Macau Pension Fund Essay Example for Free

Macau Pension Fund Essay According to the Act 84/89/M, Social Security fund would provide subsidies or assistance for unemployed, sick and retired people. This was the so-call â€Å"the first tier of social security†. At the same time, SSF was positioned as a financially independent fund under the local government. In Macau, Pension fund is included in the SSF, and there is no separation between the management of pension fund and SSF. Instead, pension fund is considered as an expense from the aspect of financial management. All the working people, including non-permanent and permanent residents, are required to contribute to SSF in each month. If they have contributed enough amounts, they can get part of or all the pension fund payment after retirement. Since 1993, the government was gradually enlarging the coverage of pension fund beneficiary. So far, most unemployed or workless people, such as housewife, could join the voluntary contributions program. After certain periods of contribution, those people are also entitled to the pension fund payment from SSF once they are over 60. 2. 0 Current Problems As a financially independent fund, SSF is supposed to maintain the operation with the contribution as its major income. However, government funding has already become the most important income of SSF in recent years. In 2010, government budget and funding from gaming tax accounted for 92% of the total income of SSF (see figure 1). For the pension fund, many people stated that the pension fund payment, maximum MOP 2,000, is not enough under the high-inflation economy. Some academies also claim that the contribution is not enough to maintain the budget balance of SSF. After all, government announced the predictable deficit of SSF since 2014 and bankruptcy in 2020 without government funding, which cause the heated discussion in Macau. 3. 1 Insufficient Contribution According to the SSF regulation, a resident who have contributed to SSF for 30 years is qualified to get MOP 2,000 per month after retirement at 65. Actually the monthly contribution to SSF has been fixed at MOP 45 per person since 1998, which means the total contribution in 30 years would be returned in 9 months after retirement. Figure 1: Income of SSF in 2010 The contribution in 2010 only accounted for 5. 35% of the annual income of SSF and 24. 4% of the pension fund payment. In other words, the contribution is obviously insufficient to support the pension fund payment. The pension fund payment has been increased from MOP 800 in 1995 to MOP 2,000 recently, so as other subsidies and assistances. Therefore, the government kept increasing funding for SSF to prepare for the increasing outcome. Millions (MOP) Figure 3: Social security expenditures by SSF 3. 2 Insufficient Pension Fund Payment According to the poverty line set up by Economic Cooperation and Development (OECD), the people with an income level lower than half of median income should be considered as poor people. Referring to 2011 median income published by Macau Statistics and Census Service, people have income lower than MOP 5,000 per month should be classified as needy. However, the maximum amount of pension fund payment is MOP 2,000, only 40% of the poverty line. The payment is even lower than the minimum subsistence index for one-person family, which is MOP 3,000 after the adjustment by Macau government on 1 Apr 2012. In view of this, some communities and organizations have called for further raise of pension fund payment. 3. 3 Inefficient Management Rate of Return Percentage Inflation Rate Figure 2: Investment return of SSF balance and Macau inflation rate Given the enlarging funding from government, the balance of SSF have increased from MOP 1. 5 billion in 2006 to MOP 6. 2 billion in 2010. However, it has been shown in Figure 2 that the investments return of SSF balance is just a bit higher than the inflation. During the financial crisis, there was even a negative return recorded in 2008. By ignoring year 2008, there is still a downward trend of the return. According to the 2010 annual report of SSF, 72. 43% of SSF balance was deposited into local bank, the remaining proportion was entrusted to fund managing company for only low-risk investments. Under the fix-rate hedging between MOP and HKD, the interest rate of Macau is close to interest rate in Hong Kong, which is similar to US interest rate. Since the 2008 financial crisis, Fed has applied the ultra low interest rate and the interest rate is believed to be maintained until 2014. So, a 72. 43% of deposit in an investment portfolio is reasonably considered as inefficient. 3. 4 Irregular government subsidies In 2008 Macau government introduced the â€Å"Wealth Partaking Scheme†. Each permanent resident will receive the cash check issue by government and each non-permanent residents would received 60% of the partaking amount to permanent resident. The aim of the scheme is to share the result of economic development under the high-inflation economy. However, in some people’s view, the scheme has been considered as supplement of social security and thus expected to transfer the scheme into regular subsidies. Beside the partaking scheme, Macau government established the â€Å"Central Saving Plan† – to inject certain capital into individual account of all the permanent attained the age of 22 in the year. The government claimed that the plan is â€Å"the second tier of social security† and the plan will enhance the living security of retired people. Under the government regulation, people could withdraw the saving fund only when they are over 65 or in urgent needs.

