than what people think.

Philippine Retirement Authority :: essays research papers

An Information Technology Audit on the Philippine Retirement Authority Special Retiree Service Syste 1.0 INTRODUCTION The previous paper illustrated the present state of the Philippine Retirement Authority, its processes, and finally concluded with an assessment of its the SWOT elements. This report follows up by asking: Given its vision of developing the Philippines into a retirement haven, will investing in information technology bring the PRA closer to its vision? We believe that there is enough impetus to pursue investments in information technology for reasons that many tourist entries are enjoyed by the country, while the number of retirees is expected to dramatically increase as worldwide populations, particularly baby boomers, age. Given the PRA’s current membership level of 3,600+ members, there exists a potential for at least 15,000 members by the end of 2010. In the face of peace and order, austerity measures, and foreign competition, the benefits seem to far outweigh the risks. It is with this conclusion that a 2-pronged approach is recommended in order to move the PRA closer to its vision. These are: (1) Enhancing marketing capability which will lead to higher sales, and (2) Building operational capacity through the creation of efficient processes, and introducing new and radical means of doing things. 2.0 A GLIMPSE INTO THE FUTURE: THE PRA IN 2034 †¦ 3.0 WITHIN REACH: THE PRA IN 2007 †¦ 4.0 NEW BUSINESS PROCESS PROJECTED With the new capabilities that can be developed, the business process of PRA can be enhanced to shift from a procedure-based perspective into a more qualitative marketing and servicing oriented thrust. A projected business process may be designed as follows: 4.1 Build/Maintain Strong Market Presence From the current â€Å"hunting† approach that involves looking, approaching and convincing clients to know about PRA and the SRRV Program, a more dynamic thrust can be established. The activities that will be covered by this step will include the expansion of accreditation of resorts, hotels, travel agencies, service/medical/care-giving facilities as well as networking with local and international marketers. The interactive website can serve as the web portal of the retirees for their special and various needs. The site may be able to generate interest among foreigners and former Filipinos. From a low-profile government agency, it is important for PRA to make itself felt and to push itself into the attention of the retirees market. The prospecting and invitation steps in the current business process will also be included in this step. All marketing communications in every media channel will also fall in this process.

