A health center should also be concerned with the personal
hygiene of its community members. It is hard to teach that there is danger from
something which cannot be seen with one's own eyes. However, many of the health
problems which affect people are invisible, either because the destructive
organisms in the environment are too small to see without a microscope, or
because the problems develop inside the body.
The health center should develop an education program which
teaches the relationship of cleanliness to health. The washing of hands with
soap and water before handling food; bathing to keep the body free from harmful
bacteria; wearing sandals or shoes to prevent penetration of parasites through
the soles of the feet; keeping the home swept and aired to discourage insect or
bacteria breeding places; keeping farm animals out of the home, should all be
part of a program to up-grade the health of the community.
An effective method of demonstrating insect or parasitic-carried
health problems might be to illustrate the cycle on a flannelgraph or flipchart.
Two suggestions follow:
The hookworm is one of a number of nematodes, which is found in
tropical and subtropical climates, and which lives as a bloodsucking parasite in
the intestines of man.
(1) the larvae of the hookworm live in moist soil which is
contaminated by human feces. (2) They penetrate exposed skin, usually the soles
of bare feet, and are carried by the blood stream (3) to the lungs, where they
cause coughing, (4) are raised into the mouth with bloody mucous and are then
swallowed (They can also be swallowed in polluted water.) (5) they then travel
to the intestine where they attach themselves with "hooks" and feed on the
body's blood supply. (6) A female hookworm can discharge 30,000 eggs a day into
the human feces, (7) which will then further contaminate the soil and more
As a result of the loss of blood to an infestation of hookworm,
a person will suffer anemia, abdominal pain, diarrhea and weakness which will
make him/her susceptible to other diseases.
In explaining this cycle of the hookworm, you can show that if a
latrine is used, the soil will not be contaminated with hookworm eggs; if shoes
or sandals are worn, the larvae cannot enter the soles of the foot; if water is
boiled, live hookworm larvae will not be swallowed. If a person has bloody
mucous, he should go to the health center to be treated with drugs which will
kill the hookworms. Each of these actions will break the hookworm's life cycle,
and will help to destroy it.
Figure 3 (NOTE: NOT TO SCALE)
This is a parasitic disease caused by blood flukes, and is found
in Asia, Africa, the West Indies, South America, and some Pacific islands.
(1) the eggs of the blood fluke are found in water, deposited
there from urine and feces of infested humans. (2) The eggs hatch and penetrate
the feet of snails where (3) they develop into a new form and are discharged
into the water. (4) The larvae are then free-swimming until they come into
contact with persons who work in, who bathe in, swim in, or otherwise come into
contact with the infested water. (The larvae can also be swallowed in polluted
water). (5) The larvae penetrate the person's skin and are carried through the
blood stream to the bowel, bladder, liver, genitals, lungs, spinal chord and
other tissues where they attach themselves. (6) The larvae develop into mature
flukes which rob these tissues of the blood they need. (7) Eggs of the mature
fluke are passed out in the feces and urine.
The disease results in general weakening and eventual death.
In explaining this cycle of the blood fluke, you can show that
if a latrine is used, the water will not become contaminated with blood fluke
eggs. If people do not bathe in infested waters, or do not do irrigation work
without rubber boots, or do not drink untreated water, the fluke larvae will not
enter their bodies. Each of these actions will break the blood fluke's life
cycle, and will help to destroy it.
If the hookworm or the blood fluke are not health problems in
your area, then perhaps you can identify another disease which is carried in a
similar fashion, and whose cycle could be broken by improving the environmental
conditions of the human population of your area.
Rodents not only destroy food crops and stored grain, they also
carry fleas which in turn carry diseases. Certain rat fleas carry typhus and
bubonic plague, and fleas also transmit several species of tapeworm. There are
chemical methods to control such rodents as rats and mice. You can also alter
their environment, which will discourage or reduce their population. Keep your
community free from trash, litter and debris where rodents can hide and nest.
Make your grain storage rodent-proof as illustrated in the Peace Corps manual,
Small Farm Grain Storage. Most especially, encourage the protection of
the predators of rats and mice. These may be birds such as hawks and owls, or
they may be any of a large number of harmless snakes. You should learn to
identify which snakes are beneficial and not harmful to people. The health
center might display pictures of those birds and snakes which help eliminate
rodents, or you might be able to keep a harmless, helpful snake as an education
aid (see Appendix F. Live Animals). Encourage people to see the snake as a
friend by explaining what he eats, by showing with pictures how he is different
from harmful snakes, and by generally developing an atmosphere of trust toward
The health center's decision to develop or support a program to
educate the community in some aspect of environmental health, should be based on
what the specific problems of your area are. Perhaps instead of disease or
nutrition, it is the mental health of the community which is suffering from the
stress of a crowded and competitive urban environment. Perhaps air pollution is
severe enough to cause lung or skin damage, and needs to be explained. The
community should be alerted to those aspects of its environment which can cause
harm to its members, and should be shown how to improve their health by making
beneficial changes in the