Factors change Essay Example for Free

Factors change Essay After I have recorded all the results and written into tables, I used the data to make graphs, which are voltage against current. When I finished marking all the points on to the graphs, I put a line of best fit through. There are five graphs in total, each represents a thickness, on a graph there are five lines of best fits, and each represents a length of a thickness. Then I pick a point on the lines of best fits and calculate the gradient (resistance) by dividing the point on y-axis (voltage) by the point on the x-axis (current) as the ohms law states that V=IR. Finally, I have to draw five graphs to show the relations between length (on the x-axis) and resistance (on the y-axis). Also, I have to draw another graph to show the relations between thickness (on the x-axis) and resistance (on the y-axis). Evaluating Although the whole experiment has been going very well, but the results seems to show some bias or errors as in one or two of the graphs, the pattern is quite strange because some of the gradient (resistance) is not proportional to the lengths. Overall, the experiment can be said as a success. The aim of this experiment is to measure how the resistance change as the factors change. There are so many variables-temperature of surroundings, length, thickness, material, temperature of the wire, surface area, magnetic properties, coated or not and purity-that can be chosen to measure in this experiment. But in this experiment I am only going to measure two of them, which are length and thickness because these two are the easiest to measure and show the effects on the resistance. Prediction: The result should be showing that the resistance increase as the length or thickness increase. This happens because when length or thickness increases, the current will decrease. As the voltage wont change, if the current decreases, then the resistance will increase. Method: In the experiment I will need to use apparatus listed below.

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

Black Elk Speaks :: essays research papers

Black Elk Speaks   Ã‚  Ã‚  Ã‚  Ã‚  The book Black Elk Speaks was written in the early 1930's by author John G. Neihardt, after interviewing the medicine man named Black Elk. Neihardt was already a published writer, and prior to this particular narrative he was at work publishing a collection of poems titled Cycle of the West. Although he was initially seeking infor-mation about a peculiar Native American religious movement that occurred at the end of the 19th century for the conclusion his poetry collection, Neihardt was instead gifted with the story of Black Elk's life. Black Elk's words would explain much about the nature of wisdom as well as the lives of the Sioux and other tribes of that period.   Ã‚  Ã‚  Ã‚  Ã‚   The priest or holy man calling himself Black Elk was born in the December of 1863, to a family in the Ogalala band of the Sioux. Black Elk's family was well known, and he counted the famed Crazy Horse as a friend and cousin. Black Elk's family was likewise acknowledged as a family of wise men, with both his father and grandfather themselves being holy men bearing the name Black Elk. The youngest Black Elk soon experienced a vision as a young boy, a vision of the wisdom inherent in the earth that would direct him toward his true calling of being a wichasha wakon or holy man like his predecessors. Black Elk's childhood vision stayed with him throughout his life, and it offered him aid and wisdom whenever he sought it. It is from the strength of this vision, and the wisdom in his heart that Black Elk eventually realized his place as a leader and wise man in the Ogalala band of the Sioux.   Ã‚  Ã‚  Ã‚  Ã‚  The wisdom possessed by Black Elk is immediately present in his recollections of various lessons learned by himself and by others. These stories ran the whole gambit of life experiences from the most innocent acts of a boy in love, to the hard les-sons learned from the treachery of the whites. Through these stories a greater insight can be gained into the ways of the Sioux, as well as lessons into the nature of all men. Most important in these lessons on the nature of man was wisdom, and in all of Black Elk's recollections somewhere a deeper wisdom can be found.   Ã‚  Ã‚  Ã‚  Ã‚  The story of High Horse's Courting stands out as a perfect example of one of Black Elk's narratives. Typically, Black Elk's narratives try to bestow a lesson (or les-sons) that the listener can learn from, just as the subject of the story sometimes does.