Is the Importance of Being Earnest a Satirical Play? Essay

With the definition of a satire being, ‘the use of humour, irony, exaggeration, or ridicule to expose and criticize people’s stupidity’, it is ludicrous to even propose that The Importance of Being Earnest is anything other than a satirical play, as the characters relishing in the upper class of the Victorian period unknowingly mock their own habits acquired to them due to the luxury they are spoilt with. Despite this, it is evident that the use of satire is feckless and lacks a moral point of view, in contrast with the moral point expressed through satire in other Victorian plays such as Mrs Warren’s Profession, which ‘exposes the corruption and hypocrisy of the ‘‘genteel’’ class’. Ergo, we acknowledge that the play is an ‘invention of a truly serious work of triviality has neither ancestors nor descendants’ and was unique to its genre at that period of time, yet the frivolousness of the plot results in à ¢â‚¬Ëœthe audience freely and genuinely laughs without quite being sure what it is laughing at’ – hence The Importance of Being Earnest is indisputably satirical, but a satire that has lost its sting. Lady Bracknell’s view of marriage is expressed through her account of visiting Lady Harbury, ‘I hadn’t been there since her poor husband’s death. I never saw a woman so altered; she looks quite twenty years younger’; she implies marriage is a burden and that life is only regained once freedom from marriage is embraced. Such opinions are heavily satirical and ironic as Lady Bracknell is herself married, and so by praising the widower she mocks herself. It is evident from this that Wilde is ridiculing the epitomes of the upper class and their absurd attitudes to marriage, however the ‘ridiculousness of portrayed by Wilde in the play, especially when the arranged marriage idea is summed up by Lady Bracknell, ‘An engagement should come on a young girl as a surprise, pleasant or unpleasant as the case may be’’ illustrates how deficit the satire is of a moral point of view, as Lady Bracknell continues to protest that Gwendolen will proceed with an arranged marriage despite the cruelness of her intentions. ‘The women are portrayed as sheltered, uneducated, and some as dominating figures over the men in their lives’ Jamie Crawford’s interpretation of the role of women in The Importance of Being Earnest alludes that the behaviour of the female characters is exceedingly antipodal to what would be expected in the Victorian era, ‘A wife’s duties to tend to her husband were considered crucial cornerstones of social stability by the Victorians’. There is strength to this argument as conveyed by Cecily’s language when addressing Algernon, ‘‘Oh don’t cough Earnest. When one is dictating one should speak fluently and not cough. Besides, I don’t know how to spell a cough†. The juxtaposition of Cecily instructing Algernon in order to appear domineering â€Å"Oh don’t cough Earnest† and her rebellion against receiving an education â€Å"I don’t know how to spell a cough† elaborates the unortho dox nature of the female characters Wilde has incorporated. Thereupon, Wilde’s portrayal of the relationships between men and women in The Importance of Being Earnest is majorly satirical of the conventional, as by reversing the roles of authority it derides the power men traditionally uphold over women. On the contrary, Robert J. Jordan implies Wilde’s use of satire when illustrating social differences between men and women has ‘lost it’s sting’ as the question suggests, by reason of ‘even if this satiric device is structural in the play it can hardly be a satire of great power, as the attitudes to women were modernising significantly at the period the play was written’. Consequently we observe Wilde’s failing in presenting a satirical view of women’s role in Victorian society – he was simply delineating the changes he perceived around him, thus supporting Eduoard Roditi’s interpretation and questioning whet her The Importance of Being Earnest belongs to a different genre of comedy. Previous to Wilde’s The Importance of Being Earnest, Victorian comedies consisted mostly of high and low comedy and of ‘dirty or vulgar jokes, dirty gestures, and sex’. Hence, it is possible to suggest that contradictory to Edouard Roditi’s interpretation, the Importance of Being Earnest carries a moral point of view in the fact it does not exploit sex or sexual preferences to effectuate drollery; Wilde provokes laughter through mistaken identities and the consequences of ‘bunburying’ perhaps to allude that his opinions it that sexuality is not a laughing matter. Providing this interpretation is true, it is acceptable to assume that the reasoning behind the negative criticisms the drama received when first written were due to the fact critics felt appalled that a piece of writing could prove successful without it consisting of any sexual nature and hence deemed The Imp ortance of Being Earnest as, ‘dull in comparison to other plays read over the years’. Howbeit, some critics state that ‘the word â€Å"earnest† became a code-word for homosexual, as in: â€Å"Is he earnest?†, in the same way that â€Å"Is he so?† and â€Å"Is he musical?† were also employed’, suggesting that The Importance of Being Earnest is an expression of Wilde’s hatred for marriage and his fondness of homosexuality as he praises the idea of being Earnest’. This undoubtedly contradicts the idea that the drama is unique from other plays of it’s time in the fact it lacks sexual content, and indicates that whilst The Importance of Being Earnest may carry the ‘tone of satire’ as Roditi’s argument suggests, it incontrovertibly is a form of Blue Comedy, as the moral tone traditionally associated with satirical comedy is not present, Wilde is forcing his opinions on the reader without a sufficient moral behind his beliefs. The fact the Importance of Being Earnest consists of 3 acts implies a significant beginning, middle and ending where previous feuds have been resolved and each character is content. If we are to consider the drama as conforming to a ‘traditional’ Victorian play which ‘tended to be of an improving nature with a central moral lesson at heart’, what is evidently untraditional of The Importance of Being Earnest is the rewarding of characters that have committed wrong doings –supporting Edouard Roditi’s interpretation that the drama ‘lacks a moral point of view’. If we analogize The Importance of Being Earnest with An Ideal Husband, we note the significance of the final act of An Ideal Husband in delivering the moral that that the principles of Mabel and Goring’s relationship demand that they defy society and revolt against what is traditionally expected of a marriage in order to achieve happiness, a final act which The Importance of Being Earnest lacks. Accordingly, it was perhaps Wilde’ s intention to ensure that The Importance of Being Earnest was unique by refusing to incorporate morality in order to suggest that ‘true virtue is either dead, or is confined to the lower classes’, as supported by Algernon’s satirical comment, â€Å"They seem, as a class, to have absolutely no sense of moral responsibility†. The relationship between Algernon and his servant Lane is a further example of Wilde dismantling social norms by ridiculing potent characters in their own domiciles. Lane ignorantly mimics Algernon when they are discussing marriage, as despite Algernon’s evident refusal to discuss the matter Lane continues to revive the conversation, â€Å"Is marriage so demoralizing?†¦I have only been married once†¦ I don’t know that I’m interested in your family life.. No, Sir. It is not a very interesting subject†, a witty satire of the traditional relationship of servant and master. Nevertheless the idea that satire throughout The Importance of Being Earnest has effectively ‘lost it’s sting’ is still prevalent in the persiflage of Algernon and Lane, as Algernon is a character that severely lacks depth; he is regularly mentioned as eating in the drama, â€Å"Eating as usual I see, Algy!† which infers that he yearns for something to fill a chimerical emptiness, possibly the lack of permanent company in his life as supported by Adam Ruhland’s interpretation, ‘Algernon’s readiness to lie about his food consumption reveals that he is well aware that he eats other people’s food when he feels cornered, stressed, or sad’. The fact Algernon is ‘well aware’ of his reliance on food to provide comfort delineates his ignorant attitude towards love and marriage. It is Lane’s willingness to provide Algernon with food that brings about the lack of a moral point of view to their satirical relationship and supports Edouard Roditi’s interpretation, as he is perceptive and observes Algernon’s piteous behaviour yet refuses to encourage a change in him. ‘The Importance of Being Earnest is above all an exercise in wit. There is nothing to be learned from it, no moral, no message’ defines Wilde’s play perfectly; it is a pointless facade that attempts to provide a satirical view of Victorian society, yet due to the willingness of characters to obey the restrictions accompanied with belonging to the upper class, fails miserably. Characters such as Miss Prism and Chasuble suggest the existence of another life beneath Victorian correctness through their flirtatious mannerisms, â€Å"I shall see you both no doubt at Evensong?† yet their refusal to further the ir relationship due to evident class differences, â€Å"I think, dear Doctor† depicts how Wilde’s satirical element has most definitely ‘lost its sting due to lack of moral point of view’; as the characters adhere to the conventions mocked by the satire, diminishing its efficacity. ——————————————– [ 1 ]. Oxford University Press Definitions – http://oxforddictionaries.com/definition/english/satire [ 2 ]. http://www.enotes.com/mrs-warrens-profession [ 3 ]. Roger Sale – The Hudson Review, Vol.56, No.3– Being Earnest. Published Autumn 2003 [ 4 ]. Roger Sale – The Hudson Review, Vol.56, No.3– Being Earnest. Published Autumn 2003 [ 5 ]. Satire & Wit in Oscar Wilde – by Danielle N.Baxley, published 28th March 2010 [ 6 ]. Point, Counterpoint, Thrust: Wilde’s Pun Burying in The Importance of Being Earnest by Jamie Crawford. [ 7 ]. http://en.wikipedia.org/wiki/Women_in_the_Victorian_era [ 8 ]. Satire and Fantasy in Wilde’s ‘The Importance of Being Earnest’ by Robert J. Jordan [ 9 ]. http://en.wikipedia.org/wiki/Theatre_in_the_Victorian_era – Theatre in the Victorian era published 18th February 2013. [ 10 ]. Samantha (Bookworms and Tea) – published March 29th 2011. [ 11 ]. http://en.wikipedia.org/wiki/The_Importance_of_Being_Earnest – Theo Aronson, Published 23rd Feb 2013. [ 12 ]. http://en.wikipedia.org/wiki/Victorian_literature – [ 13 ]. http://resources.mhs.vic.edu.au/earnest/background.htm – The Norton Anthology of English Literature: The Victorian Age, 2008. [ 14 ]. Adam Ruhland – The Role of Food in The Importance of Being Earnest [ 15 ]. The Importance of Being Earnest Review- Roger Ebert, May 24th 2002

A Funny Thing Happened On The Way To The Forum Essay

Throughout this play we follow along with a group of people from Roman times. Its the culmination of a bunch of events happening on just one street with three houses shown. the play’s primary objective is that of a comedy, therefore to tell the story with true hilarity. Many of the characters in this play had objectives. Pseudolus is a Slave and his main objective was to obtain freedom. Hero has an objective of getting the love of his life, a beautiful courtesan from next door. Philia is the courtesan that Hero has his heart set out for. Miles Gloriosus is a decorated captain and is looking for a virgin to lay. Tactics are used throughout by all characters in order to try and get what they want. Pseudolus tries in the beginning to gain his freedom through purchase from his masters so he heads out and tricks citizens into gambling with him and gets money, but then gets caught cheating and has to return the money to the guy who he had dooped. Hero’s tactic to get to his objective had him offer Pseudolus his freedom in return for getting him the love of his life. Pseudolus’ tactic was to accept the offer given to him by Hero. There were many actions throughout the play for each character to try and achieve their objective. In â€Å"A Funny thing Happened On The Way To The Forum† behavior set the tone for the entire play. Whether it was just to make a laugh or to advance the story forward. For example how each character carried themselves helped with the story plot and how you perceive the role and place of each character. It showed through Domina throughout the play. She spoke loud and condescendingly throughout the play to show that she was an old, heartless, bitch that was disliked by all. Hysterium’s behavior was that of being insecure and a frantic mess who tried to please everyone. It was shown through his singing, shaking when talked to, and playing along with Pseudolus, even though through blackmail. What i liked best in this play was that it was a comedy. Personally i like to laugh, i feel like that is the best. The physical humor was a little  overdone but you always get a laugh from weeing peple throw themselves to the floor. It was enjoyable as well during the courtesan scene with presenting the people of the Lycus dwelling. What i did not appreciate in this play was the musical numbers. i have never been much of a fan of seeing actors sing and singing along with the orchestra kinda music was never for me. The other elements of the stage had a good amount to do with the story telling. They worked hard on a set that gave a small effort to make you feel that you were in the time. Was very well lit the entire time and lighting not once changed even though they tried with the change of coloring to the light with not much avail. Props looked cheap and unreal such as the ladder taped up with sports tape, and an awful table that was used during the courtesan presentation and hysteriums’ funeral. They tried so that was okay. The music was light and funny except when Gloriosus was around. I got what they were going for with costumes it was a good effort to fit the time period when they wanted to and dress up people funny for comedies sake.