Comparing the Power of Love in Uncle Tom’s Cabin and Beloved :: Comparison Compare Contrast Essays

The Power of Love in Uncle Tom’s Cabin and Beloved There are several common themes in the film Beloved and the book Uncle Tom’s Cabin. They both deal with the effects of slavery on the white and black communities. They both address the brutal treatment of blacks within slavery, including the sexual mistreatment of black women by their masters. A prevalent theme out of both works is the power of a mother’s love for her children. The film Beloved paints a grim picture of what it was like to be a black woman in the 1860’s. Like the book Uncle Tom’s Cabin, it takes us through the story of an escaped slave in the South traveling to the North in order to gain freedom. The main characters, Sethe, in the movie Beloved, and Eliza, in the book Uncle Tom’s Cabin, are both mothers who want nothing more that to see their children delivered from the bonds of slavery. Although the film and the book were created using very different styles, their objectives are somewhat similar. In Stowe’s book Uncle Tom’s Cabin we follow Eliza through a dramatic escape from her plantation after she learns about the impending sale of her only son. Determined to take him out of slavery or die trying, she runs away in the night with him holding on to her neck. Stowe focuses much attention on the power of maternal love. She felt strongly against slavery because it often broke the bonds of maternal love by ripping children away from the mothers. Families were continually being torn apart by the auction block; Stowe wanted the reader to be aware of the effects of this horrible institution. Logic tells us that no mother would ever willingly put her children or herself in danger. However, through Eliza’s character in Uncle Tom’s Cabin we see the desperation that many women had to experience to save their children. Harriet Beecher Stowe’s novel, though fictional, did more to change the hearts of Americans who were standing on the edge abolitionism than any other work at that time. In fact, near the conclusion of the Civil War she was invited to the White House in order that President Lincoln might meet the â€Å"little woman that started this big war.† Stowe felt that she had an obligation to inform the world of what really went on in the South, what life was really like for slaves.

Ancient Egypt :: World History

Ancient Egypt The Egyptians were the first to make bread that is soft, light and filled with air. They also made the first ovens, because they need a different way to bake the larger mass of dough used for this new kind of bread. The Egyptians used mud bricks that have been dried in the sun to make houses. The sun is shining on our backs. In town ,we shall be paid fish for our barley. That was a song of Egyptian farmers , more than 3,000 year ago. Wall paintings in ancient tombs show farmers at work in their fields. The early Egyptians had hundreds of signs for words or for parts of words. Like other ancient people, the Egyptians often wrote on clay tablets or stone. It was from one such stone, the Rosetta Stone, that we learned ancient languages. Cheops was the name of a king in ancient Egypt who wanted a place to stay when he died. So he ordered his men to build a huge stone house in the shape of a pyramid. A pyramid looks somewhat like a giant tent. The base of this pyramid is almost big enough to fill ten football fields. Its peak is as high as a stairway with more than eight hundred stairs. Kings of Egypt used to be buried in great tombs with jewels and golden vases, and even thrones and chariots. The tombs had so many valuable things in them, that thieves used to break into them and steal their treasures. So later kings decided to hide their tombs. They left orders for their burials to be in a secret place called the Valley of the Kings. The graves were not to be marked. But, still, the jewels in golden vases and thrones and chariots were stolen. When historians checked it out they found out who stole the treasures, that’s right the men who were supposed to guard the tombs. The Great Sphinx The Great Sphinx was built almost 5,000 years ago , when Khafre was king of Egypt. It had a human head and a lions body. It stands 66 feet high and more than 240 feet long. Both head and body were carved from solid rock. The head of the Sphinx has been damaged more than once by people who destroy things on purpose. Over the centuries, desert sand storms have also warn away some of the stone. Ancient Egypt :: World History Ancient Egypt The Egyptians were the first to make bread that is soft, light and filled with air. They also made the first ovens, because they need a different way to bake the larger mass of dough used for this new kind of bread. The Egyptians used mud bricks that have been dried in the sun to make houses. The sun is shining on our backs. In town ,we shall be paid fish for our barley. That was a song of Egyptian farmers , more than 3,000 year ago. Wall paintings in ancient tombs show farmers at work in their fields. The early Egyptians had hundreds of signs for words or for parts of words. Like other ancient people, the Egyptians often wrote on clay tablets or stone. It was from one such stone, the Rosetta Stone, that we learned ancient languages. Cheops was the name of a king in ancient Egypt who wanted a place to stay when he died. So he ordered his men to build a huge stone house in the shape of a pyramid. A pyramid looks somewhat like a giant tent. The base of this pyramid is almost big enough to fill ten football fields. Its peak is as high as a stairway with more than eight hundred stairs. Kings of Egypt used to be buried in great tombs with jewels and golden vases, and even thrones and chariots. The tombs had so many valuable things in them, that thieves used to break into them and steal their treasures. So later kings decided to hide their tombs. They left orders for their burials to be in a secret place called the Valley of the Kings. The graves were not to be marked. But, still, the jewels in golden vases and thrones and chariots were stolen. When historians checked it out they found out who stole the treasures, that’s right the men who were supposed to guard the tombs. The Great Sphinx The Great Sphinx was built almost 5,000 years ago , when Khafre was king of Egypt. It had a human head and a lions body. It stands 66 feet high and more than 240 feet long. Both head and body were carved from solid rock. The head of the Sphinx has been damaged more than once by people who destroy things on purpose. Over the centuries, desert sand storms have also warn away some of the stone.

A Discussion of the Final Chapter of Dr Jekyll and Mr Hyde Essay

In the final stages of Dr Jekyll and Mr Hyde, there are many ways in which the author, Robert Louis Stevenson, both explores human nature, and also creates a sense of sympathy on the part of the reader for Dr Henry Jekyll, which could be said to extend to Mr Edward Hyde as well. In reference to the author’s exploration of the nature of humanity, the settings of the story itself are very important. Previous to the writing of this story, there had been a firm tradition of horror stories being set exclusively in rural areas, perhaps due to the fact that only a minority of people lived in these areas, and so to those elsewhere it would have seemed far more remote and exotic. Stevenson’s thriller was ground-breaking in that it focussed its plot in an urban setting, by name London, but also with extraordinary resemblance to Stevenson’s home city of Edinburgh. This setting reflects the idea of urban expansion into the countryside, but more importantly the more modern appearance of this particular horror story. Because a large majority of the readers of this book would have been living in the city, it brings the story closer to them, and allows them to become more involved in the events of the plot. Stevenson’s use of the city as the setting for his story also is also representative of early manifestations of writers of this era moving towards using the city as a representation of fear and darkness, rather than its previous role as a deeply romanticized place. In terms of Stevenson’s investigation of human nature, the proximity of Jekyll’s laboratory and his fine house is very significant. The laboratory represents, in my opinion, the hidden, secretive side of his life, involving his work, as well his life as Mr Edward Hyde. The fact that this laboratory is so close to Jekyll’s expensive and upper-class house, representing his professional and social life as a doctor and a well-respected member of society, signifies the proximity of the two parts of his character, in fact their intricate relationship, intertwined and connected in so many different aspects. This idea is also mentioned by Jekyll himself in the final chapter, in his account of events, emphatically saying; â€Å"It was the curse of mankind that these two incongruous faggots were thus bound together-that in the agonized womb of consciousness, these polar twins should be continuously struggling.† I have decided to quote this sentence because I believe it is very revealing about the â€Å"thorough and primitive duality of man† explored in the text. Jekyll talks of â€Å"incongruous faggots† being bound together, meaning that the two elements do not combine, but that they are still as one. The phrase â€Å"polar twins,† is almost a contradiction in terms, and shows that the two elements of Dr Jekyll’s psyche are both united in their existence, but also that they are totally opposite. The phrase â€Å"duality of man,† used earlier in this chapter, also expresses the idea of two parts to every mind or conscience, an ego and a superego. Mr Edward Hyde is the ego, an utterly self-absorbed being, merely concerned with and conscious of themselves. Dr Jekyll, however, is the superego, the element of the character which socialises the entirety, enabling it to interact with others. No man is complete without both of these parts, and neither can truly exist without the other. However, Jekyll’s apparent desire to appear arid and utterly professional externally, and his recognition of his chief fault as â€Å"a certain impatient gaiety of disposition† seems to have forced him into a desire to separate the two parts of his character, the superego and the ego. This, in his mind, would allow him to live as two men, but his failure to predict the nature of these two individual characters leads to his suffering and isolation. In the final chapter, his retrospective account, he concedes, â€Å"all human beings, as we meet them, are commingled out of good and evil: and Edward Hyde, alone in the ranks of mankind, was pure evil.† Stevenson himself shares some parallels with the character of Jekyll. Born into a strictly religious, part of the Calvinist movement, Stevenson grew up with the belief, although possibly inescapable, that there was an underlying and constant presence of sin in everything; every action and every person. This is shown in the character of Henry Jekyll, and the underlying evil that is personified by Edward Hyde. In Jekyll’s earlier life, he was forced to conceal his pleasures from his family, becoming rebellious against his father, just as Jekyll himself feels urged to do in the story, and from which the beginnings of his familiarity with a double-life or, as he says â€Å"a profound duplicity of life†, can be traced. The context of the story is also important in terms of the sympathy created by the author for Hyde. The period in which the book is set was one of enormous scientific progress and discovery, and in my opinion, this adds a further element to the reasons for a feeling of sympathy for Henry Jekyll. Jekyll himself cites a burning ambition inside himself as being a key reason for his unquenchable thirst to discover the true nature of humanity, and thus his desire to become Hyde. The intensity of the scientific world of the period, and the temptation which face Jekyll after his first experience of the transformation both appear to contribute towards his inability to stop himself becoming Hyde. Jekyll himself seems to realise the responsibility of these factors towards the end of the book, in his account of events. One particular example of this is; â€Å"Strange as my circumstances were, the terms of this debate are as old and commonplace as man: much the same inducements and alarms cast the die for any tempted and trembling sinner; and it fell out with me, as it falls with so vast a majority of my fellows, that I chose the better part and was found wanting the strength to keep it† This clearly shows Jekyll’s impotence to stop himself from leaning towards the temptation of his new life, and also that this was not a vice exclusive to him as an individual, but that it was something unavoidably and unquestionably natural for mankind. This creates a sense of sympathy on behalf of the reader, because it emphasises Jekyll’s lack of power and control over his actions, as well as explaining to the reader that the evil which is brought out of Henry Jekyll is not something that he is to blame for, instead that he is a victim of his own ambition and daring, as well as the ambition and aspirations of the society in which he lived. Another remark which shows this idea is, â€Å"It was thus the exacting nature of my aspirations, than any particular degradation in my faults, that made me what I was†, expressing the feeling of blamelessness in Jekyll, and thus the sympathy in the reader for him. Another way in which the reader is led to sympathise with Jekyll is the way in which Jekyll is tempted to become Hyde by his feelings of restriction and his desire to find pleasure, whilst keeping his life as Dr Henry Jekyll separate from this. In his account, Jekyll explains that, in becoming Hyde, he is free â€Å"from the bonds of obligation† and is able to, â€Å"like a schoolboy, strip off these lendings and spring headlong into the sea of liberty.† These quotations clearly show the immense need for freedom that Dr Jekyll faces, and the extent to which he is prepared to act in order to obtain this freedom. There seems, to me, to be a certain resemblance to the idea of sin and temptation in this element of the story. Jekyll clearly feels restricted by, and in, the world in which he lives, and the fact that he is aware of a way out of this world causes his inability to resist the temptation of taking the path to freedom. When he has experienced the freedom for the fi rst time, he is unable to stop himself from using the potion in order to free himself from the burdens of society. The sympathy induced by Stevenson is not, however, limited to the character of Dr Jekyll. To a certain extent, Mr Hyde is worthy of some pity himself. The main way in which this applies is in relation to Hyde’s death and disappearance. Hyde commits suicide because he is afraid of being caught, and subsequently punished for his violent actions. If we are to believe that Hyde is evil incarnate, and that he possesses no element of good in his character, then the fact that he is unable to forgive himself his wrongdoings, and that he makes excuses for his actions, would seem to suggest that he cannot be seen as utterly ruthless, and thus in a sense he is weak. This inability to ignore his conscience, means, in my opinion, that he is not in fact entirely evil, and that the relationship between good and evil, and between Dr Henry Jekyll and Mr Edward Hyde, is not as defined as one might think, that there are â€Å"shades of grey† to be considered. I believe that this creates sympathy for Hyde, making him appear wretched and pitiful. Indeed, Dr Jekyll himself creates and expresses a certain degree of pity for Hyde, admitting that he cannot wholly condemn his actions, because he himself envies the way in which Hyde embraces his freedom. He says, â€Å"But his love of life is wonderful†¦I find it in my heart to pity him† The fact that even Jekyll feels pity for his wretched inner self merely serves to encourage similar feelings in the reader. In conclusion, I believe that Dr Henry Jekyll bravely sacrifices his own life in order to prevent the evil Edward Hyde from being free. In this sense, I feel that he shows another side of human nature which is almost entirely exclusive to Jekyll’s superego, the conscience. Jekyll shows an ability to consider the situation of others above himself, and importantly, an ability to recognise between good and evil.